One Year Later: The State of Health in Haiti

The massive earthquake that shook the Haitian capital of Port-au-Prince to its core on January 12, 2010, was just the beginning of a very long and challenging year for the people of the Caribbean nation.

Not only did the quake claim the lives of more than 230,000 people, it decimated many of the city’s structures, leaving more than a million homeless and living in makeshift tent cities. To make matters even worse, a cholera epidemic broke out in the fall – killing thousands more.

And while humanitarian aid has been pouring into Haiti since the earthquake hit, the country is still reeling from the effects — and will be for some time.

Jason Erb, deputy country director in Haiti for International Medical Corps, has been in the country since March 2010. He spoke with by phone from Port-au-Prince.

Q: Tell us about the state of Haiti now – one year later.

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A: “When I first arrived, the roads were still choked with rubble, and the camps were still relatively new. There was a lot of work that still needed to be done, especially with drainage. A lot of the service provisions, as far as the medical services, the child services, the food provision services were also fairly new, and the camps in many ways were very insecure.”

Q: What kind of progress have you made since then?

A: “There are fairly well-established services now. Our primary health clinics used to be in tents. Now we have permanent wood structures at some of the camp locations. We’ve moved into six buildings. There are more fixed locations where these services are being provided, and again, I think there’s a lot more stability in these tent cities. We have 13 clinics running right now in Port-au-Prince and in the surrounding areas. Through these clinics, we’ve treated more than 150,000 people over the past year.”

SLIDESHOW: International Medical Corps in Haiti.

Q: How would you describe the camps now?

A: “Some people are starting to move out. Some people, unfortunately, have been pushed out by land owners where the camps have been set up on. But again, there’s a bit of stability and that’s not necessarily a good thing. We don’t want these camps to become permanent settlements for these people. These are not healthy environments. They are better than they were, since a lot of these organizations, like International Medical Corps, have come in and provided a lot of support and saved a lot of lives by making sure people are not dying of basic illnesses. So again, it’s a better situation, but it’s just a short-term, quick solution.”

Q: What kinds of health problems are you seeing in these tent cities?

A: “It’s mostly diarrhea, malaria and pneumonia. These are the biggest illnesses we find in these camps in terms of the most serious ones as far as infectious diseases. In the primary health clinics, we’re also seeing things like the flu or an infection that someone has contracted – it kind of runs the gamut of what a primary health clinic will see. But the ones that are really serious are generally the ones like diarrhea, especially among children, malaria and pneumonia. And this is especially true during the rainy season. It’s gotten better right now because we’re in the dry season, but during the rainy season, things can get really ugly in the camps.”

Q: The cholera outbreak is very serious – what is the prognosis?

A: “Haiti, being one of the poorest countries in the Western Hemisphere and one of the poorest countries in the world – there are a lot of things that just aren’t in place in Haiti to make a response effective. 2010 was probably the worst year for Haiti. Aside from this earthquake, we’ve also seen the cholera outbreak where at this point, there have been thousands of deaths, with hundreds of thousands of people getting ill, and it’s really struck quite a blow against Haiti. It also came in the middle of the hurricane season, and while Haiti wasn’t hit that strongly, they were hit by Hurricane Tomas, and shortly after, there was an election season and we’re now in a contested election, and so that has contributed to the critical instability of the country. So, cholera has really been difficult because of all of the other problems that already exist in the country.”

Q. How is the mental health of the Haitian people?

A: “There are a lot of preexisting mental health conditions here in Haiti. The country, I think, has only two mental health facilities and the standard of quality care provided at these hospitals is really quite low, and so there are not a lot of people who are able to get professional mental health services. We’ve seen hundreds of patients and have also treated hundreds of severely mentally ill disabled individuals in the country. We have provided significant psychological support – basically psychological first aid – trying to help people cope with the highly stressful situations that they are encountering. There is a lot of stress and a lot of pressure on people here with not a lot of services to help them. This is the kind of situation that pushes people over the edge.”

Q: How are you working to make Haiti a more self-sufficient nation?

A: “Beyond this emergency work that we do, we also try to do development work by working within the Haitian medical system to strengthen the system so it can respond to this type of situation so it can meet the needs effectively, but also respond to these crises more effectively on their own, without international support. One of the ways we are doing this is by developing an emergency medical services capacity in the country, and by that we mean, emergency responders, ambulance services, emergency room capacity and responsibility within the Haitian medical community.”

Q: Are you optimistic about the future?

A: “In the longer term – yes – I am optimistic, but the country has really significant challenges. Again, the critical instability, the contested election that has just taken place and the severe underdevelopment in the country makes significant improvements difficult. It’s going to take a couple of years to recover from these events. I think improvements are always made in a very slow and gradual way – but if Haiti can survive some of these very serious disasters in the next couple of years, I think they will be back on the road to more rapid development and improvements for the people that live there.”

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