HomeMy WebLinkAboutItem #67 - Discussion Item��fqq
�1
NTEA t HIUII►N STUIN S
CEKftR FOR HAITIAN OUDIIES, INIC,
CaHeSs
BOARD OF DIRECTORS
Bryan Page. Ph.D
Seymour Stern. Esq
Louis Bernard Antoine, M.D.. FA A P
Dominique Leroy
Cassandra Gayle. MSW
Joseph Patterson, Dr. PH
Carmeus Jacob
David Newman
Ruth Rosow
Price Smith, Ph.D.
Larry Pierre. M.D.. MPH
Executive Director
N
September 28, 1992
Mayor Xavier Suarez
3500 Pan American Drive
Miami, Florida 33133
Dear Mayor:
The Center for Haitian Studies, Inc. (CHS) is a non-
profit community -based organization duly registered in
the State of Florida. The Center was founded in 1988 for
the purpose of serving the Haitian community in the areas
of health education and social services. The Center,
which is funded by HRS, the National Institute of Mental
Health, the Metropolitan Dade County and the University
of Miami, currently offers a variety of community based
programs to an estimated 25,000 Haitians living in the
City of Miami.
In the aftermath of Hurricane Andrew, the Center for
Haitian Studies conducted a needs assessment among
Haitians living in Homestead/Florida City. Among the
most pressing needs were lack of access to existing
services, language and other cultural barriers leading to
lack of information about available services (See
attached copy of CHSSIs needs assessment report). The
needs identified in this survey reflect those of the
Haitian population living in the City of Miami.
The staff and board members of CHS have the type of
expertise that is unmatched by any other agency in the
County in providing services to the Haitian community of
the City of Miami.
In order to intervene in this crisis, CHS is requesting
$SO,000 from the City of Miami to provide vital services
to the Haitian population of Little Haiti. The proposed
services include translation, advocacy and referral
services to Haitians who have resided and/or have been
relocated in the Little Haiti area as a result of the
devastation of Hurricane Andrew.
We request that this item be included in the agenda of
the next City commission meeting.
Sinc ly yours,
ry Pierre, M.D., M.P.S.
Executive Director
8325 N.E. 2nd Avenue - Miami, Florida 3313B /iirrfM��
=.a (305) 757-9555 - Fax: 1305) 756-8023 7
e/ CHS is a private non-profit Community -based Organization
An equal opportunity employer ,^�
THE ACT OF HURRICANE ANDREW
Clm
OF
SOUTH DADE
A REPORT BASED ON OBSERVATIONS/SURVEYSMMD INTERVIEWS
IN HOMESTEADPLORIDA CITY
ON
AUGUST 29,1992 AND SEPI'EMBER 05,1992
CENTER FOR HAITIAN STUDIES, INC.
8325 N.E. Sewed Avenue, Mh iL Fk"da 33138
Phone (305) 7S1A5SS Fax (305) 7S64M
92- 3
TABLE OF CONTENTS
1. INTRODUCTION
2. METHODS OF ASSESSMENT ..................................... 1-4
3. PSYCHOLOGICAL IMPACT' ...................................... 4-6
4. ACCESS TO INFORMATION ...................................... 7-8
S. HOUSING ..................................................... 8-9
6.JOB............................................................ 9
7. CLOTHING AND CLOTHING ...................................... 10
8. HEALTH EDUCATION/PREVENTION .. 10
9. CULTURAL AND SOCIAL IMPLICATIONS ........................... 11
IO.RECOMMENDATIONS......................................... 11-13
11.REFERENCES........................................... ..... 14
I
INTRODUCTION
On the 24th of August 1992, Hurricane Andrew devastated South Florida, leaving 63,000
destroyed houses, over 180,000 homeless citizens and a total of 8000 destroyed businesses.
An immediate response to the crisis has brought to South Florida over 30,000 troops from
the U.S. Army and the National Guard. Thousands of private volunteers have also
intervened in an effort to rebuild South Florida and provide help to those in need. The
hurricane has worsened socioeconomic conditions in a county already affected by a high
unemployment rate and at the fourth highest poverty level in the nation. As a result of the
crisis caused by Hurricane Andrew, experts on economics predict that tougher days are
ahead for the Metropolitan Dade County.
