Introduction
The Hispaniola Island was initially inhabited by the native Taino. However, this ethnic group was later annihilated by settlers from Spain within a period of two decades. Hispaniola also witnessed a massive influx of French settlers during the early 17th century. Before the close of this century, the French people secured the western portion of the island from the Spanish settlers. It is the western division that became Haiti in later years (Arthur, 2002).
Sugar and forestry were the backbones of the French economy. As a result, the colony amassed a lot of wealth and became among the richest spots in the Caribbean. In addition, slave importation from Africa contributed to the rapid growth of the French economy (Arthur, 2002).
However, slave resistance under Toussaint L’Ouverture took place in Haiti towards the end of the 18th century. Consequently, Haiti gained the leadership of a black person for the first time. However, Haiti’s economy is among the worst in the region. The larger part of Haitian history has been punctuated with political instability. In February 2004, President Jean-Bertrand Aristide went into exile after he was forcibly removed from office through an armed rebellion. Thereafter, new elections were organized by the interim government under the watchful eye of the UN. In spite of the delays, a new government was put in place in May 2006 (Wamai & Larkin, 2011).
Haiti was stricken by a massive earthquake in early 2010. Over 300,000 people died with over 1 million left without homes. The country is still struggling with several socio-economic challenges up to date.
Burden of disease
The disability-adjusted-life-year is used to measure disease burden according to the standards adopted by the World Health Organization. In this case, premature mortality is measured against the number of years an individual has lived in poor health (Gage & Marie, 2006).
In Haiti, the burden of disease has been witnessed across major infections. For example, typhoid fever, hepatitis A and E, as well as diarrhea caused by protozoa and bacteria, are some of the major infectious diseases in Haiti. Currently, the degree of risk towards these infections is quite high. They are all considered to be food and waterborne infections (Gage & Marie, 2006). Disease burden has also been significantly contributed by vectors. Malaria and dengue fever are the two main vector-borne diseases in Haiti. In addition, Tuberculosis is still a major health challenge in this country.
Socioeconomic determinants of health
After birth, individuals are exposed to different living conditions before they eventually age and die. Such conditions are known as the socioeconomic determinants of health (Wamai & Larkin, 2011). Lack of adequate resources and poor leadership are some of the factors that influence the socioeconomic determinants of health. Health inequities are mainly addressed under the social determinants of health. Health inequities arise when healthcare services are not offered uniformly across different countries.
The accumulation of foreign debt is a key issue of concern in Haiti. For instance, over $1.2 billion of debt had been accumulated by Haiti between 1970 and 2004 (Gage & Marie, 2006). During the early 1980s, the country experienced a massive state of economic deterioration coupled with unfavorable terms of trade. As a result, the Breton Woods Institutions (IMF and World Bank) chipped in to initiate a recovery program. Although the program was meant to boost the socio-economic status of the Haitians, it led to several negative health outcomes (Wamai & Larkin, 2011). Hence, the Structural Adjustment Program worsened the socio-economic well-being of the Haitian people. The country is still reeling back under the effects of the long-forgotten SAP initiative. Worse still, the production of food and other agricultural products is still below the expected amount. Both the local and international trade is also not performing well. Therefore, the government can hardly establish better health standards due to the poor economy. Besides, individual citizens find it difficult to access the competitive healthcare services offered by the private sector due to the low-income levels. These are some of the socioeconomic determinants of health in Haiti.
Access to healthcare and healthcare inequality
The adult population in Haiti that faces the threat of HIV/AIDS infection amounts to about 2 percent (Gage & Marie, 2006). Access to healthcare facilities is still a challenge bearing in mind that the government is struggling to offer basic treatment to opportunistic infections such as Tuberculosis (TB). The incidence of TB infection is believed to be over 10 times more than those of other regions in South America. Malaria affects over 30,000 Haitians annually (Raum, 2012). This implies that healthcare inequality is high in this nation. As already mentioned in the above section, healthcare inequality is being experienced in Haiti largely due to the low wages and the poor economy. The latter has also been contributed by the lack of clean running water. About 75% of the Haitian population cannot access safe and clean drinking water (Wamai & Larkin, 2011). Access to healthcare facilities is a reserve of 40% of the entire Haitian population (Gage & Marie, 2006).
