Introduction: Haiti
The healthcare situation differs greatly between different countries around the world. It is affected by many factors, ranging from finances and education to governmental policies, climate, weather conditions, natural disasters, predispositions towards certain diseases, and others. As it often happens, countries with high mortality rates tend to be poor and have weak economies, which contributes to the spreading of many diseases, since they are unable to sustain an adequate level of healthcare services (Skolnik, 2016).
The country chosen for this term paper is Haiti, as it one of the few countries whose high mortality rates are associated with repetitive natural disasters such as hurricanes, which are further extrapolated by inefficient government policies and inadequate actions on the part of humanitarian and healthcare organizations.
Location and Geography
Haiti is a country that occupies the western part of Hispaniola – an island located in the Caribbean Sea. It is neighboring the Dominican Republic, which takes the eastern half of the island. The country itself is shaped like a horseshoe with two main peninsulas located in the north and south, and its total area equates to about 28,000 sq.km. It also controls four islands, such as Ile de la Gonâve, Tortuga, Grande Cayemite, and Ile à Vache (“General information on Haiti,” 2017).
The country possesses several mountain ranges that form natural barriers against winds and other kinds of climate movements. However, the central part and southern-most parts of the country are not protected by mountains, and thus are particularly vulnerable to storms and hurricanes. The country has a humid and hot tropical climate and is subjected to floods and droughts caused by deforestation (“General information on Haiti,” 2017).
Population
According to the UN population census of 2011, the Haitian population stands at around 10 million people (“General information on Haiti,” 2017). The population density constitutes at around 350 people per square kilometer, with the majority of the people living in cities and urban areas located in the plains and along the coastline (“General information on Haiti,” 2017). The population is predominantly black, with the majority of Haitians being descendants of black African slaves. Other population groups include Haitians of European, Arab, and Indian descent. A great number of Haitians live and work abroad due to the humanitarian crisis in their own country. Life expectancy for Haitians is 44 years for men and 50 years for women (“General information on Haiti,” 2017).
Government
Haiti is a semi-presidential republic, with two major figures being the President and the Prime Minister, elected by the government and appointed by the head of state. The country’s legislative system is represented by two chambers of the National Assembly of Haiti, which is tasked with legislative functions as well as allocating budgetary spending into various important areas, such as education, healthcare, social expenses, etc. (“General information on Haiti,” 2017).
Ever since the foundation of Haiti, its governmental status has been unstable, having suffered through numerous coups. It is considered to be among the most corrupt countries in the world, and one of the most impoverished. The country is currently in large quantities of debt to various foreign entities (“General information on Haiti,” 2017).
Economy
Haiti is considered to be one of the poorest countries in the world and has a very vulnerable economy. This is due to a history of occupation and economic domination by the US, foreign interventions into the governing and electoral processes, civil unrest, and vulnerability to large-scale natural disasters, such as hurricanes. Its GDP per capita currently resides at around 1,200 USD (“General information on Haiti,” 2017).
Despite the country having a potentially viable tourism industry due to the location of the country, a favorable climate, and plenty of historical monuments and sightseeing value, Haiti is unable to realize its full potential due to perpetual debt, civil unrest, and an extremely corrupt government. Its industry exports small amounts of products, with the main export values coming from the fabrics and clothes industry.
The majority of the country’s budget (90%) comes from a lucrative oil contract with Petrocaribe, which is a Venezuelan oil giant. The economic position of the majority of the population is poor. The 2015 census states that approximately 70% of the population lives on less than two USD a day (“General information on Haiti,” 2017). Haitian economy largely survives on humanitarian imports and economic aid from the US and the UN.
State of Health
Haiti is currently undergoing a humanitarian crisis caused by the Earthquake of 2010, which killed between 45,000 to 310,000 people (“General information on Haiti,” 2017). It was followed by a Cholera epidemic, which affected over 300,000 people, and Hurricane Tomas, which caused significant damage to the already destroyed suburbs of Port-au-Prince and killed several dozen people. These factors, combined, caused a catastrophe for the impoverished country, as many citizens were displaced, homes were destroyed, and businesses closed. Ever since, Haiti has become heavily reliant on humanitarian aid and international healthcare organizations to combat the cholera epidemic.
The lack of centralized and well-maintained healthcare infrastructure caused outbreaks of various other diseases, such as diarrhea, neoplasms, tuberculosis, AIDS/HIV, Zika virus, and various others (CDC, 2017). Due to the state of unemployment or underemployment, crime rates are high, especially in urban city areas such as Port au Prince. The slums of Port au Prince are considered to be some of the most dangerous places on earth, with levels of gang violence and the probability of injuries being high.
