Thousands of Haitians have moved to the U.S. and elsewhere -- and psychologically, it can be as hard to watch the crisis from a distance than to be in the thick of it. They worry about family back home. They have a personal link to the country. Expatriates are at risk for psychological trauma that may last for years after the rubble has cleared.
"The communications systems are still down, so that's the major concern right now," said Guerlince Semerzier, president of the Haitian Coalition of Somerville, a Boston suburb. "Everyone's still trying to get a hold of their loved ones. I think in a situation like that, people feel hopeless. What can they do? There's nothing they can do to help out."
Semerzier left Haiti in 1990, at the age of 15. But he has family there, including his father and sister, who were visiting for Christmas and were scheduled to come back to the U.S. this week. He has not been able to reach them.
He said tragedy is not only felt by people with family there.
"Every single Haitian is affected by that tragedy," said Semerzier. "Even if it may not be directly, you know someone who has someone that's down there."
The feeling of being unable to help can have a strong effect on people in the United States who feel a personal connection with Haiti but did not go through the actual quake.
"People aren't going to know for days and days who's alive," said Dr. Charles Raison, a psychiatrist and clinical director of the Mind-Body program at Emory University. "The longer that goes on, the more likely people are to develop emotional problems."
Semerzier said his organization is focusing mostly on aid for Haiti, but is prepared to help people in the local community.
"Right now, we try to calm everyone down, and also provide some trauma assistance, counseling," he said.
Even once people have made contact, they are still psychologically vulnerable.
"We catch emotions from each other like a virus, and trauma is certainly one of those emotions," said Raison.
Evidence of this, he said, can be seen in studies of the children of Holocaust survivors, who may encounter more stress in their lifetimes than their counterparts whose parents did not go through it, even though they themselves may not suffer any more in their own lives.
"It's as if they caught it by osmosis," Raison said.
Other factors may also play a role in how much the tragedy strikes them.
"There is some interesting research that happened post-9/11 about the effects of watching traumatic events on television and reading about it in newspapers and magazines," said Dr. Joan Cook, a psychiatrist with Yale University who specializes in traumatic stress.
"There is indeed a significant relationship between watching media coverage of trauma -- i.e., terrorist attacks -- and stress symptoms," she said. "However, it is unclear if watching these events are the cause of the increased distress or if people who are more prone to stress reactions watch more coverage of the trauma on TV.
"The media can play a critical role, obviously sometimes good, sometimes bad, in the aftermath of a disaster. We can guess that for many Haitians who cannot find out about the status or whereabouts of their family members, they may be turning to news coverage quite often."
While some of these factors can create more stress for people with loved ones in Haiti, there are things they can do to help themselves -- and possibly their loved ones as well.
"If a person can respond to adversity with action, with corrective action…that in some ways [alleviates] the situation, that's hugely protective for peoples' mental health," said Raison.
Community can help as well.
"It's important in these kinds of times to depend on the support of family members and friends," said Tom Barrett, a psychologist with the University of Denver, who previously served as a senior mental health consultant for the World Health Organization. He said faith-based organizations could also provide some solace.
"It's important that people recognize what services are available and take advantage of those services," he said.
"In general, two of the strongest variables related to recovery from a traumatic event are subsequent life stress and social support," said Cook. "So let's hope that the Haitians currently in the disaster zone and those residing in this country get all the support and information they need to recover from this horrible event."
Doctors said most people will not need professional help to move past the tragedy, but a fair number might.
"My guess is that, all other things equal, there would not typically be long-lasting effects of the disaster on Haitians currently residing in U.S.," said Cook. "That said, there are always qualifiers and thus, it might depend on the level of devastation."
Past disaster relief efforts have brought some attention to the dangers faced by workers who seek to help victims, but the psychological trauma may be sometimes overlooked.
"It's important that the aid organizations pay attention to the psychological well-being of people providing assistance here as well," said Barrett, noting that aid workers exposed to the aftermath of a disaster may face psychological trauma themselves.
Of course, any trauma suffered by someone in the United States is likely to be less stressful than what is experienced by someone in Haiti.
"The more fully you experience something traumatic, the more likely you are to suffer post-traumatic stress disorder afterwards," said Raison. "The closer it is to your own skin, the more likely you are to have troubles."
"In a serious disaster like this, physical consequences are of the utmost importance right now," said Barrett. "But it's also important in the long run to look at the psychosocial impact of these situations."