Health Factors and Diseases
Various factors contribute to the overall health of an individual, a community, and a population. These factors may be environmental, occupational, nutritional, or unintentional injuries. Each factors can be seen individually or assessed collectively. Environmental factors are anything outside of an individual's immediate control; occupational factors can be considered on the job factors, which could include exposures to chemicals, loud noises, and communicable diseases; nutritional factors take into consideration malnutrition - both undernourished and overnourished - diet, and vitamin intake; finally, unintentional injuries are, as the name states, any injury that occurs without intention, road injuries, poisonings, falls, fires and drownings. Many of these health risks can be cross-linked between categories, unintentional injuries can be from an occupational hazard, poor nutrition can be caused by an environmental factor, and so forth.
In this page, I will focus on the environmental and nutritional risk factors that affect the health status of a country. A study reported by Skolnik (2019) stated that 25-33 percent of the global burden of disease can be attributed to environmental factors. Skolnik defines environmental factors as "external, physical, chemical and microbiological exposures and processes that impinge upon individuals and groups and are beyond the immediate control of individuals." It also includes factors that are controllable such as sanitation, water and household air pollution. Moving on, nutrition greatly corelates with health status. Skolnik (2019) explains "nutritional status is fundamental to the growth of young children, their proper mental and physical development, and their health as adults. In addition because of the impact of nutrition on health, nutritional status is directly linked with whether or not children enroll in school, perform effectively while there, and complete their schooling."
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Environmental
Haiti is one of the countries with the highest levels of environmental degradation in the world. The lack of a healthy environment has had severe social, economic and health consequences for the Haitian population over the years. In addition, the degradation of watersheds and the high rates of deforestation leave the population particularly vulnerable to flooding.
Insufficient water and sanitation and poor water quality present major public health risks in Haiti. PAHO/WHO estimates that diarrhea accounted for 16% of under-5 deaths in Haiti before the earthquake. 50% of the rural population and 33% of the urban population do not have access to an improved water source. 84% of the rural population and 62% of the urban population do not have improved sanitation facilities. 75% of the demand for energy is satisfied by wood or charcoal. Less than 10% of the solid waste in Port-au-Prince is collected (PAHO, 2019).
"The earthquake of January 12, 2010 damaged Haiti’s already weak water and sanitation systems and created enormous challenges with thousands of people forced into temporary settlements. After the earthquake, water quality, sanitation and hospital waste management quickly became priorities due to the heavy load of medical activities and surgeries. In addition to leading the Health Cluster, PAHO/WHO also participated in the Water, Sanitation and Hygiene Cluster (WASH) to improve water quality and promote proper health care waste management" (PAHO, 2019).
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In the October of 2010, the cholera epidemic started in the country with 285,239 cases of cholera and 4,865 deaths (PAHO, 2019).
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Health Promotion
The earthquake and the cholera epidemic wounded millions of Haitians and caused great casualties. Nonetheless, despite the considerably high number of deaths, given the historical contextual factors of poverty, lack of clean water and limited health services, the coordinated response to the cholera epidemic is saving thousands of lives.
PAHO/WHO and partners have worked together to form an integrated and comprehensive approach, from creating alert and response teams in each department for improved surveillance to mobilizing thousands of community health promoters with cholera prevention messages to monitoring water quality and waste disposal in health facilities (PAHO, 2019). PAHO/WHO and partners are intensifying efforts at improving environmental health in Haiti, not only for the prevention of further cholera outbreaks, but for a healthier and more sustainable future for Haiti (PAHO, 2019).
