PIH

According to UNICEF, Haiti's health system is "on the verge of collapse" with six out of 10 hospitals in the country barely operational. UNICEF emphasised that violence, mass displacement, dangerous epidemics, and increasing malnutrition have put the country's already weakened health system under great strain but it may be supply chain breaks that cause it to collapse. Getting vital supplies, health care staff, and patients to where they need to be has become logistically challenging and dangerous due to gang-violence.  It remains unclear, even after all this time, when the Kenyan-led security force will arrive - and without security, access to health care will suffer.  The full BBC article by Jaroslav Lukiv follows.  

After several days, the destructive aftermath of Hurricane Matthew is clearer.  Haitians say the heart can't feel what the eyes don't see - so look at these photos from Al Jazeera and the Miami Herald as well as aerial footage by the United Nations.  There is concern that the flooding could cause an upsurge in cholera cases.  Given the scale of destruction, Haiti's elections have been postponed and a new date has not been determined.  The humanitarian needs are real - but so too is the need to better plan for and respond to future hurricanes.  Elections are rescheduled for November 20th. 

Today marks one year since the earthquake.  There has been a great deal of commentary, dialogue, and debate over what is going well, what is not, what should be improved and how.  Much of Port au Prince is still in ruins, a cholera epidemic has yet to peak, and the most recent elections were a debacle.  The anniversary provides an opportunity for us to consider what will get Haiti out of survival mode and on the path to development.  Doing so will depend in large part upon the Haitian government, its willingness to change, and ability to lead.

Plumpynut, a peanut based paste, has revolutionalized the way in which severely malnourished children around the world are treated.  Many young lives have been saved as a result.  There is now increasing attention on how Plumpynut variants can prevent children from becoming malnourished in the first place.  In Haiti, both Meds and Food for Kids (MFK) and Partners in Health (PIH) produce products similar to Plumpynut.  In the below New York Times article, Andrew Rice describes the promise, politics, and profitability of Plumpynut.  Considering the negative impact that malnutrition has on the health and cognitive development of children in Haiti, it is well worth a read. 

The United Nations has called this the most challenging disaster response in its history.  More challenges lie ahead, one of which is the upcoming rainy season.  While it will not begin for several weeks, heavy rains are already occurring sporadically.  Recently, eight people were killed in flooding around Les Cayes.  The rains also caused a landslide that destroyed a school in Cap Haitian two weeks ago.  Those who have been displaced in Port au Prince require solutions, whether that be temporary shelter or staying with a host family.  Their protection, health, and well being depends upon finding shelter before the rains become a daily event.

Here's the good news - the first hurricane of 2009 passed on by.  The bad news is that we've got a long way to go until hurricane season is over.  The US National Oceanic and Atmospheric Administration (NOAA) predicts that there will be seven to eleven named storms in the Atlantic before the end of November, with the potential for three to six hurricanes.  As we saw last year, tropical storms can wreck havoc on both crops and infrastructure.  Humanitarian responders are gearing up. 

World TB Day was on March 24.  If this were a blog about HIV/AIDS, I could write about the progress that Haiti and the rest of the world is making.  However, this is a blog on tuberculosis and a fight we are losing.  More than two billion people, one third of the world’s total population, are infected with TB bacilli, the microbes that cause TB.  People living with HIV are at greater risk.  For Haiti, much more remains to be done.

There is a Haitian Proverb, “fanm se poto mitan.” It  means that women are the central pole of life, they support society.  Sadly, the maternal clinics in Port au Prince are not able to support the numbers of pregnant mothers seeking a safe facility to give birth in. Jacqueline Charles of the Miami Herald describes the under-resourced hospitals, their over-worked staff, and the negative impact on the health of women and children.  As Paul Farmer notes in the article, ``…If you are really serious about reducing maternal mortality, you have to stay in the game a long time.''  You can read this and other Haiti related stories on the Miami Herald website. Then take a look at the short video and photos that convey the gravity of the situation.