The crisis borne by the hurricane is likely to exacerbate social and economic problems,
especially among already underserved minority groups. In the multiethnic population of
Dade County, certain groups face linguistic and cultural barriers. Because of these barriers,
some aspects of emergency relief efforts have bypassed a significant portion of this
population: the Haitian population. Linguistic and cultural barriers make access by
Haitians to presently available relief difficult, but the pre-existing absence of adequate
services in the Haitian community represents a more deep rooted problem. Local
authorities lack appropriate information about the real needs of this underserved population.
In keeping with its mission to help improve the quality of life of the Haitian people of South
Florida, the Center for Haitian Studies Inc., (CHS) has assembled a team of experts with
background in social and medical sciences to conduct a preliminary assessment of the needs
of the Haitian people living in the areas most heavily affected by Hurricane Andrew. The
purpose of this assessment is to assist Federal, State, Local, Public and Private entities in
making decisions on meeting the needs of the targeted population. In his article entitled
: "Public Health Aspects of Disaster Management", William H. Foege indicated that
physicians and nurses have been sent into disaster areas in numbers far in excess of actual
need and that following a disaster, the desire to provide immediate relief may lead to hasty
decisions which are not based on the actual needs of the population (Public Health and
Preventive Medicine, 1990). The purpose of this preliminary assessment is to describe
some of the needs of the underserved and long- neglected Haitian population of South
Florida.
The team of experts who volunteered their time to conduct this assessment included two
anthropologists, one epidemiologist/public health specialist, one psychiatrist/pediatrician,
one psychologist, one educator, one real estate broker, one architect, one nurse, one medical
records technician, two social worker/case managers, one computer specialist, one journalist
and three ministers of religion. Most of the members of this team have considerable
experience working with Haitians living in South Florida.
Methods of Assessment: On August 29, 1992, three investigators from the CHS went to
Homestead/Florida City to initiate contact with the Haitian population living in these areas
heavily affected by Hurricane Andrew. The purpose of the initial investigation was to
92- 747.1
S
coordinate the visit of an assessment team in the target area. On September 5, 1992, the
entire assessment team arrived in Florida City at 9:30 a.m. at 5015 N.W. 6th Avenue.
Along with the assessment team was another group of three with a truck loaded with food,
clothing and baby products. After a briefing on the mission of the team, a questionnaire
was distributed to the members to be administered during home visits in this community.
The team was divided into three different groups to cover five blocks (2 groups to
administer the questionnaire to adults living in the selected houses in the 5 blocks and a
third group to administer a post traumatic stress test to children living in these houses). In
addition to houses located in the 5 selected blocks, random interviews were also conducted
across Homestead/Florida City within Census Tracts 112.01, 112.02, 113 and 114. At 2:00
p.m, the group met to discuss the preliminary findings/observations of each member. The
team divided the task of writing an observational report among its members with special
consideration to respective fields of expertise. The team's interviewers completed 57
surveys which the staff of the CHS analyzed. The field interviews yielded the following
results:
1. Income of the population:
The average weekly income is $152.25 with a standard deviation of 65.74 and a
median income of $140.00
2.
0,
100% of the population are wage earners who work as maids in nearby hotels,
restaurants, farm workers in plantations, and landscape workers.
Percentage of population who was working prior to hurricane:
7n AM
4. Percentage of population who was working after the hurricane: 14.89
5. Population's length of stay in the U.S.:
63% over a year
18.5% between 6 and 12 months
18.5% less than 6 months
6. Number of people per household:
Average: 5.348
Standard deviation: 2.79
Median: 5.5
7. Living status of population
88.9% tenants
11.1% homeowners
Rent payment:
Average: $263.00 per month
standard deviation: 69.157
Median: $250.00
Mortgage payment:
Average: $453.00
Standard deviation: 34.395
Median: $440.00
9. Size of homes relative to percentage of people living in them:
21.4% of the population lives in 4 bedroom houses
21.4% of the population lives in 3 bedroom houses
42.9% of the population lives in 2 bedroom houses or apartments
14.4% of the population lives in 1 bedroom apartments
10. Percentage of people who paid rent since hurricane: 7%
Note: Most tenants have not been asked to pay since hurricane or do not have
enough money to pay rent.
