Trauma, Mental Health, & Haiti Final Project - Katie Guidera April 2014 | Page 5

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discrimination
 and
 stigma
 (Surkan
 et
 al.
 2010).

The
 2010
 Earthquake

On
 January
 12,
 2010,
 an
 area
 near
 Port-­‐au-­‐Prince
 was
 struck
 by
 a
 7.0-­‐magnitutde
 earthquake,
 which

wreaked
 havoc
 over
 a
 40-­‐radius
 and
 had
 immediate
 physical
 and
 psychological
 effects
 on
 nearly
 all
 Haitians.

As
 a
 result
 of
 the
 earthquake,
 over
 220,000
 were
 killed
 and
 over
 1.5
 million
 were
 displaced
 from
 their
 homes

(OCHA
 2011).
 Many
 of
 those
 individuals
 left
 homeless
 were
 forced
 to
 move
 to
 internally
 displaced
 persons

(IDP)
 settlements
 around
 Port-­‐au-­‐Prince.
 In
 addition,
 the
 earthquake
 dealt
 a
 critical
 blow
 to
 health

intervention
 efforts
 around
 the
 nation,
 claiming
 the
 lives
 of
 almost
 10%
 of
 Haiti’s
 medical
 staff
 and
 destroying

almost
 60%
 of
 all
 facilities
 in
 the
 country
 (Médecins
 Sans
 Frontiéres
 2010).
 The
 combination
 of
 displacement

to
 IDP
 camps
 and
 a
 sudden
 breakdown
 of
 health
 care
 infrastructure
 forced
 PLWHA
 into
 potentially
 highly

disruptive
 situations,
 both
 physically
 and
 emotionally.

HIV
 &
 Mental
 Health
 Care
 Post-­‐Earthquake

Studies
 on
 the
 successes
 of
 HIV
 care
 in
 post-­‐earthquake
 have
 reported
 mixed
 results.
 One
 study

reported
 that
 85%
 of
 the
 6,000
 AIDS
 patients
 receiving
 care
 before
 the
 earthquake
 in
 a
 major
 Port-­‐au-­‐Prince

clinic
 returned
 after
 the
 earthquake
 (Pape
 et
 al.
 2010).
 Other
 reports
 indicated
 that
 antiretroviral

procurement
 and
 distribution
 as
 well
 as
 HIV
 prevention
 and
 treatment
 services
 were
 “back
 on
 track”
 within
 a

year
 after
 the
 earthquake
 (CDC
 2010,
 UNAIDS
 2011).
 However,
 reports
 also
 estimated
 resumption
 of
 care
 to

be
 at
 rates
 of
 less
 than
 40%,
 with
 much
 lower
 numbers
 of
 HIV
 tests
 being
 conducted
 (Pape
 et
 al.
 2010,
 UNAIDS

2011).
 Since
 the
 earthquake,
 numerous
 international
 and
 domestic
 organizations
 have
 worked
 to
 provide

post-­‐disaster
 mental
 health
 services
 in
 the
 country,
 including
 the
 development
 of
 wide-­‐scale
 community

based
 mental
 health
 services
 (Raviola
 et
 al.
 2012).
 However,
 a
 limited
 number
 of
 studies
 have
 focused
 on
 the

mental
 health
 of
 PLWHA
 since
 the
 earthquake.

Table
 1
 presents
 key
 literature
 that
 has
 been
 published
 since
 the
 earthquake
 on
 PLWHA
 in
 Haiti,
 along

with
 explanations
 of
 each
 paper’s
 key
 findings
 related
 to
 mental
 health.
 Taken
 together,
 a
 few
 major

implications
 for
 integrated
 HIV
 and
 mental
 health
 care
 emerge.
 First,
 it
 is
 clear
 that
 more
 research
 must
 be

done
 examining
 mental
 health
 outcomes
 of
 PLWHA
 in
 Haiti,
 as
 very
 few
 post-­‐earthquake
 studies
 have
 done
 so

to
 date.
 Studies
 that
 have
 been
 done
 point
 to
 the
 need
 to
 focus
 on
 risk
 factors
 such
 as
 domestic
 violence

specific
 to
 women
 and
 youth,
 when
 designing
 interventions
 that
 address
 post-­‐disaster
 mental
 health
 needs

among
 Haitian
 PLWHA
 (Devieux
 et
 al.
 2013,
 Glemaud
 et
 al.
 2014,
 Malow
 et
 al.
 2010,
 Malow
 et
 al.
 2013).

Studies
 also
 point
 to
 issues
 of
 alcohol
 and
 substance
 abuse
 that
 tend
 to
 become
 exacerbated
 by
 the