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Sample records for haiti

  1. Drug Trafficking in Haiti

    National Research Council Canada - National Science Library

    Burns, DeEtta

    2002-01-01

    .... The thesis argues that Haiti's geographic location, political culture, illegal immigrants, entrepreneurial class and weak institutions have made it a major transshipment point for drugs to the United...

  2. Haiti DevResults

    Data.gov (United States)

    US Agency for International Development — DevResults is a web-based portfolio management system that tracks program data for the Haiti Mission that was awarded in April of 2013. (The Mozambique and/or...

  3. IDRC in Haiti

    International Development Research Centre (IDRC) Digital Library (Canada)

    residents how to grow food in small spaces. They have reaped many benefits: improved diets and health, greater concern for the environment, reduced spending on food, increased self-esteem, and stronger neighbourhood bonds. IDRC. IDRC in Haiti. INTERNATIONAL DEVELOPMENT RESEARCH CENTRE. G. A. IN. U.

  4. Fundraising for Haiti

    CERN Multimedia

    2010-01-01

    YOU ARE WONDERFUL, THANK YOU! 58 750 CHF collected for Haiti! Following the appeal launched on 15 February, the CERN Management and Staff Association would like to express their heartfelt gratitude and thank the whole of the CERN community for its generosity towards the victims of the Haiti earthquake. This is a record, an unprecedented show of solidarity at CERN, equal to the immense needs following this catastrophe. Thank you on behalf of the Haitians, they will most certainly need it in the coming months.   The donations will be shared out among various institutions and associations in both Host States, in accordance with the established practice in the event of a catastrophe hitting a non-Member State. The size and activities of each of them have been taken into account. After studying the various requests for aid, the beneficiaries are now known and will receive:     - IFRC - International Federation of Red Cross   and Red&...

  5. Thanks from Haiti

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Cessy, 7 September 2010 Subject: Thanks for the evening of solidarity in favour of the victims of the Haiti earthquake organised by the CERN Fitness Club. The "HAÏTI-ECOLES" Association wishes to thank everyone who took part in the event. The donation of 2080 CHF paid onto the Association's account will be transferred in its entirety to our partners in Haiti who are in charge of running the Verrettes and La Chapelle schools. They are responsible for meeting the needs of families affected by the earthquake: buying food, helping to pay the rent on small houses, payment of school fees when school starts again in September. The number of children enrolled in the schools has risen from 2300 to 2500 following the huge influx of families who fled Port au Prince in the aftermath of the earthquake. The Association's principal role is helping with the schooling of disadvantaged children in Verrettes and La Chapelle and keeping the school canteens running to make sure that the children ...

  6. Congenital rubella syndrome in Haiti

    Directory of Open Access Journals (Sweden)

    Golden Nancy

    2002-01-01

    Full Text Available Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS in Haiti, a country without a national rubella immunization program. Methods. During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered.

  7. Congenital rubella syndrome in Haiti

    Directory of Open Access Journals (Sweden)

    Nancy Golden

    2002-10-01

    Full Text Available Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS in Haiti, a country without a national rubella immunization program. Methods. During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered.

  8. Fund Raising for Haiti

    CERN Multimedia

    Association du personnel

    2010-01-01

    Dear Colleagues, Following the devastating earthquake that hit Haiti on 12 January 2010, the CERN Management and the Staff Association are organizing a collection to help the victims. The money collected will be transferred to associations or bodies guaranteeing proper use of the funds, such as the Association Haïti Ecoles based in Cessy, which our Long Term Collections supported for several years. From today you can pay your donations into a special UBS account, indicating “Séisme Haïti” as the reason for payment . SWIFT : UBSWCHZH12B IBAN : CH85 0027 9279 HU10 6832 1 Account Holder : Association du personnel du CERN We are counting on the generosity of the CERN community to support the Haitian people at this very difficult time. Thank you on their behalf. Rolf Heuer Director-General Gianni Deroma President of the Staff Association

  9. Ending Haiti's Crime Wave | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2012-04-17

    Apr 17, 2012 ... ... leaders and the western donors that the situation will deteriorate further still. ... the January 2010 earthquake killed an estimated 158,000, poll after poll ... aggressive demands for employment from Haiti`s traumatized youth.

  10. Seismic hazard maps for Haiti

    Science.gov (United States)

    Frankel, Arthur; Harmsen, Stephen; Mueller, Charles; Calais, Eric; Haase, Jennifer

    2011-01-01

    We have produced probabilistic seismic hazard maps of Haiti for peak ground acceleration and response spectral accelerations that include the hazard from the major crustal faults, subduction zones, and background earthquakes. The hazard from the Enriquillo-Plantain Garden, Septentrional, and Matheux-Neiba fault zones was estimated using fault slip rates determined from GPS measurements. The hazard from the subduction zones along the northern and southeastern coasts of Hispaniola was calculated from slip rates derived from GPS data and the overall plate motion. Hazard maps were made for a firm-rock site condition and for a grid of shallow shear-wave velocities estimated from topographic slope. The maps show substantial hazard throughout Haiti, with the highest hazard in Haiti along the Enriquillo-Plantain Garden and Septentrional fault zones. The Matheux-Neiba Fault exhibits high hazard in the maps for 2% probability of exceedance in 50 years, although its slip rate is poorly constrained.

  11. Haiti ja saatan / Mihhail Lotman

    Index Scriptorium Estoniae

    Lotman, Mihhail, 1952-

    2010-01-01

    Haiti maavärinas on süüdistatud nii USA-d kui ka üleloomulikke jõude. Vastuseks Abdul Turay artiklile "Kustutage haitilaste võlg!" ütleb autor, et päästetööd Haitil takerduvad mitte valitsuse rahapuudusesse, vaid olematusse infrastruktuuri

  12. Haiti. Educating factory workers.

    Science.gov (United States)

    Hughes, H

    1990-04-01

    There are approximately 50,000 workers employed in the light assembly industry in Haiti. About 70% are women, the majority of whom are aged between 25 and 34 years, and are either single or in a nonpermanent relationship with the father of their children. Many live and work in appalling conditions, surviving on very low wages to support several children and an extended family. The acquired immunodeficiency syndrome (AIDS) is now a visible problem in many factories. In October 1988, the Center for the Promotion of Women Workers (Centre de Promotion des Femmes Ouvriers/CPFO) launched a pilot AIDS education program for factory women. The Center, based in a large industrial zone near the airport, runs a health clinic and courses in literacy, communications skills, health promotion and family planning. The new AIDS program allowed CPFO staff to gain entry into factories for the 1st time. Other courses were held outside working hours and outside factory premises. Staff contacted manages by telephone to arrange a meeting to discuss AIDS and to ask permission to hold educational "round tables" with workers. Of 18 managers in the factories approached over a 12-month period, only 2 refused entry to CPFO staff. Almost all managers reported they had registered between 2 and 5 deaths from AIDS among their employees over the past couple of years. A total of 85 educational sessions, each lasting about 2 hours, were held within 28 different factories, community or labor organizations reaching 3063 workers (male and female). In each session, the presentation was carried out by 2 CPFO trained monitors and included a slide show, flip charts, and the video "Met ko," originally produced for Haitian immigrants in New York. The most important aspect of the program was the training of 38 volunteer factory-based health promoters. These promoters attended the round table sessions, where they facilitated discussion and distributed condoms and were subsequently available for counseling co

  13. The Case for Commitment to Haiti

    Science.gov (United States)

    2010-04-14

    1900-1934. Lexington: University Press of Kentucky, 1983. Madiou, Thomas. Histoire d’Haiti. Port-au-Prince, Impr.J. Verrollot, 1904. Maguire...Madiou Histoire d’Haiti for early Haitian history and Amy Wilentz The Rainy Season for 1970-2005 history. A-5 Appendix B Problem Framing The first

  14. Congenital rubella syndrome in Haiti (Short communication).

    Science.gov (United States)

    Golden, Nancy; Kempker, Russell; Khator, Parul; Summerlee, Robert; Fournier, Arthur

    2002-10-01

    To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered.

  15. Special Report: Haiti. Hope for the Future

    Science.gov (United States)

    2007-06-01

    visitors. Haiti offers beautiful white beaches, an exotic culture, outstanding artists and musicians, and French cuisine . According to recent press...divided between a small, well-educated, affluent, French -speaking elite and a large, uneducated, Creole-speaking, impoverished peasant population...indigo, and hides made Haiti the richest French colony in the New World. Haitian society was composed of thirty thousand Europe- ans, an equal number

  16. Haiti, insecurity, and the politics of asylum.

    Science.gov (United States)

    James, Erica Caple

    2011-09-01

    In this article, I seek to show how states of insecurity provoked by ongoing social, economic, and political ruptures in Haiti can disorder individual subjectivity and generate the flight of individuals seeking asylum within and across borders. Nongovernmental actors working in Haiti and with Haitians in the diaspora frequently managed the long-term psychosocial effects of insecurity. Their interventions can range from repressive to compassionate and influence the formation of identity and the embodied experiences of trauma for vulnerable Haitians. The case of a young Haitian refugee who was repatriated to Haiti from the United States in the 1990s demonstrates how insecurity is both an existential state reflecting the disordering of embodied experience, as well as a collective sociopolitical condition the effects of which cannot be managed or contained within national borders. The case is emblematic of the plight of thousands of Haitians affected by the January 12, 2010, earthquake.

  17. Overview of the 2010 Haiti earthquake

    Science.gov (United States)

    DesRoches, Reginald; Comerio, Mary; Eberhard, Marc; Mooney, Walter; Rix, Glenn R.

    2011-01-01

    The 12 January 2010 Mw 7.0 earthquake in the Republic of Haiti caused an estimated 300,000 deaths, displaced more than a million people, and damaged nearly half of all structures in the epicentral area. We provide an overview of the historical, seismological, geotechnical, structural, lifeline-related, and socioeconomic factors that contributed to the catastrophe. We also describe some of the many challenges that must be overcome to enable Haiti to recover from this event. Detailed analyses of these issues are presented in other papers in this volume.

  18. An Editor's Journey: Return to Haiti

    Science.gov (United States)

    Moy, Yvette

    2012-01-01

    This paper recounts the author's story as she returned to Haiti in February to join a building project near Port-Au-Prince and to document efforts by U.S. higher education institutions to help the country rebound from the devastating 2010 earthquake. The author describes how consortiums have been formed in order to support the development of the…

  19. Koolera paneb Haiti valmiduse proovile / Hendrik Vosman

    Index Scriptorium Estoniae

    Vosman, Hendrik

    2010-01-01

    Haitis puhkenud koolerapuhang on nõudnud juba 253 inimelu, nakatunute arv ületab 3100 piiri, bakter võib sealsete ebahügieeniliste olude tõttu kaasa tuua teise humanitaarkatastroofi pärast 12. jaanuari maavärinat. Kaart

  20. Nursing and nursing education in Haiti.

    Science.gov (United States)

    Garfield, Richard M; Berryman, Elizabeth

    2012-01-01

    Haiti has long had the largest proportion of people living in poverty and the highest mortality level of any country in the Americas. On January 12, 2010, the most powerful earthquake to hit Haiti in 200 years struck. Before the earthquake, half of all Haitians lacked any access to modern medical care services. Health care professionals in Haiti number around one-fourth of the world average and about one-tenth the ratio present in North America. The establishment of new primary care services in a country where half of the people had no access to modern health care prior to the earthquake requires advanced practice roles for nurses and midwives. With a high burden of infectious, parasitic, and nutritional conditions, Haiti especially needs mid-level community health workers and nurses who can train and supervise them for public health programs. As in many other developing countries, organized nursing lacks many of the management and planning skills needed to move its agenda forward. The public schools prepare 3-year diploma graduates. These programs have upgraded the curriculum little in decades and have mainly trained for hospital service. Primary care, public health program management, and patient education had often not been stressed. Specializations in midwifery and HIV care exist, while only informal programs of specialization exist in administration, surgery, and pediatrics. An advanced practice role, nonetheless, is not yet well established. Nursing has much to contribute to the recovery of Haiti and the revitalization if its health system. Professional nurses are needed in clinics and hospitals throughout the country to care for patients, including thousands in need of rehabilitation and mental health services. Haitian nursing colleagues in North America have key roles in strengthening their profession. Ways of supporting our Haitian colleagues are detailed. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Development Assistance in Haiti: Where Has the Money Gone?

    Science.gov (United States)

    2014-12-01

    importance of collaboration in humanitarian logistics when receiving aid, specifically comparing the responses in Haiti and Chile when each suffered an...Humanitarian Logistics: Comparative Analysis of Disaster Response in Chile and Haiti 2010,” (master’s thesis, Naval Postgraduate School, 2010), 51–53. 29...economic influence to control those that are elected. Haiti also has a small middle class consisting primarily of immigrants , which has had a

  2. The cost of antiretroviral therapy in Haiti

    Directory of Open Access Journals (Sweden)

    Fitzgerald Daniel W

    2008-02-01

    Full Text Available Abstract Background We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART to patients with AIDS in Haiti. Methods We examined data from 218 treatment-naïve adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers.