11. Number of days notice prior to hurricane received by the population:
12%: 3 days
20%: 2 days
32%: 1 day
36%: same day
12. Language in which population was notified:
11.1% in English
61.1% in Creole
27.8% in both
13. Percentage of population who stayed home during hurricane:
66.66%
14. Damages inflicted by hurricane:
22.2% of houses were totally destroyed
70.4% of houses were partially destroyed
7% of houses stayed intact
14.8% of workplaces were totally destroyed
15. Immediate needs of population (priority order from most important to least
important):
a) Housing
b) Job
c) Clothing
d) Food
e) Health Care
Based on past experiences with major disasters, the assessment team anticipates a
change in the rank of the above priority as the crisis stabilizes and the transitional
phase is being completed.
K�
92- 747*t�:'
I
16. Last visit to a physician:
43.8%: 6 months or less
52.2%: more than 6 months
N.B.: Most Haitians do not seek medical care unless they experience symptoms
and/or required to do so for employment and adjustment of their immigration status.
17. Source of information:
60% of population gets information from radio
7.4% of population gets information from television
0% of population gets information from newspaper
43.3% of population gets information from conversations with neighbors
18. Sentiment:
60% of population feels sad
25% of population feels hopeless
15% of population feels hopeful
19. Education:
84.6% of population: Illiterate
15.4% of population has reached high school level
0% of population has reached college
PSYCHOLOGICAL IMPACT:
In addition to the above survey, the team also administered a survey of post -traumatic stress
to children living in these households. Prior to Hurricane Andrew, very little attention has
been paid to the medical and mental health needs of the growing population of the Haitian
communities of Homestead and Florida city which constitute a significant segment of
migrant workers involved in the area citrus industry. The population includes recent
arrivals from other part of the state and also relocated refugees from the recent
Guantanamo resettlement program. This group has had very little experience with large
social agencies providing assistance and even less with military helping civilian population.
The CHS felt it was important to assist both the governmental and non -governmental
agencies involved:in this gigantic relief and recovery effort with a description of the needs
of the Haitian community of Homestead and Florida city. It is our hope that this document
will help break the cultural barriers that are likely to keep this group in social isolation and
let it remain a growing field for public health and mental health problems in the future.
A groupof mental health workers all affiliated with the University of Miami and including
a Psychiatrist/Pediatrician, two anthropologists, one psychologist, one psychiatric nurse and
one mental health technician walked in an area previously identified as inhabited mainly by
Haitians and interviewed both adults and children about general psychosocial conditions and
more specifically about Anxiety and Posttraumatic Stress symptoms. We were particularly
1``� s 1 4
4
1 s
interested in how the children and adolescents of this community were coping in the
aftermath of the hurricane that has struck the area three weeks prior to this assessment.
A two -level screening method was used. A 10-item scale was extracted from a general
trauma checklist and translated into creole. The 10 items were : nightmares, feeling of
impending doom (omen), dissociations/depersonalization, unexplained sadness, feeling
overwhelmed, crying spells,increased startle response, derealization, persistent thoughts
about the hurricane, feeling of hopelessness. The possible answers ranged from never to
always. Any individual with three positive answers were administered a second
questionnaire. This questionnaire was a 20-item scale extracted from the Posttraumatic
Stress Disorder module of the DISC-2. Those items were translated into Creole and the
answered followed the original range used in the DISC ( No, sometimes, yes, I don't know).
A total of eight scales were filled out on questionnaire I and six on questionnaire U.
Children who did not have the language ability to respond to those questions, or children
whose parents objected to their children answering our questions were excluded. In one of
the families, the father came back home and interrupted the interview that was taking place,
stating that his children did not have any psychological problems and that he did want us
to ask all those personal questions. After some negotiation, he agreed to let his four
children draw.
All children were given drawing material and asked to draw whatever they wanted. The
purpose of the drawing was to obtain some projective ideas about the themes that the
children were dealing with at an unconscious level. The children were also asked to tell a
little story about their drawings.
RESULTS: Six of the eight children who responded to the screening questions had scores
that justified administration of the more detailed instrument. Face value of the items in this
instrument may be instructive in assessing the status of these children. At least half
reported that they had experienced either nightmares, or depersonalization, or unexplained
sadness, or crying spells, or persistent thoughts about the hurricane. A sub -group of these
children reported almost constant sadness, hopelessness, startle response, and/or persistent
thoughts about the hurricane. These conditions may be fairly common among Haitian
children in the Homestead/Florida City area. They therefore merit further investigation.
