Visualizing Haiti’s new and improving health landscape

Children walk in a settlement north of Port-au-Prince, Haiti. ( AP Photo/Dieu Nalio Chery)

By Lauren Hashiguchi, special to Humanosphere

Five years after a massive earthquake devastated Port-au-Prince, the crowded capital of Haiti, killing between 160,000 and 200,000 people and displacing more than 1.5 million people to tent camps, there are signs of improvement.

Many have criticized the international community’s response to the disaster, including many Haitians who wonder where all that aid money went. The recent legal decision immunizing the UN from being held liable for the cholera outbreak has also been widely denounced.

But there have been successful efforts to repair and strengthen the infrastructure, prompting the number of displaced persons in tent camps to drop sharply. Some say Haitians are doing well to rebuild industry and there is data to support claims they are making gains to improve health.

The number of earthquake-related deaths not only dominated media attention, but also Haiti’s 2010 health data. Comparing main causes of death between 2005 (Figure 1, Global Burden of Disease data) and 2010 (Figure 2, GBD data), we can see how significant and unprecedented the number of deaths from the earthquake was, with orange representing deaths from disaster.

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Figure 1: Cause of death patterns by age in Haiti, 2005

GBDHaiti2005

Figure 2: Cause of death patterns by age in Haiti, 2010

GBDHaiti2010

However, in five years, the health landscape has shifted significantly in Haiti, according to the latest results from the Global Burden of Disease study, an ongoing project to measure the impact of disabling and deadly conditions around the globe.

These new data indicate that years of life lost to death and disability caused by the earthquake have fallen by 60% since 2010.

Furthermore, other sources state that the number of cholera-related deaths has fallen by 97% since 2011 thanks to infrastructure improvements, extensive campaigns to combat the epidemic, and fewer people living in crowded tent camps. While the effects of the earthquake and cholera persist, this public focus obscures the present health challenges faced by Haitians.

The following screen grab, taken from the Institute for Health Metrics and Evaluation’s most recent Global Burden of Disease study, shows the top ten causes of death for all countries in the Caribbean in 2013. In Haiti, the leading causes of death are HIV/AIDS, lower respiratory infections, diarrhea, stroke, and malnutrition.

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Top ten causes of death in Haiti compared to global and regional trends

GBD Caribbean

While Haiti’s neighbors are, in general, facing non-communicable diseases that affect adult populations, like heart disease, stroke, and diabetes, Haiti’s top causes of death are dominated by communicable and childhood diseases.

Notably, Haiti remains the only country in the Caribbean where HIV/AIDS is still the number-one cause of death. Conditions disproportionately affecting infants and young children (lower respiratory infection, diarrhea, protein energy malnutrition, and neonatal sepsis) are leading causes of death.

Half a decade after the earthquake, it is time to consider Haiti’s health and development with a fuller lens.

While the effects of the earthquake remain, the present challenges include the highest burden of maternal and newborn conditions, tuberculosis, and malnutrition in the region. While Haiti has experienced good progress in the past few years, the world must look past the 2010 earthquake to consider the country’s true health landscape.

lauren-200This is a guest post by Lauren Hashiguchi, MSPH, a policy translation specialist at the University of Washington’s Institute for Health Metrics and Evaluation.

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