Haitian Health Factors and Disease
Occupational Factors Affecting Health
Haiti’s garment industry is ripe with occupational hazards, per Cahn and Clifford (2013) who research the industry for financers and per Berthold (2014), who reported on the many updates his organization facilitated through the International Labour organization. Berthold reports that as of 2011 there were no health and safety committees at any of Haiti’s garment factories. As of the 2014 report, 23 factories had such committees. (Incidentally, these factories send all of their products to the U.S.). These committees were established to remediate key safety issues in their workplace, promoting a safe work environment. Key topics include lack of protection from needlestick injuries, lack of fire safety programs (or access to fire extinguishers), and lack of adequate air conditioning for factory workers, especially in the hottest parts of the Haitian summers (Berthold, 2014).
Cahn and Clifford (2013) report additional safety concerns for these factory workers including lack of proper machine safety equipment (needle guards and eye shields). Many musculoskeletal disorders (MDS) are directly related to lack of proper ergonomics over time. As these factory workers are repetitively sewing, cleaning, repairing, and cutting they are prone to these MDS related to proper lighting, working alignment, and lack of adjustable positioning of seats, etc., while performing these repetitive activities. Cahn and Clifford also state that the spot cleaning chemicals were a source of occupational hazards as those performing those tasks with chemicals often did not have proper ventilation or utilized improper respirators. In some cases, employees were using surgical masks in place of respirators while using chemicals. In another, a fan was blowing in the face of someone working with these hazardous chemicals. These chemical exposures, without proper ventilation, can lead to acute and chronic respiratory illness (Cahn and Clifford, 2013).
Environmental Factors Affecting Health
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According to Skolnik (2016), “25-33% of the global burden of disease can be attributed to environmental risk factors” (p. 171).
Though it is surrounding by the ocean and streams run through the terrain, Haiti lacks adequate access to clean water. Skolnik states, “reasonable access” to water is defined as availability of at least 5 ¼ gallons of water a day within 0.6 mile from home (Skolnik, 2016, p. 180). That sounds like a lot of water until one begins to think of all of the ways we need water: to cook, to toilet, to bathe, to drink, to wash hands. According to World Bank (2015), only 24% of Haitians have access to a toilet. Less than 50% of rural Haitians have access to water. To promote health, sustainable water sources and/or water purification systems need to be implemented and properly maintained.
Deforestation has played a part in Haiti’s compromised water supply as lack of trees mean increased runoff and decreased soil saturation. Farmers struggle to deal with long-lasting droughts or heavy rains, accompanied by flooding (USAID, 2018). Adequate drainage and storage/treatment of water runoff could be a two-fold advantage for Haiti.
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Additionally, lack of adequate waste management, especially in urban areas, leads to infiltration of the waste into drinking water supplies, which increases incidence of diarrheal diseases, among other illnesses (USAID, 2018). Haiti desperately needs sustainable ways to manage their waste/garbage to reduce spread of disease and protect their already vulnerable water sources.
Accidents
According to Skolnik (2016), Latin America and the Caribbean have the highest death rate of unintentional injuries, likely reflecting the potential of many natural disasters. This rate reflects the death toll on Haiti related to the 2010 earthquake (Skolnik, 2016). According to the CDC (2018), Haiti’s seventh and ninth leading causes of death are unintentional injuries and transportation injuries, respectively.
Nutritional factors affecting health
Access, to food, is a huge barrier to adequate nutrition. As mentioned above, Haiti’s agricultural system can be volatile, depending on the severity of the season’s weather. Most of Haiti’s food is imported. Six out of ten persons live on less that $2 a day. More than 24% of Haitians live on less that $1 per day. This lack of income decreases even further the access to food (USAID (2017).
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Infant and child nutrition are affected by multiple factors. Less than 50 % of infants are breastfed exclusively. Less than 20% of children under two years old receive adequate nutritional supplements. Of children under 5, 65% are anemic. Forty-nine percent of women of child-bearing age are anemia. This anemia is likely a nationwide malnutrition cycle as anemic mothers are to tired, and maybe too sick, to continue the work of breastfeeding for the ideal time period, which leads to undernourished infants. Exclusive breastfeeding for the first six months has been promoted through community promotions. Malnutrition has begun to be addressed through supplements provided for children considered high risk (USAID, 2017). Sustained efforts in these two areas as well as developing and making readily available fortified foods will be essential to reverse the cycle of malnutrition and anemia (Skolnik, 2016).
Relationship between the above factors and health
It does not take a deep thinker to see how the above factors (occupational, environmental, and nutritional) all affect health. The complexity of providing for positive changes in some of these factors for Haiti in particular, is the impact of Haiti’s environment (lack of trees, period of severe drought or deluge) on its ability to grow crops, have regular access to clean drinking water, and maintain proper disposal of waste. If these basic necessities of life cannot be properly maintained, illness and malnutrition will thrive, while the people fail to do so. This lack of access to food, leads to a failure to improve the Gross Domestic Product (GDP), which continues the cycle of poverty and disease (Skolnik, 2016).
Much is being done in Haiti through international corporations and humanitarian efforts. Though a large proportion of Haitians do not have access to a toilet or running water, in regards to disease management, the most cost effective way to manage disease is to promote handwashing (Skolkni, 2016). A study conducted by Contzen and Mosler (2013) after the devastating earthquake of 2010 and the subsequent outbreak of cholera, revealed the urgency of promoting timely handwashing. This study analyzed behavior components that hindered integration of handwashing as well as which promotion activities and communication modes were most effective. In short, the study found that radio announcements and programs as well as "hygiene trainings" were the most effective modes of positively promoting handwashing at "key times" (p. 561) These key times included after contact with feces (as with toileting or caring for a child) and before food preparation. It is important to note that, even in such an impoverished country, mass media was the number one route of health promotion (Contzen and Mosler, 2013).
References
Berthold, R (2014, April 25). How Haitian workers are getting a handle on job safety. International Labour Organization Blog Work in Progress. Retrieved from https://iloblog.org/2014/04/25/how-haitian-workers-are-getting-a-handle-on-job-safety/
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Cahn, D., Clifford, R. (2013). Health, Safety and environmental issues in Haiti. Inter-American Development Bank (IDB). Retrieved from http://www.thecahngroup.com/uploads/6/4/2/1/64212261/2013-12-health-safety-environmental-issues-in-haiti.pdf
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Centers for Disease Control and Prevention. (2018, October 11). Global Health- Haiti. Retrieved from https://www.cdc.gov/globalhealth/countries/haiti/
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Contzen, N., & Mosler, H.-J. (2013). Impact of different promotional channels on handwashing behaviour in an emergency context: Haiti post-earthquake public health promotions and cholera response. Journal of Public Health (09431853), 21(6), 559–573. https://doi-org.proxy.lib.odu.edu/10.1007/s10389-013-0577-4
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Skolnik, R. (2016) Global Health 101 (3rd ed). Burlington, MA: Jones and Barlett Learning
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USAID. (2018, August 16). Haiti: Environment. Retrieved from https://www.usaid.gov/haiti/environment
USAID. (2017). Haiti: Nutrition Fact Sheet. Retrieved from https://www.usaid.gov/sites/default/files/documents/1862/FINAL_Nutrition_Fact_Sheet_March_2017.pdf
The World Bank. (2015, May 27). 5 things you need to know about water in Haiti. http://www.worldbank.org/en/news/feature/2015/05/27/five-things-you-need-to-know-about-water-in-haiti