Category- Figure (2001)
Area- 27,500 sq. km
Population- 8.087 million (2000)
Birth Rate- 31.68 per 1,000 (2001)
Death Rate- 15 per 1,000 (2001)
Population growth- 1.4% (2001)
Doctors- 25 per 100,000 (1998)
Infant mortality- 95 per 1,000 (2001)
Maternal mortality- 457 per 100,000 (1999)
Under age 5 mortality rate- 129 per 1,000 (2000)
Below poverty level- 80% (1998)
Unemployment rate- more than 2/3 outside the formal economy
Illiteracy rate- 54% (1998)
Fertility Rate- 4.4%/Women (2001)
Access to safe water- 46% (2000)
HIV/AIDS Adult Prevalence Rate- 5.17% (1999)
People living with HIV/AIDS- 210,000 (1999)
Life expectancy- 51 female, 48 male (2001)
Medical History of Haiti:
Occupying the western third of the Caribbean island of Hispaniola, Haiti is the poorest country in the Western Hemisphere. The average income per capita for their nearly 10 million people is $250 U.S./year. This poverty contributes to Haiti's endemic nutritional deficiencies, tuberculosis, typhoid fever, bacterial and protozoal dysenteries, and malaria.
Within 60 years of Columbus' 1492 landing on Hispaniola, the indigenous Carib Indian population had largely disappeared. Slaves were imported from many parts of western Africa beginning as early as 1503. By 1790 the more than 500,000 slaves outnumbered the white population by 16 to 1. French military hospitals were established in Cap-Haitien, Port-au-Prince, and Aux Cayes by the year 1700. However, slaves were treated in sick houses and, at times, chained to beds under conditions that did little to encourage hospitalization for any lengthy period. The practice of medicine during the 17th century, as throughout Europe and the rest of the Western Hemisphere, was dominated by unsound theories, including liberal use of mercury and bloodletting.
By 1791, political events in Europe and the Caribbean precipitated a slave revolt that led to independence. The French army under Le Clerc, sent to suppress the revolution, was so decimated by yellow fever that it was forced to abandon its efforts. In January 1804, Jean Jacques Dessalines, a former slave, signed the Act of Independence. He was declared emperor and ushered in a century of international isolation during which there were few advances in the sciences and medicine.
Although the hospital-associated school in Port-au-Prince had been referred to as a medical school since 1838, no degrees were awarded until 1870. One notable exception to the poor state of medical education was provided by Dr. Leon Audian, who instituted the first system of accessible health records for the independent nation. Under his leadership, a medical journal, La Lanterne Medicale, was published every two months from 1899 to 1911, and a laboratory of parasitology and clinical bacteriology was established in 1905.
The U.S. occupation of Haiti, which began in 1915, led to changes in medical practice. A National Public Health Service was organized in 1917, with a training school for nurses that produced 80 graduates by 1929. Extensive use of bismuth and arsenical agents sharply cut the incidence of endemic yaws. Although Americans did not attempt to alter physician training at first, the responsibility for medical education was gradually transferred to the U.S. Public Health Service. A new medical school was dedicated, and by 1929 the country had 15 relatively modern hospitals.
Little progress in medicine occurred between 1930 and 1950. Tuberculosis was the major cause of death in Haitian hospitals, and both yaws and malaria were prevalent. In 1950, medical resources were concentrated in Port-au-Prince, with only 26 physicians for a total population of 2.5 million people. The Haitian government contracted with WHO and UNCIAL in 1950 to attempt to eradicate yaws. By 1954, almost 90% of the population had received long-acting penicillin therapy, with spectacular results. Malaria was the target of another campaign, and in 1961 a program financed by the U.S. government was begun by the Service National d'Eradication de Malaria (SNEM). Widespread spraying with DDT or dieldrin led to only temporary results; falciparum malaria continues to be a prevalent and serious problem.
Because of emigration, Haiti has continually lacked medical personnel. Between 1928 and 1960, over 70% of the 960 physicians who graduated Haiti's medical school emigrated. In 1969, a government decree explicitly prohibited doctors, dentists, nurses, and laboratory technicians from leaving the country without authorization by the Department of Public Health. Graduating medical doctors are required by law to spend one year in rural medical districts or in a program of preventive medicine.
Currently, it is estimated that there are 30 hospitals in Haiti serviced by a total of 400 physicians. There is one doctor for every 7,180 inhabitants and one nurse per 2,290 persons. Hospital beds average one per 2,000 persons.
Today the food crisis is worse than ever before. Mothers have been feeding their children with cookies made from mud from a plateau, mixed with salt and oil, since they could not afford to buy food. Now, with the cost of oil, salt, and yes, even the dirt they purchase, has increased and they are finding it hard to survive.
The cost of fossil fuel oils makes it almost impossible for Haitians to drive. There are efforts to find alternative fuel sources, but this will take months and even years before it can be implemented.