Cholera in Haiti among the Pregnant Women

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Cholerain Haiti among the Pregnant Women

Cholerain Haiti among the Pregnant Women

Thehealth care systems of various countries vary considerably. Developednations tend to have better facilities as compared to those in theunderdeveloped countries. Also, the quality, cost, and access to carediffer significantly. Some of the variances are evident whenconsidering women’s health, disease management, impact onvulnerable communities, and lifestyle issues.

Thehealthcare systems also differ due to culture. Culture influences howpeople seek medical attention. The Chinese medicine is a good exampleof how culture affects health. People across the globe appreciateChinese medicine considering it natural. By traversing across theworld, one would realize the medical care differs in many aspects.One such country is Haiti. It is deemed to be a 3rd world country orworse. This is because it has a weak infrastructure and the healthcare system is also fragile. This paper will discuss the healthcarefacilities in Haiti. Apart from that, the paper will show how peopleperceive the sick. Haitians views on people with cholera and HIV/AIDSis based on culture. Discussing Cholera among Pregnant Haitians willalso be a major undertaking in this paper.

Analysisof the Healthcare System

Accordingto Alfred (2012), Haiti is the poorest nation in the America.Additionally, the country suffers from gross inequalities withroughly 75 percent of the entire population living on less than $2.50daily. The report also ranked the country at 154 out of 177 nationson the Human Development Index (HDI). As per the research, incomeinequality is quite high. For instance, back in 2001, the Ginimeasurement (inequality measurer) for the country was 0.66. Thecountry suffers from governance, social, and economic crises (Alfred,2012). Regardless of the intervention of foreign aid in thehealthcare as well as other sectors, the country’s maternal andinfant mortality rates are obstinately high. Moreover, lifeexpectancy continues to be one of the lowest in the Caribbean andLatin America with only 45 percent of kids receiving vaccinations. A2014 audit of the USAID $100 million medical infrastructure plan inHaiti showed a shortage of sustainable financing techniques forhealth institutes (Alfred, 2012).

Comparisonwith the United States

Accordingto WHO, the healthcare system in Haiti is largely owned by thegovernment. In addition to that, only 11 percent of its nationalbudget is channeled towards health care. Roughly 80 percent of thebudget is spent on salaries and a mere 20 percent left for drugs andfurniture. On the other hand, the United States has a unique healthcare system that is provided by several distinct organizations.According to the WHO, 58 percent of the hospitals are non-profit, 21percent for profit, and 21 percent are owned by the government(Rosenthal, 2013). From this statistic, it is evident that the UnitedStates is far wealthier than Haiti.

Haitiansare mostly directed by culture. The cultural aspects make Haiti andthe United States different. For instance, the Haitians make theirhealth decisions following Voodoo. Voodoo is considered a religionand is at the epicenter of most of their decisions. The voodoopractitioners who dwell in folk medicine are well respected withinthe society. They mostly assist in treating supernatural sicknesses.The procedures include incantations, conversing with the spirits,prayers, and dancing. Diagnosis is made using trances, shells, andcards. Haitians who follow these beliefs make decisions based on itno matter their locations, that is, even immigrants. Voodoo affectsthe daily happenings within the society (Jessie. M, 2010). However,in the U.S. health decisions are not based on culture. In otherwords, folk medicine is rarely practiced by the U.S. natives seekingguidance from qualified health practitioners.

Regardinglifestyle concerns and hereditary issues, Tuberculosis and AIDShappen to be the most predominant. Common beliefs perceive TB as apoverty disease since it mainly affects malnourished individuals.They also believe AIDS and TB are due to spells. Obesity is alsoviewed to signify wealth, whereas thinness is a sign of unhealthinessand economic hardships. These assumptions are quite detrimental tothe lifestyle of Haitians. They do not appreciate vaccinations hencethe high rates of TB. Additionally, many cases of TB are not reportedin time to be contained. Viewing both AIDS and TB as a result ofspells causes stigmatization hence they are hardly reported (Joel.K., 2012). Though obesity cases in the United States are continuouslyrising, people are aware of the causes. Unlike Haitians, Americans donot make health decisions based on cultural beliefs.

