Health

Haiti's healthy life expectancy at birth is only 44 years [other estimates are 50 years] and the infant mortality rate is 79 per 1000 live births. The mortality rate among children under 5 is 123 per 1000 live births. Most Haitians lack clean drinking water, proper sewage systems and reliable electricity. Less than half the population has access to clean drinking water, a rate that compares poorly even with other less-developed nations. Poor sanitation and hygiene, coupled with inadequate nutrition, have contributed to a high incidence of physical challenges, ranging from congenital deformities and amputations to stroke-related paralysis and head and spinal cord injuries.

Medical facilities in Haiti are scarce and for the most part sub-standard; outside the capital standards are even lower than in Port-au-Prince. Medical care in Port-au-Prince is limited, and the level of community sanitation is extremely low. Life-threatening emergencies often require evacuation by air ambulance at the patient's expense. Doctors and hospitals often expect immediate cash payment for health services.

Deficient sanitation systems, poor nutrition, and inadequate health services have pushed Haiti to the bottom of the World Bank's rankings of health indicators. According to the United Nations World Food Program, 80 percent of Haiti's population lives below the poverty line. Consequently, malnutrition is a significant problem. Half the population can be categorized as "food insecure," and half of all Haitian children are undersized as a result of malnutrition. The World Health Organization (WHO) estimates that only 43 percent of the target population receives the recommended immunizations.

In terms of health care spending, Haiti ranks last in the western hemisphere. Economic instability has limited any growth in this area. Per capita, Haiti spends about US$83 annually on health care. There are 25 physicians and 11 nurses per 100,000 population. Only one-fourth of births are attended by a skilled health professional. Most rural areas have no access to health care, making residents susceptible to otherwise treatable diseases. In 2003, for example, the WHO confirmed an outbreak of typhoid fever in Haiti that, because of a lack of access to doctors and safe water, led to dozens of deaths.

Haiti has the highest incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) outside of Africa. Sex tourism and lack of health education led to the beginning of the epidemic in the early 1980s. Estimates vary, but the United Nations projects the national prevalence rate to be 4.5 percent of the population. Other estimates place the rate as high as 12 percent in the urban population and 5 percent in rural regions. Annually, 5,000 Haitian babies are born infected with the AIDS virus. The disease causes a fifth of all infant deaths and has orphaned 200,000 children.

There are about 60 orphanages in Port-au-Prince alone, many run by religious organizations.Many of those orphaned without physical disabilities have lost one or both of their parents to AIDS. Haiti has one of the highest rates of HIV / AIDS infection outside of Africa; an estimated 250 000 are living with the disease, according to WHO. In 2001, 30 000 Haitians died from AIDS: twice the number who succumbed to the disease in the US. The country's Global Fund-supported HIV/AIDS programs managed to serve their communities uninterrupted thanks to some pre-emptive disbursements of funds and medications ahead of the worst crisis. The fund has allocated US$66.9 million over 5 years to the programs.

Considered to be the poorest nation in the Western Hemisphere, with about 80% of its population living below the poverty line, Haiti is also stricken with a "dying" public health care system. A 2003 Red Cross study indicates there is fewer than 1 hospital bed for every 1000 patients throughout Haiti and, 209 surgical beds for the 6 million people living outside Port-au-Prince. Only about 60% of Haiti's 8 million residents have access to any form of health care services, according to the Pan American Health Organization (PAHO). Most people rely on public facilities where they must pay a minimal fee based on income and family size.