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Haiti Is a two hour flight from Miami, FL. Haiti Child Mortality Rate: 123 per 1,000 births Florida Child Mortality Rate: 7.2 per 1,000 births Nearly 10 million people Mostly Rural 39% Urban 61% Rural 80% of rural population live below poverty line according
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Modern health services are inadequate, mostly private and largely urban. Most extreme aspects of poverty in the country, region, and hemisphere. Lowest rates of child immunization, pre- and postnatal care in the Western Hemisphere
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UN Millennium Development Goals http://www.unicef.org/progressforchildren/2004v1/latinCaribbean.php UN Millennium Development Goals http://www.unicef.org/progressforchildren/2004v1/latinCaribbean.php
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What Socio-Cultural and Ecological Factors Contribute to Rural Haiti’s Extremely High Infant and Child Mortality Rate?
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Social Inequality Resource Landscape Parental Investment
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Poverty –76% of Haitians live on 2$/day –55% live on less than 1$/day –Mostly women in market place Economics –Political Situation
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Preventable Deaths from Diseases: –Tb, AIDS/HIV, Parasites, Diarrhea Malnutrition – 42 below age 5 malnourished and easily preventable maladies like malnutrition and diarrhea kill 28 percent and 20 percent of children age 0-5 respectively. –Food supply covers only 55% of the population –Daily food insecurity affects 40% of Haitian homes –Forced to import subsidized foods –Poor agricultural advancement Stripped land for fuel (trees) Susceptible to hurricane damage yearly
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http://www.unicef.org/progressforchildren/2004v1/latinCaribbean.php
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Geographic Economic Socio-cultural
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Disconnected from the health care services that are concentrated in and around the capital city of Port-Au-Prince
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Economically active women (96%), mostly traders –More than any other poor nation Women are in charge of day-to-day acquisition of food Patriarchal Families Most women do not make medical decisions completely independently Negotiation with partner for transportation and costs of care and medicine
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“Folk” or “Traditional” beliefs Voodoo Leaf Medicine “Folk” or “Traditional” beliefs Voodoo Leaf Medicine Cheaper (not always) Easily Acceptable Perceived as the obvious and best treatment
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Unconvinced of importance of immunization? –Not worth the effort to take preventative measures because so many children die anyway from the prevalence of extrinsic risks
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Presence of older children Scolded and embarrassed by infant’s weight
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Expense for a day at the doctor is preparing the day’s main meal and generating enough income to feed one’s family (Among other things.)
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Health Care=A Basic Human Right Some things are not meant to be sold.
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http://www.unicef.org/progressforchildren/2004v1/latinCaribbean.php Geographic: Access/availability to Clinics, Hospitals, Health Care Workers, Midwives, etc. Geographic, Economic and Political: Access/availability to clean sources of water/food. Socio-cultural: Unaware of importance to health. Economic: Income restrictions.
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Understanding Haitian attitudes and responses to illness and disease will help in the analysis of barriers to preventative health care and treatment, because belief systems assist in the recognition of illness and help the patient to rationalize treatment actions.
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Access to Clinics, Hospitals, etc: Mediated by having community members taking charge of health in their communities. Water/food: Monitor needs for food, water, housing and help the community communicate and organize to fight for rights to access Unawareness: Educate the community about keeping themselves free from disease and preventable deaths. Income: Free healthcare to all.
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Address broader barriers to health, including oppression, violence, and social and economic injustice
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Works Cited Bishop, Patricia L. Haitian Women's Beliefs and Behaviors Regarding Diarrhea in Children. Thesis. University of Washington, 1989. Seattle: University of Washington, 1989. “Caring for orphans and abandoned children." NPH International - Caring for orphans and abandoned children. N.p., n.d. Web. 03 June 2009..http://www.nph.org/?page=homes/home.php 〈 =en&org=11 Coreil, Jeannine. "Social and Psychological Costs of Preventative Child Health Services in Haiti." Social Science and Medicine 38 (1994): 231-37. Dominican Republic and Haiti Country Studies (Area Handbook Series). New York: Library of Congress, 2001. Farmer, Paul. Aids and Accusation Haiti and the Geography of Blame. Berkeley: University of California P, 2006. Farmer, Paul. Pathologies of Power: Health, Human Rights and the New War on the Poor. London: University of California P, Ltd., 2003. Farmer, Paul. Infections and Inequalities: The Modern Plagues. Berkeley: University of California P, Ltd., 1999. Gesler, Wilbert M. Cultural Geography of Health Care. Pittsburgh, Pa: University of Pittsburgh P, 1991. "Haiti." CIA The World Factbook: Haiti. Central Intelligence Agency: The World Factbook, n.d. Web. 03 June 2009..http://www.cia.gov/library/publications/the-world-factbook/geos/ha.html JN Baptiste, Marie Agathe. Can Haiti Deliver on Its Promise to Offer Everyone a Basic Package of Health Services? An Analysis of Health Workforce Needs. Diss. University of Washington, 2008. Seattle: University of Washington, 2008. "Partners In Health: Healthcare Delivery." Partners In Health. 12 May 2009. Perry, Henry B. "Health Equity Issues at the Local Level: Socio-geography, Access, and Health Outcomes in the Service Area of Hopital Albert Schweitzer-Haiti." International Journal for Equity in Health 6 (2007). Perry, Henry. "Long-Term Reductions in Mortality Among Children Under Age 5 in Rural Haiti: Effects of a Comprehensive Health System in an Impoverished Setting." American Journal of Public Health 97 (2007): 240- 46. "UNICEF: Latin America and the Caribbean." UNICEF - UNICEF Home. N.p., n.d. Web. 02 June 2009..http://www.unicef.org/progressforchildren/2004v1/latinCaribbean.php White, Kari. "Health Seeking Behavior Among Pregnant Women in Rural Haiti." Health Care for Women International 27 (2006): 822-38. "WHO | Haiti." 17 May 2009 http://www.who.int/countries/hti/en/.http://www.who.int/countries/hti/en/
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