PTSD module:(partial translation from DISC-2 (Questionnaire II): Of the six respondents
to the DISC-2 instrument, over half self reported sleeping disorders, persistent thoughts
about trauma, recurrence of events, somatic response to events, and fear of dying. The
answers to the second questionnaire identify children with positive posttraumatic symptoms.
It is obvious from those responses that the majority of the children surveyed had been
exposed to significant trauma even prior to the hurricane. Those events ranged from
witnessing killing back in Haiti to journey on frail sailing boat to the U.S. This level of
symptomatic response in such a small group of Haitian children suggests that we should
investigate the extent of these kinds of symptoms in the Haitian population and begin to
formulate plans to deliver mental health care in a culturally appropriate fashion to Haitian
61
92- 747.1
W
children affected by both the storm and their traumatic journey to the United States.
DRAWINGS:
The drawings obtained from these adolescent children had many things in common. They
were mostly sailboats and houses . The accompanying stories were about people being
rescued at sea and houses being destroyed by winds. There was also a story about a giant
turtle who would find its way back to the water and swim to Haiti where the rest of its
friends and family are. The colors used were very bright and were mostly joyful.
DISCUSSION:
The survey showed significant symptomatology for Posttraumatic Stress Disorder, although
none of the youngsters surveyed would meet the full criteria requirement for a diagnostic
entity as required by DSM-III-R (American Psychiatric Association, 1987). Nevertheless,
multiple factors place this population at risk for long term psychiatric morbidity. Those
factors are, among others, repeated geographical moves, low SES, unemployment,
dysfunctional family with poor interaction between parents and children, inadequate setting
for early childhood enrichment (lack of day care facilities), cultural barriers to help seeking
behaviors, unawareness of own psychological needs, and negative attitude towards mental
illness. Other factors attributable to the kind responses given to this disaster by the
governmental agencies might contribute into maintaining postdisaster psychiatric morbidity.
Those factors are: absence of social support, inadequate attention to the distress experienced
by the victims, emotional unavailability of the parents who are still mourning their property
loss or loss of status. This morbidity is not likely to subside without intervention. As the
incidence of psychiatric disorders increases, there is likely to be increased utilization of
medical services. This population should be offered both primary and secondary intervention
programs to address those needs. Psychiatric and medical care should be made culturally
and physically accessible.
The needs assessment questionnaires which were developed by Center for Haitian Studies
consist of a combination of direct, yes or no and open-ended types of questions based on
experiences acquired by CHS in conducting research among Haitians. This survey was
conducted by Creole -speaking members of the assessment team in order to assess the
damages and needs of the Haitian population of Homestead and Florida City after the wake
of Hurricane Andrew. The assessment is done on selected neighborhoods of both cities.
The sample's size is 57 adults from 57 different households subdivided into 5 different
blocks (block 1= 10 surveys; block 2 = 12 surveys; block 3 = 8 surveys; block 4 = 9 surveys;
block 5 = 11 surveys; 7 random surveys in Homestead/Florida City). The surveyed houses
are located on the Northern and the Southern side of Lucie Street in Homestead/Florida
City --Eligibility criteria : Being Haitian resident of Homestead or Florida City, aged 21 or
over--- one person per household. The post traumatic stress was administered to one child
per household. All findings are based on the Empirical Rule whereby almost all responses
are contained within the mean plus or minus three times standard deviation.
T
10t''I'T�: 92- 747.1
ACCESS TO INFORMATION AND SERVICE:
Even before the hurricane, information was not available to many Haitians in South Dade,
specifically, those without radios or television, those who do not know English, those who
live away from the main roads. We talked to some in Florida City who had not even known
a hurricane was coming. Others had heard, but had no fore -knowledge of its potential
strength. One woman said that a police car had come by her house around midnight,
announcing in English to evacuate if the house was "not good" because a hurricane was
coming. She said there was not time to prepare to evacuate.
The houses the Haitians rent in Florida City were inferably not in good repair prior to
Andrew. But Andrew took off large portions of roof; walls, floors and furniture are wet.
One household was staying on the porch because inside the house, the roof had fallen in.
