PORT-AU-PRINCE, Haiti - The battered bodies may be mending, but the minds still struggle.
As many as one in five Haiti earthquake victims have suffered trauma so great with the multiple shock of lost homes, jobs and loved ones that they won't be able to cope without professional help, doctors say.
In a country where mental health services barely existed before the quake, building the required support is a huge challenge. The symptoms can't be diagnosed by stethoscopes, blood tests and X-rays, and can take time to surface after the initial shock of the disaster.
"It's not about immediate psychological counseling," said Dr. Lynne Jones, a senior medical adviser for the International Medical Corps. "It's about assisting mourning. People cannot recover if their social needs are not met." Jones, a veteran of natural disasters and wars from Bosnia to Indonesia, is teaching front-line doctors how to identify "disabling fear" and, quite literally, hold people's hands and listen.
"The doctors in such situations tend only to hand out tranquilizers," Jones said. "We don't want them to do that."
Port-au-Prince's only psychiatric hospital is barely functioning. All but 11 of its more than 100 pre-quake patients were removed by relatives who feared the building would collapse in another quake, said Dr. Peter Hughes, an Irish psychiatrist who arrived late last week and is studying what to do.
It is not known how many mental health workers are available to help in Haiti. Pan American Health Organization officials who are coordinating medical care among more than 200 aid groups have only just begun to create a database of hospitals, patients, doctors and medical resources.
Dr. Jorge Castilla, lead coordinator of the aid groups in Haiti, put out an urgent request yesterday for mental health professionals. "But this is not easy because they have to be able to adapt to the culture and the language," he said. "I can't have hundreds of volunteers coming here who don't speak the languages."
Palpitations - rapid, fluttering or pounding heartbeats - are rampant among them, doctors say.
At Port-au-Prince's general hospital, Louna Jean-Baptiste waits in line under a punishing sun to be seen. She's had heart palpitations since the quake. "My heart is racing all the time," said the 34-year-old mother of four. "Sometimes I feel like my heart is in my throat. Other times I can't breathe and feel like I'm going to die."