By Savinia Exantus @TheSaviNurse
Amongst other infrastructure-related issues, healthcare is categorically one of the most challenging in Haiti. We are faced with not only the common illnesses such as cardiovascular diseases, diabetes, etc. – but also, after the devastating earthquake of 2010, a rise in vector-borne diseases such as cholera and chikungunya. Let’s assess some of our most lethal ailments in recent years.
According to the Centers for Disease Control (CDC), cardiovascular diseases are the deadliest in Haiti. These include heart disease, heart attack, stroke, heart failure, arrhythmias, and heart valve problems. They are often diagnosed too late or upon an incident leading to the patient’s demise. The major risk factor for these cardiovascular diseases is none other than hypertension. Despite the fact that Haitians walk to most places, hypertension is still prevalent due to the fact that we consume an excessive amount of salt. According to a study conducted by the heads of the Ministry of Public Health and Population (MSPP). “Haitians consume 30 to 35 g of sodium (Na) daily in their diet. This is in dramatic contrast to the 4 g recommended by WHO. Haitians eat nearly 9 times as much salt as is recommended!” This disturbing reality can only be counteracted through education.
The second deadliest affliction is none other than tuberculosis (TB). According to USAID, Haiti is among the highest per capita rate of tuberculosis in the Latin America and Caribbean region. It has become one of the most infectious causes of mortality in both children and young adults. Few of these young people are diagnosed, and even fewer have access to treatable care. In the wake of the 2010 earthquake, there was a rise in tuberculosis cases in Haiti due to malnutrition and poor sanitary conditions in camps. The WHO estimated that Haiti had the highest tuberculosis incidence in the Americas (230 per 100,000 population in 2010), a rate nearly 10-fold higher than the regional incidence of 30 per 100,000. About half of the tuberculosis cases in Haiti occur in the West Department; this includes Port-au-Prince, which was most heavily affected by the earthquake.
… cardiovascular diseases are the deadliest in Haiti. These include heart disease, heart attack, stroke, heart failure, arrhythmias, and heart valve problems. They are often diagnosed too late or upon an incident leading to the patient’s demise. The major risk factor for these cardiovascular diseases is none other than hypertension. Despite the fact that Haitians walk to most places, hypertension is still prevalent due to the fact that we consume an excessive amount of salt. According to a study conducted by the heads of the Ministry of Public Health and Population (MSPP). “Haitians consume 30 to 35 g of sodium (Na) daily in their diet. This is in dramatic contrast to the 4 g recommended by WHO. Haitians eat nearly 9 times as much salt as is recommended!” This disturbing reality can only be counteracted through education.
Severe cholera broke out following the earthquake in 2010, causing 700,000 cases of illness and approximately 8,500 deaths. This epidemic was surprising, as no cholera outbreak had been reported in Haiti in more than a century. In 2014, 27,750 residents of Haiti reported having cholera, and 296 deaths resulted from the disease. Symptoms of cholera include diarrhea, which comes on suddenly and may quickly cause dangerous fluid loss. It resembles water in which rice has been rinsed (rice-water stool). Other symptoms include nausea and vomiting; dehydration ranging from mild to severe; and electrolyte imbalances that can lead to shock. However devastating cholera was and still can be, in January of this year, the UNICEF revealed that the number of cases significantly declined over the past 8 years. Roughly 100 suspected cases were recorded, which is the lowest level since the epidemic began in October 2010, and there was no explosion of cases last year, even during the rainy season.
Talking about Haiti’s deadliest illnesses would not be complete without addressing the country’s broken healthcare system. In Haiti, hundreds of people die every day for preventable reasons that might be averted by something as simple as a health awareness campaign to educate the public about the simplest ways to be aware of your own health. It is as much as an epidemic as any other disease – and surprisingly, this epidemic is not due to a lack of medical facilities, but rather a lack of primary care and investment in public health. In a report done by the World Bank, “the annual per capita public health spending in Haiti is $13, compared with $781 in nearby Cuba and $180 in the Dominican Republic. Public investment in health care has plummeted from 16.6 percent of the total Haitian government budget in 2004 to 4.4 percent in the current budget.”
The solution is not as complex as one would think. According to the World Bank, an increase in spending as well as a reallocation of funds with more emphasis on primary clinics and preventative care, and less spending on hospitals, would solve more than half of the problems. This would save countless lives. Let us all agree that this solution may seem unreasonable in light of our other social issues – but it is definitely not impossible.
References
Haiti’s killer cholera epidemic could end this year – UN. (2018, January 20). Retrieved December 6, 2018, from https://www.rappler.com/world/regions/latin-america/194091-haiti-cholera-epidemic-end-2018
Jean-Charles, R. R. (2014). Challenges in Hypertension: The Haiti Experience [Abstract]. Journal of Clinical Hypertension. Retrieved December 1, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237537/.
Koenig, S. P., Rouzier, V., Vilbrun, S. C., Morose, W., Collins, S. E., Joseph, P., . . . Pape, J. W. (2015). Tuberculosis in the aftermath of the 2010 earthquake in Haiti [Abstract]. Bulletin of the World Health Organization. http://dx.doi.org/10.2471/BLT.14.145649
Piarroux, R., Barrais, R., Faucher, B., Haus, R., Piarroux, M., Gaudart, J., . . . Raoult, D. (2011). Understanding the Cholera Epidemic, Haiti. Emerging Infectious Diseases. http://dx.doi.org/10.3201/eid1707.110059 Young, N. (2017, June 30). Haiti’s Troubled Healthcare System. Retrieved December 12, 2018, from https://nonprofitquarterly.org/2017/06/30/haitis-troubled-healthcare-system/