  3. The Geology of Haiti: An Annotated Bibliography of Haiti’s Geology, Geography and Earth Science

    Science.gov (United States)

    2010-07-01

    nannoplankton; Neogene; North Africa ; paleobathymetry; paleosalinity; plankton; Plantae; Pliocene; Protista; shallow-water environment; Southern Europe...Descriptors: Goat farm management; Goat industry/Haiti; Veterinarians; Biological & Agricultural. Notes: Illustration. ISSN: 0003- 1488. Vila, J...eastern border, which is formed partly by the Pedernales River in the south and the Massacre River in the north . The Dominican Republic is Haiti’s only

  4. Positioned for impact: Haiti's first baccalaureate nursing program.

    Science.gov (United States)

    Burger, Jeanne M

    2011-01-01

    Haiti's first baccalaureate nursing programn the Faculty of Nursing Science of the Episcopal University of Haiti (FSIL), educates professional nurses as clinicians, leaders, and change agents, preparing graduates to a global standard set by the World Health Organization. FSIL was founded on Christian principles, expressing a vision of nursing as a ministry of Jesus Christ. Near the epicenter of the 2010 Haiti earthquake, the remarkable response of FSIL students and faculty saved lives, gave hope to a community in need, and demonstrated the impact of well-educated nurses on the health of a nation.

  5. Uncovering the 2010 Haiti earthquake death toll

    Science.gov (United States)

    Daniell, J. E.; Khazai, B.; Wenzel, F.

    2013-05-01

    Casualties are estimated for the 12 January 2010 earthquake in Haiti using various reports calibrated by observed building damage states from satellite imagery and reconnaissance reports on the ground. By investigating various damage reports, casualty estimates and burial figures, for a one year period from 12 January 2010 until 12 January 2011, there is also strong evidence that the official government figures of 316 000 total dead and missing, reported to have been caused by the earthquake, are significantly overestimated. The authors have examined damage and casualties report to arrive at their estimation that the median death toll is less than half of this value (±137 000). The authors show through a study of historical earthquake death tolls, that overestimates of earthquake death tolls occur in many cases, and is not unique to Haiti. As death toll is one of the key elements for determining the amount of aid and reconstruction funds that will be mobilized, scientific means to estimate death tolls should be applied. Studies of international aid in recent natural disasters reveal that large distributions of aid which do not match the respective needs may cause oversupply of help, aggravate corruption and social disruption rather than reduce them, and lead to distrust within the donor community.

  6. Reconstruction of Haiti : Research Capacity Building in Latin ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Colegio de México, A.C. (El). Institution Country. Mexico. Institution Website ... for a research agenda in Haiti : prepared for the International Development and Research ... Linking research to urban planning at the ICLEI World Congress 2018.

  7. Consolidation of Research Centres on Reconstruction in Haiti ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... and process evidence on the impact of their military and civil cooperation efforts. ... and Mexico have begun studying Haiti's social, economic and political problems, ... IDRC “unpacks women's empowerment” at McGill University Conference.

  8. Land tenure and the adoption of agricultural technology in Haiti:

    OpenAIRE

    Smucker, Glenn R.; White, T. Anderson; Bannister, Michael

    2000-01-01

    There has long been an active debate in Haiti - as in many other developing countries - over whether or not the customary tenure system constrains technology adoption and agricultural development, and whether cadaster and land titling should be national priorities. This paper contributes to this debate by reviewing and interpreting the body of literature and new empirical evidence concerning the relationship between land tenure and the adoption of technology in rural Haiti. The findings sugge...

  9. Republic of Haiti - Towards Greater Fiscal Sustainability and Equity : A Discussion of Public Finance

    OpenAIRE

    World Bank

    2015-01-01

    Haiti has a vision to become an emerging economy by 2030. Haiti has comparative advantages, including its proximity and access to major markets; a young labor force and a dynamic diaspora; and substantial geographic, historical, and cultural assets. Areas of economic opportunity for Haiti include agribusiness, light manufacturing, and tourism. Recognizing these opportunities, the Governmen...

  10. 76 FR 29000 - Extension and Redesignation of Haiti for Temporary Protected Status

    Science.gov (United States)

    2011-05-19

    ...), 80 percent of Haiti's population is living below the poverty line. Per capita gross domestic product... approximately 1,300 internally displaced persons (IDPs) camps in Haiti. Although statistical reports vary, the... of the vulnerability of the public health sector of Haiti. Although statistical reports have varied...

  11. Effects of the 2010 Haiti Earthquake on Women's Reproductive Health.

    Science.gov (United States)

    Behrman, Julia Andrea; Weitzman, Abigail

    2016-03-01

    This article explores the effects of the 2010 Haiti earthquake on women's reproductive health, using geocoded data from the 2005 and 2012 Haiti Demographic and Health Surveys. We use geographic variation in the destructiveness of the earthquake to conduct a difference-in-difference analysis. Results indicate that heightened earthquake intensity reduced use of injectables-the most widely used modern contraceptive method in Haiti-and increased current pregnancy and current unwanted pregnancy. Analysis of impact pathways suggests that severe earthquake intensity significantly increased women's unmet need for family planning and reduced their access to condoms. The earthquake also affected other factors that influence reproductive health, including women's ability to negotiate condom use in their partnerships. Our findings highlight how disruptions to health care services following a natural disaster can have negative consequences for women's reproductive health. © 2016 The Population Council, Inc.

  12. Hydro-Quebec line crew returns home from Haiti

    Energy Technology Data Exchange (ETDEWEB)

    Horne, D.

    2005-04-01

    This article recounted the experience of a 14-member Hydro-Quebec line crew and support group that travelled to Haiti in November 2004 to help re-establish essential electricity services. The work was conducted together with Electricite d'Haiti (EDH). The team installed 400 poles, 10 km of conductors and 85 transformers, restoring service to water pumps; La Providence and Raboteau hospitals; a centre housing Doctors without borders; a CARE distribution centre; and several convents and schools. The installation of street lights at strategic points allowed lighting to be restored in several districts of Gonaives. Hydro-Quebec was able to extend their mission to Haiti and purchase more poles and transformers with the help of a $500,000 contribution from the Canadian International Development Agency. Hydro-Quebec was the only company who came to the aid of EDH. The total budget for the project was $4 million. 2 figs.

  13. Cholera in Haiti: Reproductive numbers and vaccination coverage estimates

    Science.gov (United States)

    Mukandavire, Zindoga; Smith, David L.; Morris, J. Glenn, Jr.

    2013-01-01

    Cholera reappeared in Haiti in October, 2010 after decades of absence. Cases were first detected in Artibonite region and in the ensuing months the disease spread to every department in the country. The rate of increase in the number of cases at the start of epidemics provides valuable information about the basic reproductive number (). Quantitative analysis of such data gives useful information for planning and evaluating disease control interventions, including vaccination. Using a mathematical model, we fitted data on the cumulative number of reported hospitalized cholera cases in Haiti. varied by department, ranging from 1.06 to 2.63. At a national level, 46% vaccination coverage would result in an () cholera vaccines in endemic and non-endemic regions, our results suggest that moderate cholera vaccine coverage would be an important element of disease control in Haiti.

  14. Disaster mobile health technology: lessons from Haiti.

    Science.gov (United States)

    Callaway, David W; Peabody, Christopher R; Hoffman, Ari; Cote, Elizabeth; Moulton, Seth; Baez, Amado Alejandro; Nathanson, Larry

    2012-04-01

    Mobile health (mHealth) technology can play a critical role in improving disaster victim tracking, triage, patient care, facility management, and theater-wide decision-making. To date, no disaster mHealth application provides responders with adequate capabilities to function in an austere environment. The Operational Medicine Institute (OMI) conducted a qualitative trial of a modified version of the off-the-shelf application iChart at the Fond Parisien Disaster Rescue Camp during the large-scale response to the January 12, 2010 earthquake in Haiti. The iChart mHealth system created a patient log of 617 unique entries used by on-the-ground medical providers and field hospital administrators to facilitate provider triage, improve provider handoffs, and track vulnerable populations such as unaccompanied minors, pregnant women, traumatic orthopedic injuries and specified infectious diseases. The trial demonstrated that even a non-disaster specific application with significant programmatic limitations was an improvement over existing patient tracking and facility management systems. A unified electronic medical record and patient tracking system would add significant value to first responder capabilities in the disaster response setting.

  15. Vulnerability and livelihoods before and after the Haiti earthquake

    OpenAIRE

    Echevin, Damien

    2011-01-01

    This paper examines the dynamics of poverty and vulnerability in Haiti using various data sets. As living conditions survey data are not comparable in this country, we first propose to use the three rounds of the Demographic Health Survey (DHS) available before the earthquake. Decomposing household assets changes into age and cohort effects, we use repeated cross-section data to identify a...

  16. Research Consortium for the Development of Agriculture in Haiti ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Even before it was hit by a devastating earthquake in January 2010, Haiti's children suffered some of the worst rates of undernutrition in Latin America and the Caribbean. According to UNICEF, in 2005, one out of every three children under five was stunted or chronically undernourished. Since the earthquake, agriculture ...

  17. U.S. Haiti Policy: An Evolving Comprehensive, Multilateral Approach

    Science.gov (United States)

    2011-03-24

    disaster; a cholera -stricken capital region; and an unresolved NOV 10 national election. Haiti can start anew, building on the current ravages. Former...have sustained limited military engagements to respond to threats emanating in Venezuela, Mexico , and throughout the Americas as drug cartels and

  18. Supporting future university educators in Haiti – Phase 2 | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Supporting future university educators in Haiti – Phase 2 ... ISTEAH recently created five research centres and IDRC will support master's ... and entrepreneurship will support students in building their careers. ... The 2017 World Conference of Science Journalists was an opportunity for the awardees to develop their skills ...

  19. Increasing immunization, reducing child mortality in Haiti | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-02

    May 2, 2016 ... A contributing factor is Haiti's extremely low rates of immunization—some of the lowest in ... of factors increased coverage, including greater parental awareness, ... Impact on health policy and practice. ... Canadian initiative leading the way for equitable health systems and improved maternal, child health.

  20. Vicious cycle of poverty and environmental degradation: Haiti

    DEFF Research Database (Denmark)

    Conde, Dalia Amor; Christensen, Norman

    2008-01-01

    Haiti is the poorest country in the Western Hemisphere and one of the most environmentally degraded. Over 60% of its income comes as aid from the USA and other countries, and 65% of its people survive on less than $1 a day. Almost all of the country was originally forested but now there is less t...

  1. International cooperation Brazil-Cuba-Haiti: the role of community radios in strengthening social mobilization in the public health context in Haiti.

    Science.gov (United States)

    Gomes, Renata Machado Dos Santos; Oliveira, Valdir de Castro

    2015-01-01

    The present article investigates the role of Haitian community radios in strengthening social mobilization, with the aim of supporting the actions undertaken in the field of public health in Haiti, based on the development of the Workshop for community radios, as part of the Tripartite Cooperation Brazil-Cuba-Haiti. The qualitative methodology is justified because of the study content, an analysis of documents and direct observation, through a case study presented at the Workshop held in the department of Hinches, in Haiti. This meeting was held in the context of the Working Group on Tripartite Communication, under the responsibility of the Health Channel/Fiocruz, in partnership with the Department for Health Promotion and Environmental Prevention of the Ministry of Health and Population of Haiti (DPSPE/MSPP/Haiti), with a proposal to better structure a network of multipliers in health promotion.

  2. Stories from Haiti: a comparison of three approaches.

    Science.gov (United States)

    Baumann, Steven L; Bellefleur, Carmelle

    2014-04-01

    Two stories from Haiti are considered from three different perspectives. The first story is about a boy named Joseph Alvyns, whose mother died from cholera in 2011. His story is told in a short film titled Baseball in the time of Cholera. The second story is about Mme. Yolande Marie Nazaire, who was the Director of the Haiti National School of Nursing in Port-au-Prince on the morning of January 12, 2010, when an earthquake killed 90 students and faculty. The three perspectives discussed here are: (a) Critical Reflective in health professional education as used by the University of California at San Francisco (UCSF) School of Medicine; (b) The Capacities of Stories, which is part of a socio-narratology methodology; and(c) Story Theory with implications for global health nursing.

  3. Assessment of Risk of Cholera in Haiti following Hurricane Matthew.

    Science.gov (United States)

    Khan, Rakib; Anwar, Rifat; Akanda, Shafqat; McDonald, Michael D; Huq, Anwar; Jutla, Antarpreet; Colwell, Rita

    2017-09-01

    Damage to the inferior and fragile water and sanitation infrastructure of Haiti after Hurricane Matthew has created an urgent public health emergency in terms of likelihood of cholera occurring in the human population. Using satellite-derived data on precipitation, gridded air temperature, and hurricane path and with information on water and sanitation (WASH) infrastructure, we tracked changing environmental conditions conducive for growth of pathogenic vibrios. Based on these data, we predicted and validated the likelihood of cholera cases occurring past hurricane. The risk of cholera in the southwestern part of Haiti remained relatively high since November 2016 to the present. Findings of this study provide a contemporary process for monitoring ground conditions that can guide public health intervention to control cholera in human population by providing access to vaccines, safe WASH facilities. Assuming current social and behavioral patterns remain constant, it is recommended that WASH infrastructure should be improved and considered a priority especially before 2017 rainy season.

