As more medical and rescue teams arrive in Haiti , mental health experts say these volunteers and soldiers may be risking not just their safety, but the sanctity of their own minds in the earthquake-shattered capital Port-au-Prince.
Stefano Zannini, head of mission Doctors Without Borders said the streets of Haiti are crowded with people looking for help. "They're trying to find their families or their friends. I can see thousands of them walking the stress asking for help." At night, they sleep on the streets covered with blankets or plastic bags.
As of Friday, Zannini expected more people would be pulled from the rubble alive. But as the citizens of Haiti search for family members, for food or for medical care, the government of Haiti has already sent trucks around the city to pick up dead bodies.
"Doctors have an advantage in that they're trained and experienced for trauma, and for serious injury and they deal with death on a regular basis," said Dr. Carol North, a psychiatrist with the Veterans Affairs Medical Center in Dallas and an expert in post-disaster mental health.
Experienced aid workers, like those who work for Doctors Without Borders, may be tougher than the average citizen, but North warns, "That may not prepare them for the massive scope of severe injury, the many, many dead bodies … and people who are frantic.
"Nothing can prepare a human being for something that massive," said North, who is also a professor of psychiatry at the UT Southwestern Medical Center in Dallas, Texas.
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Doctors Without Borders expects to have psychologists on the ground soon -- both for the medical staff and for their patients. But Zannini says for now the priority remains "surgical activities."
"We have thousands of people in our courtyards who are in need of attention," he said.
North said there's no quick way to tell which of these patients would be in need of extra care and attention for their mental health. Eventually, she would worry most about people developing post traumatic stress disorder, or PTSD.
But, she said, "In the early stages of a disaster, everybody's upset, and it takes time for the dust to settle to see what is healing and what is developing into psychiatric illness.
"Really, the fist mental health interventions are to tend to people's physical needs," she added.
People who feel "safe, warm, medical treatment, connected to their loved ones," in the days after a disaster are likely to survive the mental burdens better "in the long run," North said.
Relief workers in Port-au-Prince said providing that basic care -- medical treatment, food and help finding loved ones -- is one of the best ways to help them deal with their own psychological burdens of the disaster.