In terms of access to healthcare, several hospitals lack the most basic infrastructure such as beds and other admission facilities. The healthcare personnel is also not adequate to serve the entire Haitian population. The latter has been a chronic challenge in the healthcare sector (Raum, 2012).
Status of child health-control of infectious diseases
Although immunization is a crucial healthcare practice for children below the age of five years, healthcare statistics reveal that nearly 50% of Haitian children have not been vaccinated (International Monetary Fund, 2008). Children who are not vaccinated face several incidences of disease attacks and are highly likely to die before they attain the age of five years. This explains why the infant mortality rate in Haiti has remained considerably high over the years.
Children are also under the threat of infectious diseases. For example, HIV/AIDS accounted for nearly 50 % of Haitian deaths before the earthquake in 2010 (International Monetary Fund, 2008). Mother-to-child transmission of the HIV/AIDS virus is yet to be fully controlled by healthcare agencies. Diarrhea, meningitis and respiratory infections are also common among children in Haiti. Moreover, intestinal parasites and waterborne diseases affect nearly 90 % of children in Haiti according to the estimates provided by the World Health Organization.
Non-communicable diseases
There are several non-communicable diseases that have been reported in Haiti. For example, the estimated prevalence of diabetes stands between 2-8 percent of the population (Raum, 2012). Furthermore, about half of all the amputations carried out at the Haiti University Hospital are occasioned by incidences of diabetes. However, a lack of diagnosis has been witnessed in 50 percent of the cases.
The Haiti State University Hospital admits close to 40 % of cases related to cardiovascular diseases. Seventy percent of the admissions are closely associated with HTA (Raum, 2012). In 1997, a total of 2,300 injuries were recorded. The violence that erupted during the same year claimed about 380 lives (International Monetary Fund, 2008).
Nutrition
The poor production in agriculture has significantly affected the local supply of food substances. This has led to poor nutrition bearing in mind that the cost of basic foodstuffs is always skyrocketing (Gage & Marie, 2006).
Conclusion and recommendations
To recap, it is evident that the socioeconomic determinants of health in Haiti have worsened the overall standard of living. From the above discussion, the political and economic turmoil in Haiti is significantly responsible for the poor state of health and the economy. The country has not been politically stable for long. In addition, both local and international trade has failed to resuscitate the Haitian economy. External factors have also contributed to the poor performance of the Haitian economy. For instance, the Structural Adjustment Program adopted by the Breton Woods Institutions led to several negative outcomes contrary to the expectations of the policymakers.
In regards to access to healthcare services, it is vivid that only 40 % of Haitians can access such services. Children are also facing a similar brunt because nearly 50% are not immunized against infectious diseases. These are worrying trends that need to be addressed urgently.
The socioeconomic wellbeing of the Haitian population can be enhanced if the following rafts of measures are put in place. First, both the health and development governance should be improved (Wamai & Larkin, 2011). In other words, a rigorous process of policy formulation and implementation should be initiated at the central government level. Moreover, the processes of policy formulation and implementation should be made participatory. Second, health inequalities ought to be reduced. This can be attained by promoting better health practices. Therefore, the current health sector can be reoriented from the lower to the upper level. Finally, accountability in the governance of public affairs should be increased in all organs of the Haitian government. The same progress must be monitored and appraised regularly.
References
Arthur, C. (2002). Haiti in Focus: A Guide to the People, Politics, and Culture. New York: Interlink Publishing Group.
Gage, A. J., & Marie, G. C. (2006). Effects of the physical accessibility of maternal health services on their use in rural Haiti. Population Studies, 60(3), 271-288.
International Monetary Fund (2008). Haiti: Poverty Reduction Strategy Paper. Washington DC: IMF.
Raum, E. (2012). Haiti. London: Global Library Limited.
Wamai, R.G. & Larkin, C. (2011). Health Development Experiences in Haiti: What can be learned from the past to find a way forward? JMAJ 54(1): 56–67.