The fragility of the health system, the inability of the most vulnerable to comply with the measures and the stigma of suspected cases weigh down the response.
The arrival of the new coronavirus in Haiti has set off all the alarms in the poorest country in the western hemisphere. The government announced the first infections on March 19 and decreed a state of emergency to combat the outbreak, but Haiti faces a triple challenge that threatens to complicate this containment.
The humanitarian coordinator of the UN mission in Haiti, Bruno Georges Lemarquis, warns that Haiti has a “fragile” medical system, with “limited capacity” that could be overcome if infections continue a geometric progression. As of Thursday, the authorities had confirmed eight cases.
Not in vain, the successive natural disasters and the growing medical needs experienced by Haiti in this last decade have worsened in the last year, with an economic, social and political crisis that has left the country practically “paralyzed”, warns Lemarquis in statements to Europa Press.
In the wake of this crisis, the prices of basic medicines have shot up 29 percent and those of hospital care 15 percent, which “has made it much more difficult for the most vulnerable women and children to access medical care” .
As of today, only 31 percent of the population has access to medical care and 2.3 million people need humanitarian-type health care, including more than a million children and more than 300,000 pregnant women, according to estimates by the ONU.
To these deficiencies are added the poor conditions of sanitation networks and hygiene systems, basic in the opinion of the World Health Organization (WHO) to face the pandemic. Lemarquis recalls that 60 percent of households do not have soap or water and two out of three do not treat the water before drinking it, with the consequent risk that it carries for the spread of diseases.
The United Nations has begun to distribute batches of hand washing for the Government to distribute in health centers and, both UN agencies and NGOs, collaborate in the dissemination of messages to raise awareness among the population of maintaining correct measures of hygiene.
WHO has also collaborated with the Haitian Ministry of Health to prepare the country for the emergency, but the United Nations does not hide its “concern” for a system that “lacks the resources and capacity to respond appropriately to this outbreak. if the cases continue increasing “, in the words of its spokesman.
Haitian President Jovenel Moise announced last week a battery of measures to contain the outbreak, from the closure of educational centers and factories to a nightly curfew in effect for the entire national territory. The Government has also recommended avoiding contact and keeping distances that seem unfeasible in certain contexts.
“Many people live in densely populated areas where it is very difficult to isolate suspected cases,” says Lemarquis, who fears that this accumulation of people and the lack of hygiene measures will end up “accelerating” the expansion of the coronavirus.
The UN humanitarian official also acknowledges that the measures can be “difficult to apply” if they “seriously affect the livelihoods and access to basic services” by the population, since “most lack savings or safety nets to turn to if they can’t get out of the house. “
Large-scale confinement would bring a halt to economic activity with “humanitarian consequences”, as was already seen in the wave of protests that Haiti experienced in September and October 2019, says Lemarquis. Then, the population had difficulties in obtaining food, medical attention and education and there was an increase in violence.
More than six million Haitians live below the poverty line – less than $ 2.41 a day – and more than 2.5 million are at extreme levels – less than $ 1.23 a day per capita -. For all of them, abiding by a quarantine would mean making their delicate situation even worse.
Haiti still has a recent cholera outbreak that lasted for nine years and was not terminated until 2019, after more than 10,000 people had lost their lives. So stigma and discrimination marked the social response to the disease.
Lemarquis sees “probable” that this time the situation will repeat itself. “There have already been several violent incidents against suspected or confirmed cases since the pandemic began,” and “these incidents are likely to increase as the number of cases also rises,” he warns.
The UN asked for $ 2 billion on Wednesday to deal with the pandemic in fifty hundred vulnerable countries, including Haiti. Humanitarian organizations had already launched on March 13 for this country a response plan estimated at $ 36 million.
Lemarquis explains that the Haitian government has established “a platform for consultation that brings together technical and financial partners, as well as civil society, to guarantee coherence and coordination” in the face of the emergency. The spokesperson insists that, in the case of Haiti, the response to the pandemic cannot be just medical.