The trauma signature of 2016 Hurricane Matthew and the psychosocial impact on Haiti

Figures & data

Figure 1. NASA satellite image of Hurricane Matthew at Category 4 strength near the north coast of South America and south of Haiti on Oct 2, 2016. Photo by NASA. Source: https://worldview.earthdata.nasa.gov/?p=geographic&l=VIIRS_SNPP_CorrectedReflectance_TrueColor(hidden),MODIS_Aqua_CorrectedReflectance_TrueColor(hidden),MODIS_Terra_CorrectedReflectance_TrueColor,Reference_Labels(hidden),Reference_Features(hidden),Coastlines&t=2016-10-02&z=3&v=-97.34765625,1.44140625,-52.34765625,23.58984375

Figure 2. NASA satellite image of Hurricane Matthew as Category 4 strength directly over Haiti on Oct 4, 2016. Photo by NASA. Source: https://www.nasa.gov/feature/goddard/2016/matthew-atlantic-ocean

Figure 3. Water vapor image of Hurricane Matthew, Monday evening, Oct. 3, 2016. Source: NOAA Geostationary Satellite Server. http://www.goes.noaa.gov/

Figure 4. Aerial Damage Survey: Jeremie-Haiti. © Pacific Disaster Center. Reproduced by permission of Pacific Disaster Center. Permission to reuse must be obtained from the rightsholder. Source: http://www.pdc.org/event-products/preview/?id=1321

Table 1. Hazard profile: 2016 Hurricane Matthew in Haiti.

Disaster Type	Initial Event Classification	Natural Disaster:
		• Meteorological: Category 4 Hurricane
		• Hydrological: Surge, floods, mudslides
	Ongoing Event Classification	Complex Emergency:
		Natural disaster followed by large-scale displacement, infrastructure damage, and epidemic cholera
	Forces of Harm	Wind hazards:
		• Hurricane force winds
		• Tropical storm force winds
		• Tornadoes
		Water hazards:
		• Deluging rains
		• Coastal surge
		• Storm surge
		• High tides
		• Mudslides
		• Inland flooding
Magnitude and Severity	Hurricane winds	Category 4
	Saffir-Simpson Hurricane Wind Scale (SSHWS)
	Precipitation (rainfall)	Up to 30+ inches
		Duration: 3 d
		Area: Entire nation
Place Dimension	Hurricane landfall	Tiburon Peninsula close to Jeremie
	Rainfall	Precipitation throughout entire country (27,750 km^2)
	Geography/Geology	Steep, deforested mountainous terrain
		Low-lying peninsula
	Built Environment	Poorest nation in Western Hemisphere
		• Human Development Index: 163/188
		• 55 percent below extreme poverty index
		• Widespread structural deficiencies
Time Dimension	Landfall	October 4, 2016
	Duration	Landfall and eyewall encounter: 8 hours
		Storm system interaction effects: ∼4 days
	Health risk: duration	Months
	Post-storm disruption: duration	Years

Table 2. Disaster stressors associated 2016 Hurricane Matthew in Haiti.

Hurricane Matthew Pre-impact and Impact Phase Stressors
Exposure to Hazards	Losses	Life Changes
Direct traumatic storm exposures	Mass mortality	Change in living situation
• Exposure nationwide to deluging rains, floods, and mudslides on deforested hillsides • Exposure along the southern coast to high wave action • Exposure in Western Haiti to tropical storm and hurricane force winds • Exposure in the Tiburone Peninsula to direct landfall with maximum winds near the eyewall • Exposure to record-setting wave heights and storm surge near center of circulation • Extensive and progressive electrical power outages Personal physical harm • Physical injury • Severe pain • Entrapment Potentially traumatic exposures • Perceptions: Fear of extreme harm Fear of threat to life • Witnessing: Injury to others Death of others Mass casualties Grotesque scenes	• Death of loved ones • Death of friends • Death of community leaders Separation from loved ones • Desperate searching • Digging through debris Compounding losses • Loss of home • Loss of possessions • Loss of lands • Damage to crops • Loss of animals Community-wide destruction • Loss of utilities (power, water) • Loss of survival necessities • Loss of community services • Loss of schools • Loss of businesses • Impact on coastal industries • Impact on agricultural production • Crop destruction • Food insecurity	• Evacuation from home • Displacemen • Stranding of survivors out of reach of help • Living without shelter • Living in shelters Community impact • Massive property damage • Extensive hurricane debris • Lack of security • Lack of power • Lack of clean water • Lack of services • Gender based violence • Transportation disruption • Schools closed • Food insecurity

