LAUSR

changes were created specifically for this natural disaster (with salient anthropogenic elements). Results: Psychological risk characteristics of this event included compounding exposures to: deluging rains that triggered mudslides along steep, deforested terrain; battering hurricane winds (Category 4 winds in the “eyewall” at landfall) converting the built environment into projectile debris; flooding “storm surge” moving ashore and submerging areas along the Tiburon peninsula; and piling wave action destroying infrastructure along the coastline. Many coastal residents were left defenseless to face the ravages of the storm. Hurricane Matthew’s slow forward progress as it remained over superheated ocean waters added to the duration and degree of the devastation. As an overlay to the havoc of the storm itself, the risks for infectious disease transmission were exacerbated, particularly in relation to the ongoing epidemics of cholera and Zika. Conclusion: Hurricane Matthew was a ferocious tropical cyclone whose meteorological characteristics amplified the system’s destructive force during the storm’s encounter with Haiti. TSIG analysis facilitates an accounting of the prominent risks to Haiti’s mental health.