Dominican Republic and Haiti: Country Studies

Haiti: The Society and Its Environment
and acute respiratory illness
(25 percent). In this age-group,
the mortality rate of children born to women with no education
is three times that of children born to women who have
completed secondary school. Smaller family size and wider
spacing between children correlate with lower child mortality
rates.
Acute respiratory infections and diarrheal diseases are the
most common illnesses treated at primary health care clinics.
Other serious diseases are bronchopneumonia, malaria, syphilis,
tetanus, typhoid, tuberculosis, parasitic diseases, meningococcemia,
measles, and xerophthalmia. In addition to
malnutrition, poor sanitation is a key contributor to poor
health indicators. Investment in this area has not kept pace
with urban growth. Access to safe water declined in the mid-
1990s, going from 60 percent in 1985 to less than 30 percent of
urban residents and 25 percent of rural residents. In 1984 less
than 20 percent of the population had toilets or latrines. In the
1980s and 1990s, violence has been a major public health problem,
especially political violence.
The earliest cases of Kaposi's sarcoma in Haiti, later identified
as AIDS (acquired immune deficiency syndrome), were
diagnosed in Port-au-Prince in 1979 and the early 1980s. In
response, Haitian physicians and scientists formed the Haitian
Study Group on Kaposi's Sarcoma and Opportunistic Infections
in 1982. Review of the evidence suggests that the virus was
then new to Haiti, and that the emergent Haitian epidemic was
closely related to an earlier North American epidemic of AIDS.
In its early stages, the Haitian epidemic affected men more
than women, and tended to be correlated with prostitution and
contact with non-Haitians or returned Haitians.
The total number of confirmed cases of AIDS in Haiti is
unknown at present because there has been no systematic
reporting of AIDS diagnosis since 1992. Human immunodeficiency
virus (HIV) studies were carried out in rural and urban
zones in 1986 and 1992. Some monitoring of Red Cross blood
transfusion centers has occurred. The Centers for Disease Control
(CDC) studied the incidence of HIV among Haitian refugees
at Guantanamo in 1992. In the absence of systematic study
of the broader population of Haiti, the best data on the incidence
of HIV and AIDS stem from studies of pregnant women.
Such data have been used as the basis for broader population
projections.
357