Haiti

THE REPUBLIC OF HAITI occupies the western third of the island of Hispaniola, while the Dominican Republic covers the remaining area. Haiti has a long history of repression and political violence that began in the late 15th century. In the early 17th century, the sugar and forestry industries flourished through the work of African slaves. Haitian slaves eventually revolted against the French who had taken over the island from the Spanish. In 1804, Haiti became the first black republic to declare its independence.

However, independence did not put an end to the political instability. Authoritarian regimes, corruption, and drug trafficking have all taken a heavy toll on Haiti, and the infrastructure and social systems are virtually unworkable. In addition to government mismanagement and political strife, the weather plays a major role in Haiti's economic problems. The country is subject to hurricanes, earthquakes, and periodic droughts.

Haiti is the poorest country in the western hemisphere, with an abject poverty level of 80 percent. Within the Americas, Haiti has the worst record of health indicators and the highest infant and maternal mortality rates. Nearly half of the population suffers from malnutrition. Some 60 percent of all rural households suffer from chronic food insecurity. Approximately two-thirds of the population has no formal jobs, even though there is a shortage of skilled labor. Underemployment is also common. Approximately 66 percent of the labor force are involved in subsistence agriculture.

The World Health Organization estimates that Haiti's health services reach from 40 to 60 percent of the population, leaving the rest to their own resources. General health is further threatened by the fact that over half of Haiti's population lacks access to safe water and proper sanitation. There are only 25 physicians for every 100,000 residents and affordable essential drugs are available to less than half the people. Haitians have a total expected life span of 52.92 years. The median age is 18.03 years. Nearly 43 percent of the population are under the age of 14, and 3.4 percent [Page 458]have reached the age of 65. With an HIV/AIDS prevalence rate of 5.02 percent, Haiti has the highest incidence of this disease in the Americas. According to 2003 estimates, there are 280,000 people living with the disease, which has caused 24,000 deaths.

Infant mortality in Haiti is high at 73.45 deaths per 1,000 live births. Female infants are much hardier, with a mortality rate of 66.79 per 1,000 as compared to 79.92 deaths per 1,000 for males. There has been a marked improvement in infant mortality since 1970, when 140 infants died out of every 1,000 live births. However, between 1996 and 2000, infant mortality increased from 73.8 to 80.3 deaths per 100,000 live births in response to increasing poverty, poor access to health-care, and the rising HIV/AIDS epidemic. The mortality rate for children under the age of 5 dropped dramatically from 221 to 123 deaths per 1,000 between 1970 and 2002 but continues to be high for the same reasons that infant mortality is excessive in Haiti.

A major component for reducing childhood mortality in Haiti is continuing to cut down on the number of children who are malnourished and increasing childhood immunization rates. Between 1980 and 2000, the number of children under the age of 5 who were malnourished was more than halved, from 37 to 17 percent. Even so, four percent of all children under 5 years of age are severely underweight, and 28 percent of all babies are underweight at birth. Some 23 percent of under-5s suffer from moderate to severe stunting, and five percent experience moderate to severe wasting. Haiti's rate of childhood immunizations continues to be abysmal. While 71 percent of infants are immunized against tuberculosis, only 53 percent receive measles immunizations, and 43 percent receive DPT and polio immunizations. Among children between the ages of 12 and 23 months, only 53 percent have been immunized against measles and 43 percent have received immunization against DPT3.

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