Others said that the house was completely "kraze" (destroyed). These displaced people must
crowd in with others. Those who rent are waiting for the owner of the house to come and
fix the house or tell them what to do. Everyone says that they have not seen or heard from
the owner of the house, and they are very worried about how they will pay the rent. Only
one household said that the owner had come by: he gave them a roll of plastic for the roof,
then left. When we were in the house, a soldier came to the door and asked if the
household needed help. There was no communication: the family speaks Creole, the
soldier English. Once there was interpretation and they understood each other, the soldier
went to get some others to help the resident with the roof.
One family said that they were just waiting for the government to help them. There is no
information available in Creole to these Creole -speaking families.
None of the Haitians we talked to knew about the tent city, the kitchens, the showers. One
household said we were the first to come with any information at all (9/5/92, almost two
weeks after the hurricane). There are fifteen people in this two room house with half of its
roof missing. They asked how would they get to the tent city with their possessions, with
the babies. They have no transportation.
For those who were working in the fields, specifically the lime crop, there is no more work.
Many of the men listed that as their top priority: a job. They want to make money because
they have wives and children back in Haiti; they do not want to accept handouts and live
in the tent cities. They also want English classes which they say ceased after Andrew, for
lack of facilities. Acquisition of English is very important for them; they know it increases
their chances of finding a job. (There are calls for labor crews, but Haitians awaiting INS
hearings do not know if they are eligible to work or not.)
The children are anxious to return to school. They did not know that it is supposed to start
two weeks late. They did not know about having to go to other schools or how they will get
there. (How are schools notifying their students, especially in families who do not speak
7
l
English, who are illiterate, who do not have a TV or workable radio, who may be displaced
from their address?)
The few people who have radios do not have batteries. We asked about radios at one Army
outpost and they said they had run out three days before.
There is need for medical attention. Among a group of men we were talking with on the
street, all of whom only in the United States not quite three months, two expressed concern
about their health (breast lump, rash). They do not know where to go. A woman who is
"sezi" - who cannot swallow, cannot eat, talks hoarsely with her eyes full of tears - needs
more than the doctor who gave her anti -bacterial pills.
Limited access to information limits access to services. Limited access is due to the
language barrier (those who need the information do not speak English; those who provide
the information are not utilizing interpreters) and to the lack of media: TV/radio/batteries.
If these media cannot be made available to the needy, outreach delivery of information in
their language is perhaps even more effective.
At the site of the services, access is again impaired by the communication barrier, but also
by the distance between client and provider cultures and by prejudices felt toward refugees
in this area.
HOUSING:
To experience the disaster and destruction of Hurricane Andrew in areas that had major
tree damage such as Miami and North Miami was an experience that most people
considered very serious. Even with the television reporting, one cannot imagine the type
of first hand destruction you feel when encountering and walking through what was left of
a community and a city. My first impression was to view the areas as if a nuclear device
had hit the area.
Commercial and residential structures that were considered to be somewhat safe and built
by building code specifications and to standards set by city and national agencies were
destroyed to a point of being partially habitable or completely destroyed.
The housing in Florida City was at best in very poor condition before the impact of
Hurricane Andrew. At this point we are looking at a situation where people and families
are either displaced by complete destruction of their homes or having to live in homes that
have parts of roofs, wall, windows, and doors missing.
Haitians occupy approximately 1,000 houses in the Homestead/Florida City area of Dade
County. Our assessment indicates that family units/homes have an average of 5.348 people.
There is a destruction factor of 200 homes in the Haitian sector alone. Within this area
there are also African Americans and Mexican farm workers who have experienced the
7474
f,
destruction in their homes. Many of these people are living under the same conditions as
the Haitian community and are at the lowest level of poverty. The consensus from the
community is to remain in their homes rather than seek shelter in temporary living quarters.
Because of lack of understanding of the housing system, language barriers, fear of
deportation and limited access to proper authorities, Haitian tenants do not know their
rights and are, very often, abused by their landlord. During our survey, we have
encountered people living in unhabitable houses that should have been condemned by City
officials. The architect and the Real Estate broker members of the team noticed that the
houses inhabited by the tenants are in violation of existing City and County codes and that,
in spite of these living conditions, landlords were taking advantage of these ill-informed
tenants. Mr. Derisme was given 10 days to evacuate from his rented apartment and the
landlord refused to reimburse him the $300 he had paid to him a day prior to the
Hurricane. Similar cases of abuse of Haitian tenants have been reported to the assessment
team during the field interviews. Some of most urgent cases have been handled on a one
to one basis by the Real Estate member of team who has contacted landlords on behalf of
Haitian tenants on an in -kind basis. City and County officials have not conducted any kind
of inspection in these hazardous sites.
