Health

Even in more peaceful times, Haiti's patchwork system of governmental, charity, and private sector health care facilities were insufficient to meet the needs of the population.  Conflict with and between gangs has caused the situation to deteriorate further with over 30 private and public health care facilities having been vandalised or forced to close.  Those still open often lack staff, stocks, and security.  Haiti has only enough vaccines to last until the end of the month, health care facilities throughout the country struggle to have pharmaceuticals delivered through largely gang-controlled Port-au-Prince, and cholera is spreading on top of increasing food insecurity and malnutrition.  At this point, the situation is so difficult that re-establishing security would in and of itself be a health intervention.  The full article by Jacqueline Charles of the Miami Herald is linked and follows. 

Doctors Without Borders (Médecins Sans Frontières) works in difficult and insecure environments around the world, including Port-au-Prince.  Over half the city is controlled by gangs and fighting amongst them has caused MSF to temporarily close its maternity hospital.  Many health care facilities throughout Haiti have been negatively impacted by insecurity - to the detriment of their patients who need their services more than ever.  The full Al Jazeera article follows. 

The UN Committee on the Rights of the Child issued a brief but stark warning about the threat posed to Haitian children by gang violence, cholera, and malnutrition.  The situation in Haiti is difficult, but especially so for children.  Emboldened gangs, a growing cholera epidemic, and worsening malnutrition are negatively impacting the well-being of Haitian children.  The government is weak, the gangs are in many cases better armed than the police, and core development issues like agriculture, education, infrastructure, and human rights have once again taken a back seat to insecurity.  Restoring security won't solve Haiti's problems but it is at least a prequisite.

Haiti has yet to deliver a single dose of COVID-19 vaccine.  There are many reasons for this - a weak government, political instability, an already over-burdened health system, other pressing problems such as gang violence, and a false sense of confidence that the pandemic would affect Haiti only minimally.  According to the Miami Herald, USAID announced a $16.1 million commitment to assist Haiti in the battle against COVID-19, it was providing lab equipment, disease surveillance, hand-washing stations and 50 oxygen concentrators to be distributed to 16 hospitals.  It remains to be seen whether Haiti will be able to secure and use vaccines that the United States could provide.   The full article by Jacqueline Charles is linked and copied below. 

As of April 2021, Haiti still does not have vaccines to offer its population of over 11 million people.  Political instability, insecurity, and poor governance continue to hinder efforts to procure vaccine and sensitize the public.  Haiti was slated to receive 756,000 doses of the AstraZeneca vaccine but missed a crucial deadline for doing so.  The more the Haitian government is prepared to do in responding to COVID-19, the more the international community can support it.  The full article in the Guardian follows. 

Weak governance and political instability continues to hinder progress in Haiti, but it is important to highlight what is working.  For example, Haiti has cut malaria cases in half from 2010 by working with a range of international and national partners including the Global Fund to Fight AIDS, TB, and Malaria, the World Health Organisation, the Clinton Health Access Initiative, the U.S Centers for Disease Control and Prevention (CDC), the CDC Foundation, and the Carter Center.  This is welcome news, especially for pregnant women and children under five who are most vulnerable.  An update from the Haitian Minister of Health Marie Greta Roy Clement in the Miami Herald follows. 

In the week leading up to the election, the Trump Administration has scaled up deportation flights to Haiti.  Many were deported while they asylum cases were pending using a 1944 public health law, thereby sidestepping legal obligations to give asylum seekers a fair hearing.  The 1944 law allows for emergency measures to prevent the introduction of communicable diseases.  The reality is that the United States is the country most affected by COVID-19 and is placing Haiti at risk by deporting people who may be infected.  Haiti's political instability and poor health care system leave it under-prepared to respond to a significant increase in cases.  COVID-19 continues to be a tool for the Trump Administration to block asylum to the maximum extent possible - even for those already here.  The full article by the Guaridan's Julian Borger follows. 

Haiti’s investment in health has dropped from 16.6 percent in 2004 to 4.4 percent in 2017 despite everything its people have been through since then - unrest, cholera, natural disasters, the earthquake, COVID-19, gender-based violence, and grinding poverty.  Opportunities to consult formally trained mental health workers rmeain rare.  For a country of nearly 11 million, Haiti also only has 23 psychiatrists and 124 psychologists.  Some alternatives, such as hotlines, are beginning to emerge in response.  Linked and below is an article by Jessica Obert in the New Humanitarian about the mental health situation in Haiti.  

Haitians have long worked in the Dominican Republic due to the lack of opportunities at home.  With the Dominican economy contracting due to the pandemic, many Haitian migrants are returning home.  The World Health Organisation's western hemisphere branch (Pan American Health Organisation) has established screening and quarantine centers at border crossings in the region but with 269 informal crossing points and only four formal crossing points ensuring the health needs of returning migrants is a daunting task - especially when they fear their own communities may stigmatise them.  The full article by New York Time journalist David Waldstein follows. 

In the New Humanitarian, Jessica Obert writes that Haiti never fully recovered from the earthuqake let alone cholera, political instability, and subsequent natural disasters.  While Haitians themselves are resilient their government and the systems that are supposed to be in place to ensue their health, safety, and well being are not.   Haiti's ever-fragile economy had already contracted 1.2 percent last year due to protests and the pandemic could result in a contraction of 2.7 percent this year according to the Haitian Ministry of Finance.  Physcial distancing does not work well in settings where people are living day to day due to economic hardship.  If there are positives, Haiti's population is younger and it has a history of working together with the Dominican Republic on infectious diseases.  As with other countries, Haiti will be living with the pandemic for a long time to come.