Healing Haiti: Treating older people's trauma
HelpAge's psychosocial programme includes group activities and games like Five Flowers for Six Men, above.
Photo: Frederic Dupoux/HelpAge International
Surviving an ordeal like the Haiti earthquake is a traumatic experience. But for many survivors the most difficult aspect of a disaster is not the event itself, it is coping with day-to-day life in the aftermath.
Resilience is one of the key traits that enables people to survive traumatic events. But is resilience enough when people are faced with so much loss - loss of their families, destruction of their homes, loss of everything that was?
Resilience is not enough
Stephanie Citron is a US psychologist who specialises in psychosocial support. This focuses on a person's psychological development and social interaction. She believes that for vulnerable people resilience alone is not enough.
Stephanie says that in general, for people who have been through a terrible ordeal, having the basic means for survival – feeling safe, having shelter, food and water – means they can recover quite quickly.
But this is not the case for the hundreds of older Haitians still living in camps. Stephanie and her colleague Gordon Dodge have been working with HelpAge's Haiti team to train staff and volunteers, so they can provide psychosocial support to these older people.
Stephanie explains: "The issue for many older people in Haiti is that the conditions in the camps are still so dire. There are limited food supplies, a lack of tents and sanitation is completely inadequate with a severe, long-term threat of cholera.
"This unstable environment means that restoring resilience is extremely challenging."
Establishing stability
The need for stability is one of the reasons why humanitarian organisations work so hard to establish at least temporary facilities.
Jo Wells, HelpAge's Humanitarian Policy Adviser says:
"There is much evidence to show that getting life back to normal as soon as possible creates a sense of security that enables people to recover.
"That is why so many people work to get children back to school as soon as possible, even if this means building temporary schools. Children need the routine that they have been used to, not to mention the reassurance of seeing their friends and teachers again.
"Likewise for their parents and often grandparents, rebuilding livelihoods is key to recovery. Finding work enables people to provide an income to support their family and to keep busy and focus on the positive."
"Friends" ease older people's trauma
Edith, 60, was very proud of making her own dress. She took part in our dress making and flower arranging activity, as part of our psychosocial programme.
Photo: Frederic Dupoux/HelpAge International
Older people are one of the most vulnerable groups affected by a disaster. But a recent HelpAge International study found they are often the most overlooked in the humanitarian response.
So exactly how is HelpAge's psychosocial work hoping to redress this by meeting the specific needs of older people?
Gordon and Stephanie's programme for HelpAge staff and volunteers in Haiti is called "Friends". The friends, many of them older people who themselves live in the camps, have volunteered to take care of their peers.
Each friend looks after around 20 older people living in camps. They visit them twice a day, help with personal care when needed, give them the latest information about security and health issues, or simply offer support.
Describing some of the issues they face, Stephanie said: "One older woman was struggling with heart palpitations, agitation and anxiety, re-activated by her fear of Hurricane Tomas as it approached the Caribbean in October 2010.
"Through the trauma work, I helped her focus on the sensations in her body as she remembered a day in May when a clean water source finally arrived at the camp. We concentrated specifically on sensations of the cool water running through her when she could finally drink, and feeling the water on her hands as she washed her clothes and dishes."
This visualisation exercise helped the older woman overcome her fear that a tree would crush her tent in the hurricane winds. As a result her body settled to a calmer, more balanced state.
A healing asset for Haiti
Now almost half of the 200 friends have been trained in a trauma model which promotes psychological resiliency.
Stephanie added:
"Older people who have lost everything in the earthquake are now living in camps for internally displaced people. They often have no family around, or have a grandchild or two that is solely in their care. Living conditions are poor with leaky tents and noise and violence everywhere.
"The HelpAge model here in Haiti has cast a palpable lifeline for older people who have lost everything in the earthquake. The volunteer structure made it possible for us to reach many people. I am amazed and inspired by the results.
"Early on in the project, the friends were remarkably enthralled by the task ahead. At first they just talked about needing more cash to give older people to buy food.
"Then finally they agreed they had something incredibly important to give by helping older people resist trauma upon trauma. The friends have become a healing asset for their country."
Empowering older Haitians
HelpAge staff are working with the friends to set up designated meeting areas in the camps. This will provide a space for older people to congregate in the spirit of the Haitian community lakou - to talk, share ideas about improving camp life, tell stories, sing and dance.
All of these psychosocial initiatives empower older people to help each other, so that they can feel useful, involved and self-determined, rather than isolated and a burden.
