Poverty, Profit and Disease
Haiti and Health Care
By HELEN REDMOND
Genyen tout yon sosyete ki pou change.
(There is a whole society to be changed.)
— Haitian Proverb
It is no exaggeration to say the forty-five second, 7.0 earthquake
that rocked the capital of Haiti on January 12th and reduced hospitals
and clinics to rubble set the country on a trajectory back to a
medical stone age. Forty-five seconds.
The earthquake destroyed the health care infrastructure in Port-au-
Prince and shut down basic services critical for the delivery of
health care: the electrical grid, transport, water and sanitation
systems. The country didn’t have much of a health care system to
topple. Haiti lacks modern medical resources: state-of-the-art
hospitals and clinics; sufficient numbers of trained nurses, doctors
and other medical staff; medical devices, diagnostic technology and
medicines.
Haiti is a medical backwater, an island trapped in a time capsule
where disease, disability and death stalk impoverished Haitians year
after year. About 80 percent of Haitians live in poverty (on less than
a $1 day) and 54 percent live in “abject poverty.” No one should die
of tuberculosis: medicines to cure the disease have existed for half a
century. Yet in Haiti, over 5000 a year die and rates of TB infection
are increasing. HIV/AIDS is considered a chronic disease treated by a
cocktail of anti-retroviral drugs. But not in Haiti – over 7000 die
every year. AIDS is the leading of cause of death for those between
the ages of 15 to 49. TB and AIDS are the infections of inequality and
unremitting poverty.
Dozens of foreign non-governmental organizations (NGOs) have provided
medical care to Haitians for decades. Haiti has become a “medical
missionary’s mission.” Thousands of committed and compassionate nurses
and doctors travel to the island to offer medical services and then
fly back to the developed world. Paul Farmer, a physician and
anthropologist at Harvard University, has brought attention to poor
Haitians dying from curable diseases. The organization he founded,
Partners in Health, has offered basic medical services to Haitians for
20 years. In his groundbreaking book, Infections and Inequalities, The
Modern Plagues, Farmer explains how the social determinants of health
collude at every turn to debilitate and kill.
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