The Problematic Issues Of Public Health In Haiti

Haiti has remained one of the western hemisphere’s weakest nations since the late 1400’s when Christopher Columbus claimed the territory and enslaved the Haitian population. After establishing independence, the nation continued to suffer from extreme tropical storms, political corruption, and lack of industrialization. Through years of turmoil, Haiti has built a democratic government and successfully ended the future ruling of dictators. Due to the powerful series of natural disasters in the past decade and lack of medical advancements, the most urgent issue in Haiti currently is public health. Currently, experts are implementing new National Health Policies, organizing and educating the population, and accepting foreign funding to combat Haiti’s poor public health as a direct result of the frequent string of natural disasters, poor determinants of health, and lifestyle choices. The universal purpose of a public health system is to prolong and improve the future quality of life for citizens and their communities. This is done through the promotion of “healthcare equality, quality, and accessibility” and looking at the population as a whole, not narrowing down on an individual level. The focus of public health is to stunt recurrences of mortality factors by “implementing educational programs, recommending policies, administering services, and conducting research,'' as opposed to medical professionals who provide treatments to those currently ill. Preventative nature is immediate attention as it is far more productive and cost-efficient than developing and distributing cures or treatments. Public Health is trained to detect dangerous issues as soon as possible and work toward prevention options. The Public Health Department has trained local health laboratories around the country with individual tasks of inspecting food and water sources, quickly responding and controlling disease outbreaks, educating citizens on healthy lifestyle choices, spread awareness, researching various diseases, aiding in injury prevention, and working on a global scale to reduce health threats. All of these tasks are honed at the targeted international goal of “striving to close the inequality gap between people and encourage equal opportunities for children of all ethnicities and genders”.

Public Health is determined by one’s heredity, environment, lifestyle, and socio-economic conditions. Genetic makeup is unalterable and a major predeterminer to future health problems such as diabetes, mental retardation, or cancer. Heredity determines lifespan and healthiness. Changes in the environment, like air, water, or climate, all can cause disease. This includes the internal environment, the system of the body, and the external environment, the physical, biological, and psychological that introduces exposure. It has a direct influence on the physical, mental, and social wellbeing of an individual. One’s lifestyle contributes a lot to their overall health. Culture, behavior, and habits can all either strengthen or diminish health. Balanced eating, keeping active, smoking, drinking, are all variations of how we deal with daily stress and challenges in life. Socio-economic conditions including education, income, nutrition, employment, and housing are all important factors for estimated adequate health. Education helps citizens to understand the importance of maintaining a healthy lifestyle and a clean environment. Poor education can be linked to lower self-confidence and increased stress. Income determines the quality of medical attention you can receive. The wealthy portion can afford higher quality healthcare but are more prone to disease due to inactivity and a sedentary lifestyle. Nutrition is a major concern in Haiti right now. Malnutrition stunts growth and promotes a weak immune system for fighting infections and illness. Employment is an indicator of the availability of healthcare. Those unemployed don’t have access to any form of healthcare. Many employment opportunities cause health issues due to agricultural production and manufacturing. Tobacco farming, fishing, forestry, farming, and livestock all have direct ties to various diseases and illnesses. Haitian healthcare remains in a fragile state with “limited coverage of primary care services, suboptimal health-care performance, and accessible health risk and vulnerability for the population. ” Haiti’s 1986 Constitution, Article 19, declares that the states have an “absolute obligation to guarantee the right to life, health, and respect of the human person for all citizens without distinction”. However, due to numerous setbacks, the nation has not been able to make significant progress towards this promise. They are currently working on improving emergency responses to disease, ensure water security along with sanitation and hygiene. Due to the lack of restroom availability, the practice of open defecation is common. Poor sanitation establishes the Zika virus as the main concern for Haiti. With suspected 3,036 cases, 19 biologically confirmed positive. The disease surveillance system has expanded and strengthened, both TB response rates have increased and HIV clinical surveillance efforts have advanced. Currently, the Government of Haiti has the worst health metrics in the entire western hemisphere as they finance less than 15% of the total national expenditures for healthcare.