Table 3. 2016 Hurricane Matthew Trauma Signature Summary.

Risk Factors for Psychological Distress and Mental Disorders	Hurricane MatthewDisaster Characteristics	Exposure Severity
Exposure to Hazards		N/A	Low	Moderate	Severe	Very Severe	Extreme
Exposure to Tropical Storm Hazards	Entire population of Haiti exposed to strong rains associated with Matthew	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
Strong Fear/Panic/Life Threat	Most intensely experienced by residents of Tiburon Peninsula close to landfall;	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
	1.4 million in need of humanitarian aid
Personal Physical Injury Requiring Medical Care	438 confirmed injuries	N/A	<100	>100	>1,000	>10.000	>100,000
Epidemic Infectious Disease	Increased risk for ongoing cholera outbreak; >1,000,000 need vaccination	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
Entrapment or Delayed Rescue	Entrapment in collapsed structures	N/A	<100	>100	>1,000	>10.000	>100,000
Witnessing Death or Serious Injury	Most intensely experienced by residents of Tiburon Peninsula close to landfall	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
Witnessing Grotesque Scenes and/or Dead Bodies	Most intensely experienced by residents of Tiburon Peninsula close to landfall	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
Human Generated Contribution	Extensive deforestation leading to mudslides and uncontrolled flooding	N/A	Low <20%	Moderate 20–40%	Severe 40–60%	Very Severe 60–80%	Extreme 80–100%
Intentional Human Causation	Not applicable	N/A	Low <20%	Moderate 20–40%	Severe 40–60%	Very Severe 60–80%	Extreme 80–100%
Multiple High Intensity Impacts	Compounding effects of damaging wind and water hazards	N/A	Low	Moderate	Severe	Very Severe	Extreme
Exposure to Loss		N/A	Low	Moderate	Severe	Very Severe	Extreme
Mortality	546 confirmed deaths	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
Bereaved Survivors (Loss of Immediate Family)	Bereavement for several thousand primary family members of the victims	N/A	<4,000	>4,000	>40,000	>400,000	>4 million
Loss of Friend, Peer, Pet	Bereavement for community members, extended family of the deceased victims	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
Loss of Primary Dwelling	Severe storm surge and wind damage to homes and structures with displacement	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
National Financial Losses	Flash appeal for relief: $120 million Total damages, agricultural losses: >$1B	N/A	<$10 million	>$10 million	>$100 million	>$1 billion	>$10 billion
Exposure to Change		N/A	Low	Moderate	Severe	Very Severe	Extreme
Total Affected Persons	2.1 million affected; 1.4 million in need of immediate humanitarian aid	N/A	<100,000	>100,000	>1 million	>10 million	>100 million
Evacuation	142,000 displaced following storm impact	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
Long-term Displacement/Relocation	142,000 displaced following storm impact	N/A	<1,000	>1,000	>10,000	>100,000	>1 million
Disruption of Essential Services	Widespread loss of electrical power, communications	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
Lack of Food, Clean Water	750,000 need WASH (water, sanitation, hygiene) services for 3 months or more	N/A	<10,000	>10,000	>100,000	>1 million	>10 million
Damage to Infrastructure	Near total destruction of infrastructure in Jeremie and nearby areas on Tiburon Peninsula	N/A	Low	Moderate	Severe	Very Severe	Extreme
Ecological/Environmental Impact	Deforestation and storm damage leading to floods, mudslides, destruction of agricultural lands	N/A	Low	Moderate	Severe	Very Severe	Extreme