Thoughthe political state in Haiti has improved, it is still quite fragile.Historically, the country has been tied to coup d’états, internalconflicts, military juntas, and regime changes. The politicalinstability has impacted negatively on the healthcare system. UnlikeHaiti’s system, the U.S. has a stable political system thatchampions democracy. The two-party system has propelled the countryinto making considerable progress especially in the health caresystem (Rosenthal, 2013).

Distributionof Health Services in Haiti

Mostof the populace seek out attention from the public services,specifically, the Ministry of Health or private ones governed bychurches and aid organizations. These amenities are centralizedwithin urban regions. The quality of duty, as well as reliability,tends to deteriorate in the less populated regions. In that respect,the patients usually ignore the local amenities to seek attention inthe already overburdened or rather overcrowded central facilities.Additionally, medical service pricing is fickle and has a propensityof fluctuating depending on the donor packages. The families areincapable of gauging the value to reach a suitable decision for theirinadequate resources due to the fluctuating quality, service mix, andpricing. This difficulty and mix-up often lead to delays. In otherwords, the patients do not seek medical attention on time when theailment is still treatable. Some resort to the medical facilitiesonly during emergencies (Chan, 2013). Due to the Country’s economicand political situations, most of the Haitians have moved to theUnited States and Canada to seek better lifestyles as well aseconomic advancements (Kirmayer, 2010).

Outbreakand Management of Cholera

Cholerais a serious, dehydrating, acute diarrhea that can kill within twelvehours and is caused by the Vibrio cholera bacterium. The treatmentvaries depending on the extent of the infection. Haiti experiencedone of the most devastating earthquakes with a magnitude of 7.0 inJanuary 2010. Several aftershocks followed the event. The seismicactivity epicenter was in the most populated regions including thecapital city. An estimated 200,000 people died whereas thousands wereinjured. Apart from that, thousands of the citizens were renderedhomeless (Merlin, 2010). Before the disaster, the country’s povertylevels and infrastructure were still weak. Even though the medicalfacilities were quite feeble before the earthquake, cholera cases hadnot been reported. The first instance was reported ten months afterthe tremor. After being displaced people began living in camps thatbecame overcrowded leading to the outbreak.

Threehypotheses were developed to explain the onset of the disease. One ofthe theory purports that an atmospheric strain of V. cholera whichusually dwells in the Gulf of Mexico moved to Haiti naturally throughthe ocean currents as a result of the 2010 earthquake. Another theoryproposed that a native non-toxigenic V. cholera transmuted into aninfectious pathogenic strain that spread all over Haiti. In the thirdideology, the origin of the outbreak was accredited to an infectedperson who moved into Haiti. Since the epidemic, more than 500,000incidents have been reported with around 7,000 deaths (Malik, 2014).

Althoughmany international bodies, as well as the healthcare workers, werewithin the country, cholera spread at an alarming rate. As a matterof fact, at the end of November, eight provinces were affected out ofthe ten in the country. The local healthcare providers had noexperience to respond swiftly. They were overwhelmed by thehappenings and due to limited training had no clue how to deal withthe outbreak. There was no suitable plan of containing the disease. Asurvey conducted by the Haitian Ministry of Health indicated that thefacilities lacked healthcare workers. To be precise, the statisticsillustrated that only 100 doctors, 2,200 support staff, 30,000 socialworkers, and 1,000 nurses were available to contain the epidemic. Thesame groups were tasked with dealing with the resulting health crisis(Merlin, 2010).

Womenand Maternal Child Health

Accordingto UNICEF statistics, 75 percent of births in Haiti are conductedoutside the health facilities. Additionally, 15 percent of thepregnant women do not benefit from any parental care. The same bodyascertained that malnutrition rates among 5-year olds or below areconsiderably high. Furthermore, 24 percent of the cases are chronic,9 percent distinct, and 22 percent extreme (Merlin, 2010).

Choleraamong pregnant women is linked to heightened chances of abortion orstillbirth. This is because the mother is dehydrated and hence thebaby lacks sufficient oxygen, nutrients, and blood flow. Theavailable literature shows that fetal loss differs from 13.5 percentto 53 percent. Since the advent of the cholera outbreak in Haiti,there has been a rise in fetal loss among pregnant women in thecholera treatment sectors (Merlin, 2010). In most cases, the womentake long to seek medical attention. As a result, the babies die dueto dehydration.