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In addition, the American Red Cross (2014) reports "to date, the American Red Cross has reached more than 556,000 people with increased access to water and sanitation infrastructure. Together with its partners, the American Red Cross has improved access to safe drinking water for thousands of households by building more than 5,300 water points benefiting more than 246,000 people.partnered with the International Committee of the Red Cross to rebuild a prosthetics and physical rehabilitation center." Also, "to date, the American Red Cross has funded the construction of more than 3,600 sanitation facilities benefitting more than 177,000 people" (American Red Cross, 2014). Furthermore, this organization supports a network of community health officers and volunteers who promote health education, manage cases, follow up, and refer patients to appropriate healthcare. These officers and volunteers will also gather health data and survey possible outbreaks. This program will leverage the wide reach of the Haitian Red Cross volunteer network to offer health services in remote areas and extend the reach of the Ministry of Health services to the most vulnerable communities (American Red Cross, 2014).
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Below shows some of the Health achievements of American Red Cross
(American Red Cross, 2014)
Nutritional
USAID (2015) reports "Food insecurity is persistent: nearly a third of the population are food insecure, and of these, 600,000 need external food assistance to survive.4 After the earthquake, the average number of meals per person decreased from 2.48 per day to 1.58 per day.5 Poverty and food insecurity have placed the highest burden on young children and women in terms of undernutrition and micronutrient deficiencies. Nutrition outcomes are affected by health care system constraints, especially the shortages of health workers and the low retention rates and skill levels. Though there have been reductions in stunting, underweight and wasting in children under 5, one in five children remain stunted, and more than half of all children and almost half of all women of reproductive age are anemic. During pregnancy, only 30 percent of women are meeting the recommended intake for iron; lack of iron intake contributes to anemia and complications for mother and baby.6 Regional variations in chronic undernutrition are evident, with the highest rates in the Southeast (29 percent) and Center (28 percent) departments and lowest rates in the West (17 percent), Nippes (17 percent) and Metropolitan Area (15 percent) departments."
("Haiti: Nutrition Profile", 2021)
Health Promotion
(Borgen, 2015)
The USAID's (2015) report the following:
To improve nutrition and food security, the Government of Haiti launched ABA Grangou, a national strategic framework to eradicate hunger and malnutrition by 2025. The three strategic focus areas include social safety net programs to improve access to food for the most vulnerable, agricultural investment programs to increase domestic food production, and programs that deliver essential services to the most vulnerable families, including health and nutrition, improved water and sanitation infrastructure, and crop storage.
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Additionally, Feed the Future, the U.S. Government’s global hunger, and food security initiative has a multiyear strategy that emphasizes rural agriculture-led growth and income generation, taking account of Haiti’s challenging topography and microclimates. Feed the Future Partnership North and Feed the Future Partnership West, focus on the development of rural agriculture but do not have any explicit nutrition linkages.
The two nutrition-focused projects of Feed the Future are the Nutrition Security Program (NSP) and the Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project. NSP aims to improve the nutritional status of children and pregnant and lactating women in Feed the Future’s three geographic focus corridors through a 5 percent reduction of the prevalence of underweight among children under 5 years of age. The project relies on holistic community health, nutrition and livelihoods approach that works through local NGOs to develop health and nutrition care groups and engages and integrates assistance activities within the existing government health and nutrition systems. By the program’s end, expected results include improved nutrition behaviors through essential nutrition actions, improved access to and consumption of a diverse and quality diet, and increased livelihood opportunities for vulnerable households. On the other hand, the SPRING project's goal is to support pregnant and lactating women and children under 5 and to strengthen referrals made between community groups and health facilities. SPRING also works to harmonize national and donor social and behavior change communication strategy (SBCC) tools and related training in facilities on nutrition topics that fall under Essential Nutrition Actions.
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Another project that the government launched is the Food and Nutrition Technical Assistance (FANTA) III which helped meet its nutrition-related goals outlined in the Nutrition Strategic Plan. FANTA III activities included promoting the integration of nutrition assessment, counseling, and support (NACS) into HIV programs; using an advocacy tool called PROFILES to analyze costs and consequences of nutrition deficiencies and interventions; developing a social and behavior change communication strategy (SBCC) to promote improved nutrition practices among vulnerable adults and adolescents; and strengthening food security and nutrition surveillance systems to improve responses to emergencies.