What the World Could Learn From the Haitian Resilience While Managing COVID-19

Abstract

In the 1st trimester of 2020, there were mixed feelings among Haitians about the spread of the COVID-19 pandemic. In effect, many of the concerns emanating from the relatively weak health infrastructure in Haiti were analyzed from a resilience perspective. Many professionals living in Haiti with whom we have conversed believe that Haitians were better prepared to cope with the social distancing and mental health outcomes associated with the pandemic because of their 3-month exposure to the effects of Peyi Lòk (“country in lockdown”) as well as previous major natural disasters. In that regard, previous traumatic exposures may serve as a buffer against the debilitating effects of the COVID-19 pandemic among Haitians. For the past 3 months, Haitians have naturally adopted a practical posture to cope with the pandemic where only school buildings are closed. Consequently, we remain convinced that from a psychological perspective, individuals from high-income countries that are severely affected by the COVID-19 pandemic could learn from the Haitian way of coping with large-scale disasters.

On December 31, 2019, Chinese health authorities confirmed that dozens of people in Wuhan, a small town in China, were hospitalized for pneumonia from an unknown cause. It is alleged that many of the infected patients had visited a live animal market in Wuhan. From this outbreak, this novel coronavirus (COVID-19) spread throughout the globe. Indeed, on January 30, 2020, it was declared a public health emergency of international concern. Three months later, on March 11, the World Health Organization ([WHO], 2020b) officially declared (COVID-19) to be a pandemic. According to the latest WHO updates (WHO, 2020a), COVID-19 has spread to over 227 areas, countries, and territories, with over seven million individuals contracting the virus, resulting in over 400,000 deaths across the globe.

In Haiti as of June 15, there are more than 4,000 confirmed COVID-19 cases and over 70 deaths reported by the Ministère de la Santé Publique et de la Population (MSPP; République d’Haïti, MSPP, 2020). Meanwhile, in the Dominican Republic (the other half of the island of Hispaniola), more than 20,000 confirmed cases of COVID-19 and over 600 deaths have been reported (República Dominicana, Commision de Alto Nivel Para la Prevencion y el Control del Coronavirus, 2020).

From a psychological standpoint, the life-threatening characteristic, the disruption in our daily routines, the loss of jobs, the increased stress, and the growing uncertainty generated by the pandemic led to the consideration of COVID-19 as a potentially traumatic event. As such, world-renown public health researchers became concerned about the substantial increases in anxiety, depression, substance use, loneliness, and domestic violence. They also feared the possibility of an epidemic of child abuse as an adverse effect of the exposure to the COVID-19 pandemic (Galea, Merchant, & Lurie, 2020; Pfefferbaum & North, 2020; and Rajkumar, 2020).

In this context, as mental health professionals focusing on psychological trauma and resilience and who have firsthand experience with the 2010 Haiti earthquake and the recovery process of affected individuals, we highlight herein several lessons from the Haitian resilience that the world could leverage as it copes with the devastating effects of COVID-19.

What Is the Current Situation of COVID-19 in Haiti?

Prior to COVID-19, Haiti emerged from a political lockdown that lasted from September 2019 to December 2019. When the first case of COVID-19 arrived in March 2020, the country was just beginning to regain a certain sense of normalcy despite the socio-economical and psychological ramifications of being on lockdown. This violent civil unrest was initially triggered by an abrupt increased of fuel price, a movement that became known in Creole as Peyi Lòk (“country in lockdown”; Jerome, 2020). Peyi Lòk is considered as a new form of resistance in Haiti, where protesters blocked most of the streets, preventing people and vehicles from circulating, demanding changes at various levels of society. It occurred as the longest period of continued protests since the election of the current president, Jovenel Moise. The first lockdown lasted 7 days in 2018. During the most recent Peyi Lòk, which lasted over three months, there were roadblocks and barricades in every corner of the country, with considerable repercussions for the education system, the transportation sector, and the economy. Thus, when COVID-19 was plaguing China and many European countries, the majority of Haitians continued to engage in their daily routines as if they were desensitized to effects of disasters and forced social distancing imposed by constant lockdown of the country with the Peyi Lòk movement.

Could Haitians Be Mentally Better Prepared to Cope With the COVID-19 Mental and Social Distancing Outcomes?