  4. Personal review and justice analysis of nursing experiences in Haiti.

    Science.gov (United States)

    Emmott, Helen

    2008-08-01

    Health care providers frequently struggle to develop wise applications of theoretical knowledge. As a nurse studying traditional approaches in ethics while simultaneously volunteering in Haiti, I wrestled with the notion of justice in the midst of radical material inequities. Paul Farmer, physician and anthropologist, provides an analytic perspective for health care providers who work in poor and underserved countries by expanding the liberation theology of the 1970s to include social applications. Analyzing my past experiences in Haiti using Farmer's methodology provided insight into my successes and failures and prompted me to search for personal and professional reasons to provide care for the poor in the future. This type of reflection is essential for health care providers who work with the underserved, regardless of their religion or the country in which they work.

  5. The tragedy of Haiti: A reason for major cultural change.

    Science.gov (United States)

    Brown, Geraldine

    2010-01-01

    With the recent earthquake in Haiti, it is most befitting to discuss my travel to this poor country more than a decade ago. The travel was a mission that examined the health status and the education of residents in the capital city of Port- au-Prince. After close observation, it seems that the health and educational status then, today and since the tragedy, is basically the same with less, if any, possible improvement. This article examines the present state of health and education of the Haitian people, in the wake of its recent tragedy. Although, the people were very poor in economics, they were rich in culture and exhibited polite mannerisms that made me feel overly welcomed in their homes and to the few resources they had to offer It appears that in past years, this country was and still is noted as the poorest country in the Americas, however, it is not the poorest country in the Western Hemisphere. On many occasions, it has been publicly and widely reported that Haiti experienced political violence throughout its history. The government of Haiti is known for corruption. It also appears that an earthquake the magnitude of 7.0 would not have easily destroyed so many of its infrastructure and people, if in the past, the surrounding countries, including the United States, would have assisted in providing this country with safer and stronger foundations for buildings and especially shelter for the residents and the many visitors who were the true victims. Despite the repressive regime, Haiti's location, history and culture were very attractive to tourists in the 1960s and 1970s. Visitors returned home with memorable artifacts that included cave paintings, wood statues (figurines) and hand made jewelry.

  6. Availability, prices and affordability of essential medicines in Haiti.

    Science.gov (United States)

    Chahal, Harinder Singh; St Fort, Nazaire; Bero, Lisa

    2013-12-01

    Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. We conducted a cross-sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days' wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days' wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days' wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most medication regimens are largely unaffordable

  7. On the probability of extinction of the Haiti cholera epidemic

    Science.gov (United States)

    Bertuzzo, Enrico; Finger, Flavio; Mari, Lorenzo; Gatto, Marino; Rinaldo, Andrea

    2014-05-01

    Nearly 3 years after its appearance in Haiti, cholera has already exacted more than 8,200 deaths and 670,000 reported cases and it is feared to become endemic. However, no clear evidence of a stable environmental reservoir of pathogenic Vibrio cholerae, the infective agent of the disease, has emerged so far, suggesting that the transmission cycle of the disease is being maintained by bacteria freshly shed by infected individuals. Thus in principle cholera could possibly be eradicated from Haiti. Here, we develop a framework for the estimation of the probability of extinction of the epidemic based on current epidemiological dynamics and health-care practice. Cholera spreading is modelled by an individual-based spatially-explicit stochastic model that accounts for the dynamics of susceptible, infected and recovered individuals hosted in different local communities connected through hydrologic and human mobility networks. Our results indicate that the probability that the epidemic goes extinct before the end of 2016 is of the order of 1%. This low probability of extinction highlights the need for more targeted and effective interventions to possibly stop cholera in Haiti.

  8. Commodity Tracker: Mobile Application for Food Security Monitoring in Haiti

    Science.gov (United States)

    Chiu, M. T.; Huang, X.; Baird, J.; Gourley, J. R.; Morelli, R.; de Lanerolle, T. R.; Haiti Food Security Monitoring Mobile App Team

    2011-12-01

    Megan Chiu, Jason Baird, Xu Huang, Trishan de Lanerolle, Ralph Morelli, Jonathan Gourley Trinity College, Computer Science Department and Environmental Science Program, 300 Summit Street, Hartford, CT 06106 megan.chiu@trincoll.edu, Jason.baird@trincoll.edu, xu.huang@trincoll.edu, trishan.delanerolle@trincoll.edu, ralph.morelli@trincoll.edu, jonathan.gourley@trincoll.edu Price data for Haiti commodities such as rice and potatoes have been traditionally recorded by hand on paper forms for many years. The information is then entered onto computer manually, thus making the process a long and arduous one. With the development of the Haiti Commodity Tracker mobile app, we are able to make this commodity price data recording process more efficient. Officials may use this information for making inferences about the difference in commodity prices and for food distribution during critical time after natural disasters. This information can also be utilized by governments and aid agencies on their food assistance programs. Agronomists record the item prices from several sample sites in a marketplace and compare those results from other markets across the region. Due to limited connectivity in rural areas, data is first saved to the phone's database and then retransmitted to a central server via SMS messaging. The mobile app is currently being field tested by an international NGO providing agricultural aid and support in rural Haiti.

  9. Cross-sectional serological survey of human fascioliasis in haiti.

    Science.gov (United States)

    Agnamey, P; Fortes-Lopes, E; Raccurt, C P; Boncy, J; Totet, A

    2012-01-01

    Fasciola hepatica, the aetiological agent of fascioliasis in the Caribbean region, occurs throughout the major islands of the Greater Antilles and in localised zones on two islands (Martinique and Saint Lucia) of the Lesser Antilles. However, apart from Puerto Rico, information regarding human fascioliasis in islands of the Caribbean is out of date or unavailable, or even nonexistent as in Haiti. The authors conducted a retrospective, cross-sectional serological survey in Port-au-Prince using a Western blotting test (LDBIO Diagnostics) on human fascioliasis in Haiti. A total of 216 serum samples obtained from apparently healthy adults were tested. The frequency of antibodies in serum samples of the study population was 6.5% (14/216). The immunodominant bands recognised in Western blots were 27-28 kDa (100%), 42 kDa (64%), 60 kDa, and 8-9 kDa (28%). This is the first survey to reveal a relatively low proportion of asymptomatic F. hepatica-infected humans in Haiti.

  10. Cross-Sectional Serological Survey of Human Fascioliasis in Haiti

    Directory of Open Access Journals (Sweden)

    P. Agnamey

    2012-01-01

    Full Text Available Fasciola hepatica, the aetiological agent of fascioliasis in the Caribbean region, occurs throughout the major islands of the Greater Antilles and in localised zones on two islands (Martinique and Saint Lucia of the Lesser Antilles. However, apart from Puerto Rico, information regarding human fascioliasis in islands of the Caribbean is out of date or unavailable, or even nonexistent as in Haiti. The authors conducted a retrospective, cross-sectional serological survey in Port-au-Prince using a Western blotting test (LDBIO Diagnostics on human fascioliasis in Haiti. A total of 216 serum samples obtained from apparently healthy adults were tested. The frequency of antibodies in serum samples of the study population was 6.5% (14/216. The immunodominant bands recognised in Western blots were 27-28 kDa (100%, 42 kDa (64%, 60 kDa, and 8-9 kDa (28%. This is the first survey to reveal a relatively low proportion of asymptomatic F. hepatica-infected humans in Haiti.

  11. The Challenges of Haiti's Future: Implications for U.S. Policy and Strategy

    National Research Council Canada - National Science Library

    Simmons, J

    2002-01-01

    .... Unfortunately, Haiti's immediate future is quite bleak. Unless President Aristide can establish internal security, implement meaningful political reforms, and resurrect the dormant economy, the prospects for Haiti remain dim. So far, President Aristide has proven incapable of providing the requisite leadership necessary to make a difference.

  12. Cholera management and prevention at Hôpital Albert Schweitzer, Haiti.

    Science.gov (United States)

    Ernst, Silvia; Weinrobe, Carolyn; Bien-Aime, Charbel; Rawson, Ian

    2011-11-01

    In October 2010, Hopital Albert Schweitzer Haiti treated some of the first patients with cholera in Haiti. Over the following 10 months, a strategic plan was developed and implemented to improve the management of cases at the hospital level and to address the underlying risk factors at the community level.

  13. Education and Conflict in Haiti: Rebuilding the Education Sector after the 2010 Earthquake. Special Report 245

    Science.gov (United States)

    Luzincourt, Ketty; Gulbrandson, Jennifer

    2010-01-01

    In Haiti, education both promotes and ameliorates conflict. This report describes the education sector before the 2010 earthquake, then presents recommendations on how Haiti and the international community can increase access to and the quality of Haitian schools and modernize the organization and function of the national education sector.…

  14. Cordaid's post-disaster shelter strategy in Haiti : Linking relief and development

    NARCIS (Netherlands)

    Janse, H.C.; Van der Flier, C.L.

    2014-01-01

    Haiti was struck by a heavy earthquake in 2010 and international aid poured into the country. News reports in 2011 were not very positive about the results of post-disaster reconstruction: “The relief efforts are only putting Haiti on lifesupport instead of evolving into the next stage of

  15. Seeking Information after the 2010 Haiti Earthquake: A Case Study in Mass-Fatality Management

    Science.gov (United States)

    Gupta, Kailash

    2013-01-01

    The 2010 earthquake in Haiti, which killed an estimated 316,000 people, offered many lessons in mass-fatality management (MFM). The dissertation defined MFM in seeking information and in recovery, preservation, identification, and disposition of human remains. Specifically, it examined how mass fatalities were managed in Haiti, how affected…

  16. The experience of violence against children in domestic servitude in Haiti: Results from the Violence Against Children Survey, Haiti 2012.

    Science.gov (United States)

    Gilbert, Leah; Reza, Avid; Mercy, James; Lea, Veronica; Lee, Juliette; Xu, Likang; Marcelin, Louis Herns; Hast, Marisa; Vertefeuille, John; Domercant, Jean Wysler

    2018-02-01

    There have been estimates that over 150,000 Haitian children are living in servitude. Child domestic servants who perform unpaid labor are referred to as "restavèks." Restavèks are often stigmatized, prohibited from attending school, and isolated from family placing them at higher risk for experiencing violence. In the absence of national data on the experiences of restavèks in Haiti, the study objective was to describe the sociodemographic characteristics of restavèks in Haiti and to assess their experiences of violence in childhood. The Violence Against Children Survey was a nationally representative, cross-sectional household survey of 13-24year olds (n=2916) conducted May-June 2012 in Haiti. A stratified three-stage cluster design was used to sample households and camps containing persons displaced by the 2010 earthquake. Respondents were interviewed to assess lifetime prevalence of physical, emotional, and sexual violence occurring before age 18. Chi-squared tests were used to assess the association between having been a restavèk and experiencing violence in childhood. In this study 17.4% of females and 12.2% of males reported having been restavèks before age 18. Restavèks were more likely to have worked in childhood, have never attended school, and to have come from a household that did not have enough money for food in childhood. Females who had been restavèks in childhood had higher odds of reporting childhood physical (OR 2.04 [1.40-2.97]); emotional (OR 2.41 [1.80-3.23]); and sexual violence (OR 1.86 [95% CI 1.34-2.58]) compared to females who had never been restavèks. Similarly, males who had ever been restavèks in childhood had significantly increased odds of emotional violence (OR 3.06 [1.99-4.70]) and sexual violence (OR 1.85 [1.12-3.07]) compared to males who had never been restavèks, but there was no difference in childhood physical violence. This study demonstrates that child domestic servants in Haiti experience higher rates of

  17. Tungiasis in Haiti: a case series of 383 patients.

    Science.gov (United States)

    Louis, Shesly J; Bronsnick, Tara; Louis, Frantz J; Rao, Babar

    2014-08-01

    Tungiasis is endemic in poverty-stricken communities of South and Central America, Africa, Asia, and the Caribbean. This ectoparasitosis, caused by the female sand flea Tunga penetrans, is associated with considerable longterm morbidity in severely affected patients, including toe deformation and limited mobility. In Haiti, tungiasis is poorly documented but is known to occur. This study is the first formal investigation of tungiasis in Haiti. A total of 383 patients in four regions (Belle Fontaine, Vallue, Savanette, Cerca Carvajal) were examined and interviewed to determine disease prevalence, demographics and clinical presentation, and tungiasis-related behaviors. Prevalences of tungiasis ranged from 10.6 to 81.8% across the four regions. The overall prevalence of tungiasis in the patients examined was 31.1%. Of the affected patients, 63% were male and 37% were female, 37% were aged 0-10 years, and 100% reported pain and pruritus. Lesions occurred on the feet in 93.3% and on the hands in 22.7% of affected patients. The most common complications observed were chronic inflammation (54.2%) and hyperkeratosis (48.2%). This study establishes tungiasis as endemic in four regions of Haiti and reveals disease characteristics similar to those reported previously, suggesting that there are common factors underlying this disease in various regions, which are likely to be poverty-related. These findings emphasize the need to acknowledge tungiasis as a clinically relevant public health issue in order to decrease the frequency of tungiasis-related morbidity in endemic areas. © 2014 The International Society of Dermatology.

