Haiti has experienced many major natural disasters in the past decade that included Hurricane Matthew which led to mass damage to property, a depletion of basic resources, human fatalities and injuries, and mental health consequences that affected the poorest. The current study focused on the psychological effects of Hurricane Matthew on Haitian children and adolescents. Children display heightened depression, and PTSD symptoms in the aftermath of disasters (Hausman et al., Journal of Family Psychology 34:836-845, 2020), however, the researchers anticipated that children living in orphanages would display more severe mental health symptoms than those living with their families, because of their additional stressor of family loss. Using a convenience sample, quantitative data was collected using several instruments, in a survey format, that were individually administered to a sample of 77 adolescents. Participants had high depressive scores and reported multiple adverse events and limited access to basic needs. In comparing subgroups, we found children who were in orphanages reported significantly fewer adverse childhood experiences than those living with their families. This is likely because orphanages in Haiti consistently provide children with a safe and stable environment, buffering them against the traumatic effects of disasters. In contrast, children living with their families reported witnessing or experiencing interpersonal violence, neglect and abuse in addition to disaster-related stress. Before addressing the issues faced by disaster-affected children in Haiti, the systemic issues that maintain the socio-economic deprivation of so many citizens must be addressed. An important step is for policymakers to collaborate with mental health providers to develop community interventions that are low-cost and easily accessible. These interventions must consider and incorporate the social context and cultural patterns of help-seeking and treatment utilization in Haiti.
INTRODUCTION: Cholera remains a significant public health threat for many countries, and the severity largely varies by the population and local conditions that drive disease spread, especially in endemic areas prone to natural disasters and flooding. Epidemiological models can provide useful information to military planners for understanding disease spread within populations and the effectiveness of response options for preventing the transmission among deployed and stationed personnel. This study demonstrates the use of epidemiological modeling to understand the dynamics of cholera transmission to inform emergency planning and military preparedness in areas with highly communicable diseases. MATERIALS AND METHODS: Areas with higher probability for a potential cholera outbreak in Haiti followed by a natural disaster were identified. The hotspots were then used to seed an extended compartmental model, EpiGrid, to simulate notional spread scenarios of cholera originating in three distinct areas in Haiti. Disease parameters were derived from the 2010 cholera outbreak in Haiti, and disease spread was simulated over a 12-week period under uncontrolled and controlled spread. RESULTS: For each model location, scenarios of mitigated (intervention with 30% transmission reduction via international aid) and unmitigated (without intervention) are simulated. The results depict the geographical spread and estimate the cumulative cholera infection for each notional scenario over the course of 3 months. Disease transmission differs considerably across origin site with an outbreak originating in the department of Nippes spanning the largest geographic area and resulting in the largest number of cumulative cases after 12 weeks under unmitigated (79,518 cases) and mitigated (35,667 cases) spread scenarios. CONCLUSIONS: We modeled the notional re-emergence and spread of cholera following the August 2021 earthquake in Haiti while in the midst of the global COVID-19 pandemic. This information can help guide military and emergency response decision-making during an infectious disease outbreak and considerations for protecting military personnel in the midst of a humanitarian response. Military planners should consider the use of epidemiological models to assess the health risk posed to deployed and stationed personnel in high-risk areas.
BACKGROUND: Since climate change, pandemics and population mobility are challenging healthcare systems, an empirical and integrative research to studying and help improving the health systems resilience is needed. We present an interdisciplinary and mixed-methods research protocol, ClimHB, focusing on vulnerable localities in Bangladesh and Haiti, two countries highly sensitive to global changes. We develop a protocol studying the resilience of the healthcare system at multiple levels in the context of climate change and variability, population mobility and the Covid-19 pandemic, both from an institutional and community perspective. METHODS: The conceptual framework designed is based on a combination of Levesque’s Health Access Framework and the Foreign, Commonwealth and Development Office’s Resilience Framework to address both outputs and the processes of resilience of healthcare systems. It uses a mixed-method sequential exploratory research design combining multi-sites and longitudinal approaches. Forty clusters spread over four sites will be studied to understand the importance of context, involving more than 40 healthcare service providers and 2000 households to be surveyed. We will collect primary data through questionnaires, in-depth and semi-structured interviews, focus groups and participatory filming. We will also use secondary data on environmental events sensitive to climate change and potential health risks, healthcare providers’ functioning and organisation. Statistical analyses will include event-history analyses, development of composite indices, multilevel modelling and spatial analyses. DISCUSSION: This research will generate inter-disciplinary evidence and thus, through knowledge transfer activities, contribute to research on low and middle-income countries (LMIC) health systems and global changes and will better inform decision-makers and populations.
Purpose The purpose of this paper is to analyze the context of the emergence of a skin infection outbreak in the aftermath of Hurricane Matthew in Haiti and detail the role of community-based participatory research in mobilizing local action in a country with low state capacity. Design/methodology/approach While implementing a post-disaster study that combined a survey of 984 households and 69 community leaders with 23 focus groups, 60 ethnographic interviews and community mapping, a skin infection outbreak was detected. Using study results, the research team in partnership with different stakeholders responded to the outbreak with a health intervention. Findings The findings illustrate how pre-existing conditions shape local communities’ vulnerability to health crises in the aftermath of disasters and the critical role research can play in informing the recovery processes. Community-based approaches to emergency health reinforced by multi-stakeholder partnerships with local government can strengthen post-disaster response and governance structures setting the groundwork for the development of local resilience. Research limitations/implications The health intervention was implemented as a result of the study. Patients served were not derived from the study sample but were self-selected based on their need for skin-related medical treatment. Originality/value This article highlights the integral role research can play in identifying the health impacts of disaster events in vulnerable, hard-to-reach communities and strengthening government involvement in disaster governance.
