April 2, 2019
NPHW 2019: Violence Prevention
On our first day in Les Cayes we met Ti Pasteur, an inspiring community health educator on our Cholera Response Team who has been working for Doctors of the World in Haiti for over two decades.
“One of the hardest things about our work is when parents lose their child to cholera and we have to explain to them that their child’s body has to be taken and decontaminated before it is buried,” said Ti Pasteur with a grim look on his face. Ti Pasteur has witnessed first hand the tragedies Haitians have faced since the 2010 earthquake hit, but his lively and energetic community health workshops aide entire communities in their efforts to combat cholera and learn about water sanitization procedures. The 2010 earthquake that struck Haiti killed around 220,000 people and destroyed vital infrastructure such as roads, sewage systems and hospitals. While the country was plunged into mourning for those killed, a deadly cholera epidemic erupted and quickly swept across the country.
The epidemic killed almost 10,000 people and overwhelmed the public health system. Among the general population, there was little understanding of how the disease was contracted which further exacerbated its spread. Although health workers such as Ti Pasteur worked tirelessly to combat the outbreak, cholera remains a constant risk for Haitians. The risk is especially high during and after hurricanes, such as Hurricane Matthew in 2016 (during which cholera cases spiked) and Hurricane Irma which is expected to causes intense rainfall and storm surges across the northern coast of the country.
(Left, Josephina, a grandmother and cholera survivor)
After a bumpy 6 hour drive through coastal towns and bustling markets, we spent the second half of our trip meeting with team members in Port-au-Prince. In addition to our work on cholera, we also provide a variety of health and medical services across Haiti such as emergency response during natural disasters, primary healthcare, and access to sexual and reproductive care. While our work in rural towns such as Les Cayes and Jérémie tends to focus on educational workshops, our work in Port-au-Prince is centered on strengthening sexual and reproductive health (SRH). In Port-au-Prince we met Guy Weber, the Medical Coordinator for our program in Haiti.
“For a population living in extreme poverty, sexual education is just not a priority”, he explained. “Many adolescents in Haiti have little understanding of how their bodies function and become sexually active very early on – leading to unwanted pregnancies, which are seen as shameful,” he continued. In Haiti, if a girl becomes pregnant while in high school, she will be asked to leave and cease her studies – greatly reducing her future ability to find a job and provide for her family. Our team in Haiti have also witnessed some especially painful incidents where victims of sexual violence were forced to marry their aggressor to avoid the perceived “shame” of rape.
In Port-au-Prince, Doctors of the World is currently active in strengthening the provision of SRH and post abortion care for women in need alongside partner organizations like SOFA (link), a Haitian organization working to promote women’s reproductive rights. To reinforce the Ministry of Health’s capacity we supply health workers to the maternity sections of hospitals and donate medical equipment and medication. We have also supported the deployment of 83 community educators who in the past 1 and a half years have spoken to 30,000 women on issues such as unwanted pregnancies, maternal mortality, and abortions.
The Haitian public health system remains chronically under funded (only 5% of the national budget goes towards the Ministry of Health), yet despite the daily challenges that many of our team members face in order to care for Haitians in need, they remain optimistic that progress is being made to increase access to life-saving healthcare.