  18. Peripartum cardiomyopathy in the Hospital Albert Schweitzer District of Haiti.

    Science.gov (United States)

    Fett, James D; Carraway, Robert D; Dowell, Duane L; King, Mary Etta; Pierre, Ronald

    2002-05-01

    This report details current epidemiologic information on peripartum cardiomyopathy in 1 district of Haiti and represents the initial report of an ongoing investigation that addresses potential etiologic and prognostic factors. Another goal is to alert the medical community of what appears to be a high-incidence area. A detailed peripartum cardiomyopathy registry has been implemented to include a review of case records from 1994 to 2000 and subsequently to identify new cases from February 1, 2000, to July 1, 2001. The Hospital Albert Schweitzer District of Haiti is a 600-square mile area with approximately 258,000 population served by a hospital, an associated clinic, and outlying health centers. There are approximately 7740 live births annually. This report details epidemiologic information on the HAS District peripartum cardiomyopathy patients including incidence, mortality rate, complications, and prognostic factors. There were 47 confirmed patients (retrospective cohort, 20 patients; prospective cohort, 27 patients), which was approximately 1 case per 400 live births (compared with an incidence of 1 case per 3000 to 4000 live births in the United States). There were 4 deaths (14% of 29 patients with follow-up), and 7 complications (pulmonary embolism, 1 case; hemiplegia, 1 case; subsequent deterioration of heart function, 5 cases). The prognosis for subsequent pregnancy was 4 of 5 cases (80%) of recurrent congestive heart failure. Peripartum cardiomyopathy appears to be relatively common in the Hospital Albert Schweitzer District of Haiti. A core group of patients is identified for ongoing epidemiologic and immunohematologic investigation of risk factors and potential etiologic factors.

  19. Epidemiological, Clinical, and Histopathological Features of Breast Cancer in Haiti

    Directory of Open Access Journals (Sweden)

    Vincent DeGennaro Jr

    2018-02-01

    Full Text Available Purpose: Little is known about the epidemiology of breast cancer in developing countries, and Haiti has perhaps the least data of any country in the Western Hemisphere. Methods: We conducted a retrospective review of all patients enrolled in an ongoing breast cancer treatment program in Port-au-Prince, Haiti, from July 1, 2013, through June 30, 2017. Data were drawn from each patient's electronic medical record, paper chart, and biopsy results. Results: The records of 525 women with breast cancer were reviewed for this study. The median age at presentation was 49 years (n = 507. The risk factors observed were as follows: postmenopausal, 50.8% (n = 354; nulliparity, 15.7% (n = 338; hormonal contraception use, 35.0% (n = 309; never breastfed, 20.6% (n = 316; family history of any cancer, 22.0% (n = 295; overweight, 51.5% (n = 332; and smoking, 5.0% (n = 338. Of all those staged, 83.9% (n = 447 of the patients presented with stage III/IV disease and more than half delayed care for > 12 months after first noticing a breast mass. For the subset of tumors for which estrogen receptor (ER; n = 245 and human epidermal growth factor receptor 2 (HER2; n = 179 status was available, the prevalence of ER-positive tumors was 51.8%, of HER2-positive tumors was 19.6%, and of triple-negative tumors was 38.5%. The 12-month mortality rate (n = 425 was 18.4% overall and 27.5% for those who presented with stage IV disease. Median survival was not reached. Conclusion: Breast cancer in Haiti presents at an early age and advanced stage. Triple-negative, ER-negative, and high-grade tumors are common. Delays in seeking care and incomplete treatment likely contribute to the high mortality rate; however, as in black women in the United States, the distribution of tumor types may contribute to disparate outcomes.

  20. Quality and uptake of antenatal and postnatal care in Haiti.

    Science.gov (United States)

    Mirkovic, Kelsey R; Lathrop, Eva; Hulland, Erin N; Jean-Louis, Reginald; Lauture, Daniel; D'Alexis, Ghislaine Desinor; Handzel, Endang; Grand-Pierre, Reynold

    2017-02-02

    Despite improvement, maternal mortality in Haiti remains high at 359/100,000 live births. Improving access to high quality antenatal and postnatal care has been shown to reduce maternal mortality and improve newborn outcomes. Little is known regarding the quality and uptake of antenatal and postnatal care among Haitian women. Exit interviews were conducted with all pregnant and postpartum women seeking care from large health facilities (n = 10) in the Nord and Nord-Est department and communes of St. Marc, Verrettes, and Petite Rivière in Haiti over the study period (March-April 2015; 3-4 days/facility). Standard questions related to demographics, previous pregnancies, current pregnancy, and services/satisfaction during the visit were asked. Total number of antenatal visits were abstracted from charts of recently delivered women (n = 1141). Provider knowledge assessments were completed by antenatal and postnatal care providers (n = 39). Frequencies were calculated for descriptive variables and multivariable logistic regression was used to explore predictors of receiving 5 out of 10 counseling messages among pregnant women. Among 894 pregnant women seeking antenatal care, most reported receiving standard clinical service components during their visit (97% were weighed, 80% had fetal heart tones checked), however fewer reported receiving recommended counseling messages (44% counselled on danger signs, 33% on postpartum family planning). Far fewer women were seeking postnatal care (n = 63) and similar service patterns were reported. Forty-three percent of pregnant women report receiving at least 5 out of 10 counseling messages. Pregnant women on a repeat visit and women with greater educational attainment had greater odds of reporting having received 5 out of 10 counseling messages (2 nd visit: adjusted odds ratio [aOR] =1.70, 95% confidence interval [CI]: 1.09-2.66; 5+ visit: aOR = 5.44, 95% CI: 2.91-10.16; elementary school certificate: a

  1. Estimating the Direct Economic Damage of the Earthquake in Haiti

    OpenAIRE

    Cavallo, Eduardo; Powell, Andrew; Becerra, Oscar

    2010-01-01

    This paper uses simple regression techniques to make an initial assessment of the monetary damages caused by the January 12, 2010 earthquake that struck Haiti. Damages are estimated for a disaster with both 200,000 and 250,000 total dead and missing (i.e., the range of mortality that the earthquake is estimated to have caused) using Haiti’s economic and demographic data. The base estimate is US$8.1bn for a death toll of 250,000, but for several reasons this may be a lower- bound estimate. An ...

  2. External Interferences and Maintenance of Public Order in Haiti

    Directory of Open Access Journals (Sweden)

    VANESSA BRAGA MATIJASCIC

    2012-01-01

    Full Text Available This paper will discuss which characters interfered in internal affairs in Haiti over the history, especially in the 1990's. We will analyze the profile of the military and police forces which established in the country, as an important element to understand that, many times, instead of protecting citizens, the same forces helped to have oppression, instability and insecurity for most of Haitian population. Finally, we will hold the balance of the activities promoted by international organizations in the 1990's.

  3. Malaria elimination in Haiti by the year 2020: an achievable goal?

    Science.gov (United States)

    Boncy, Paul Jacques; Adrien, Paul; Lemoine, Jean Frantz; Existe, Alexandre; Henry, Patricia Jean; Raccurt, Christian; Brasseur, Philippe; Fenelon, Natael; Dame, John B; Okech, Bernard A; Kaljee, Linda; Baxa, Dwayne; Prieur, Eric; El Badry, Maha A; Tagliamonte, Massimiliano S; Mulligan, Connie J; Carter, Tamar E; Beau de Rochars, V Madsen; Lutz, Chelsea; Parke, Dana M; Zervos, Marcus J

    2015-06-05

    Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d'Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on "Elimination Strategies for Malaria in Haiti" on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of

  4. The (Impossibilit y of Time Travel: Haiti ’s Pre- and Post-Earthquake Futures

    Directory of Open Access Journals (Sweden)

    Landon Yarrington

    2012-12-01

    Full Text Available Review of:Travesty in Haiti: A True Account of Christian Missions, Orphanages, Fraud, Food Aid and Drug Trafficking [second edition]. Timothy T. Schwartz. Charleston SC: Booksurge, 2010. xlvii + 262 pp. (Paper US$ 15.99Haiti in the Balance: Why Foreign Aid Has Failed and What We Can Do About It. Terry Buss . Washington DC: Brookings Institute Press, 2008. xvi + 230 pp. (Paper US$ 28.95Backpacks Full of Hope: The UN Mission in Haiti. Eduardo Aldunate. Waterloo ON: Wilfrid Laurier University Press, 2010. xx + 230 pp. (Paper US$ 34.95

  5. ÜRO rahuvalvemissiooni juhtinud brasiillane leiti Haiti hotellist surnult / Heiki Suurkask

    Index Scriptorium Estoniae

    Suurkask, Heiki, 1972-

    2006-01-01

    ÜRO Haiti rahuvalvemissiooni juht Urano Teixeira da Matta Bacellar sooritas enesetapu. ÜRO rahuvalvemissioon MINUSTAH on Haitil 2005. aastast pärast nelja-aastast eemalolekut, samas jätkub seal vägivald

  6. Treating Childhood Malnutrition in Rural Haiti: Program Outcomes and Obstacles.

    Science.gov (United States)

    Cuneo, C Nicholas; Dansereau, Emily; Habib, Anand R; Davies, Mary; Ware, Samuel; Kornetsky, Kenneth

    Haiti has the worst malnutrition rate in the Western hemisphere. In October 2010, a cholera epidemic erupted and spread rapidly throughout the country, straining Haiti's already fragile health infrastructure across all levels of care. This study reviews data from an outpatient therapeutic feeding program (OTP) for acute childhood malnutrition at a clinic in rural Haiti with a focus on the effect of the 2010 cholera epidemic on program operations. A retrospective chart review was conducted for the complete set of patients who were enrolled in the OTP from its inception in March 2009 through January 2014. A total of 187 charts were retrieved representing 176 unique patients, of whom 5 were currently enrolled in care. At admission, 96 (51.3%) met criteria for severe acute malnutrition, 88 (47.1%) met criteria for moderate acute malnutrition, and 3 (1.6%) did not meet criteria for acute malnutrition. Of the 182 completed charts, 119 (65.4%) reached their target weight (≥-1 weight-for-height z-score) by discharge (ie, were "cured"), 43 (23.6%) defaulted, 11 (6.0%) were discharged prematurely, 8 (4.4%) died, and 1 (0.5%) was hospitalized. A total of 11 patients (6.3%) who were initially admitted relapsed after discharge and were later readmitted. Data from 170 complete records (93.4%) were included in a multivariate logistic regression. Severe (vs moderate) acute malnutrition was negatively associated with likelihood of being cured when controlling for other patient- and care-related factors (OR = 0.261, P = .002). Average cholera burden was negatively correlated with likelihood of OTP treatment cure when controlling for patient- and care-related variables (OR = 0.859, P = .002) but was insignificant when controlling for year. Results from the study have been used to inform a restructuring of the clinic's acute malnutrition program toward a more community-centered model of management, the context and implications of which are discussed in relation to the existing

  7. Health Outcomes for Children in Haiti Since the 2010 Earthquake: A Systematic Review.

    Science.gov (United States)

    Dube, Annie; Moffatt, Madeline; Davison, Colleen; Bartels, Susan

    2018-02-01

    Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being. A literature search was conducted identifying articles published from January 2010 through May 2016 related to pediatric health outcomes in Haiti. Two reviewers screened articles independently. Included research articles described at least one physical health, psychological health, or socioeconomic outcome among children less than 18 years of age in Haiti since the January 2010 earthquake. Fifty-eight full-length research articles were reviewed, covering infectious diseases (non-cholera [N=12] and cholera [N=7]), nutrition (N=11), traumatic injuries (N=11), mental health (N=9), anemia (N=4), abuse and violence (N=5), and other topics (N=3). Many children were injured in the 2010 earthquake, and care of their injuries is described in the literature. Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake, with cholera being one of the most important etiologies. The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder (PTSD), peri-traumatic stress, depression, and anxiety, and that food insecurity and malnutrition continue to be important issues. Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long

  8. Organize or Die: Farm School Pedagogy and the Political Ecology of the Agroecological Transition in Rural Haiti

    Science.gov (United States)

    Moore, Sophie Sapp

    2017-01-01

    This article examines the political and pedagogical role of the farm school in Haiti's largest and oldest peasants' movement, the Peasants' Movement of Papaye (MPP). It draws upon ongoing ethnographic research with MPP as well as documentary and historical analyses of agrarian politics in Haiti to situate the movement's land-based decolonial…

  9. Documentation for Initial Seismic Hazard Maps for Haiti

    Science.gov (United States)

    Frankel, Arthur; Harmsen, Stephen; Mueller, Charles; Calais, Eric; Haase, Jennifer

    2010-01-01

    In response to the urgent need for earthquake-hazard information after the tragic disaster caused by the moment magnitude (M) 7.0 January 12, 2010, earthquake, we have constructed initial probabilistic seismic hazard maps for Haiti. These maps are based on the current information we have on fault slip rates and historical and instrumental seismicity. These initial maps will be revised and improved as more data become available. In the short term, more extensive logic trees will be developed to better capture the uncertainty in key parameters. In the longer term, we will incorporate new information on fault parameters and previous large earthquakes obtained from geologic fieldwork. These seismic hazard maps are important for the management of the current crisis and the development of building codes and standards for the rebuilding effort. The boundary between the Caribbean and North American Plates in the Hispaniola region is a complex zone of deformation. The highly oblique ~20 mm/yr convergence between the two plates (DeMets and others, 2000) is partitioned between subduction zones off of the northern and southeastern coasts of Hispaniola and strike-slip faults that transect the northern and southern portions of the island. There are also thrust faults within the island that reflect the compressional component of motion caused by the geometry of the plate boundary. We follow the general methodology developed for the 1996 U.S. national seismic hazard maps and also as implemented in the 2002 and 2008 updates. This procedure consists of adding the seismic hazard calculated from crustal faults, subduction zones, and spatially smoothed seismicity for shallow earthquakes and Wadati-Benioff-zone earthquakes. Each one of these source classes will be described below. The lack of information on faults in Haiti requires many assumptions to be made. These assumptions will need to be revisited and reevaluated as more fieldwork and research are accomplished. We made two sets of

  10. Tsunamis triggered by the 12 January 2010 Earthquake in Haiti

    Science.gov (United States)

    Fritz, H. M.; Hillaire, J. V.; Molière, E.; Mohammed, F.; Wei, Y.

