Introduction and the General State of Healthcare: Haiti
For decades, dozens of non-governmental organizations (NGOs) have played a crucial role in disseminating healthcare to Haitians, making the country a “medical missionary’s mission.” Numerous compassionate and committed medical professionals from the developed world volunteer to offer healthcare services in Haiti. For this reason, I have chosen to study the country’s population health and healthcare system to understand why it heavily relies on medical charity. Haiti is a Caribbean country on Hispaniola Island with a population of 10.98 million people on a land area of 27,560 square kilometers (WHO, 2017). According to the World Health Organization (WHO), Haiti is the poorest nation in the Western world, ranking position 68on the Human Poverty Index scale by UNDP. Haiti is also known for poor public health for generations. The country’s extreme poverty rates engendered by natural disasters and political instability have led to ineffective healthcare structures, leading to persistent healthcare problems.
Haiti’s profile represents some of the world’s worst health indicators, which have constantly suppressed the country’s development. By 2000, the country’s infant mortality was 80.3 per 1,000 live births, a 6.5% rise from 1996 (WHO, 2017). WHO associates this rise with increasing levels of poverty, ineffective health systems, and the influence of the AIDS epidemic. Top causes of death among children and infants in 1999 were chronic diarrhea, perinatal infections, malnutrition, and chronic respiratory infections. 21.6% and 5.8% of deaths of adults and the youth are attributed to AIDS. Tuberculosis was also ranked among the leading causes of death in the country. In 2000, maternal mortality was rated at 523 per 100,000 live births, registering a 15% increase from 1995. Factors that led to this growth include eclampsia, arterial hypertension, and violence and sexual abuse towards women and girls (WHO, 2017). Accessibility to clean water is also a challenge among Haitians. In 1999, less than half of the populations in the rural, secondary cities, and Port-au-Prince are accessed potable water.
From the mentioned indicators, Haiti’s public health and healthcare systems are troubled. Political instability is one of the factors that have harmed the health systems of the country. Haiti has been plagued by unending political violence. In October 2015, for instance, the national elections were indefinitely deferred due to fraud allegations (Human Rights Watch, 2018). In 2016, fraud and irregularities were identified in the 2015 elections, subsequently scheduling new elections in October 2016. However, the occurrence of Hurricane Mathew forced the country to postpone the elections to 2017 when the new president was sworn in. These challenges and other political issues like corruption have led to persistent protests, hence violence, which has significantly crippled the establishment of health policies, plans, and programs (Human Rights Watch, 2018). The country is lagging behind all the eight Millennium Development Goals apart from achieving universal primary education.
Poverty has also exacerbated the incapacitated healthcare. Persevering political instability has led to massive and deep poverty in Haiti. Approximately 60% of the country’s population lives below the national poverty line: they spend less than $2.41 per day (Taft-Morales, 2017). Over 24% of the population lives in extreme poverty. In 2015, the GDP growth rate was 1.7%, a decline from 5.5% in 2015. Haiti’s population increases averagely by 2%, therefore, any growth below 2% of GDP is too small to match the demographic pressure (Taft-Morales, 2017). Political instability and insufficient resources have hindered the Haitian government’s ability to implement the necessary programs to establish a sustainable and resilient economy. The country’s imports are three times the exports, reflecting the unstable economy that has led to poor healthcare status. Poverty stunts development including healthcare because the country allocates most of its resources on social care. Furthermore, populations living in extreme poverty are unable to access quality care due to increased costs of care. The income is prioritized for needs considered basic such as food and shelter or the purchase of painkillers to only relieve the pain. Additionally, poverty-stricken people are most likely to drop out of school due to a lack of tuition fees and other educational materials (Human Rights Watch, 2018). Such people may lack basic knowledge of disease prevention and treatment, which can result in little or no control over their health, hence poor status.
Environmental problems have played a central role in Haiti’s substandard healthcare. The region is prone to severe tropical storms and earthquakes. In 2010, for instance, the health system and other institutions and infrastructure were debilitated by an earthquake. In 2015, Hurricane Mathew led to approximately 32% drop in the GDP (Taft-Morales, 2017). Furthermore, the country is vulnerable to significant soil erosion and floods due to deforestation. For three decades, Haiti’s natural resources have been rapidly depleted due to population growth, poverty, and excessive consumption of charcoal and firewood for cooking. Furthermore, deforestation has shrunk water catchment areas, and urban settlement has led to the invasion of protected watersheds, thus, contamination of water. When people, especially the poor, lack access to clean water, they become susceptible to waterborne diseases. As the Haitians clear forests, phenomena like El Nino are likely to occur, disrupting the agricultural processes. The inability to produce enough agricultural products greatly affects the economic wellness of the people, plunging them into extreme poverty, thus, limited healthcare access.
Political instability, poverty, and natural disasters have led to ineffective health structures. The health system is made up of the public sector, the private sector: both for-profit and non-profit, and the traditional health system. Political problems have stalled health legislation since all the health institutions are coordinated by the public sector, which has not been able to make significant progress since most of the country’s resources are in the private sector (WHO, 2017). In 2000 Haiti’s health services were only accessible to 40% to 60% of the population. Close to 40% of the population, especially in rural areas, relied on traditional medicine (WHO, 2017). There are insufficient health facilities and medical schools, as well as workforce because of a lack of funds, which prevents the appointment of more professionals. The country commits only 0.8% to 1% funds of the GDP to healthcare, hence underdevelopment in the health sector. Manifested by the devastating health indicators stated earlier, the existing health structure is ineffective, thus, requires reconstruction.
Haiti’s health journey is disrupted by political instability, poverty, and natural disasters, which have led to ineffective health systems. Political problems have rendered the government unable to implement effective health policies while natural disasters have constantly suppressed development in the health sector. Health indicators like high infant-maternal mortality, prevalent HIV/AIDS, insufficient water, and high rates of tuberculosis, diarrhea, and acute respiratory diseases reflect the country’s health crisis. There is a need for epidemiological surveillance and supply of enough health equipment and medicines. All health centers should have potable water supply, and emergency operating blocs should be established in hospitals. There is a need for more intensive training for emergency medical personnel and health campaign promotions by both the public and private sectors.
Human Rights Watch. (2018). World Report, 2018: Haiti. Human Rights Watch. Retrieved from https://www.hrw.org/world-report/2018/country-chapters/haiti
Taft-Morales, M. (2017, Dec 1). Haiti’s political and economic conditions: In brief. Congressional Research Service. Retrieved from https://fas.org/sgp/crs/row/R45034.pdf
WHO. (2017). Haiti: Country profile. WHO. Retrieved from https://www.who.int/hac/crises/hti/background/profile/en/