Haiti

In response to the January 12, 2010 earthquake in Haiti, ITC senior directors (MD’s & PhD’s) were deployed by Partners in Health (PIH), the Joint Force Maritime Component Commander (JFMCC), and the Harvard Medical School’s Disaster Medicine Section to (1) provide psychological and psychosocial stabilization to PIH staff in Mirabalais and Saint Marc and to train these PIH staff in culturally specific Psychological First Aid  and self care protocols, (2) geo-tag the migration patterns of tent city survivors and homeless earthquake survivors, and (3) conduct assessments of Port Au Prince and Mirabalais medical clinics and the Port Au Prince General Hospital (HUEH). ITC accomplished all three missions and began a long term relationship with several strategic Haitian partners with a focus towards prevention and preparedness and resiliency based psychosocial programs for Haitian youth in the most at risk environments.

After the January 12, 2010 earthquake that devastated the island of Haiti, Child in Hand (CiH), a 501(c)(3) tax exempt organization, teamed with the International Center for Disaster Resilience (ITC) and the Haitian  Ministry of Youth-Sports-Civic Action to implement a state-of-the-art, sustainable program aimed at (1)  medical-psychosocial assessment and treatment; (2) Healthcare infrastructure enhancement initiatives that provide evidence-based medical and psychosocial treatment and education programs; (3) Promoting  child-wellness by utilizing evidenced based interventions to address the complex, inter-woven health needs and  long term recovery care for earthquake exposed youth survivors and their adult care-giving systems. The program started in 2011 with a Pilot Phase in Port Au Prince and Croix des Bouquets.

Pilot Phase-January 2011 through October 2011: During our pilot phase CiH assembled and funded in part, a Haitian managed network of 10 Sanctuary Centers, providing child protection, public health services, medical health and psychosocially-informed, trauma-sensitive programs for 1,287 youth survivors. 537 earthquake exposed youth completed the ITC medical-psychosocial assessment survey and preliminary data results indicate extremely high levels of psychological trauma, and stress related illnesses, along with a high prevalence of major disease, particularly of infectious etiologies. On further examination of the data, our initial premise, that within post-disaster populations there is a high incidence of psychosocial etiologies to medical symptomatology, and a high incidence of medical disease contributing to psychosocial trauma, is being proven-out. The preliminary findings were presented at an International Emergency Medicine Congress in Greece this September, 2011.

Human resource capacity building and Interventions: Over 90 Haitian staff and adjunct Haitian professionals providing services to the 10 CiH Sanctuary Centers were credentialed, in Haitian Creole, by CiH training and education programs in basic and advanced psychosocial and medical acute stabilization interventions to provide ongoing and sustainable medical and psychosocial support for the Sanctuary Centers. 60 of the Sanctuary Staff have completed a first round implementation of the Community-Culture-Classroom Based Intervention (CBI) providing psychological and psychosocial stabilization to approximately 300 of the 537 youth assessed as having high levels of psychosocial trauma. During our Phase One the trainees will receive a booster/upgrade training to become qualified paraprofessional providers of the psychosocial and medical interventions.

Strategic Partnerships:  CiH has built select partnerships to support the sustainability of programming and assure the highest levels of evidence based practice and preparedness for future challenges that will impact Haiti and Haitian youth. Our current  partnerships include theHaiti-Ministry of Youth, Sports and Civic Action, Haiti General Hospital (HUEH), Former Minister of Health-Dr. Alex Larsen, Be-Like-Brit Foundation, Harvard Medical School-Disaster Medicine Section, providing medical personnel and expertise customized for the different Sanctuary Centers, Americares, assisting with prescription medicine supply chain for the Sanctuary Centers Network, the U.S. National Haitian Mental Health Network, assisting with translation, culturally effective training and jobs creation programs for new Haitian social workers, College of Visual and Performing Arts-George Mason University, providing environmental arts assessments and interventions for the Sanctuary Centers, Haiti Sweet Sleep, assisting with  mattress donations for over 1,000 Sanctuary Center youth and One Laptop per Child Foundation (OLPC), providing learning systems that reduce disruptions in education during disasters.

During our pilot phase OLPC has provided 268 X/O Laptops for Sanctuary Center Youth. CiH also includes a robust trauma informed sports program sponsored by USA Volleyball and geared to promote wellness of the youth in CiH programs.

Phase One-November 2011 through December 2013:

The CiH has its local office headquartered at the Haiti National Sports Center, National Route 2, Croix des Bouquets, Haiti. CiH is uniquely positioned and co-funded to finish construction of a Sports Facility that will double as an emergency and preventive medicine training center and psychosocial intervention facility. CiH is ready for the launching of Phase One of its sustainable recovery and preparedness initiatives based upon the success and data results from the CiH Pilot Phase. We propose, over the next two years, to expand our current initiatives and Sanctuary Center Network by doing the following:

  1.  Recruit and bring on-board 30 new Sanctuary Centers, primarily school and community based programs, which will increase our youth service recipients from 1,287 youth to 57,500 youth per year or 115,000 over the project term. We will increase our credentialed CiH Haitian staff from 90 to 120. We will then provide basic and advanced medical–psychosocial and preparedness training for the 120 CiH staff who will then provide the medical, CBI and other combined psychosocial programs to all 115,000 youth.
  2. Provide our medical-psychosocial assessments to an additional 500 trauma exposed youth in order to further expand the results of our pilot data and refine our assessment tools for Haitian culture.
  3. We will provide monitoring and evaluation of the interventions and jobs creation program to ensure fidelity of dissemination and ongoing integration of our program with local infrastructure to assure transition and sustainability of the program to the Haitians by 2014.
  4. Assemble support to provide additional OLPC X/O laptops to CiH Sanctuary Center youth.

CiH will continue to design and build strong relationships with local networks of service providers including International and Haitian NGOs as well as emerging government services (Health, Education, Youth-Sports-Civic Action, and Labor) in order to disseminate our expertise and human resource capacity building to other organizations, and to ensure Haitian managed program sustainability in 5 years. Child in Hand has embarked on a program of assessment and intervention for the most at risk population in post-earthquake Haiti-the children.

Through combined medical and psychosocial assessment, education, and treatment programs, CiH provides comprehensive care of the child and matches that care with wellness interventions that include clean food and water, provision of clothing and shoes, art programs, sports programs, and civic action programs.

Through evidence-based practices and ongoing objective data analysis, the CiH program ensures a sustainable and successful intervention for the youth of post-earthquake Haiti. Over the next 2 years the program will provide approximately 120 new jobs for Haitian workers as well as significant skill acquisition and professional development for these new employees.

CiH will assure dual use of its primary initiative efforts including cross training in medical and psychological stabilization and prevention techniques for all Haitian CiH employees and interventionists, triple use of the National Sports Center CiH structure as a training center, a treatment center, and an emergency shelter.

CiH, ITC and their partners have contributed over $545,000 in direct funding, in-kind-contributions and labor to the program since January 2010. It is our mission to guide the program into a transition that will work for the Haitian partners we train and employee.

CiH, using its monitoring and evaluation program, will develop a transition plan to ensure that the Haitian CiH employees, the Sanctuary Center Team Leaders and the CiH interventionists will be able to take over the program by the end of 2014 with fully chartered governance, trained trainers with training materials and sustainable funding to continue maintenance and expansion of the Sanctuary Centers.