    2010-12-01

    On 12 January 2010 a magnitude Mw 7.0 earthquake occurred 25 km west-southwest of Haiti’s Capital of Port-au-Prince, which resulted in more than 230,000 fatalities. In addition tsunami waves triggered by the earthquake caused at least 3 fatalities at Petit Paradis. Unfortunately, the people of Haiti had neither ancestral knowledge nor educational awareness of tsunami hazards despite the 1946 Dominican Republic tsunami at Hispaniola’s northeast coast. In sharp contrast Sri Lankan UN-soldiers on duty at Jacmel self-evacuated given the memory of the 2004 Indian Ocean tsunami. The International Tsunami Survey Team (ITST) documented flow depths, runup heights, inundation distances, sediment deposition, damage patterns at various scales, and performance of the man-made infrastructure and impact on the natural environment. The 31 January to 7 February 2010 ITST covered the greater Bay of Port-au-Prince and more than 100 km of Hispaniola’s south coast between Pedernales, Dominican Republic and Jacmel, Haiti. The Hispaniola survey data includes more than 20 runup and flow depth measurements. The tsunami impacts peaked with maximum flow depths exceeding 3 m both at Petit Paradis inside the Bay of Grand Goâve located 45 km west-southwest of Port-au-Prince and at Jacmel on Haiti’s south coast. A significant variation in tsunami impact was observed on Hispaniola and tsunami runup of more than 1 m was still observed at Pedernales in the Dominican Republic. Jacmel, which is near the center of the south coast, represents an unfortunate example of a village and harbor that was located for protection from storm waves but is vulnerable to tsunami waves with runup doubling from the entrance to the head of the bay. Inundation and damage was limited to less than 100 m inland at both Jacmel and Petit Paradis. Differences in wave period were documented between the tsunami waves at Petit Paradis and Jacmel. The Petit Paradis tsunami is attributed to a coastal submarine landslide

  11. Detection of Sickle Cell Hemoglobin in Haiti by Genotyping and Hemoglobin Solubility Tests

    Science.gov (United States)

    Carter, Tamar E.; von Fricken, Michael; Romain, Jean R.; Memnon, Gladys; St. Victor, Yves; Schick, Laura; Okech, Bernard A.; Mulligan, Connie J.

    2014-01-01

    Sickle cell disease is a growing global health concern because infants born with the disorder in developing countries are now surviving longer with little access to diagnostic and management options. In Haiti, the current state of sickle cell disease/trait in the population is unclear. To inform future screening efforts in Haiti, we assayed sickle hemoglobin mutations using traditional hemoglobin solubility tests (HST) and add-on techniques, which incorporated spectrophotometry and insoluble hemoglobin separation. We also generated genotype data as a metric for HST performance. We found 19 of 202 individuals screened with HST were positive for sickle hemoglobin, five of whom did not carry the HbS allele. We show that spectrophotometry and insoluble hemoglobin separation add-on techniques could resolve false positives associated with the traditional HST approach, with some limitations. We also discuss the incorporation of insoluble hemoglobin separation observation with HST in suboptimal screening settings like Haiti. PMID:24957539

  12. The “First” Case of Cholera in Haiti: Lessons for Global Health

    Science.gov (United States)

    Ivers, Louise C.; Walton, David A.

    2012-01-01

    Cholera is an acute watery diarrheal disease caused by infection with Vibrio cholerae. The disease has a high fatality rate when untreated and outbreaks of cholera have been increasing globally in the past decade, most recently in Haiti. We present the case of a 28-year-old Haitian male with a history of severe untreated mental health disorder that developed acute fatal watery diarrhea in mid-October 2010 in central Haiti after drinking from the local river. We believe he is the first or among the first cases of cholera in Haiti during the current epidemic. By reviewing his case, we extracted lessons for global health on the importance of mental health for overall health, the globalization of diseases in small communities, and the importance of a comprehensive approach to the health of communities when planning services in resource-poor settings. PMID:22232448

  13. ["Tèt asanm pou la sante": ethnographic notes on international cooperation for health in Haiti].

    Science.gov (United States)

    Esteves, Uliana

    2016-01-01

    This article discusses the functioning of a health-oriented development project pursued in an emergency situation and its impacts beyond its stated goals. The tripartite project between Brazil, Haiti, and Cuba was designed to strengthen Haiti's health and epidemiologic surveillance system, introduced in 2010 as part of the aid effort after the earthquake. An essentially ethnographic perspective is taken, with a focus on describing the practices and perspectives of the agents involved in the program. The networks of agents were mapped out, paying particular attention to translators, drivers, and journalists, who were understood as being "cooperation brokers". Finally, the article discusses the project's position in the broader context of international health initiatives in Haiti.

  14. ART Attrition across Health Facilities Implementing Option B+ in Haiti.

    Science.gov (United States)

    Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner

    2018-01-01

    Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.

  15. Sustainable Community Sanitation for a Rural Hospital in Haiti

    Directory of Open Access Journals (Sweden)

    Jason Jawidzik

    2012-12-01

    Full Text Available A fully sustainable sanitation system was developed for a rural hospital in Haiti. The system operates by converting human waste into biogas and fertilizer without using external energy. It is a hybrid anaerobic/aerobic system that maximizes methane production while producing quality compost. The system first separates liquid and solid human waste at the source to control carbon to nitrogen ratio and moisture content to facilitate enhanced biodegradation. It will then degrade human waste through anaerobic digestion and capture the methane gas for on-site use as a heating fuel. For anaerobic decomposition and methane harvesting a bioreactor with two-stage batch process was designed. Finally, partially degraded human waste is extracted from the bioreactor with two-stage batch process and applied to land farming type aerobic composter to produce fertilizer. The proposed system is optimized in design by considering local conditions such as waste composition, waste generation, reaction temperature, residence time, construction materials, and current practice. It is above ground with low maintenance requirements.

  16. Satellite Map of Port-au-Prince, Haiti-2010-Infrared

    Science.gov (United States)

    Cole, Christopher J.; Sloan, Jeff

    2010-01-01

    The U.S. Geological Survey produced 1:24,000-scale post-earthquake image base maps incorporating high- and medium-resolution remotely sensed imagery following the 7.0 magnitude earthquake near the capital city of Port au Prince, Haiti, on January 12, 2010. Commercial 2.4-meter multispectral QuickBird imagery was acquired by DigitalGlobe on January 15, 2010, following the initial earthquake. Ten-meter multispectral ALOS AVNIR-2 imagery was collected by the Japanese Space Agency (JAXA) on January 12, 2010. These data were acquired under the Remote Sensing International Charter, a global team of space and satellite agencies that provide timely imagery in support of emergency response efforts worldwide. The images shown on this map were employed to support earthquake response efforts, specifically for use in determining ground deformation, damage assessment, and emergency management decisions. The raw, unprocessed imagery was geo-corrected, mosaicked, and reproduced onto a cartographic 1:24,000-scale base map. These maps are intended to provide a temporally current representation of post-earthquake ground conditions, which may be of use to decision makers and to the general public.

  17. The aetiology of vaginal symptoms in rural Haiti.

    Science.gov (United States)

    Bristow, Claire C; Desgrottes, Tania; Cutler, Lauren; Cutler, David; Devarajan, Karthika; Ocheretina, Oksana; Pape, Jean William; Klausner, Jeffrey D

    2014-08-01

    Vaginal symptoms are a common chief complaint amongst women visiting outpatient clinics in rural Haiti. A systematic sample of 206 consecutive women over age 18 with gynaecological symptoms underwent gynaecologic examination and laboratory testing for chlamydia, gonorrhoea, syphilis, HIV infection, trichomoniasis, candidiasis, and bacterial vaginosis. Among 206 women, 174 (84%) presented with vaginal discharge, 165 (80%) with vaginal itching, 123 (60%) with vaginal pain or dysuria, and 18 (9%) with non-traumatic vaginal sores or boils. Laboratory results were positive forChlamydia trachomatisin 5.4% (11/203), syphilis in 3.5% (7/202), HIV in 1.0% (2/200), andNeisseria gonorrhoeaein 1.0% (2/203). Among those that had microscopy, hyphae suggestive of candidiasis were visualized in 2.2% (1/45) and no cases of trichomoniasis were diagnosed 0% (0/45). Bacterial vaginosis was diagnosed in 28.3% (13/46). The prevalence of chlamydia was 4.9 (95% CI: 1.3-17.7) times greater among those 25 years of age and under (10.8%) than those older (2.3%). Chlamydia and bacterial vaginosis were the most common sexually transmitted infection and vaginal condition, respectively, in this study of rural Haitian adult women. The higher risk of chlamydia in younger women suggests education and screening programmes in young women should be considered. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Water-resources reconnaissance of Isle de la Gonave, Haiti

    Science.gov (United States)

    Troester, J.W.; Turvey, M.D.

    2004-01-01

    Isle de la Gonave is a 750-km2 island off the coast of Haiti. The depth to the water table ranges from less than 30 m in the Eocene and Upper Miocene limestones to over 60 m in the 300-m-thick Quaternary limestone. Annual precipitation ranges from 800-1,400 mm. Most precipitation is lost through evapotranspiration and there is virtually no surface water. Roughly estimated from chloride mass balance, about 4% of the precipitation recharges the karst aquifer. Cave pools and springs are a common source for water. Hand-dug wells provide water in coastal areas. Few productive wells have been drilled deeper than 60 m. Reconnaissance field analyses indicate that groundwater in the interior is a calcium-bicarbonate type, whereas water at the coast is a sodium-chloride type that exceeds World Health Organization recommended values for sodium and chloride. Tests for the presence of hydrogen sulfide-producing bacteria were negative in most drilled wells, but positive in cave pools, hand-dug wells, and most springs, indicating bacterial contamination of most water sources. Because of the difficulties in obtaining freshwater, the 110,000 inhabitants use an average of only 7 L per person per day.

  19. Complex rupture during the 12 January 2010 Haiti earthquake

    Science.gov (United States)

    Hayes, G.P.; Briggs, R.W.; Sladen, A.; Fielding, E.J.; Prentice, C.; Hudnut, K.; Mann, P.; Taylor, F.W.; Crone, A.J.; Gold, R.; Ito, T.; Simons, M.

    2010-01-01

    Initially, the devastating Mw 7.0, 12 January 2010 Haiti earthquake seemed to involve straightforward accommodation of oblique relative motion between the Caribbean and North American plates along the Enriquillog-Plantain Garden fault zone. Here, we combine seismological observations, geologic field data and space geodetic measurements to show that, instead, the rupture process may have involved slip on multiple faults. Primary surface deformation was driven by rupture on blind thrust faults with only minor, deep, lateral slip along or near the main Enriquillog-Plantain Garden fault zone; thus the event only partially relieved centuries of accumulated left-lateral strain on a small part of the plate-boundary system. Together with the predominance of shallow off-fault thrusting, the lack of surface deformation implies that remaining shallow shear strain will be released in future surface-rupturing earthquakes on the Enriquillog-Plantain Garden fault zone, as occurred in inferred Holocene and probable historic events. We suggest that the geological signature of this earthquakeg-broad warping and coastal deformation rather than surface rupture along the main fault zoneg-will not be easily recognized by standard palaeoseismic studies. We conclude that similarly complex earthquakes in tectonic environments that accommodate both translation and convergenceg-such as the San Andreas fault through the Transverse Ranges of Californiag-may be missing from the prehistoric earthquake record. ?? 2010 Macmillan Publishers Limited. All rights reserved.

  20. Interaction from tourism development in Port-au-Prince, Haiti

    Directory of Open Access Journals (Sweden)

    Claudel Mombeuil

    2018-05-01

    Full Text Available Intensive or inadequate management of tourism and related development may affect the nature, integrity and the dominant features of an area. Local communities hosting tourism often are the weaker link which interacts with guests and service providers within the tourism value chain. Therefore, tourism development should embrace the paradigm of sustainability by improving the living conditions of host communities, ensuring efficient use of the resources available, and valorizing and preserving local heritage and traditions from any damages or loss. This paper examines the extent to which tourism development may affect social, economic, and environmental conditions of communities of the Sud Department of Haiti particularly Les Cayes. To meet the objective of this paper, we surveyed of 453 residents and examined their views on the influence of tourism development in the region. By using conducting this survey, we gathered insights on what is considered significant for the respondents, and also an assessed the influence of number of residents, place of residence, and coastal vs. Inland on residents' perceptions.

