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Haïti

Haïti © Olivier Papegnies

Haïti

 6,445

suspected cases of cholera in Grand’Anse and Sud in 2016

31%

of women use contraception

350

mothers die for every 100,000 births

Background

An ongoing epidemic

Cholera has raged in Haiti since October 2010. Although the epidemic has been partially contained since then, it is still a major public health problem in the country. The Grand'Anse, at the south western tip of the island, is still affected by the epidemic. Strong outbreaks affect the population regularly, especially during the rainy season and particularly in the most isolated areas. If the disease is not caught within a few hours after the first symptoms appear, it can lead to rapid death. The shortage of health workers, equipment and medicines is currently limiting the ability of health centres and cholera treatment centres to take care of the victims.

 

Dangerous births

Haiti is also one of the countries with the highest maternal mortality rate in the Americas. The geographical distance of facilities is one of the main causes: it takes on average 3 hours for women to reach a health centre. The high cost of care and the influence of cultural traditions are other significant factors limiting access to healthcare. Moreover, the population, and especially adolescents, have little awareness of sexual and reproductive health issues. Finally, the quality and availability of public services and the failings of the health system do not improve the situation.

 

Dangerous abortions

Abortion is the third leading cause for consultation and of mortality in the emergency obstetric and neonatal services in Haiti. Despite the legal prohibition of abortions, many women choose to have them. Only 31% of women use contraceptive methods, even though they all claim to know of at least three, and these are all available in the healthcare facilities.

 

Post-Matthew Emergency

The force 4 hurricane Matthew struck the southwest coast of Haiti on the night of the 3rd and 4th of October 2016, destroying trees, crops, infrastructure and homes in its path, with winds reaching 230 km/hour. Whilst the greatest damage was recorded in the Sud and Grand'Anse regions, most other parts of Haiti were also hit by the cyclone. In the weeks that followed, heavy rains caused extensive flooding and landslides affecting both the town of Jérémie and Cayes.

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies

What we do

Deprived of healthcare

Combatting Cholera

Since the management of the cholera treatment centres was transferred to the Ministry of Health in 2012 in Grand'Anse, Doctors of the World continues to support health centres and works as closely as possible with communities, including those most remote. Working from Jérémie, the capital of the region, the association runs a monitoring system to trigger automatic early warnings when cases are identified. It also sends out three emergency field teams when outbreaks are reported. In collaboration with Acted, the association is also working to decontaminate the affected areas. Moreover, the teams are trying to raise public awareness of basic measures to prevent the spread of the epidemic.

 

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies

Doctors of the World is continuing its advocacy work to ensure that the public health system can deploy adequate and appropriate aid and that cholera is incorporated into the basic service package of health facilities.

 

Grand’Anse
Grand’Anse

In 2016

We have:

  • Supported 41 cholera treatment facilities in Sud and Grand’Anse

  • Supported 21 facilities during 62 outbreaks of cholera

  • Trained 331 key figures (healthcare providers, doctors, hygienists)

  • Raised awareness among 9,190 people in the community

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies

Women and children 

Support in cases of unwanted pregnancies

 

In partnership with two civil-society organizations, POZ (Promotion Objectif Zerosida) and SOFA (Solidarity of Haitian Women), Doctors of the World is working in Port-au-Prince to improve women's access to sexual and reproductive healthcare. The aim is to better inform them about their rights, to raise awareness about family planning and to inform them about the risks associated with unsafe abortions. Medical staff must also be trained to be able to handle incomplete abortions.

 

In addition, some 20 associations have been mobilized to form a collective to advocate for sexual and reproductive rights and the decriminalization of abortion in Haiti. In January 2016, the work of the Presidential Commission, responsible for the reform of the justice system in Haiti, successfully led to a formal proposal to decriminalize abortion.

 

Grand’Anse
Grand’Anse

In 2016

We have:

  • Trained 34 care providers to carry out abortions

  • Supported the intake of 136 women for post-abortion care in Port-au-Prince.

  • Trained 12 stakeholders and 89 peer educators to raise awareness about sexual and reproductive health.

  • Informed 31,883 people about their sexual and reproductive health rights.

 

 

Doctors of the World is working in Haiti to provide women with sexual and reproductive healthcare services. © Benoît Guénot
Doctors of the World is working in Haiti to provide women with sexual and reproductive healthcare services. © Benoît Guénot

Women & Children

SUpporting maternal and child health

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies
Grand’Anse
Grand’Anse

In 2016

We have:

  • Assisted the health authorities in the organisation of 22 healthcare institutions

  • Strengthened the capacity of two health divisions

Doctors of the World is working to improve access to maternal and child healthcare and family planning in the Grand'Anse, Sud and Nord-Ouest regions, in close collaboration with the Ministry of Public Health and Population, via the Health and Family Directorate. Health facilities are refurbished, equipped, supported financially, and the nursing staff are offered training and mentoring.

 

Community outreach workers are also trained to raise awareness in local communities of sexual and reproductive health issues and our teams support advocacy efforts by local associations.

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies

Victims of crises

Providing care after Matthew

All Doctors of the World teams in Sud and Grand'Anse were directly affected by the hurricane. All suffered substantial property damage, many lost their homes and personal belongings. However, thanks to their commitment to the humanitarian values of the association, everyone worked together the day after the hurricane.

In December, mobile clinics were sent out to 60 villages in Grand'Anse and 30 villages in Sud, providing approximately two visits per month. Simultaneously, Doctors of the World has deployed 13 cholera teams. These teams support the operation of cholera treatment centres and, when the situation at institutional level is normal, set up quarantined zones within the community.

 

Grand’Anse
Grand’Anse

In 2016

We have:

  • Received 11,624 people for consultations

  • Provided 308 antenatal consultations

  • Treated 546 injuries

  • Screened 1,957 children for malnutrition

 

 

 

 

Haïti © Olivier Papegnies
Haïti © Olivier Papegnies
History
1989
Start of maternal-child healthcare programme in Grand’Anse.
1994
Start of a gender-based violence programme in Port-au-Prince.
2010
Emergency intervention in Port-au-Prince; start of a program to fight cholera in Grand’Anse.
2014
Launch of a programme on unwanted pregnancies in Port-au-Prince.
2016
Launch of the TIMAMA program in 3 Haitian regions (GA, Sud and NO).
2016
Opening of a base in Cayes for the deployment of operations in the Sud region.
2016
Emergency Response to Hurricane Matthew in Grand'Anse and Sud.

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