In the first trimester of 2020, there were mixed feelings among Haitians about the spread of the COVID-19 pandemic. In effect, many of the concerns emanating from the relatively weak health infrastructure in Haiti were analyzed from a resilience perspective (Yves, 2020). Many professionals living in Haiti with whom we have conversed believe that Haitians were better prepared to cope with the social distancing and mental health outcomes associated with the pandemic because of their 3-month exposure to the effects of Peyi Lòk as well as previous major natural disasters. In that regard, previous traumatic exposures may have served as a buffer against the debilitating effects of the COVID-19 pandemic among Haitians. These specific attributes of the Haitian resilience could be summarized as follows: hardiness, creativity, and belief in traditional and complementary healing. Each attribute is discussed in the next three sections.

Hardiness

Hardiness is often considered an important factor in psychological resilience. Hardiness is a personality style that helps a person cope, withstand, and actively engage in transformational coping when faced with stressful events (Mosley & Laborde, 2016). We found it rather remarkable that one of our colleagues, Ralph Emmanuel Francois, a renowned expert in the field of disaster preparedness, did not seem to be concerned about the possible negative impact of COVID-19 on the mental health outcomes in the Haitian population, although he was unsure whether to call this resilience. Francois told us:

Haitian people have a specific vision of life. They are convinced that as long as there is oxygen, breath, movement, there is hope. When there is no movement, there is no hope. Therefore, because they are breathing, there is a way out. This is hope, this is the Haitian way of life!

(R. François, personal communication, April 8, 2020; Saint-Juste, 2020)

A number of colleagues working in the health system in Haiti, as well as people on social media platforms, are unanimous in their comments concerning how the exposure to the 2010 earthquake, the October 2010 imported cholera outbreak, and the recurring Peyi Lòk episodes prepared them to adapt to the COVID-19 pandemic.

Creativity

The famous Haitian anthropologist Jean Price-Mars once defined Haitians as follows: “ce peuple qui chante et qui souffre, qui peine et qui rit, et qui danse” (“these people who sing and suffer, who sorrow, laugh, and dance”; Price-Mars, 1998, p. 20).

Haitians’ ability to create and make art from their suffering is their trademark. They are known as an artistic nation. Thus, it is no surprise that during the COVID-19 pandemic, Haitian Konpa groups based in Haiti and in the diaspora are performing weekly on social media to help their fans cope with the pandemic.¹ For example, during the recent Easter season, the musical parade known as Rara was leveraged to raise awareness about the COVID-19 pandemic (Marcelin, 2020).

Belief in Traditional and Complementary Healings

Although there is considerable variation in their use of complementary and traditional medicine, many Haitians highly regard traditional healers, herbal preparations, and other culturally specific interventions as a means of restoring harmony and balance. As such, Haitians in Haiti and the diaspora (e.g., New York, Florida, and France) who are seriously affected by COVID-19 are turning to traditional medicine to reinforce their immune system to ward off the infection (Lalime, 2020). Furthermore, religious and spiritual beliefs, which are a major component in Haitian society, have been used as seemingly effective tools to deal with the pandemic as well. In this Afro-Caribbean nation, every event is interpreted through the lens of religious and spiritual beliefs. As was the case during the 2010 Haiti earthquake, Haitians are now coping with the pandemic by largely relying on their belief system (Blanc, Rahill, Laconi, & Mouchenik, 2016).

Discussion

On June 15, 2020, Haitian health authorities stated that the COVID-19 pandemic had reached its peak. They indicated that there was a decrease in the number of cases that have been detected. Based on that observation, they cautiously expect that the predictions regarding the pandemic might not be as catastrophic as expected (Saint-Juste, 2020). It is also conceivable that this is due to a lack of testing and limited tourist activities and commercial relationships with the outside world. For historical and socioeconomic reasons, global health authorities were anxious about the impact of COVID-19 on the first Black republic, along with other low-income countries. These concerns stemmed from the fact that the Haitian population for the most part does not have the luxury to be in complete confinement, to telecommute, and to adequately implement a remote learning system for all students because of their unacceptably low socioeconomic status. For the past 3 months, Haitians have naturally adopted a practical posture to cope with the pandemic, where only school buildings are closed. Consequently, we remain convinced that from a psychological perspective, individuals from high-income countries that are severely affected by the COVID-19 pandemic could learn about the Haitian way of coping to large-scale disasters.