  1. Ecosystem Considerations for Postdisaster Recovery: Lessons from China, Pakistan, and Elsewhere for Recovery Planning in Haiti

    Directory of Open Access Journals (Sweden)

    Susan A. Mainka

    2011-03-01

    Full Text Available As the world joins forces to support the people of Haiti on their long road of recovery following the January 2010 earthquake, plans and strategies should take into consideration past experiences from other postdisaster recovery efforts with respect to integrating ecosystem considerations. Sound ecosystem management can both support the medium and long-term needs for recovery as well as help to buffer the impacts of future extreme natural events, which for Haiti are likely to include both hurricanes and earthquakes. An additional challenge will be to include the potential impacts of climate change into ecosystem management strategies.

  2. Community health facility preparedness for a cholera surge in Haiti.

    Science.gov (United States)

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert

    2013-01-01

    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  3. Activity-based costing of health-care delivery, Haiti.

    Science.gov (United States)

    McBain, Ryan K; Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

    2018-01-01

    To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient's medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

  4. Sexual Violence and Reproductive Health among Youth in Port-au-Prince, Haiti

    Science.gov (United States)

    Gómez, Anu Manchikanti; Speizer, Ilene S.; Beauvais, Harry

    2013-01-01

    We examine sexual violence and reproductive health outcomes among sexually experienced youth in Port-au-Prince, Haiti, using the Priorities for Local AIDS Control methodology to identify participants in locations where sexual partnerships are formed. Sexual violence is common and is significantly associated with condom use, pregnancy experience and recent STI symptoms. PMID:19380102

  5. The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

    Science.gov (United States)

    Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

    2012-11-01

    On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

  6. An Island Drifting Apart. Why Haiti is mired in poverty while the Dominican Republic forges ahead

    NARCIS (Netherlands)

    Frankema, E.H.P.; Masé, A.

    2014-01-01

    The 2010 earthquake in Haiti has exposed the extreme vulnerability of a society where the state and the economy simultaneously fail to deliver. The Dominican Republic has witnessed several phases of rapid economic growth since the 1870s and, from the 1970s onwards, a sustained process of political

  7. An Island Drifting Apart. Why Haiti is mired in poverty while the Dominican Republic forges ahead

    NARCIS (Netherlands)

    Frankema, E.H.P.; Masé, A.

    The 2010 earthquake in Haiti has exposed the extreme vulnerability of a society where the state and the economy simultaneously fail to deliver. The Dominican Republic has witnessed several phases of rapid economic growth since the 1870s and, from the 1970s onwards, a sustained process of political

  8. An Island Drifting Apart : Why Haiti mires in poverty while the Dominican Republic forges ahead

    NARCIS (Netherlands)

    Frankema, E.H.P.; Masé, A.

    2012-01-01

    Abstract The 2010 earthquake in Haiti has exposed the extreme vulnerability of a people living in a country where the state and the economy simultaneously fail to deliver. Haiti’s neighbor, the Dominican Republic, has witnessed several phases of strong economic growth since the 1870s and an

  9. The genetic structure of populations from Haiti and Jamaica reflect divergent demographic histories.

    Science.gov (United States)

    Simms, Tanya M; Rodriguez, Carol E; Rodriguez, Rosa; Herrera, Rene J

    2010-05-01

    The West Indies represent an amalgamation of African, European and in some cases, East Asian sources, but the contributions from each ethnic group remain relatively unexplored from a genetic perspective. In the present study, we report, for the first time, allelic frequency data across the complete set of 15 autosomal STR loci for general collections from Haiti and Jamaica, which were subsequently used to examine the genetic diversity present in each island population. Our results indicate that although both Haiti and Jamaica display genetic affinities with the continental African collections, a stronger African signal is detected in Haiti than in Jamaica. Although only minimal contributions from non-African sources were observed in Haiti, Jamaica displays genetic input from both European and East Asian sources, an admixture profile similar to other New World collections of African descent analyzed in this report. The divergent genetic signatures present in these populations allude to the different migratory events of Africans, Europeans, and East Asians into the New World.

  10. Complex rupture mechanism and topography control symmetry of mass - wasting pattern, 2010 Haiti earthquake

    NARCIS (Netherlands)

    Gorum, T.; van Westen, C.J.; Korup, Oliver; van der Meijde, M.; Fan, Xuanmei; van der Meer, F.D.

    2013-01-01

    The 12 January 2010 Mw 7.0 Haiti earthquake occurred in a complex deformation zone at the boundary between the North American and Caribbean plates. Combined geodetic, geological and seismological data posited that surface deformation was driven by rupture on the Léogâne blind thrust fault, while

  11. Teacher Incentive Systems, Final Report. Policy Research Initiative: Haiti, Liberia, Somalia, Yemen Arab Republic.

    Science.gov (United States)

    Kemmerer, Frances; Thiagarajan, Sivasailam

    Findings of a study that examined the implementation of a teacher incentives initiative in four countries--Haiti, Liberia, Somalia, and Yemen--are presented in this paper. The countries are participating in a 10-year initiative founded in 1984, Improving the Efficiency of Educational Systems (IEES). Methodology involved interviews with…

  12. Haiti Start-Up mission design cold chain mango-avocado

    NARCIS (Netherlands)

    Oostewechel, René; Régis, Yves-Laurent; Brouwers, Jan

    2018-01-01

    This report shares the findings of the first start-up mission to Haiti, exploring all relevant elements pertaining to the design of the mango and avocado cold chain for fruit export to the USA, with the possibility to extend logistics services to other fruits like pineapple. Findings of the mission

  13. Building damage assessment after the earthquake in Haiti using two postevent satellite stereo imagery and DSMs

    DEFF Research Database (Denmark)

    Tian, Jiaojiao; Nielsen, Allan Aasbjerg; Reinartz, Peter

    2015-01-01

    In this article, a novel after-disaster building damage monitoring method is presented. This method combines the multispectral imagery and digital surface models (DSMs) from stereo matching of two dates to obtain three kinds of changes: collapsed buildings, newly built buildings and temporary she...... changes after the 2010 Haiti earthquake, and the obtained results are further evaluated both visually and numerically....

  14. Haiti and the Earthquake: Examining the Experience of Psychological Stress and Trauma

    Science.gov (United States)

    Risler, Ed; Kintzle, Sara; Nackerud, Larry

    2015-01-01

    For approximately 35 seconds on January 10, 2010, an earthquake measuring 7.0 on the Richter scale struck the small Caribbean nation of Haiti. This research used a preexperimental one-shot posttest to examine the incidence of posttraumatic stress disorder (PTSD) and associated trauma symptomatology from the earthquake experienced by a sample of…

  15. Seeing through the clouds: Processes and challenges for sharing geospatial data for disaster management in Haiti

    DEFF Research Database (Denmark)

    Clark, Nathan Edward; Guiffault, Flore

    2018-01-01

    This article examines the ways in which the production and sharing of geospatial data for disaster management purposes have evolved in Haiti, within the context of the 2010 earthquake and 2016 Hurricane Matthew. The conditions for these developments are traced through the institutional and operat...

  16. Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of Haiti

    Science.gov (United States)

    Jacobson, Erik

    2008-01-01

    An estimated 800,000 persons have disabilities in Haiti, but there are no data that refer specifically to those with intellectual disabilities. Traditional fears and stigma about disability are widespread. While the constitution supports the idea that people with disabilities should have autonomy and education, there are no laws to mandate…

  17. Haiti vajab suurt abi, et jalule tõusta / Heiki Suurkask

    Index Scriptorium Estoniae

    Suurkask, Heiki, 1972-

    2010-01-01

    ÜRO palub maailmalt maavärinas kannatanud Haiti jaoks rohkem kui pool miljardit dollarit. EBRD ja Maailmapank on sel aastakümnel Haitile ülesehituseks andnud sadu miljoneid dollareid, USA on 5 aasta jooksul Haitisse investeerinud 800 mln. dollarit. Riiki on püütud reformida, kuid korruptsioonist pole vabanetud

  18. Strong ground motion in Port-au-Prince, Haiti, during the M7.0 12 January 2010 Haiti earthquake

    Science.gov (United States)

    Hough, Susan E; Given, Doug; Taniguchi, Tomoyo; Altidor, J.R.; Anglade, Dieuseul; Mildor, S-L.

    2011-01-01

    No strong motion records are available for the 12 January 2010 M7.0 Haiti earthquake. We use aftershock recordings as well as detailed considerations of damage to estimate the severity and distribution of mainshock shaking in Port-au-Prince. Relative to ground motions at a hard - rock reference site, peak accelerations are amplified by a factor of approximately 2 at sites on low-lying deposits in central Port-au-Prince and by a factor of 2.5 - 3.5 on a steep foothill ridge in the southern Port-au-Prince metropolitan region. The observed amplification along the ridge cannot be explained by sediment - induced amplification , but is consistent with predicted topographic amplification by a steep, narrow ridge. Although damage was largely a consequence of poor construction , the damage pattern inferred from analysis of remote sensing imagery provides evidence for a correspondence between small-scale (0.1 - 1.0 km) topographic relief and high damage. Mainshock shaking intensity can be estimated crudely from a consideration of macroseismic effects . We further present detailed, quantitative analysis of the marks left on a tile floor by an industrial battery rack displaced during the mainshock, at the location where we observed the highest weak motion amplifications. Results of this analysis indicate that mainshock shaking was significantly higher at this location (~0.5 g , MMI VIII) relative to the shaking in parts of Port-au-Prince that experienced light damage. Our results further illustrate how observations of rigid body horizontal displacement during earthquakes can be used to estimate peak ground accelerations in the absence of instrumental data .

  19. Reducing under-five mortality through Hôpital Albert Schweitzer's integrated system in Haiti.

    Science.gov (United States)

    Perry, Henry; Cayemittes, Michel; Philippe, Francois; Dowell, Duane; Dortonne, Jean Richard; Menager, Henri; Bottex, Erve; Berggren, Warren; Berggren, Gretchen

    2006-05-01

    The degree to which local health systems contribute to reductions in under-five mortality in severely impoverished settings has not been well documented. The current study compares the under-five mortality in the Hôpital Albert Schweitzer (HAS) Primary Health Care Service Area with that for Haiti in general. HAS provides an integrated system of community-based primary health care services, hospital care and community development. A sample of 10% of the women of reproductive age in the HAS service area was interviewed, and 2390 live births and 149 child deaths were documented for the period 1995-99. Under-five mortality rates were computed and compared with rates for Haiti. In addition, available data regarding inputs, processes and outputs for the HAS service area and for Haiti were assembled and compared. Under-five mortality was 58% less in the HAS service area, and mortality for children 12-59 months of age was 76% less. These results were achieved with an input of fewer physicians and hospital beds per capita than is available for Haiti nationwide, but with twice as many graduate nurses and auxiliary nurses per capita than are available nationwide, and with three cadres of health workers that do not exist nationwide: Physician Extenders, Health Agents and Community Health Volunteers. The population coverage of targeted child survival services was generally 1.5-2 times higher in the HAS service area than in rural Haiti. These findings support the conclusion that a well-developed system of primary health care, with outreach services to the household level, integrated with hospital referral care and community development programmes, can make a strong contribution to reducing infant and child mortality in severely impoverished settings.

  20. Long-term impacts of tropical storms and earthquakes on human population growth in Haiti and the Dominican Republic

    OpenAIRE

    Christian D. Klose; Christian Webersik

    2011-01-01

    Since the 18th century, Haiti and the Dominican Republic have experienced similar natural forces, including earthquakes and tropical storms. These countries are two of the most prone of all Latin American and Caribbean countries to natural hazards events, while Haiti seems to be more vulnerable to natural forces. This article discusses to what extent geohazards have shaped both nation's demographic developments. The data show that neither atmospheric nor seismic forces that directly hit ...

  1. Long-term impacts of tropical storms and earthquakes on human population growth in Haiti and Dominican Republic

    OpenAIRE

    Christian D. Klose; Christian Webersik

    2010-01-01

    The two Caribbean states, Haiti and the Dominican Republic, have experienced similar natural forces since the 18th century, including hurricanes and earthquakes. Although, both countries seem to be two of the most prone of all Latin American and Caribbean countries to natural hazard events, historically, Haiti tends to be more vulnerable to natural forces. The purpose of this article is to understand to what extent geohazards shape demographic changes. Research findings of this study show tha...

  2. Evidence for higher tropical storm risks in Haiti due to increasing population density in hazard prone urban areas

    International Nuclear Information System (INIS)

    Klose, Christian D

    2011-01-01

    Since the 18th century, the Republic of Haiti has experienced numerous tropical cyclones. In 2011, the United Nations Global Assessment Report on Disaster Risk Reduction outlined that the worldwide physical exposure to natural hazards, which includes tropical storms and hurricanes in Haiti, increased by 192 per cent between 1970 and 2010. Now, it can be hypothesized that the increased physical exposure to cyclones that made landfall in Haiti has affected the country's development path. This study shows that tropical storm risks in Haiti increased due to more physical exposure of the population in urban areas rather than a higher cyclone frequency in the proximity of Hispaniola island. In fact, the population density accelerated since the second half of the 20th century in regions where historically more storms made landfall, such as in the departments Ouest, Artibonite, Nord and Nord-Ouest including Haiti's four largest cities: Port-au-Prince, Gonaïves, Cap-Haïtien and Port-de-Paix. Thus, urbanization in and migration into storm hazard prone areas could be considered as one of the major driving forces of Haiti's fragility.

