Social Worker and NASW Member Meg Kallman had never seen such devastation.
“Buildings were flattened like pancakes, streets were impassable with debris, cement and dust everywhere ... just everywhere,” she said, struggling for the words to convey her first impression of Port-au-Prince, Haiti.
On Jan. 13, just a day after a 7.0-magnitude earthquake brought that Caribbean island nation to its knees, killing hundreds of thousands of people and injuring countless more, Kallman and her colleagues with the New Jersey-1 Disaster Medical Assistance Team received orders that they were to be deployed to Haiti. Eighty percent of Haiti’s approximately 9 million people live in abject poverty, according to the CIA World Factbook, making it the poorest country in the Western Hemisphere.
Several states have DMATs, which are groups of highly trained medical personnel capable of triaging patients and providing medical care in austere situations. Kallman, who specializes in treating people for sudden and traumatic loss, is the New Jersey-1 DMAT’s mental health specialist for both the crew and disaster victims. Being a DMAT member means always having your bags packed, ready to go in case Uncle Sam beckons, she explained.
Days after arriving on Jan. 14 in the Haitian capital of Port-au-Prince, the New Jersey-1 DMAT set up a two-tent hospital amid the rubble in nearby Pétion-Ville, where they treated hundreds of patients daily.
“There were broken bones, pieces of kids’ feet that were gone, scalps exposed, people were dehydrated,” recalled Kallman, who is once again stateside after spending more than two weeks in Haiti.
She said whenever possible, more seriously injured patients were stabilized and taken by medevac to either a better-equipped makeshift hospital or the U.S. Navy’s Comfort, an oil tanker retrofitted as a floating hospital and anchored off the coast of Haiti.
Nevertheless, demand outpaced supply and the DMAT physicians sometimes found themselves forced to make the tough decision of denying life-prolonging care to people who clearly would not survive their injuries, according to Kallman.
The trip to Haiti was Kallman’s first overseas mission, though she has assisted in several domestic disaster relief efforts, including in Louisiana and Mississippi post-Hurricane Katrina.
Many times Kallman’s expertise in sudden and traumatic loss was called upon. She brought up one harrowing event where a man was hit by a water truck, and after efforts to save his life failed, he was pronounced dead.
“About a half-hour later his brother came, so I worked with the brother and the Army chaplain,” she said. It was also Kallman who escorted the shaken man to identify his brother’s body.
Amy Bess, NASW senior practice associate for human rights and international affairs, said that in the wake of disaster, it’s important for officials to recognize that psychosocial well-being is on a par with physical health.
“It’s not enough to mend broken bones; you’re inevitably going to have to deal with broken hearts as well,” Bess said. “That’s where social workers come in, and that’s why professionals like Kallman are indispensible to the relief effort.”
“In addition to their mental health expertise, Bess adds, “social workers are ideal for providing crisis management, coordinating joint needs assessments and carrying out family tracing and reunification,” among other things.
Kallman believes it is social workers’ systems training and having the wherewithal to understand the “bigger picture,” in addition to their clinical training, that make them well suited to assist in disaster relief efforts.
While in Pétion-Ville, Kallman made it a point to meet with the workers of nongovernmental organizations also assisting in the relief effort.
“I talked with them to find out what they were doing so that we could try to connect the dots a little bit,” she said. “I think social workers are uniquely skilled at coordinating resources.”
However, Kallman has a warning for individuals, including social workers, thinking of just parachuting in.
“I don’t think the situation in Haiti is for the faint of heart,” she said, observing that safety is a serious consideration. “There were people there that definitely went without doing their homework.”
She continued: “We ate nothing but MREs [meals ready to eat], and while we had bottled water, on some days our supply got low.”
Kallman also said malaria and dengue fever — diseases spread by mosquitoes — are a problem in Haiti, emphasizing the need to be properly vaccinated and to know the symptoms.
Luisa Lopez, NASW’s director for human rights and international affairs, agrees with Kallman. “Individual social workers shouldn’t try to go it alone,” she said. “Even highly skilled folks can’t just show up and do their best. Everybody has to be connected to each other, because what we’re talking about is a total system collapse — the legal system, education system, food and so on.”
Lopez suggests that those interested in being directly involved in relief efforts in Haiti, or anywhere else for that matter, should consider linking up with NGOs experienced with disaster relief, such as the International Committee of the Red Cross or members of InterAction.
Lopez encourages social workers with prior international disaster relief experience to register as volunteers with the Center for International Disaster Information, which provides information and guidance in support of appropriate international disaster relief.
Because the conditions in Haiti were already difficult prior to the earthquake — the number of people living in substandard housing with limited food and water, for example — the recovery effort will last well beyond the emergency phase, said Lopez.
“Once they’ve transitioned out of the emergency response phase, organizations will need social workers to help with revitalizing communities, re-establishing social norms, restoring trust and social cohesion and helping communities stabilize and normalize toward durable solutions and sustainable peace,” Lopez said.
Social workers seeking longer-term positions with NGOs within Haiti can visit ReliefWeb: Jobs for more information.
NASW’s own policy, co-written by Kallman and articulated in Social Work Speaks (8th Ed.), is to support participation in and advocate for programs and policies that serve individuals and communities in preparation for, during and in the wake of disaster.
And there are multiple ways for social workers to contribute to disaster relief efforts, both directly and indirectly, Lopez said.
“Social workers need not travel to Haiti to make a profound difference,” she said.
There are plenty of people in the U.S. who are in need, Lopez noted.
“There are friends and family of people back in Haiti, and often, they need assistance to cope with the trauma and fear of what happened to their loved ones.”
She said states with large Haitian communities include Florida, Massachusetts and New York.
Bess pointed out that social workers will be instrumental in coordinating efforts to assist unaccompanied and separated children by implementing best practices for family tracing, reunification and interim care, and identifying longer-term alternative care solutions that are family-based.
Lopez said that in the aftermath of Hurricanes Katrina and Rita, both of which in 2005 wreaked havoc on states along the Gulf Coast, NASW worked with the American Red Cross and the U.S. Department of Health and Human Services in efforts to build the ranks of skilled professionals ready to volunteer.
Today, there are online resources such as the cultural competency curriculum for first responders that people can take for continuing education credits, available at OMH's Cultural and Linguistic Competency.
“I would like to see more social workers get themselves trained to be emergency responders and be ready to volunteer for the next time,” urged Lopez, who serves on the task force that developed the curriculum.
“Social workers are often among the first to respond to disasters both nationally and abroad,” NASW Executive Director Elizabeth J. Clark said. “The people of Haiti need our help now more than ever, and we are committed to providing any assistance we can to one of the world’s poorest countries during this terrible tragedy.”
Social workers have contributed heavily to the NASW Foundation’s Social Work Disaster Assistance Fund — previously established to provide financial assistance and support to social work and social workers affected by disasters such as the 2004 tsunami in the Indian Ocean and Hurricane Katrina in 2005. At this story’s deadline, the fund had received more than $20,000 in individual donations.
NASW has set up a page on its Web site devoted entirely to the relief effort in Haiti. There, visitors will find information on child protection and adoption, links to standards for psychosocial and mental health response in emergencies, resources for family members coping with this disaster and resources for social workers who want to help, as well as a link to the NASW Foundation’s Social Work Disaster Assistance Fund.