Healthcare in Haiti, how NGOs threaten the National Healthcare System, Vodou Beliefs about illness and how grassroots organizations help.

1. Haiti
Key
Problems
faced
by
the
Na3onal
Healthcare
System
(NHS)

2. Overview
•
Haiti’s Healthcare Background
•
Vodou religion as a system of healthcare
•
Problems faced by Haiti’s National Healthcare System (NHS)
•
NGOs and Healthcare Privatization
•
Grassroots Healthcare

3. Hai)’s
Popula)on
Pyramid

4. Hai)’s
Popula)on
Sta)s)cs
•
Ranks :149 out of 182 on the United Nations Human Development Index.
•
Population: 10,173,775
•
Ethnicity: 95% Black; 5% Mulatto and White
•
Urban-rural proportion:: 53% - 47%
•
Life expectancy: 62 (total); 64 years (women); 61 years (men)

5. Hai)
and
Poverty
•
Haiti is the third hungriest country in the world after Somalia and Afghanistan.
•
The richest 1% of the population controls nearly half of all of Haiti’s wealth.
•
The poorest country in the western hemisphere and one of the poorest
countries in the world.
•
Poverty 78% of Haitians live on less than $2 US per day.

6. Comparing
H ai)
a nd
t he
D ominican
R epublic
•
Haiti and the Dominican Republic are neighboring countries that occupy the
same island, Hispaniola.
•
Exposed to similar level of natural hazards (earthquakes and tropical storms).
•
Politically, underwent a series of regime changes (but have different outcomes).

7. Comparing
H ai)
a nd
t he
D ominican
R epublic
Life Expectancy (2011) - 62
Life Expectancy (2011) - 73
Death Rate (2011) - 9
Death Rate (2011) - 6
Infant Mortality (2011) - 53
Infant Mortality (2011) - 21
Access to improved drinking water resources (2010) – 69%
Access to improved drinking water resources (2010) – 86%
Access to improved sanitation facilities (2010) – 17%
Access to improved sanitation facilities (2010) – 83%

8. Hai)’s
Health
Issues
•
Top 3 causes of death (across all ages):
- Infectious and parasitic diseases (e.g. pneumonia, tuberculosis)
- HIV/AIDs
- Cardiovascular diseases (e.g. stroke)

9. Current Healthcare Capacity

10. Tents used as makeshift hospitals.

11. Hai)’s
Current
Healthcare
Capacity
•
0.25 docs per 1000, rural 0.02
•
USD 65 per head
•
4% of national budget
•
Private insurance is rare
•
Haitians have to pay for healthcare “Out-of-Pocket”.
•
70% of the health budget in Haiti is funded externally by these NGOs under
the coordination of WHO, with more NGOs per capita than any developing
country apart from India.

12. Cultural Beliefs about Illness

13. Vodou
•
Religion plays a crucial role in the life of Haitians
•
Vodou: the prevalent religion among the society
•
Definition of illness: religious versus medical
•
Maladi Bondyè (visible or ordinary physical illnesses), Maladi fè-moun mal or
maladi diab (invisible, secret or magic), and Maladi lwa (spiritual)
•
Stigmatisation & taboo: mental illness and HIV/AIDS
•
Vodou religion as a system of healthcare
•
Health is dependent on the connection of an individual and their religion and
morality

14. Aspects
of
social
structure
&
culture
affec)ng
types
and
use
of
services
•
Traditional versus modern medical services.
•
Cost of consulting a traditional healer can be up to a thousand times more than
that of a professional medical practitioner.
•
Deep-rooted trust in the cultural healing practices among the people.
•
Help-seeking behaviour heavily influenced by family, especially since most of
the Haitians live together in small communities.

15. How
Hai)an’s
choose
Healthcare
•
Location, religion, social class
•
Most medical centres located at more urban areas, thus rural populations
would have difficulties accessing them.
•
Access to clean drinking water
•
HIV patients tend to move away from alternative healing practices after their
interaction with the professional doctors.
•
Patients with mental distress decides their choice of healers by the quality of
care given
•
The elites of the Haitian society do not engage in religious practice of Vodou

16. Key Problems (NHC)

17. Key
Problems
faced
by
Hai)’s
NHS
• Healthcare financing
• Healthcare Privatization
• Inadequate and underpaid workforce
• Disruption to medical supply routes after the 2010 earthquake
• Subsequent cholera epidemic and food and water insecurity

18. Recipients
of
Humanitarian
Funding

20. Haiti’s leaders have limited
influence over the planning
and activities of the numerous
foreign actors in the health
sector.

21. Key Problems
Caused by the Privatization of Healthcare

22. Problems
caused
by
Priva)za)on
Increasing Privatization
= Lack of Medical Capacity in the Public Sector
= Inability to provide competent healthcare treatment, coverage
+ inability to retain workforce
Private healthcare providers “compete” with local healthcare providers.

23. The Haitian community wants to
alleviate itself from a system that
cannot rely on its public sector and
has too much dependence on
foreign aid.

24. Grassroots
Movements
and
CHWs
differ
from
NGOs
•
Ground up initiatives driven by the politics and social conditions of a community
•
Important because they are able to reach the chronically poor majority
•
Seek support to replace the need for a government funded public sector and
more autonomy from a system dependent on international support
•
Besides basic healthcare, address problems like food security, deforestation and
poverty, and fill the need for leadership, employment and social support.
•
Role is to put in place local initiatives and programs that could work with and
possible be absorbed by the Haitian State.

25. Grassroots and Community Health

26. Ame Sade community health workers
Sacre Coeur Hospital in Milot
The Papaye Peasant Movement
“Road to Life yard” in Central Plateau’s Eco Village