A new goal has been placed to respond to the need to establish “health services and programs with a public sector backbone to promote stability and continuity, and above all, support national efforts to provide universal access to health care”. Postearthquake, the Haitian government has experienced a slow recovery of expenditures and the need to hire and retain more adequate human resources. Haiti has begun developing programs dependent on external donors to “sustain adequate staffing levels to prevent the loss of the skilled workforce. ” Haiti has not problem educating citizens in the medical field but struggles to keep graduates to practice in the country. Social determinants of society and one’s lifestyle choices have major impacts on general health. Social determinants are underlying factors regarding health care, environmental exposure, and health behavior. The study of social determinants reveals these factors can be a precursor to an estimated 80% of premature mortality. In impoverished nations like Haiti, poor social determinants significantly increase mortality rates. A significant social determinant is Healthcare. The high population of unemployment leaves many uninsured and poor quality medical care. Currently, Haiti has the lowest coverage among any country in America. The mental health care system is extremely lacking in funding and personnel. For every 100,000 inhabitants, there are 1. 7 beds, 0. 28 psychiatrists, 0. 14 general practitioners, 0. 38 nurses, and 0. 86 social workers at a mental healthcare system. These numbers are extremely below recommended averages. The general healthcare system has a lack of human resources as well. For every 100,000 inhabitants in the public sector, there are 14 physicians and 18 nurses. The United States employs 295 physicians for every 100,000 inhabitants at a total of almost 5. 6 million, compared to Haiti’s whole nation only having 700 doctors. Poor environments can include damaging agents such as asbestos, carbon dioxide, and industrial waste. These detrimental conditions expose the low working class to an additional risk of illness with greater impact. Another strong predictor of health is isolation and how big one’s social network connects are. Poor social connections expose people to 1. 9-5 times higher mortality risk. Proportionately, clustered populations increase the risk of transmitting sexually transmitted diseases and puts citizens at a greater risk of exposure.

How one chooses to manage stress contributes to general health. Tobacco causes a great risk and is commonly abused by low income and low education citizens who cannot afford future medical care. Alcohol is another resource commonly abused by the lower working class. Moderate consumption is healthy and has evidence of prolonging life and wellbeing, however high consumption rates are linked to mortality risks. High mortality rates can be addressed by improving the components of education, income, and occupation. Education is the key to breaking the cycle of poverty. It not only “shapes future occupational opportunities and earning potential”, but is a significant predictor of a variety of diseases. A complete education, including early educational experiences during critical periods, can lead to long term benefits like “increasing human capital, boosting productivity, augmenting lifetime earnings, and improving the socialization of the next generation”. It provides the nation with an opportunity to dig itself out of poverty. Haiti’s desire to increase education investments is currently suspended as an increase in school funding would decrease funding to healthcare which is the primary focus. Elementary school completion rates have decreased to 66% from 68% in 2001. Less than 10% of the total population of completed secondary education. The education dilemma increases one’s chance of early age pregnancy and developing an addiction to tobacco and alcohol. In addition to an educational degree, income is a major social determinant. Low income can be linked to low birth weight, cardiovascular disease, hypertension, arthritis, diabetes, and cancer. A steady income means the opportunity for better nutrition, housing, education, and recreation. A randomized trial studied an experimental group of high household income children, which reported having fewer health problems and better cognitive functioning. Intervention policies are currently being tested as contemporary solutions to stunt existing inequalities and have a positive impact on health outcomes.

A low job status introduces the risk of physical injury, exposure, and psychosocial problems. Haiti has remained one of the weakest nations in the western hemisphere as a direct result of repeated natural disasters. From torrential rains, tropical storms, hurricanes, and earthquakes, the Haitian nation has been stripped of the little comfort and stability they have held. Haiti lies on the hurricane path and is most vulnerable from August to November. The “powerful, slow-moving storms whose destructive forces include heavy rains, floods, cyclonic winds, and tidal waves” and cause damage ranging in the billions. The 2010 earthquake killed more than 300,000, displaced 2 million, and caused $8 Billion of major economic damage to national infrastructure. The problem of overcrowded living created the perfect breeding conditions for communicable diseases, leaving the public health system suffering, underfunded, and understaffed. The massive 7. 0 magnitude earthquake followed by 59 aftershocks destroyed millions of homes, deforestation, and damage to the agricultural and livestock system. A “majority of residential and commercial buildings… as well as communication and transportation networks were severely impacted”. Natural disasters simply reinforce the cycle of debt and poverty. The World Bank’s 2010 statement addresses the recent earthquake by “waiving any payments on this debt for the next five years and at the same time we are working to find a way forward to cancel the remaining debt. ” This will hopefully give Haiti needed time to reorganize and develop a plan to break the cycle of debt.

10 December 2020
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