  3. Maritime security report. April 1997 [Maritime smuggling of drugs and contraband goods through Haiti adversely impacting legitimate commerce and development; Partnering : a key to growing challenges confronting maritime security

    Science.gov (United States)

    1997-04-01

    Haiti is a significant transshipment conduit for South American cocaine destined for the United States. This smuggling is facilitated by Haitis system of seaports which remain largely unmonitored. Smuggling and trafficking contraband merchandise aver...

  4. Report from the Field: Psychological First Aid for Haiti's Storm Orphans.

    Science.gov (United States)

    Giraldo, Gloria

    2008-07-01

    In 2004, the final death toll in Haiti from Tropical Storm Jeanne was recorded at 3,006; of these, 2,826 in Gonaïves, a city floating in ruins. The road to Gonaïves was washed out, leaving the city and the department of Artibonite cut off for days from the rest of the country. Dr Juan Carlos Ch�vez, who headed the Cuban medical team in Haiti at the time, recalls that 17 Cuban health professionals were working in the area when the storm barrelled through, among the 400 already serving in the country. They were later joined by another 72 doctors, nurses, technicians and engineers sent directly from Cuba.

  5. Energy Justice and the Stakeholders Involved: A Case Study of Solar Power in Rural Haiti

    Science.gov (United States)

    Romulus, Elijah Rey Asse

    This paper explores and analyzes energy justice and the stakeholders involved. Energy insecurity, specifically the lack of access to electricity effects over 1.3 billion people worldwide and energy justice is a way to address it. This paper is supported by a case study with data collected in the southern rural regions of Haiti regarding energy justice communities. Three cities were studied: Les Cayes, Anse-a-Veau, and Les Anglais. It examines how solar businesses can aid energy justice communities seeking access to electricity. Stakeholders such as the communities themselves, solar businesses, and nonprofits in the region are studied and analyzed. The paper concludes solar businesses are helping said communities but needs participation from other stakeholders to be successful. Finally, there are five recommendations to build capacity, develop infrastructure in the region, explore the possibility of solar cooperatives, strengthen the solar economy in Haiti, and demand reparations.

  6. Impacts of the 2010 Haitian earthquake in the diaspora: findings from Little Haiti, Miami, FL.

    Science.gov (United States)

    Kobetz, Erin; Menard, Janelle; Kish, Jonathan; Bishop, Ian; Hazan, Gabrielle; Nicolas, Guerda

    2013-04-01

    In January 2010, a massive earthquake struck Haiti resulting in unprecedented damage. Little attention, however, has focused on the earthquake's mental health impact in the Haitian diaspora community. As part of an established community-based participatory research initiative in Little Haiti, the predominately Haitian neighborhood in Miami, FL, USA, community health workers conducted surveys with neighborhood residents about earthquake-related losses, coping strategies, and depressive/traumatic symptomology. Findings reveal the earthquake strongly impacted the diaspora community and highlights prominent coping strategies. Following the earthquake, only a small percentage of participants self-reported engaging in any negative health behaviors. Instead, a majority relied on their social networks for support. This study contributes to the discourse on designing culturally-responsive mental health initiatives for the Haitian diaspora and the ability of existing community-academic partnerships to rapidly adapt to community needs.

  7. Orphans and at-risk children in Haiti: vulnerabilities and human rights issues postearthquake.

    Science.gov (United States)

    Nicholas, Patrice K; George, Erin K; Raymond, Nadia; Lewis-OʼConnor, Annie; Victoria, Stephanie; Lucien, Sergeline; Peters-Lewis, Angelleen; Hickey, Nancy; Corless, Inge B; Tyer-Viola, Lynda; Davis, Sheila M; Barry, Donna; Marcelin, Naomie; Valcourt, Roodeline

    2012-01-01

    The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.

  8. Seroprevalence of hepatitis C and associated risk factors among an urban population in Haiti

    OpenAIRE

    Hepburn, Matthew J; Lawitz, Eric J

    2004-01-01

    Abstract Background The seroprevalence of hepatitis C varies substantially between countries and geographic regions. A better understanding of the seroprevalence of this disease, and the risk factors associated with seropositive status, supply data for the development of screening programs and provide insight into the transmission of the disease. The purpose of this investigation was to determine the seroprevalence of hepatitis C and associated risk factors in an urban population in Haiti. Me...

  9. Determinants of primary school enrollment in Haiti and the Dominican Republic

    OpenAIRE

    Gönsch, Iris

    2011-01-01

    Education is considered an important means of alleviating poverty and of improving an individual's job and earnings prospects. Nevertheless, in Haiti and the Dominican Republic school enrollment is far from complete and shows notable regional variation. This paper analyzes determinants of primary school enrollment and investigates to what extent differences in schooling are due to individual factors compared to family or community influences. Using data from the Demographic and Health Surveys...

  10. Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau.

    Science.gov (United States)

    Keys, Hunter M; Kaiser, Bonnie N; Kohrt, Brandon A; Khoury, Nayla M; Brewster, Aimée-Rika T

    2012-08-01

    Haiti's 2010 earthquake mobilized mental health and psychosocial interventions from across the globe. However, failure to understand how psychological distress is communicated between lay persons and health workers in rural clinics, where most Haitians access care, has been a major limitation in providing mental health services. The goal of this study was to map idioms of distress onto Haitian ethnopsychologies in a way that promotes improved communication between lay persons and clinicians in rural Haiti. In Haiti's Central Plateau, an ethnographic study was conducted in May and June 2010, utilizing participant observation in rural clinics, 31 key informant interviews, 11 focus groups, and four case studies. Key informants included biomedical practitioners, traditional healers, community leaders, and municipal and religious figures. Deductive and inductive themes were coded using content analysis (inter-rater reliability > 0.70). Forty-four terms for psychological distress were identified. Head (tèt) or heart (kè) terms comprise 55% of all qualitative text segments coded for idioms of distress. Twenty-eight of 142 observed patient-clinician contacts involved persons presenting with tèt terms, while 29 of the 142 contacts were presentations with kè terms. Thus, 40% of chief complaints were conveyed in either head or heart terms. Interpretations of these terms differed between lay and clinical groups. Lay respondents had broad and heterogeneous interpretations, whereas clinicians focused on biomedical concepts and excluded discussion of mental health concerns. This paper outlines preliminary evidence regarding the psychosocial dimensions of tèt and kè-based idioms of distress and calls for further exploration. Holistic approaches to mental healthcare in Haiti's Central Plateau should incorporate local ethnopsychological frameworks alongside biomedical models of healthcare. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Haiti’s Downward Spiral: Causes, Consequences, and the Way Ahead

    Science.gov (United States)

    2011-05-04

    Salvador, and Honduras. Known as the “cocaine corridor” to the United States via Mexico , these states are an increasing concern for U.S. national...corridor” to the United States via Mexico , these states are an increasing concern for U.S. national security and therefore deserve SOUTHCOM’s full...water wells took on increased urgency after Haiti experienced a cholera outbreak in October 2010 that infected over 250,000 people, killing more than

  12. Performance of Charcoal Cookstoves for Haiti, Part 2: Results from the Controlled Cooking Test

    Energy Technology Data Exchange (ETDEWEB)

    Lask, Kathleen; Jones, Jennifer; Booker, Kayje; Ceballos, Cristina; Yang, Nina; Gadgil, Ashok

    2011-11-30

    Five charcoal cookstoves were tested using a Controlled Cooking Test (CCT) developed from cooking practices in Haiti. Cookstoves were tested for total burn time, specific fuel consumption, and emissions of carbon monoxide (CO), carbon dioxide (CO2), and the ratio of carbon monoxide to carbon dioxide (CO/CO2). These results are presented in this report along with LBNL testers’ observations regarding the usability of the stoves.

  13. Dog Ecology and Barriers to Canine Rabies Control in the Republic of Haiti, 2014-2015.

    Science.gov (United States)

    Schildecker, S; Millien, M; Blanton, J D; Boone, J; Emery, A; Ludder, F; Fenelon, N; Crowdis, K; Destine, A; Etheart, M; Wallace, R M

    2017-10-01

    An estimated 59 000 persons die annually of infection with the rabies virus worldwide, and dog bites are responsible for 95% of these deaths. Haiti has the highest rate of animal and human rabies in the Western Hemisphere. This study describes the status of animal welfare, animal vaccination, human bite treatment, and canine morbidity and mortality in Haiti in order to identify barriers to rabies prevention and control. An epidemiologic survey was used for data collection among dog owners during government-sponsored vaccination clinics at fourteen randomly selected sites from July 2014 to April 2015. A total of 2005 surveys were collected and data were analysed using parametric methods. Over 50% of owned dogs were allowed to roam freely, a factor associated with rabies transmission. More than 80% of dog owners reported experiencing barriers to accessing rabies vaccination for their dogs. Nearly one-third of the dog population evaluated in this study died in the year preceding the survey (32%) and 18% of these deaths were clinically consistent with rabies. Dog bites were commonly reported, with more than 3% of the study population bitten within the year preceding the survey. The incidence of canine rabies in Haiti is high and is exacerbated by low access to veterinary care, free-roaming dog populations and substandard animal welfare practices. Programmes to better understand the dog ecology and development of methods to improve access to vaccines are needed. Rabies deaths are at historical lows in the Western Hemisphere, but Haiti and the remaining canine rabies endemic countries still present a significant challenge to the goal of rabies elimination in the region. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  14. Haiti; Request for Extension of the Arrangement Under the Poverty Reduction and Growth Facility: Staff Report

    OpenAIRE

    International Monetary Fund

    2011-01-01

    According to the fifth review of the Poverty Reduction and Growth Facility (PRGF) arrangement, the Haitian authorities remain committed to macroeconomic stability under the program. On completion of the fifth review of the PRGF, they requested a new three-year Extended Credit Facility (ECF) arrangement to help sustain economic growth and to preserve macroeconomic stability. The IMF Board approved a three-year arrangement for Haiti under the PRGF. This will help ensure that endorsement of poli...

  15. Planting the Seeds: The Impact of Training on Mango Producers in Haiti

    OpenAIRE

    Irani Arráiz; Carla Calero; Songqing Jin; Alexandra Peralta

    2015-01-01

    This paper evaluates the short-term impacts of a development project that aims to increase mango yields, sales of mango products, and the income of small mango farmers in rural Haiti. Various matching methods, in combination with difference-in-difference (DID), are used to deal with the potential selection bias associated with nonrandom treatment assignment. Robustness checks are conducted to investigate whether and to what extent the results are affected by the coexistence of other similar p...

  16. Risk and protective factors for internalizing and externalizing outcomes among HIV-affected youth in Haiti.

    Science.gov (United States)

    Li, Michelle; Betancourt, Theresa; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Mukherjee, Joia; Surkan, Pamela J; Smith Fawzi, Mary C

    2015-01-01

    The present study aims to: (1) estimate the levels of internalizing symptoms and externalizing behaviors among youth affected by HIV in central Haiti; and (2) examine the risk and protective factors associated with these outcomes to identify potential areas of intervention for HIV-affected youth. Baseline data for 492 youth affected by HIV (ages 10-17) and their 330 caregivers were collected for a pilot study of a psychosocial support intervention. Participants were recruited from a list of HIV-positive patients receiving care at Partners In Health/Zanmi Lasante clinic sites. Internalizing and externalizing behaviors were assessed using the Strengths and Difficulties Questionnaire. Demographic, economic, and social indicators were collected using a structured questionnaire administered by trained social workers. Youth affected by HIV in central Haiti displayed high levels of internalizing and, to a lesser degree, externalizing symptoms. Multivariate regression analysis demonstrated risk factors most strongly associated with internalizing symptoms (socioeconomic status, parental depressive symptoms) and externalizing behaviors (household living arrangements, such as living with a stepparent). Social support had a protective effect on externalizing behaviors for both caregiver (β=-0.03, p=0.01) and self-report (β=-0.05, pHaiti and similar resource-limited settings.

  17. Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey.

    Science.gov (United States)

    Tohme, Rania A; Andre-Alboth, Jocelyne; Tejada-Strop, Alexandra; Shi, Ran; Boncy, Jacques; François, Jeannot; Domercant, Jean Wysler; Griswold, Mark; Hyppolite, Erlantz; Adrien, Paul; Kamili, Saleem

    2016-03-01

    Hepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule. Determine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT. We selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection. Of 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, pHaiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission. Published by Elsevier B.V.

  18. Glucose-6-Phosphate Dehydrogenase Deficiency A− Variant in Febrile Patients in Haiti

    Science.gov (United States)

    Carter, Tamar E.; Maloy, Halley; von Fricken, Michael; St. Victor, Yves; Romain, Jean R.; Okech, Bernard A.; Mulligan, Connie J.

