Haiti: psychosocial activities in a crisis context
The terrible earthquake in Haiti took place in a country already riddled with problems and complexity. As happened following the tsunami of 2006 in South-East Asia, this disaster generated massive international aid, including psychosocial activities. Even though certain psychosocial actors were present before the earthquake, the question remains about the pertinence of this external aid with regard to such a private issue as psychology and such a cultural issue as public and social relationships.
The shock of the earthquake
The earthquake of 12 January 2010 was a major event. It is often referred to as “the event” by people in Haiti  in order to avoid saying the word “earthquake”. Its directly observable consequences are damaged buildings such as houses, hospitals and schools, the injured and the dead, the displaced, the “camps”, etc.
This type of disaster has a major impact on human beings . Survivors are left in a state of confusion and despair. This is due, first of all, to the loss of bearings: not having somewhere to sleep, to work or to go to school. People no longer have any routine and they proceed in an internal state of emergency focused on getting what they need to survive. The normal functioning of society or community is also disturbed. Disasters accentuate the fragility of health and emergency response systems, highlighting their shortcomings at a time when they are needed the most.
The earthquake caused many deaths, injuries and led to the displacement of many people. Mourning is an internal and social state and mourning needs to take place to allow those who are still alive to accept the deaths which have taken place and carry out funerals in accordance with tradition. Not all loved ones were found by their families after the earthquake. Some of the dead were never removed from the rubble while others were buried in mass graves. It is difficult for families not to know where their loved ones are, whether they are dead or still alive, and not to be able to carry out funeral rites. Religion, and particularly Christianity and Voodoo, is deeply ingrained in Haitian culture. Whatever the religion involved, not carrying out funeral rites is very painful for those who are still alive.
Those who have been injured may remain handicapped. After having received medical care, they then have to accept their new condition and learn to live with a different body. They also sometimes become dependent on family members, for example. Unable to return to their previous lives, they often suffer from feelings of abandonment, uselessness and shame. The massive destruction of buildings, with houses completely destroyed or too dangerous to live in, has led to a large number of homeless people (as many as a million). Initially, people went into the street to be safe from collapsing buildings. Then spontaneous camps were set up in unoccupied spaces, particularly in Port-au-Prince. For these people, one of the advantages of such camps is that it allows them to stay in the neighbourhoods where they are used to living and where their loved ones are. However, life in the camps has many unsettling factors such as insecurity, lack of privacy and promiscuity.
The earthquake itself was a veritable psychological shock: living through an earthquake is a particularly harrowing experience. Each person reacts and metabolises this in a different way. However, shock and fear are often caused by the exceptional experience of the ground moving. “Concrete phobia”, the fear that people who have lived through an earthquake have of going back into buildings, the fear of aftershocks or another earthquake and of being trapped under the rubble is also very present in Haiti.
Scientific understanding of earthquakes can help to explain what has happened, but in such a context, where belief in the supernatural is very common, some believe that an earthquake can be “caused on demand” or “as a punishment”. As a result, people fall prey to their insecurities and are willing to listen to any reassuring explanations they can find. Children and adults need explanations for what has happened and what is going to happen in order to re-establish some bearings within the chaos left by the earthquake.
In Haiti, from the first moments after the earthquake after the initial shock, the need to rescue victims and the establishment of survival mechanisms allowed people to cope and remain active in order to regain control of their lives.
The exacerbation of previously existing problems
As time has passed, actors in Haiti have noticed that the earthquake as a shock is no longer the actual reason for requests for psychosocial support. The earthquake has cruelly revealed numerous, recurring problems which existed before it took place.
Psychosocial activities took place in Haiti before the earthquake. Haitian and foreign associations (NGOs and international organisations) were already present and carried out psychosocial activities on the basis of people’s needs and to deal with the effects of the cyclones in 2008. The programmes implemented were mostly development orientated. The principle themes of these pre-earthquake programmes were violence and vulnerable people. These principally involved women (e.g. single women, heads of households, young mothers and victims of domestic or sexual violence), children (e.g. living on the street, heads of households and abandoned children) and victims of violence (e.g. women, children and men affected by marital, household, street and gang violence).
The earthquake made a large part of the already vulnerable population even more fragile. Coping strategies were often adopted by people to get what they and their loved ones needed from day to day. Women and children thus found themselves increasingly subject to attacks and violence.
There is chronic violence in Haiti. This can be explained by its history which has been marked by slavery, the war for independence and dictatorships, but there is also a pronounced social hierarchy in Haiti which resembles a caste system and which is based on factors such as education, wealth, culture, language and skin colour. These factors, added to the difficult living conditions of 80% of the population (who live with less than 2 US$ per day) create a society where each person needs to fight for their place.
The position of women is particularly difficult. Traditionally, they play an important role within families (children’s education, family relations, etc.) and the household (budget, upkeep, etc.), but they are currently often alone, with children to look after, with very little education, low income which comes either from their families, from odd jobs (selling, agriculture) or sometimes from prostitution, very little awareness of their rights and a very submissive attitude to men.
The situation after the earthquake exacerbated this violence: the waiting, the unemployment, the aid which took so long to arrive, the survival conditions which dragged on, the favourable conditions for the informal economy and trafficking, the gangs, the promiscuity, hunger, hygiene, life in the camps, the elections, the anger and the discontent in reaction to the “imported” cholera epidemic... all this has increased the tension between people. There has also been a certain rise in nationalistic and religious fundamentalist attitudes.
 People met in Haiti, Groupe URD mission, September 2010.
 Hellen Mwangouya, Rendre moins vulnérable en faisant preuve d’humanité, Face à la crise n°3, IFRC, 2010.