Haiti: Difference between revisions

Port-au-Prince is the largest city in Haiti and the second largest in the Caribbean. The country struggles with having the reputation as the poorest country in Western hemisphere and its turmoils have been compounded by disastrous earthquakes and hurricanes in recent years. This has left the country in need of international aid and a devastating lack of resources. This has obviously had a dramatic effect on sexual, reproductive and women's health care needs throughout the country. Though Port-au-Prince has more civil resources available than many of the countries more rural areas, there is still undoubtedly a lot of improvement to be made in these areas. Some of the issues include the lack of availability of contraception, overpriced feminine hygiene products, lack of proper medical facilities,  unaffordable and outdated hospitals, a high rate of HIV infection and an alarming rate of sexual abuse against women<ref>[https://en.wikipedia.org/wiki/Sexual_violence_in_Haiti Sexual Violence in Haiti]</ref>. Additionally, abortion is completely illegal and there is little help from government organizations to curb the STI infection rate and lack of education on family planning. Historically, women's rights are not a high priority for the Haitian government. As of 2016, not a single woman holds a seat in the senate of Haiti.<ref>[http://www.miamiherald.com/news/nation-world/world/americas/haiti/article55358850.html No women in new Haitian parliament]</ref>

===Laws & Social Stigmas=== <!--T:5-->

 

Despite the fact that Haiti has a long history with oral contraceptives<ref>[http://ethique-tic.fr/2013/wp-content/uploads/1/2013/02/JunodMarks-pill02.pdf Women’s Trials: The Approval of the First Oral Contraceptive Pill in the United States and Great Britain]</ref>, the country has a staggeringly low rate of 37.8% of women between the ages of 15 and 49 report using any kind of contraception at all. This is the lowest rate of any Caribbean country. An overwhelming majority of women that do use birth control opt for the contraceptive injection.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> There have been multiple campaigns with mixed results to raise awareness for the use of contraceptives. Many women are raised in a conservative Christian families and don't want to admit that they are having premarital sex, so discussions about birth control are not likely to be widely discussed by most Haitians, especially amongst the youth. <ref>[http://pulitzercenter.org/reporting/family-planning-delicate-subject-haiti Family Planning is a Delicate Subject in Haiti]</ref>

===What to Get & Where to Get It=== <!--T:6-->

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* According to the International Planned Parenthood Federation, there are over 20 types of '''hormonal contraceptive pills (birth control pills)''' available. Most that are available are phasic and combined oral pills, but there is also a wide variety of hormonal implants available. There is only one hormonal IUD available by the name of "Mirena." The contraceptive ring (Nuva Ring) does not seem to available for purchase in Haiti.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=HT IPFF - Haiti]</ref>

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KORE, loosely translated, means "I've got your back" in Haitian Creole, is a brand of condom that became available in Haiti in 2013. The company aimed to provide a widely available and much more affordable condom for the people of Haiti. <ref>[http://edition.cnn.com/2013/05/29/health/haiti-condom-donation Haiti Condom Donation]</ref> A pack of 3 brand name condoms usually costs somewhere between 200-300 gourde.

==Emergency Contraception (Morning After Pill)== <!--T:9-->

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===Laws & Social Stigmas=== <!--T:11-->

The morning after pill is rarely available over the counter in Port-au-Prince. If it can be found, it is likely imported and will contain instructions in a foreign language which may render the product useless.<ref>[http://www.nytimes.com/2012/12/09/opinion/sunday/haitis-silenced-victims.html Haiti's Silenced Victims]</ref> If you are in need of emergency contraception in Haiti, you have the option of taking larger doses of regular hormonal birth control instead of the morning after pill.<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref>

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The following is a list of available oral Contraceptives used for emergency contraception (Progestin Only)<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref>

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==Sexually Transmitted Infections (STIs/STDs)== <!--T:16-->

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===Laws & Social Stigmas=== <!--T:18-->

Haiti has a 1.8 percent prevalence rate of HIV/AIDS, among the highest percentage-wise in the Caribbean region (behind the Bahamas, and Belize). However, it has the most overall cases of HIV/AIDS in the Caribbean region with an estimated 120,000 HIV/AIDS-positive Haitians.<ref>[https://en.wikipedia.org/wiki/HIV/AIDS_in_Haiti HIV/AIDS in Haiti]</ref> One of the best ways to avoid contracting HIV and other STIs is to regularly using condoms. Contact the International Planned Parenthood Federation to inquire about making an appointment for an STI test if you are sexually active. Getting tested regularly is recommended to avoid unknowingly spreading disease further as well as diagnose anything you may have contracted so it can be cured or treated before irreversible damage is potentially done to your body.

