EDUCATION
The video to the right is a mini documentary about the education system of Haiti. Education Challenges in Haiti, produced by CGTN America (2017), reports that only 50% of Haitian children attend school. Of the 50%, 60% attend private or church schools. Only 15% of Haitians attended high school: after 6th grade, the child must past a test before they are allowed to proceed with further schooling. According to this report, only 21% are able to pass this test which will allow them to 7th grade and beyond.
This video interviewed three headmasters at each of the three types of schools (public, private (for fee), and humanitarian (where the staff and teachers essentially worked for free)). The headmaster of the public school pointed out the problem of teaching children when all of the textbooks are written in French, while the common spoken language of Haiti is Creole. A headmaster of the private school stated that his school should be run by the government, but "there is no money in education," this seems to be the logical reason why the government has yet to fulfill its constitutional promise of offering education to all. He states that, of his graduating students, none will pursue a career in education. Though he and his fellow teachers believe that, "Education really is the redemption of [Haiti]" his students see the reality that education is not valued at the government level.
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According to UNICEF’s last compiled statistics as of 2013, the adult literacy rate for Haiti is 48.7 %. According to UNICEF’s definition of what fits the criteria for “adult literacy rate”, the literacy rate is the “percentage of persons at 15 and older who can read and write.” That is a concerningly low number. Confusing the matter is the fact that the national language is French, but a large proportion of the population speak only Creole. I am curious if this number takes that fact into consideration. Regardless, if French is the national language, then all signage, policies and procedures, education materials, literature, and voting materials will be provided in French, a language in which over 50% of the country cannot communicate effectively!
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hEALTH SYSTEM
Education Challenges in Haiti. https://youtu.be/mbJu4FTdZLs
ECONOMY
Per the Central Intelligence Agency’s World Factbook (2018), Haiti’s GDP as of 2011 was 2.0%. 7.6% of GDP was spent on healthcare (as of 2014). This number of dollars spent on healthcare has dropped over the past three years. According to USAID’s Health Fact Sheet from March 2017, Haiti only spends 6% of its income on healthcare (2017). Compare this number to the United State's healthcare expenditure of 17.9% (Skolnik, 2016). This percentage paid has to be a significant dollar amount in difference as the US is a "first world" country and Haiti is the poorest country in the western hemisphere (CIA, 2018).
Well over one half (60%) of Haitians live below the poverty line (CIA, 2018). According to The World Bank, 24% live on less than $1.23 a day. Additionally, over 7 million people in Haiti do not have electricity. Of the over 4200 kilometers of roadway in Haiti, 3500 of it is unpaved (CIA, 2018).
Aslan, et. al.,'s research on the links between poverty and health, affirm the idea that the current generation living with disease, DALYS, without access to proper and timely care, will have "health consequences [that] reverberate for generations" (Aslan, et. al., 2012). Those will ill health are not able to work, incur debt related to healthcare, and, often, their children miss school related to necessary care of parents and household duties (Skolnik, 2016).
Even though Haiti’s debts were erased after the earthquake and subsequent hurricane Matthew, the country has since accrued 2.7 billion in national debt, as of the end of last year (CIA, 2017).
Haiti's health system infrastructure is flailing to recover from the 7.0 earthquake of 2010, then, in relatively short succession, Hurricane Matthew in 2018, followed by a horrific cholera epidemic in the face of a country with economic struggles to begin with.
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According to a publication release in 2011 by Merlin, an international relief organization, the earthquake of 2010 destroyed political buildings (and undoubtedly key players) as well as schools of nurses (with nursing students inside) and a large portion of healthcare facilities. This report focuses on the national and international disaster response to the 7.0 earthquake in 2010, but also sheds light on the underlying structure of Haiti’s health system.
The Ministry of Health is the governing organization that coordinates how funds are distributed for public health needs. A large portion of healthcare is contracted to INGO and NGO companies. State workers are under payed and often seek work within these organizations for this reason. Inability to keep indigenous workers and lack of coordination of health care services leave Haitians lacking for adequate healthcare (Merlin, 2011). That may be the reason WorldMapper states that Haiti has the lowest amount of nurses for the greatest amount of people! (WorldMapper, 2018).
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access and barriers to health care
The cities are where the healthcare centers are located. This is the norm for low income countries tasked with finding ways to provide the most care to the most people. The rural areas are lacking greatly in access to healthcare. Often the rural clinics are too far for a pregnant woman to walk to for checkups or delivery. Often, if they are able to get to a rural clinic, the "office hours" may not coincide with the patient's arrival, or may not be staffed at all (Skolnik, 2016).
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While the video below (UNICEF, 2016) does not fully address the barriers Haitians have to healthcare, it does depict the stall in progression of normal life from the one-two punch the earthquake and hurricane Matthew had on society, on children.
References
Alsan, M. M., Westerhaus, M., Herce, M., Nakashima, K., & Farmer, P. E. (2011). Poverty, Global Health and Infectious Disease: Lessons from Haiti and Rwanda. Infectious Disease Clinics of North America, 25(3), 611–622. http://doi.org/10.1016/j.idc.2011.05.004
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Central Intelligence Agency (CIA). (2018). The World Factbook: Haiti. Last Retrieved 28 September 2018. https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html
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CGTN America (2017). Education Challenges in Haiti. https://youtu.be/mbJu4FTdZLs
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CH Global. Haiti Education. 2 October 2014. YouTube. https://www.bing.com/videos/search?q=Haiti+Education&&view=detail&mid=7C827C43BEC4BE04A9567C827C43BEC4BE04A956&&FORM=VRDGAR
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Merlin (2011). Is Haiti’s health system any better? A report calling for a more coordinated, collaborative approach to disaster response. 10 January 2011. http://www.who.int/workforcealliance/knowledge/merlinhaiti_2011report.pdf
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Skolnik, R. (2016). Global Health 101 (3rd). Burlington, MA: Jones and Bartlett Learning.
Top RN to BSN. 30 top countries in need of nurses. (2018) https://www.toprntobsn.com/countries-most-in-need-of-nurses/
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UNICEF Haiti at a glance. Last updated 27 December 2013. https://www.unicef.org/infobycountry/haiti_statistics.html
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UNICEF (2016). Hope in Haiti after hurricane Matthew. https://www.youtube.com/watch?v=1xxxVwZtUfY
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USAID.Health Fact sheet: Haiti. March 2017. https://www.usaid.gov/sites/default/files/documents/1862/FINAL_Health_March_2017.pdf
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The World Bank (2018). The World Bank in Haiti: Overview. Last updated 21 September 2018. https://www.worldbank.org/en/country/haiti/overview
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WorldMapper.com. Last retrieved 28 September 2018. https://worldmapper.org/?s=health
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