Hi Orkideh!!

Raded I can not her Eugene

sadeq

It is my computor

yes, I’m guessing the problem must be from your speaker

I hear him well

Yes, tês my dear

Tks

bonjou Kobel, good to see you!

https://www.hsph.harvard.edu/magazine/magazine_article/the-age-of-trauma/https://www.nejm.org/doi/full/10.1056/NEJMp2001507https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30208-7/fulltext

My thesis work had a qualitative strand and one of the main themes that emerged from the participants was the fact that the current unstable socio-political situation is impacting every aspect of their healthcare needs, way more than covid.

Here is some background on the Zanmi Lasante mental health system/team

https://storymaps.arcgis.com/stories/b72b191d9c024621b8bb109e5ce1c014

Sorry guys ! connectivity issues !!

It should be health AND wealth INSTEAD of health BEFORE wealth

@Ralph B. Charles: Well said. Reminds me of David Mechanic's "the best public health intervention is to build a solid middle class"

The brain drain we are facing now won't let that intervention happen soon !

Work of medical sociologist, Arlene Geronimus might be relevant— “weathering” of African Americans in face of enduring racism.

@Micheal & Michel Nathan: thank you!!definitely my next author to quote. Thanks for that amazing tip

Thank you to all the speakers today for a sobering and informative group presentations. Must run but really enjoyed this

Do you think the resiliente can be a kind of political belongs?

@maria I think it is colonial, post colonial, socio-economic, and political in Haiti

Given the dearth of providers but our commitment to task shifting and community development of mental health services, how can we also increase access to mental health services for Haitian patients who are seen in medicine, oncology, pediatrics, surgery…can you speak to where sites stand with this?

his situation is socially constructed by history, colonization, bad pollical and economic decision creating poverty and precarityThis is what Paul called structural violence

This situation is socially constructed by history, colonization, bad pollical and economic decision creating poverty and precarityThis is what Paul called structural violence

@Ralph B. Charles: This might be a start for Mechanic: https://www.healthaffairs.org/doi/10.1377/hlthaff.19.3.269

Darja ! thanks for your question. Zanmi Lasante is providing psychosocial and MH services to all those categories of patients. However, they can't replace the State. What is being done in the Central Plateau should be duplicated every where in the country ! Unfortunately this won't happen tomorrow

Weathering — http://pubmed.ncbi.nim.nih.gov/1467758/https://pubmed.ncbi.nim.nih.gov/1467758/

Mèsi anpil Eddy! Indeed, well put. I wonder what the psychiatry staffing situation is on all these units/spaces (probably very challenging) and hope that UGHE Haiti will soon lead to more medical students and residents who can get involved and train in various areas of psychiatry!!

Great !! Awaiting !!!

https://pubmed.ncbi.nlm.nih.gov/32180989/

The ZL model is a collaborative, stepped care model. We have a 70 page blueprint for a psychiatry residency. The past 3 years of insecurity have gotten in the way.

The system takes care of both common and severe mental illness, at health centers, hospitals and in the community, and delivers psychopharmacology and psychosocial interventions.

We have locally validated tools using local concepts as well to differentiate mild, moderate and severe symptoms

https://journals.sagepub.com/doi/full/10.1177/1363461514543546

It is a testament to the team at ZL that they continue to deliver care under the ongoing unstable conditions and situation.

thanks to all for the interesting discussion, see you next week

You are an inspiration Dr. Millien!

And all!

Thank you Dr Millien for organizing— you are amazing— and thanks to all the other panelists and others for a great discussion.

Indeed, thank you Dr. Millien!!

Thank you for the seminar.

And thank you all for the great discussion, as well!

mes Cher Christophe! toujours avec solidarité!!!

This seminar was somewhat healing, listening to this great conversation. Thank you everyone for a great discussion. 🙏🏾

my email is kdubique@pih.org