===What to Get & Where to Get It=== <!--T:19-->

====Testing Facilities==== <!--T:20-->

====Support==== <!--T:21-->

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==Medications & Vaccines== <!--T:23-->

===Laws & Social Stigmas=== <!--T:24-->

===What to Get & Where to Get It=== <!--T:25-->

"Fluconazole" is the name of the active ingredient in yeast infection medication. Make sure this is listed under active ingredients to ensure that you are buying an effective medication. PReP is not available to buy in Haiti.<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref> As far as HPV vaccinations go, Haiti has a "Pilot Program", which means it is available but not readily accessible to everyone. [https://www.facebook.com/search/110097772353183/places-in/134381433294944/places/intersect/ Click here] to be redirected to a list of 11 pharmacies in Port-au-Prince and their Facebook pages.<br>[http://hiccayeshaiti.e-monsite.com/ Hôpital Immaculée Conception] has a steady supply of antiretroviral HIV medication.<ref>[https://blog.usaid.gov/2016/05/delivering-life-saving-hivaids-drugs-around-the-world/ Delivering Life-Saving HIV/AIDS Drugs Around the World]</ref>

===Costs=== <!--T:26-->

In 2004, initial antiretroviral therapy (ART) in Haiti cost approximately $US 1,000 per patient per year.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/18275615 The cost of antiretroviral therapy in Haiti]</ref>

==Menstruation== <!--T:27-->

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===Laws & Social Stigmas=== <!--T:29-->

The women of Haiti have little access to education on feminine hygiene and menstruation. In one poll, nearly 25% of women surveyed did not know why they had their period. Given the income of the women ranged from an estimated $1 – $3/day, disposable sanitary pads are often too expensive. Therefore, more than 80% of the women regularly used folded cloth sheets or old T-shirts to absorb menstrual blood. The women with no access to sanitary pads are often forced them to modify daily activities such as going to school or work.<ref>[http://ganm.nursing.jhu.edu/partnership-not-aid-how-the-women-of-haiti-are-claiming-a-new-future-3/ PARTNERSHIP, NOT AID – HOW THE WOMEN OF HAITI ARE CLAIMING A NEW FUTURE]</ref>

===What to Get & Where to Get It=== <!--T:30-->

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===Costs=== <!--T:34-->

==Gynecological Exams== <!--T:35-->

===Laws & Social Stigmas=== <!--T:36-->

===What to Get & Where to Get It=== <!--T:37-->

* Dr. Serge Guichard<br>

* Marco Percque<br>

* Ronald Fouche<br>Phone: 2245-6301/ 2244-2970/ 2968<br>Email: Email: rfouche@obgyn.net<br>Address: 42, Chemin des Dalles, entre rues<br>

Medicale, P-au-P<ref>[http://photos.state.gov/libraries/haiti/231771/PDFs/LOCAL%20ENGLISH%20SPEAKING%20PHYSICIANS%20_August%202011_.pdf LOCAL ENGLISH SPEAKING PHYSICIANS - American Embassy]</ref><br>

 

===Costs=== <!--T:38-->

==Pregnancy== <!--T:39-->

===Laws & Social Stigmas=== <!--T:40-->

All women in Haiti are legally entitled to 6 weeks of maternity leave with 100% of their average pay to be compensated by their employer.<ref>[https://en.wikipedia.org/wiki/Parental_leave Parental Leave]</ref> <ref>[http://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_242615.pdf Maternity and paternity at work]</ref> However, the reality of the situation can be much different and many women find that they are not in a position to receive this aid. <ref>[http://www.nbcnews.com/id/29706995/ns/health-pregnancy/t/giving-birth-fraught-danger-haiti/#.WLVr_BJ94y4 Giving Birth is Fraught with Danger in Haiti]</ref> In Haiti, there are only 201 nurse-midwives for a population of 10 million. NGO Midwives for Haiti are trying to fill this gap with much needed help to improve mother and child survival. As of 2013, For every 100,000 babies born in Haiti, 630 women die of pregnancy-related causes.<ref>[http://www.miamiherald.com/news/nation-world/world/americas/haiti/article1957834.html Women in Haiti embracing birth control despite taboos]</ref>

===What to Get & Where to Get It=== <!--T:41-->

* An option available for women in need of medical care regarding their pregnancy is provided by the organization [http://www.msf.org/en/where-we-work/haiti Médecins Sans Frontières]has at least one location in Port-au-Prince that offers prenatal care for women with pressing health complications regarding their pregnancy. Unfortunately, their facilities are often overwhelmed with too many patients seeking aid and only have room for very few of them. However, these facilities do their best not to reject any woman in labor, regardless of their health status.<ref>[https://www.ft.com/content/4ecb945a-1e97-3369-9117-8fb3c2b61908 Improving Maternity Care in Haiti]</ref><br>

