Below is an article by Miami Herald journalist Jacqueline Charles about Haiti's response to the COVID-19 pandemic and the University Hospital of Mirebalais which plays a central role in it. The University Hospital is one of the few hospitals with the capacity to stabilise patients with COVID-19 and to provide these services free of charge. The Hospital staff are preparing for a potential surge in cases which could be caused by Haitians returning from the Dominican Republic due to lost livelihoods, the near impossibility of social distancing, and a health care system that was fragile even prior to the pandemic. If you are looking for a way to help Haiti as it responds to the pandemic, consider a donation to Partners in Health which manages the University Hospital and remains the largest non-profit health care provider in the country.
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.
Haiti's health care system, a patchwork of public and private facilities, was struggling prior to the pandemic. Instability and its root causes of poor governance, corruption, and poverty have resulted in poor access to health services for most Haitians. BBC journalist Will Grant writes below that will every country in the Americas will be impacted by the coronavrius (COVID-19) pandemic, Haiti lacks the capacity and financial resources needed to increase its preparedness. As has long been the case, the hard work of addressing growing health needs falls upon non-governmental organisations such as Partners in Health who received Haiti's first cases.
Ten years after the earthquake, and despite billions of dollars in assistance, hunger is a growing problem in Haiti. Food insecurity has been made worse by political instability and its root cause, corruption. Up to four million people are now facing severe hunger due to the downturn of an already weak economy and inflation. Hunger undermines nutrition, health, education, and stability, and economic development or, in other words, the future. Humanitarian responders like the World Food Programme (WFP) and the UN Children's Fund (UNICEF) can provide food to the most vulnerable - but they can't fix the underlying problems. This depends upon the Haitian people having an accountable, effective government that represents the interests of the many instead of the few. An article by Jassica Obert in The New Humanitarian about food insecurity in Haiti follows.
While protests are nothing new in haiti, the scale of the ongoing demonstrations againt corruption and economic hardship are the largest in recent memory. Unfortunately, the instability is negatively affecting operations at hospitals. Even prior to the protests, many Haitian health care facilities lacked the medicines and equipment necessary to treat the sick. It doesn't have to be like this and protestors understand that there will not be a better future until corruption is brought under control. Below is recent article by CNN writer Sam Kiley about the impact on on health care facilities, staff, and patients.
The United Kingdom and the United States are blocking the re-purposing of leftover UN funds already designated for Haiti that could potentially support woefully under-resourced cholera response programming. As the United Nations now acknowledges, although only as of last year, UN Peacekeeping Forces brought cholera to Haiti. The epidemic affected hundreds of thousands of Haitians and killed 10,000. To not allow unused funds to the cholera effort is both misugided and mean-spirited. Friends of Haiti in both the United States and the United Kingdom should make their voices heard to their elected officials on this important issue. The full article in The Guardian follow.
Haiti has long had a sanitation problem, being one of a very small number of countries where sanitation worsened over the last twenty five years. Port au Prince, its largest city, has no central sewage system and is unlikely to ever have one. There are other models for sewage management but implementing them without good governance, the rule of law, and a well-informed public is, as with anything else, challenging. However, there are champions for improving sanitation both within and outside the Haitian government. The full NPR article by Rebecca Hersher follows.
Haiti's infant mortality rate remains the highest in the western hemisphere. This is due in part to a lack of accessible health care facilities with sufficient staffing, training, and equipment. With funding from Every Mother Counts, Midwives for Haiti have been training skilled birth atttendants (midwives) to asist mothers during delivery. Ideally, every Haitian mother could deliver in a facility staffed by health care professionals available to them twenty four hours a day. That's isn't the reality for most Haitian mothers, making the work of skilled birth attendents critical for them and their babies. Take a look at the full Washington Post photo essay to learn more.
Doctors Without Borders, also known by its French acronym MSF, has released a report on sexual violence in Haiti. Gender-Based Violence (GBV) is a human rights and a public health issue as it can cause mental trauma, unwanted pregnancies, and transmission of HIV and sexually transmitted infections. Stigma remains intense in Haiti due to lack of access to justice and survivor-centered health care. In 2015, MSF opened a clinic in Port-au-Prince that specializes in providing health and psychological support to GBV survivors. Take a look at the report (available in English and French with summary below), and if you would like to support MSF, you can do so here.
A World Bank study recommends that Haiti and its donors focus less on building hospitals and more on preventative and primary care. Haiti spends less than 5 percent of its budget on health care meaning that it must prioritize. The best run hospitals have long been managed by or co-managed with non-governmental organizations. Public hospitals are in need of serious reform. Ninety pecent of operating budgets for hospitals are for payroll with an over-emphasis on administration. Decentralization could potentially empower health facilities by allowing staff to make their own budgetary and human resource decisions. The full article by Miami Herald journalist Jacqueline Charles follows.