Elsevier

The Lancet

Volume 384, Issue 9952, 18–24 October 2014, Pages 1413-1414
The Lancet

World Report
Haiti making good progress in health but challenges remain

https://doi.org/10.1016/S0140-6736(14)61835-3Get rights and content

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Earthquake impact

A Haitian-led health-care system seemed a distant prospect after the magnitude-7 earthquake hit, killing around 160 000–200 000 people, damaging 280 000 buildings, and displacing 1·5 million people.

The health-care system was inadequate even before the disaster. But the tremor made things worse. 37 of Haiti's 48 hospitals were put out of service by the quake, including key universities and nursing schools in the capital. Rebuilding has been slow, but the infusion of foreign aid—about US$5

Cholera setback

But the health emergency did not end there. The natural disaster was rapidly followed by a man-made catastrophe: a cholera epidemic that originated in the camp of UN peacekeeping troops from Nepal. With water systems inadequate and many refugees still crammed together in unsanitary conditions, the disease spread rapidly. Haiti had not had cholera in a century, but by 2011, it was in the midst of the world's worst outbreak with 352 033 suspected cases and thousands of deaths.

Haiti's health

Health and poverty

Basic health and nutrition indices have also shown considerable improvements. A survey undertaken by the health ministry with support from the US Agency for International Development (USAID), showed that, between 2005 and 2012, the proportion of children younger than 5 years with stunting decreased from 24% to 22%, wasting decreased from 9% to 5%, and underweight children decreased from 22 to 11%.

The ministry cites progress across a range of other areas. Prenatal visits have increased from 68%

Building a health-care system

With the immediate health crisis over and donors scaling back their commitments, the priority now is to make the best use of available resources and to transfer ownership of treatment and prevention programmes from foreign aid providers to the Haitian Government.

At the end of November, there will be a high-level meeting of donors, civil society representatives, and academics to start the discussion on health financing. The UN, USAID, and other major players have already signed several

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