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.
Food, Water and Doctors Will Help Haitians Cope Mentally
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.
Helping Others Helps Your Mind
"My sister, Lori Moise, is a registered nurse… she went into town yesterday afternoon to find someplace to help. She just loaded up the back of the truck with supplies and went. She cannot sit still when she knows there are so many people that need help," Licia Betor, who runs a shelter for 70 malnourished children in a village called Cazale outside of Port-au-Prince, wrote in an e-mail to ABCNews.com. Betor and her sister have been treating broken bones and crushed internal injuries since the earthquake hit.
Betor said the people in Cazale are quite desperate "because most cannot afford to pay the rising cost of taxi fees to get into port to see if they can even find their families. Some do not even know where to begin looking."
Annie Foster, emergency team leader for Save the Children in Port-au-Prince, said the staff in her area have been coming into work, despite the chaos.
"I can't say we have the full staff back yet. People need to take care of their extremely difficult situations at home, so not everybody shows up every day," said Foster.
Foster had 59 people stationed in Port-au-Prince. So far she's contacted 51 and learned one died during the earthquake.
"The majority of them have lost their homes or their homes are severely damaged. The staff is coming in and trying to work the best they can but they are under a great deal of stress and trauma," said Foster. "Everybody knows at least somebody who is dead."
Foster said Save the Children will stay in touch with the people working in Port-au-Prince and provide a counselor if staff requests one. However, given the organization's experience in other disasters, Foster said it's known that helping others during the crises helps individual relief workers recover as well.
"For many, many staff members -- no matter what country -- the activity of helping people and helping their communities helps assist their own path back to feeling normal again," said Foster.
"So right now all attention and activity is on the emergency response," she said
However, sometimes the inclination to help can weigh severely on rescue teams when faced with a disaster of epic proportions.
What Happens When You Can't Help Everybody
"It's almost like organized chaos. You will arrive at a location -- in this case, it will be Haiti -- you and your team will be given a specific area … a six-block area for example… you locate live victims, and see what you're going to do to get them out," said Greg Gould, who works in search and rescue for the office of fire prevention and control in New York state.
Gould said most search and rescue workers are "type A" personalities who are very driven and focused on their efforts.
During 9/11, Gould remembered workers functioned with intense focus finding people alive or dead, marking the people they see with orange paint and moving on with a rescue dog to find more.
Yet, sometimes the instinct to help an individual threatened his ability to do his job.
"The people who have loved ones are also desperate…They will look for the rescuers to help them find a specific individual. If someone would put a picture of a young child in front of your face and say 'please find my baby,' it's very hard not to react," said Gould.
"You need to, as a rescuer, kind of set that aside and focus on your task," he said.
Gould expected the Red Cross and other aid efforts would provide what is called a critical incident stress debriefing -- a time for rescue workers to talk about what's happened and how they are coping with the trauma.
However, after 9/11, Gould said he coped with the stress by talking to many friends and family members.
"The rescuer's family, I think, it's a huge thing to help. I know that cell phone coverage is pretty much down in Haiti," said Gould. "But the support they can give is a huge asset."