Many Haitians interviewed during our site visit refused to report their landlords to
authorities for violations. The lack of report on such abuses may be the consequences of
being turned in to the Immigration and Naturalization by landlords, since most of these
tenants are illegal immigrants.
The question at this point is how can this community be restored and in what fashion can
it be restored?
JOB:
The unemployment rate of Dade County reached 44 ?ercent. Our survey indicated that the
unemployment rate among the Haitian population of Homestead/Florida City has increased
to over 70 percent as a consequence of the disaster. Hurricane Andrew destroyed 100
percent of the farms in Homestead and Florida City. Prior to the Hurricane, the
Homestead Air Force was a major employer in the Homestead area. Very few Haitians
were hired at the Air Force Base due to language barriers and lack of immigration
documentation. Because of their fear for deportation, Haitians stay away from many
institutions dealing with officials. This in turn contributes to inaccuracy in the number of
Haitians living in South Florida and thereby makes it difficult to plan effectively for the
future of this underserved population. In addition to an estimated 1,500 Haitian residents
of Homestead/ Florida City who worked on farms prior to the Hurricane, it is estimated
that approximately 2000 Haitian farm workers had commuted from North Dade to these
farms on a daily basis prior to the wake of the Hurricane. Andrew has direct impact on
Haitians living in Dade County including Homestead/ Florida City and North Dade. In the
aftermath, approximately 200 Haitians living in the County have been temporarily hired by
companies for cleaning and rebuilding houses and businesses.
FOOD AND CLOTHING:
Following Hurricane Andrew, U.S. troops, volunteer organizations and independent citizens,
in an uncoordinated effort, dumped tons of perishable and non-perishable food items on the
affected areas of South Florida. During our mission, we have seen considerable amount of
food stocked in the homes of the Haitians living in the surveyed areas. The shortage of
electrical power limits the ability of members of the population to preserve perishable food
and their ability to cook. The majority of homes had received a substantial amount of food
between day 2 and day 5 in the aftermath. Even though the target population prefers
Haitian prepared meals, basic nutritional needs have been met. In an article entitled: "Aid
effort muddled, wasteful " of the Monday August 31, 1992 Miami Herald, Jon Kral and
Curtis Morgan reported: "We're seeing things on the side of the road getting ruined." An
influx of people not living in the affected areas has invaded the distribution center to obtain
food items to meet their needs and, in some instances, for reselling in other areas including
the U.S. and overseas.
During CHS distribution of items, the population was more interested in receiving diapers,
baby items rather than food items.
HEALTH EDUCATION AND PREVENTION:
The existing traditional health and prevention services in South Florida are not designed to
target the Haitian population. Because of language barriers, illiteracy, negative stereotypes
and fear of deportation, Haitians living in South Florida tend to stay away from non -Haitian
institutions where they could access information on health and social issues. As indicated
in our report, 52.2 percent of the surveyed Haitian population had not visited a physician
in the last six months. The concept of primary prevention is a rather Western View that is
almost non existent in the Haitian community.
Hurricane Andrew has further increased the gap in the delivery of services to the
underserved Haitian population of Dade County. The Hurricane has left South Florida
with 13 Nursing homes damaged, 4 Intermediate care facilities for Developmentally
Disabled damaged, 2 Crisis stabilization units for mentally ill damaged, 8 hospitals damaged
and 32 severely damaged Adult Congregate Living Facilities. The already overburdened
health care system of South Florida will worsen as a consequence of Hurricane Andrew.
Our assessment did not indicate any acute illnesses that needed emergency medical
attention. Rather than curative, there is an urgent need to conduct a labor intensive
campaign of culturally sensitive health education and prevention among Haitians living in
the affected areas of Dade County. Such interventions should include continuous
surveillance for communicable diseases, outreach and home visits conducted by Creole -
Speaking health workers.
10
��� 92- 747.)
CULTURAL AND SOCIAL IMPLICATIONS
Several features of the food, shelter, and other relief made available to people in South
Dade in the aftermath of Hurricane Andrew make that relief difficult for Haitians in Florida
City to access. The first, and most obvious, feature of the U.S. government's relief efforts
is that they are carried out largely by uniformed servicemen from the U.S. Armed Forces.