Thoughcholera affects everyone equally, women in Haiti are the most prone.As noted by the international body, UNICEF, it excessively affectsgirls and women chiefly because of the gender stereotypes and thecultural roles (Internationaux, 2016). According to the Haitianculture, women are assigned domestic chores as well as caregiving.The responsibilities entail fetching and handling water, foodpreparation, cleaning latrines and administering care to the entirefamily. In most cases, the foods and water are contaminated henceposing a threat to the women handling them. Therefore, women bear anunequal dissection of the behaviors. Much of the cholera healthprograms target such groups.

Thecultural aspects do not spare pregnant women. They continue toperform these chores until they deliver. They are also restrainedfrom consuming foods that can cause fetus irritation and are advisedto partake red fruits and vegetables. Women in Haiti tend to avoidmodern means of care thereby do not realize its importance. Pregnancyis viewed as an ordinary act in every woman’s life. Women are alsoleft in the care of midwives during the labor period with the fatherabsent. Such beliefs leave them at a high risk of contracting thedisease (Jessie. M, 2010).

Asper the UNICEF, these heightened amounts of work for women results innegative socioeconomic, emotional, and physical facets. Choleraworsens these aspects. The intensified socioeconomic toll isexemplified by the increased periods they take working at homesinstead of the outside activities that generate income like marketvending. In most cases, the girls stay at home to assist with thechores instead of going to school. The uneven physical and emotionaltoll manifests itself because growing evidence shows that the aspectsaffect caregiving. They are tasked with caring for sick familymembers, leading to sleepless nights, increased domestic tasks likelaundering and cleaning. The activities have emotional andpsychological impacts on the women. Bestowing all these upon thewomen even at their pregnancy poses a huge threat to the infants. Themother is not emotionally or even physically stable to deliver ahealthy baby. The burden of caring for the family leaves them with notime to care for themselves [ CITATION Placeholder2 l 1033 ].

Pregnantwomen in Haiti also face numerous challenges once they lose theirspouses. Since men are the breadwinners, the women are left with botheconomic and emotional burdens. Since the United Nations does notprovide remedies to the cholera victims, pregnant women and girls whoare left behind perish in poverty. Most of the females do notcontinue with their education and are in danger of marrying at tenderages. Therefore, chances of early pregnancies are quite high. Inthat regard, cholera portends to impoverish further women underminingtheir health [ CITATION Mar131 l 1033 ].

Asdiscussed earlier, people in rural areas of Haiti have limited accessto healthcare facilities. As evidenced by the United NationsChildren’s Funds (UNICEF), roughly 60 percent of the entirepopulation, especially in the rural regions, cannot access basicmedical care. The country experiences the highest maternal deathrates than any other nation in the Western Hemisphere. Skilledpersonnel attends a mere 24.6% as compared to 59.4% in the urbanizedcenters. These statistics were severed with the cholera epidemic. Thefact that rural citizens do not access appropriate care poses asignificant threat to the pregnant women. Also, if a pregnant womancontracts the disease and is not attended to by specific persons,then the chances of survival are quite minute (Internationaux, 2016).


Thecultural aspects are detrimental to the health care system in Haiti.Most of the populace make their decisions based on the cultures.Though cholera affects most of the Haitians, women are more prone.Unlike the United States that has a well-structured healthcaresystem, Haiti’s system is weak and more dependent on foreign aid.In that regard, the country does not have a quality system to handleboth communicable and non-communicable diseases efficiently.Therefore, pregnant women in Haiti face more challenges as comparedto their counterparts in the United States.


Alfred, J. (2012). What is the real cost of universal health care in Haiti. 453-458.

Chan, M. (2013). Need for High-Quality, Affordable Primary Care. 1-4.

Internationaux, B. d. (2016). Gender Issues Facing Women and Girls. Institute for Justice &amp Democracy in Haiti.

Jessie. M, &amp. C. (2010). Cultural and Clinical Care for Haitians. 1-49.

Joel. K., &amp. P. (2012). HIV/AIDS, STIs, TB, and Haitians beliefs and practices. 1-36.

Kirmayer, L. (2010). Culture and Mental Health in Haiti. 1-25.

Malik, K. (2014). Human Development Report . United Nations Development Program.

Merlin. (2010). Is Haiti’s health system any better? London.

Rosenthal, E. (2013). News Analysis – Health Care`s Road to Ruin.

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