Amongst the shacks made of US AID tents, building foundation ruins, and wood, lays a fortress called King’s Hospital. Next to the hospital is home to 32 children, who do not see outside the grounds and walls of the orphanage until they leave for secondary school (12 years of age): Imagine if you were 2-years-old when brought here, and now 8-years-old, you have no memories outside of these four walls. The hospital uses expired hand sanitizer, has no alcohol wipes, and donates expired IV fluid to state hospitals, because “when you are about to die, it does not matter if it is expired if that is all you have.” When you leave work at the hospital and return to your home, you come to find your neighbors have killed and eaten your cats, and the local gang has poisoned your dogs and killed six of your neighbors. To send your child to kindergarten, it will cost you 10,000 Haitian dollars, which calculates to approximately $220; considering some families make anywhere from $100-$350 per year, sending their child to school  is not an option. (Per 2013 World Bank report GNI per capita is $850, but 58.7% of capita are in poverty, and some reports estimate the gross annual income of the average family can range anywhere from $100-$350).

As part of the medical team, my hope is that the tools I brought can be used to help sustain the fortress that is here. I have been working primarily with the Chaplain, who has his Bachelor’s in Theological Studies. He has had classes in psychology, education, development, administration, in addition to religious studies. He serves as the counselor for patients when mental health issues arise; there is no psychologist. After exchanging knowledge about the various cases and treatment he might see and use in Haiti in comparison to the U.S., we discussed ethics and I trained him on administering a nonverbal measure of cognitive abilities intended for use with diverse cultures outside of the U.S. Many of the children in the orphanage do not know their birthdate, and some do not know their age. It was interesting to see the cultural differences in interaction: the Chaplain’s interactions with the children were initially stern and authoritative; however, it is important in psychology to be soft, gentle, and to provide reassurance, and so after observing my modeling of eliciting participation, he softened and changed his technique, which helped in rapport building and effort. A physician, two residents, and two nurses have also shown interest in learning about the measure, and some of them also observed, or attended a separate training. The measure will be left here, so that the Chaplain can continue to train the others who have an interest, and so that the measure can be used for anyone who is interested in obtaining a general measure of cognitive ability so long as the person is trained (the ages the measure can assess ranges from 6-89).

Heather, Ruthie, Marie, Jonathan and I have completed annual exams for the children, and I taught a few how to take a pulse. Their thirst for knowledge is beautiful. I inquired with whom they speak about their problems, and they had no answer. Sometimes each other. Sometimes the house mothers. Sometimes the chaplain. But usually no one. The need for mental health care here is great.

I am pleased to say that I think there is a renewed recognition for the need to provide psychological services here at King’s Hospital and the orphanage, and that they have the tools to offer such services. Matthew 6:2 reminds us not to 'sound trumpets' for what we do for others, and respect that it is the Father who shall offer rewards; however, I do believe it is important to share with others about the needs that are present throughout the world. Perhaps it will inspire others, put our own tribulations into perspective, or elicit prolonged change for the betterment of society. 

-Emily