Haitians who in many cases already have experience with uniformed representatives of the
U.S. government are unwilling to go anywhere near relief efforts manned by U.S. troops.
Some of the Haitians in Florida City are also recent arrivals from Guantanamo, where tents
and kitchens similar to those being set up in Homestead represented internment of
undesirable people.
Nevertheless, private relief efforts made food and clothing available in abundance, even to
non -English -speakers. The observational team saw hoarded canned goods in many of the
houses that we visited. The most basic immediate needs of this population were successfully
met.
Longer term needs, however, have not gotten the same attention. Living conditions before
the hurricane had been sub -standard, and the hurricane made them worse. Some of the
people interviewed in Florida City said that they might be willing to leave their housing in
favor of places that had roofs with no leaks, adequate cooking facilities (or hot meals) and
running water. This contrasts with the majority of the reports on efforts to move people
away from their ruined homes and into tent cities. Nevertheless, the form of the alternative
housing and the lack of information about how to get there militated strongly against the
Haitians' availing themselves of this kind of aid.
RECOMMENDATIONS:
1. Raise consciousness regarding isolation of this community due to language barrier.
Offer to act as a liaison between necessary information (School Board, FEMA, etc.) and
community.
2. Do a radio drive to equip the Haitians with radio sets and keep them provided with
batteries.
3. Provide Creole radio programming specifically for the South Dade Haitian
community.
4. Provide temporary shelter with Haitian sapport staff. These include health
educator and case managers.
Temporary shelters are being set up by the Army Corps of Engineers to house the families
in need of shelter. This time is an opportunity to set in motion a planning process for
meeting the needs of all Florida City residents. To work effectively, this plan must take into
11
account family structure, family size, culture, and community orientation.
The next step is to examine how this community would relate to each other in terms of
shelter, shopping, recreation, religious affiliations, and education. Planning on a large sale
such as this should also take into account how and why the destruction of homes,
apartments, and business affected certain areas and not others. An evaluation of the
orientation of housing and design, how the landscape is shaped, a format of housing types
with infrastructure of recreational, commercial and educational components should be
carefully examined.
Urban planning in general usually considers the inherent qualities of a plan for general
needs. An approach to urban planning in Florida City must be considered to meet the
needs of different cultures and different values if the future of this area is to survive.
5. Establish a housing advocacy group including Haitian Real Estate Agents, lawyers,
church leaders, health workers and businessmen to represent Haitian tenants before
City, County and Federal officials.
6. Offer job training to Haitians living in the affected areas.
7. Offer a "two day workshop" to Haitian leaders of the affected areas in order to
inform them on issues related to insurance, laws and basic post -disaster public
health prevention principles and immigration.
8. Do a drive for school supplies for Haitian students. Assist, encourage adult ESOL
classes.
9. At this phase of the recovery in the Haitian community, funds should be used to:
a. Provide 1,000 small gas stoves, pots and pans to families in need.
b. Provide 2,000 gas tanks/refill per month to 1,000 families during the first six
months of the crisis.
c. Educate charitable organizations, private, public entities and individuals to invest
funds in necessary items as assessed by field workers.
10. Encourage agencies and/or independent citizens to inform local Haitian church
leaders on needs of the population prior to bringing items to affected areas. Food
and clothing will be more needed as we enter the intermediate phase.
11. Develop a mechanism in the Haitian community to respond to specific needs for
12
i
C
W,
food and clothing among Haitians living in the affected areas from month 3 to
month 12 of the aftermath.
12. Develop and implement a culturally sensitive program designed to meet the needs
of Haitians on health education and prevention adapted to epidemiology principles
of the post- disaster period.
13. Door to door assessment of health conditions and other needs by well trained
Creole -Speaking health workers.
14. Explore the Haitian community in South Dade: demographics; services available;
integration with larger community.
