Friday, July 24, 2020

MFP, Civil rights, and the killing of George Floyd: A video.

Medicine For Peace's statement on the death of George Floyd in light of the organization's long commitment to civil rights.

Friday, July 10, 2020

Pandemic Notes from a Rural Haitian Hospital(1)

Alma Mater Hospital in Gros Morne, Haiti

Since March 19th, when the first case of COVID-19 was reported in Haiti, the Haitian Ministry of Public Health and Population has attributed a total of 6,371 confirmed cases and 113 deaths to the virus infection. These statistics are flawed because Haiti’s two virus testing sites are overwhelmed, and they are in sharp contrast to the troubling data from neighboring Dominican Republic (reporting 38,432 cases and 821 deaths). At this point in the pandemic, it seems clear that the government has grossly underestimated incidence and mortality rates and have minimized the terrible risk that this virus poses to its vulnerable population.


Initially, the Haitian government’s response was swift and effective. They closed down the country in March, and social distancing, mask wearing, and frequent hand washing was common – particularly in Port-au-Prince. However, as the pandemic continues, preventive measures have waned in the cities and are near nonexistent in the countryside.


In Gros Morne, a mountain town of 34,000 residents and the health center for the northern Artibinite region (164,000 people), hardly any precautions are being taken. The realities of poverty and the need to eke out a living to put a daily meal on the table impose overcrowding and the need for close personal interactions. As such, there is a great deal of “fever” in town, but few will admit to COVID-19 symptoms because of the stigma. Only a handful of very ill patients have come to the Alma Mater Hospital. Still, the virus takes its toll: there were thirteen funerals on Saturday and five on Sunday, far more than usual.


The Haitian government plans to allow churches to hold services starting next week and will open schools again in August. With no countrywide COVID-19 response plan and limited access to testing kits, we are bracing for an onslaught. Meanwhile, our public health workers are attempting to destigmatize the disease, educate the public on its symptoms, promote mask wearing, and encourage sick patients to come to the hospital.


Brittany Galvin, RN NP

Michael Viola, MD

Friday, May 8, 2020

COVID-19 and Hunger in Haiti



Haitians are well aware of the COVID-19 pandemic. Following the report of Haiti's first two cases on March 19, President Jovenal Moises closed Haitian airports and seaports, and locked the border with the Dominican Republic. As of May 6, there has only been a total of 79 cases and 12 deaths reported in Haiti. These numbers are incredibly low compared to reporting from Haiti's neighbor, the Dominican Republic, where there have been 8,807 cases and 362 deaths. However, only approximately 1,000 Haitians have been tested and, undoubtedly, there are many undetected cases. Still, the dreaded COVID-19 apocalypse has not appeared yet. This has raised questions of a natural or acquired immunity among Haiti's population or, more likely, suggests that the country shut down quickly (it was already in lockdown from recent surges in violence) and effectively kept coronavirus-infected foreigners outside its borders. 


The Haitian response to the pandemic has been mixed. In the capital, Port-au-Prince, a large number of people wear masks, some stores demand that masks be worn to enter, and many stores offer disinfectant gel to be used before transactions. Nevertheless, local industrial parks like the Karakol Industrial Park have returned to work in shifts. Thousands of employees are crowded together while entering and leaving the plants, despite President Moises' assurance that workers would be able to adhere to effective social distancing measures.


In the countryside where MFP works, few wear masks and most do not adhere to social distancing guidelines in the crowded markets. The major issue that occupies rural Haitians is not the COVID-19 pandemic... it’s food. Brittany Galvin, a nurse in Gros Morne, summarized the situation: “As the cost of goods has increased and the value of the goude has dropped, the average Haitian does not have enough money to put rice on the table.”


The relevant statistics are quite grim. 6 million Haitians (out of a total population of 11 million) live below the poverty line. More than 2.6 million Haitians live with food insecurity -- a million of whom have no food. There is food in the markets but, as Ms. Galvin stated, prices have risen sharply and have surpassed what most Haitians can afford. The major reasons for this dire situation include: 


·      Government corruption and incompetence. Haiti has been in a deepening recession for more than a year. The value of Haitian goude continues to spiral downward and its buying power dropped by 20% since last year.


·      Civil disruption and violence, including road blockades, have impeded the distribution of food to the countryside.


·      Heavy reliance on imported food, including 80% of rice, its staple grain. Imported food is less available and prices are inflated. The price of rice has doubled since last year. Shamefully, the destruction of the local agricultural sector by foreign aid intervention is a devastating but integral part of Haiti's history of foreign food dependency. 


·      Schools have been closed since the first of the year and will not reopen until next fall. As such, children are being denied access to the one constant source of a nutritious meal each day: the school feeding program.


·     Remittances from Haitians living abroad (approximately 3 billion dollars) is the major source of money for the average Haitian. Many in the Haitian diaspora are now unemployed. 


We believe that the critical solution to many of these societal problems is Government reform. The Haitian Government must be committed to avoiding famine in the countryside. In the meantime, foreign aid should be targeted on feeding the most vulnerable Haitians. Finally, the United States, contrary to its present stance, must support Haitian politicians who are committed to transparency and who are willing to purge the corruption that has been so prevalent in the past two administrations.