* Pran Men’m - Located in the Delmas 33 neighbourhood of Port-au-Prince, MSF’s 148-bed Centre de Référence des Urgences en Obstétrique (CRUO) <ref>[http://www.msf.org/en/where-we-work/haiti Medecins San Frontieres - Haiti]</ref><br>

* Many women, if they can afford it, choose to fly to Jimani in the Dominican Republic to give birth where healthcare is more widely accessible.<ref>[http://cronkite.asu.edu/buffett/dr/giving_birth_full.html</ref>

* [https://www.facebook.com/UNFPAHaiti/ UNFPA]: Address: LOCAL MINUSTAH, Log Base - Zone 5, Boulevard Toussaint Louverture and Clercine 18, Port-au-Prince, Haiti, Email address: Office@unfpahaiti.org, Work timetable: Monday - Thursday 7:30 AM - 4:30 PM, Friday 7:30 AM - 1:30 PM<br> Telephones: 509 2815-6000, 509 2813-0415.

 

==Abortion== <!--T:43-->

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===Laws & Social Stigmas=== <!--T:45-->

Haiti has some of the strictest laws regarding abortion in the world. There are no grounds in which abortions are legally permitted.<ref>[https://www.guttmacher.org/sites/default/files/factsheet/ib_aww-latin-america.pdf Latin America Fact Sheet]</ref> with the rare exception that it be necessary to save the mother's life, but even that is not guaranteed by law. Women often turn to highly unsafe and illegal underground abortion options. In large part, this is also due to the fact the contraception itself is not widely accepted, available or properly used. <ref>[http://www.theoaklandpress.com/general-news/20131128/women-in-haiti-embracing-birth-control-despite-taboos Women in Haiti Embracing Birth Control Despite Taboos]</ref> Despite the fact that it is illegal, abortion is common in Haiti. <ref>[http://www.truth-out.org/opinion/item/20644-a-look-at-abortion-in-haiti A Look at Abortion in Haiti]</ref> The number of post-abortion deaths in Haiti is unknown, but physicians say post-abortion complications are a leading cause of maternal death, with the health ministry estimating it could possibly account for as many as 30 percent of them. <ref>[http://www.theoaklandpress.com/general-news/20131128/women-in-haiti-embracing-birth-control-despite-taboos Women in Haiti Embracing Birth Control Despite Taboos]</ref>

===What to Get & Where to Get It=== <!--T:46-->

It is considered extremely dangerous by almost all health professionals to seek an unlicensed abortion illegally. The most affordable and safest alternative to this is to travel to the Dominican Republic or other neighboring nations and get the procedure done there. Additionally, you may be able to order the "abortion pill" by mail. Check out [https://www.womenonweb.org/en/i-need-an-abortion this link] for details

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==Advocacy & Counseling== <!--T:48-->

===Laws & Social Stigmas=== <!--T:49-->

Rape and all other sexual assault goes largely unreported throughout Haiti due to the fact that many victims are subject to victim blaming by their communities. Many women also don't report such incidents due to fear of potential reprisals from their attackers. Haiti has a long history of of enforcing minor penalties for those convicted of rape and sexual assault, but this trend has been slowly changing since new legislation was passed in 2005. The new law now holds the attackers more accountable for their crime as well as guaranteeing free health coverage for sexual assault victims. The legal procedure for reporting a sexual assault to police is convoluted and difficult, further diminishing the number of reports made. Critics of Haitian police have called their response to reported rapes inadequate. <ref>[https://en.wikipedia.org/wiki/Sexual_violence_in_Haiti Sexual Violence in Haiti]</ref>

===What to Get & Where to Get It=== <!--T:50-->

The Pran Men’m clinic (Creole for “Take My Hand”) is a facility offering the emergency medical assistance required during the 72 hours following an assault, along with longer-term medical care and psychological support. They are open 24 hours a day, 7 days a week. <ref>[http://edition.cnn.com/2016/12/08/world/cnnphotos-sexual-assault-haiti/ Sexual Assault in Haiti]</ref>

===Costs=== <!--T:51-->

==List of Additional Resources== <!--T:52-->

[http://http://www.hpvcentre.net/statistics/reports/HTI_FS.pdf Haiti HPV Vaccine Status]<br>

[http://iwhp.sogc.org/index.php?page=171 International Women's Health Program (Haiti)]

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