15. Mental Health : Hurricane Andrew should be viewed as an opportunity for policy
makers and governmental agencies to rethink their approach to finding solutions to
the numerous public health problems presented by minority groups such as the
Haitian community of Homestead and Florida city. Preventive programs should be
designed to address those needs in order to prevent further slippage into poverty and
social decay. As far as the medical and mental health needs are concerned we
recommend the following:
a) The establishment of Child enrichment center based on the Head start concept,
promoting good parenting skills and adequate parent -child interactiod . Such an
approach would remedy the problem of lack of interaction as previously been noted
by S. Widmayer, Ph.D., in her research with the migrant workers of Imrnokalee,
under a Ford Foundation grant.
b) The recruitment and training of mental health counselors to address the
psychological/psychiatric needs of both individuals and families, using an outreach
approach in order to overcome resistance to psychiatric treatment and increase
psychological mindedness through education.
c) The recruitment and training of "cultural brokers" who would not only interpret
the language of the Haitian clients, but would also be fully cognizant of both
American and Haitian cultures and be able to interpret them bi-directionally.
The above recommendations should be implemented through existing Dade County
community centers with existing contracts with the State, the Federal Government and/or
local agencies, track records on delivery of services in the proposed areas of intervention,
audit reports and appropriate qualified staff members. The utilization of existing local
centers offers: 1) unduplicated efforts which is consistent with good post -disaster
management principles, 2) cost effective management, and 3) a continuum in the delivery
of services to the Haitian community on a long term basis.
13
REFERENCES
. Census Data 1990 (Metropolitan Dade County).
. DSM-III. American Psychiatric Association, 1987.
Foege, W. Public Health Aspects of Disaster Management.
Public Health and Preventive Medicine, 1990; 4-14.
Goldberg, D.P. (Ed.) The Detection of Psychiatric Illness by
Questionnaire. Oxford University Press, London, 1972.
McFarlane, A.C., MB BS, Dip Psychother, FRANZCP.
The Flinders University of South Australia, Bedford Park, South Australia 5042
McFarlane, A.C., Policanskyt, S.K. and Irwin, C.A. longitudinal study of the
psychological morbidity in children due to a natural disaster. Psychol. Med. 1987;
17:727-738.
McFarlane, A.C. Long-term psychiatric morbidity after a natural disaster;
Implications for disaster planners and emergency services. Med. J. Aust. 1986;
145:561-563.
McFarlane, A. C. The Prevention and Management of the
Psychiatric Morbidity of Natural Disasters: An Australian
Experience. Stress Medicine, 1989; 5: 29-36.
McFarlane, A.C. Post -traumatic morbidity of a disaster: A Study of cases presenting
for psychiatric treatment. J. Nerv. Ment. Dis. 1982; 170:544-552.
Personal Communications: City of Miami officials, U.S. Troops, Red Cross, U.S.
Department of Justice, U.S. Public Health Service and Health and Health and
Rehabilitative Services.
Raphael, B. When Disaster Strikes: How Individuals and Communities Cope with
Catastrophe. Basic Books, New York, 1986.
Shaffer, David. Diagnostic Interview Schedule for Children (DISC-2.1C) Child
Version. Division of Child & Adolescent Psychiatry, New York State Psychiatric
Institute, New York, 1989.
Western K: The Epidemiology of Natural Disasters. The present State of the Art.
Dissertation, London School of Hygiene and Tropical Medicine. University of
London, 1972.
14
g. 4. • 9� 7747.1
d,
CEO TER VOR HAMAN STUDIES, INC. (C86)/HURRICANE "ANDRRV- DELEGATION
AUGUST 29 AND OWTBMBER 05, 1992
Louis B. Antoine, M.D.
Psychiatry/Pediatrics
1-800-479-4036
Richard Benzaguen
Architecture
(305)-573-0500
Lynda Brutus
Medical Records
1-800-479-4036
Debbie Conley,R.N.
Nursing
1-800-479-4036
Rev. Enock D6rosen6
Theolo
305 -726-9854
Jean-Claude Exulien
Education
305-758-2462
Dale Frincke
Computer science
305-923-3219
Carm6us Jacob
Real Estate
(305)-653-6530
Mich6le Jean -Gilles
Psychology
305)-326-0024
Michel L6andre
Journalism
(305)-625-9469
Adenet M6dacier, B.A.
Management
(305)-757-9555
Dr. Claude Noel
Theology
305 -978-2118
Ms. Claude Noel
social Work
305 -978-2118
Bryan Page, Ph.D.
Anthropology
305)-547-5631
Larry Pierre, M.D., M.P.H.
Public Health
305 -757-9555
Rev. Andr6 Roseville
Theology
(305)-726-9854
Judith Wingerd, Ph.D.
Anthropology
(305)-757-9555
92- 747. 31-Fl