Victims of the 2010 earthquake in Haiti continue to find solace and medical treatment at Dorchester’s Codman Square Health Center, which has created a special program to focus on the specific needs of the Haitian clients still coping with the after-effects of the disaster.
Olivia Appolon, a social worker at Codman who has worked there since 2001, estimates that the behavioral care staff saw an increase of 80 new Haitian patients in the first few months after the Jan. 12, 2010 earthquake.
“I’ve been here for a number of years and it had been difficult to get Haitian patients to utilize behavioral health services,” Appolon said. “People have been more receptive of these services since the quake.”
Many patients came in during the immediate aftermath with symptoms and somatic complaints like headaches, upset stomach, and feeling fatigued Appolon said.
“They would say ‘Kò m pa bon’ I’m not feeling well and when testing didn’t prove any organic causes, we realized the only thing they all had in common were that they were survivors of the quake.”
At the numerous Haiti Relief Clinics, staff provided physical check-ups and preliminary mental evaluations, along with information about post-traumatic stress disorder (PTSD) to help them manage the symptoms. Though most of the patient base was in Boston (mainly Mattapan and Dorchester) people came from Randolph, Brockton, Cambridge, Malden and Everett. These clinics lasted through July 2010.
Now, the health center is launching a new series dubbed the Haitian Support Program, which will gather survivors in a group setting every other Saturday beginning Jan. 15.
“In the beginning, the focus was to help with basic needs like immigration, housing and food,” said France Belizaire, another social worker who was part of Codman’s initial response team. “People that would come from Haiti, would get all their shots, a full check up, then see a clinician, get an evaluation and join the group.”
“There wasn’t a lot of therapy,” adds Appolon. “If [patients] needed therapy we would refer them on an individual basis. We provided what can be called psychological first-aid.”
Belizaire, then an intern, has since graduated from Simmons College’s masters of social work program and now works as one of the social workers in the support group, which started in the summer of 2010. The program is funded by a federal grant from the Substance Abuse and Mental Health Service Administration and is locally administered by the state’s Department of Public Health (DPH).
DPH was the main provider of health insurance for the first wave of survivors that came to Massachusetts. Patients received comprehensive care free of charge, which included medical, dental, eye health and behavioral services.
Staff track patient care and status in monthly reports on various issues that they discuss in sessions, including housing, immigration and nutrition. [The program] currently has 10-12 (in addition to 6-8 children) consistent clients every other Saturday.
Two years after the quake, many survivors are confronting challenges with getting jobs, access to limited benefits and immigration.
“This year, some of the clients are taking ESL courses and have jobs,” said Belizaire. “We call clients to see if they will come to the group and many cannot.”
For those who have yet to find work, learning English is important for them says Belizaire.
“The process can be stressful. They say ‘alright, I’ve been here for a year, and I applied for a job but haven’t [gotten] a job.”
Outreach manager Beatrice Martin helps many clients get access to resources. She refers clients to training programs along with Codman Square’s Health Leads program – which helps low-income residents with food stamps and bill payment.
“While many are dealing with this tough economy, they are still coping with grief and loss,” said Belizaire. “We’ve been working with the clients to help them talk about their lost family members. Many are still holding it in.”
According to the Codman staff, one of the main barriers to providing services has been immigration. Many patients have Temporary Protected Status (TPS), and while all it does allow them to remain in the US and grants legal status to work, it only provides emergency health insurance.
“Many of our clients are on emergency cash assistance. They apply to get some money, but some still [aren’t eligible] to get food stamps,” said Belizaire. “Some may get about $100 or so [every] few months, and then they have to re-apply. Not to mention, some clients have to wait for work permits after they file for TPS.”
Codman Square’s patient-centered approach that provides incoming clients with a team of providers is making a difference, said Appolon.
“We have a diverse group of providers that can relate to the population that they serve,” Appolon said. “The fact that Codman welcomes everybody, makes it a home for people in the community. People can walk-in anytime for services and we have same-day appointments… It’s a plus for the community to have access to care right away.”
Most of the health care providers involved in the Codman program are of Haitian descent. Belizaire thinks the diversity of the staff enables them to provide care in a way that makes patients comfortable.
“I wanted to work here at Codman Square because I wanted to work with Haitian clients,” said Belizaire. “I was looking for a place where …I can really help my community and to help work [against] the stigma of mental health. I wanted to educate my community and show that mental health is not about ‘moun fou’ (crazy people) – it’s about healthy living.”
Two years after the earthquake that led these survivors to Boston, to Dorchester, the providers say their patients have served as inspiration.
“Many Haitians pick up the pieces and keep pressing forward.”