Culture and Traditional Medicine
Haitian culture has a very fatalistic view on diseases and death, viewing them as tests from the Gods. At the same time, many diseases are stated to be the work of the Devil, thus requiring not only medical but also ritual practices to truly cure (“Haitian healthcare beliefs,” 2014). Practices of self-care and traditional medicines are very widespread, and it is likely for Haitians to try dealing with pain and disease on their own before addressing a healer or a medical specialist.
Haitian cultural and traditional medical aspects are based around Voodoo – a set of shamanistic rituals and practices that were in place before Christianity became the predominant religion (“Haitian healthcare beliefs,” 2014). These practices heavily rely on the placebo effect from the shamanist rituals for smaller diseases and ailments, and herbal remedies to treat more serious conditions.
Voodoo priests tend to use a variety of herbs of Haitian origin in concoction with narcotic substances to facilitate a connection with the spirits. Amulets made out of teeth and bone objects are stated to attract and trap the demons inside. The population of Haiti is highly superstitious and trusts native practices more so than trained physicians. The situation varies across the country, however, with citizens living in suburban areas being less prone to use traditional medicine, when compared to Haitians living in rural areas of the country (“Haitian healthcare beliefs,” 2014).
Healthcare System and Delivery
Governmental Healthcare Agencies
Officially, the Haitian healthcare system operates under the Haitian Ministry of Health, which encompasses all of the major government-funded hospitals in a coherent healthcare system (WHO, 2010). In reality, however, said ministry exists in name only. The earthquake of 2010 dealt a major blow to the country’s own healthcare system, reducing hospitals and nursing training facilities to rubble, causing many deaths among the medical personnel, and destroying valuable provisions and equipment (WHO, 2010). While the ministry has been receiving international aid to get back on the track, the extent of their abilities remains limited.
Healthcare Personnel and Hospitals
The situation is a humanitarian and healthcare catastrophe. According to Global Security statistics, there are roughly 25 physicians and 11 nurses per 100,000 people in Haiti (“Health,” 2017). The majority of the population may never get the healthcare they require due to how few medical professionals currently operate in the country. According to the World Databank (2017), there are 0.6 hospital beds currently available per 1,000 people, which is extremely low.
Nursing Education Systems and Accrediting Organizations
The major medical faculty that trains nurses and physicians is the FSIL, which stands for the Faculty of Nursing Science of the Episcopal University of Haiti (“Haiti nursing foundation,” 2017). Aside from that institution and affiliated learning facilities, after the earthquake, the nursing profession is largely being taught in small private nursing schools which do not require as much space and resources to run. The Haitian Ministry of Health is currently running a joint program with the Canadian Association of Schools of Nursing aimed at accreditation and accountancy of these schools. The program has been titled the HGF Project. The accreditation process is handled by the Department of Training and Development for Health Sciences (DFPSS) (“Haiti nursing foundation,” 2017).
Nursing Associations and Non-Profit Healthcare Organizations
The primary nursing association in Haiti is the Haiti Nursing Foundation, created under the patronage of FSIL (“Haiti nursing foundation,” 2017). It opened in 2005 and had ever since become the primary nursing association for the physicians and baccalaureates of the university. However, its impact is small, as the majority of healthcare is currently provided by NGOs. The major healthcare NGOs in Haiti include USAID, the Red Cross Foundation, Food for the Poor, Humanity First, SOS for Children, UNICEF, and various other Red Cross and Crescent organizations from around the world (Redmund, n.d.).
Health Priorities
The main priority for Haitian state and healthcare organizations is to rebuild the government-associated healthcare system. As it stands, it is in shambles and unable to provide even the basic necessities for the people of Haiti. In order to rebuild a national healthcare system, the country must invest not only in rebuilding the healthcare facilities but also in training and educating new nurses among the native population. While there are many nurses working under the emblem of healthcare NGOs, they provide temporary relief and could not be relied upon in a long-term perspective.
Conclusion: Nursing Implications
Nurses working in Haiti could play a part in addressing major healthcare priorities in two ways – by providing direct relief to the affected population of Haiti or by providing education and practical knowledge to prospective nurses and healthcare professionals found among the native populace. It is important since the healthcare situation in Haiti remains dire, and the country is in great need of healthcare professionals in the field as well as in classrooms.
References
CDC. (2017). Global health – Haiti.
General information on Haiti. (2017). Web.
Haitian healthcare beliefs and voodoo (voudou). (2014). Web.
Haiti nursing foundation. (2017). Web.
Health. (2017).
Redmund, H. (n.d.). Haiti and healthcare.
Skolnik, R. (2016). Global health 101. Burlington, MA: Jones & Bartlett Learning.
The World Bank. (2017). Hospital beds (per 1000 people).
WHO. (2010). Haiti – Earthquake health response. Web.