    2014-01-01

    Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A−. We estimated the frequency of G6PDd A− in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A− allele (includes A− hemizygous males, A− homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. PMID:24891465

  19. Letter to the Editor : Rapidly-deployed small tent hospitals: lessons from the earthquake in Haiti.

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, Y.; Gurman , P.; Verna, E.; Elman , N.; Labor, E. (Materials Science Division); (Superior NanoBioSystems LLC); (Fast Israeli Rescue & Search Team); (Clinique Adonai); (Mass. Inst. Tech.); (Univ. Haifa)

    2012-06-01

    The damage to medical facilities resulting form the January 2010 earthquake in haiti necessitated the establishment of field tent hospitals. Much of the local medical infrastructure was destroyed or limited operationally when the Fast Israel Rescue and Search Team (FIRST) arrived in Haiti shortly after the January 2010 earthquake. The FIRST deployed small tent hospitals in Port-au-Prince and in 11 remote areas outside of the city. Each tent was set up in less than a half hour. The tents were staffed with an orthopedic surgeon, gynecologists, primary care and emergency care physicians, a physician with previous experience in tropical medicine, nurses, paramedics, medics, and psychologists. The rapidly deployable and temporary nature of the effort allowed the team to treat and educate, as well as provide supplies for, thousands of refugees throughout Haiti. In addition, a local Haitian physician and his team created a small tent hospital to serve the Petion Refugee Camp and its environs. FIRST personnel also took shifts at this hospital.

  20. [Experience in establishing ophthalmology at the Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti].

    Science.gov (United States)

    Eisenmann, D; Bracher, H R

    2007-04-01

    Haiti is regarded as the poorest country of the Western hemisphere. The Hôpital Albert Schweitzer (HAS), founded in 1956 by Larimer Melon, is providing medical care to the Artibonite valley, an area in the centre of Haiti with over 400 000 inhabitants. Until 2001, a three-fold population was without eye care in central Haiti. In 2001, Hans Rudolf Bracher, a retired ophthalmologist from Bern, initiated the eye department at HAS and organised an eye examination unit, a microscope and further surgical equipment. Since then, eye care to the population was provided by short-term visits of ophthalmologists, nurses and orthoptists, mainly from switzerland. Additionally, teaching and surgical training was performed at university hospital in Port-au-Price, the only education centre for ophthalmologists in the country. The actual political and security situation complicates visits of western doctors. A development association for the HAS eye department was founded and with its help, an Haitian ophthalmologist is employed in a full-time position. Furthermore, logistic support is provided with drugs and surgical equipment. Today, under difficult circumstances, the eye department is well established as an effective and cost-covering institution at HAS.

  1. Cost Evaluation of a Government-Conducted Oral Cholera Vaccination Campaign-Haiti, 2013.

    Science.gov (United States)

    Routh, Janell A; Sreenivasan, Nandini; Adhikari, Bishwa B; Andrecy, Lesly L; Bernateau, Margarette; Abimbola, Taiwo; Njau, Joseph; Jackson, Ernsley; Juin, Stanley; Francois, Jeannot; Tohme, Rania A; Meltzer, Martin I; Katz, Mark A; Mintz, Eric D

    2017-10-01

    The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government's first vaccine campaign implemented in August-September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed-our analyses suggested that approximately 2.5-6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.

  2. Demonstration of the Use of Remote Temperature Monitoring Devices in Vaccine Refrigerators in Haiti.

    Science.gov (United States)

    Cavallaro, Kathleen F; Francois, Jeannot; Jacques, Roody; Mentor, Derline; Yalcouye, Idrissa; Wilkins, Karen; Mueller, Nathan; Turner, Rebecca; Wallace, Aaron; Tohme, Rania A

    After the 2010 earthquake, Haiti committed to introducing 4 new antigens into its routine immunization schedule, which required improving its cold chain (ie, temperature-controlled supply chain) and increasing vaccine storage capacity by installing new refrigerators. We tested the feasibility of using remote temperature monitoring devices (RTMDs) in Haiti in a sample of vaccine refrigerators fueled by solar panels, propane gas, or electricity. We analyzed data from 16 RTMDs monitoring 24 refrigerators in 15 sites from March through August 2014. Although 5 of the 16 RTMDs exhibited intermittent data gaps, we identified typical temperature patterns consistent with refrigerator door opening and closing, propane depletion, thermostat insufficiency, and overstocking. Actual start-up, annual maintenance, and annual electricity costs for using RTMDs were $686, $179, and $9 per refrigerator, respectively. In Haiti, RTMD use was feasible. RTMDs could be prioritized for use with existing refrigerators with high volumes of vaccines and new refrigerators to certify their functionality before use. Vaccine vial monitors could provide additional useful information about cumulative heat exposure and possible vaccine denaturation.

  3. Household food insecurity is associated with childhood malaria in rural Haiti.

    Science.gov (United States)

    Pérez-Escamilla, Rafael; Dessalines, Michael; Finnigan, Mousson; Pachón, Helena; Hromi-Fiedler, Amber; Gupta, Nishang

    2009-11-01

    Haiti is the poorest country in the Western Hemisphere and is heavily affected by food insecurity and malaria. To find out if these 2 conditions are associated with each other, we studied a convenience sample of 153 women with children 1-5 y old in Camp Perrin, South Haiti. Household food insecurity was assessed with the 16-item Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale previously validated in the target communities. ELCSA's reference time period was the 3 mo preceding the survey and it was answered by the mother. Households were categorized as either food secure (2%; ELCSA score = 0), food insecure/very food insecure (42.7%; ELCSA score range: 1-10), or severely food insecure (57.3%; ELCSA score range: 11-16). A total of 34.0% of women reported that their children had malaria during the 2 mo preceding the survey. Multivariate analyses showed that severe food insecure was a risk factor for perceived clinical malaria (odds ratio: 5.97; 95% CI: 2.06-17.28). Additional risk factors for perceived clinical malaria were as follows: not receiving colostrum, poor child health (via maternal self-report), a child BMI <17 kg/m(2), and child vitamin A supplementation more than once since birth. Findings suggest that policies and programs that address food insecurity are also likely to reduce the risk of malaria in Haiti.

  4. Is the Local Seismicity in Haiti Capable of Imaging the Northern Caribbean Subduction?

    Science.gov (United States)

    Corbeau, J.; Clouard, V.; Rolandone, F.; Leroy, S. D.; de Lepinay, B. M.

    2017-12-01

    The boundary between the Caribbean (CA) and North American (NAM) plates in the Hispaniola region is the western prolongation of the NAM plate subduction evolving from a frontal subduction in the Lesser Antilles to an oblique collision against the Bahamas platform in Cuba. We analyze P-waveforms arriving at 27 broadband seismic temporary stations deployed along a 200 km-long N-S transect across Haiti, during the Trans-Haiti project. We compute teleseismic receiver functions using the ETMTRF method, and determine crustal thickness and bulk composition (Vp/Vs) using the H-k stacking method. Three distinctive crustal domains are imaged. We relate these domains to crustal terranes that have been accreted along the plate boundary during the northeastwards displacement of the CA plate. We propose a N-S crustal profile across Haiti accounting for the surface geology, shallow structural history and these new seismological constraints. Local seismicity recorded by the temporary network from April 2013 to June 2014 is used to relocate the seismicity. A total of 593 events were identified with magnitudes ranging from 1.6 to 4.5. This local seismicity, predominantly shallow (accommodation of an important part of convergence in this area.

  5. High-frequency rugose exopolysaccharide production by Vibrio cholerae strains isolated in Haiti.

    Directory of Open Access Journals (Sweden)

    Mustafizur Rahman

    Full Text Available In October, 2010, epidemic cholera was reported for the first time in Haiti in over 100 years. Establishment of cholera endemicity in Haiti will be dependent in large part on the continued presence of toxigenic V. cholerae O1 in aquatic reservoirs. The rugose phenotype of V. cholerae, characterized by exopolysaccharide production that confers resistance to environmental stress, is a potential contributor to environmental persistence. Using a microbiologic medium promoting high-frequency conversion of smooth to rugose (S-R phenotype, 80 (46.5% of 172 V. cholerae strains isolated from clinical and environmental sources in Haiti were able to convert to a rugose phenotype. Toxigenic V. cholerae O1 strains isolated at the beginning of the epidemic (2010 were significantly less likely to shift to a rugose phenotype than clinical strains isolated in 2012/2013, or environmental strains. Frequency of rugose conversion was influenced by incubation temperature and time. Appearance of the biofilm produced by a Haitian clinical rugose strain (altered biotype El Tor HC16R differed from that of a typical El Tor rugose strain (N16961R by confocal microscopy. On whole-genome SNP analysis, there was no phylogenetic clustering of strains showing an ability to shift to a rugose phenotype. Our data confirm the ability of Haitian clinical (and environmental strains to shift to a protective rugose phenotype, and suggest that factors such as temperature influence the frequency of transition to this phenotype.

  6. Submicroscopic malaria infections in pregnant women from six departments in Haiti.

    Science.gov (United States)

    Elbadry, Maha A; Tagliamonte, Massimiliano S; Raccurt, Christian P; Lemoine, Jean F; Existe, Alexandre; Boncy, Jacques; Weppelmann, Thomas A; Dame, John B; Okech, Bernard A

    2017-08-01

    To describe the epidemiology of malaria in pregnancy in Haiti. Cross-sectional study among pregnant women in six departments of Haiti. After obtaining informed consent, whole blood samples and demographic surveys were collected to investigate malaria prevalence, anaemia and socio-behavioural risk factors for infection, respectively. A total of 311 pregnant women were screened for Plasmodium falciparum infection using a rapid diagnostic test (RDT), microscopy and a novel, quantitative reverse transcriptase polymerase chain reaction method (qRT-PCR). Overall, 1.2% (4/311) of pregnant women were tested positive for malaria infection by both microscopy and RDT. However, using the qRT-PCR, 16.4% (51/311) of pregnant women were positive. The prevalence of malaria infection varied with geographical locations ranging between 0% and 46.4%. Additionally, 53% of pregnant women had some form of anaemia; however, no significant association was found between anaemia and submicroscopic malaria infection. The socio-behavioural risk factors identified to be protective of malaria infection were marital status (P < 0.05) and travel within one month prior to screening (P < 0.05). This study is the first to document the high prevalence of submicroscopic malaria infections among pregnant women in Haiti and identify social and behavioural risk factors for disease transmission. © 2017 John Wiley & Sons Ltd.

  7. Tsunami waves generated by dynamically triggered aftershocks of the 2010 Haiti earthquake

    Science.gov (United States)

    Ten Brink, U. S.; Wei, Y.; Fan, W.; Miller, N. C.; Granja, J. L.

    2017-12-01

    Dynamically-triggered aftershocks, thought to be set off by the passage of surface waves, are currently not considered in tsunami warnings, yet may produce enough seafloor deformation to generate tsunamis on their own, as judged from new findings about the January 12, 2010 Haiti earthquake tsunami in the Caribbean Sea. This tsunami followed the Mw7.0 Haiti mainshock, which resulted from a complex rupture along the north shore of Tiburon Peninsula, not beneath the Caribbean Sea. The mainshock, moreover, had a mixed strike-slip and thrust focal mechanism. There were no recorded aftershocks in the Caribbean Sea, only small coastal landslides and rock falls on the south shore of Tiburon Peninsula. Nevertheless, a tsunami was recorded on deep-sea DART buoy 42407 south of the Dominican Republic and on the Santo Domingo tide gauge, and run-ups of ≤3 m were observed along a 90-km-long stretch of the SE Haiti coast. Three dynamically-triggered aftershocks south of Haiti have been recently identified within the coda of the mainshock (stacks, and back-projecting the arrivals to the vicinity of the main shock (50-300 km). Two of the aftershocks, coming 20-40 s and 40-60 s after the mainshock, plot along NW-SE-trending submarine ridges in the Caribbean Sea south of Haiti. The third event, 120-140 s was located along the steep eastern slope of Bahoruco Peninsula, which is delineated by a normal fault. Forward tsunami models show that the arrival times of the DART buoy and tide gauge times are best fit by the earliest of the three aftershocks, with a Caribbean source 60 km SW of the mainshock rupture zone. Preliminary inversion of the DART buoy time series for fault locations and orientations confirms the location of the first source, but requires an additional unidentified source closer to shore 40 km SW of the mainshock rupture zone. This overall agreement between earthquake and tsunami analyses suggests that land-based earthquake ruptures and/or non-thrust main shocks can

  8. Defense Management: U.S. Southern Command Demonstrates Interagency Collaboration, but Its Haiti Disaster Response Revealed Challenges Conducting a Large Military Operation

    Science.gov (United States)

    2010-07-01

    Barbados, Belize, Bolivia, Brazil, Chile , Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica...19The international liaisons at SOUTHCOM include representatives from eight countries— Argentina, Brazil, Canada, Chile ...Nongovernmental Participants Agua Viva Alliance for Rabies Control FACE Food for the Poor Haiti Resource Development Foundation Hugs Across America

  9. Haiti's food and drinking water: a review of toxicological health risks.

    Science.gov (United States)

    Schwartzbord, J R; Emmanuel, E; Brown, D L

    2013-11-01

    The Republic of Haiti is a developing country in the Caribbean region with a history that challenges toxicologists, yet the historical panoply of toxicological hazards in Haiti has received little scholarly attention. The primary objectives of this paper are to review what is known about Haiti's current toxicological hazards, with a focus on chronic food-borne aflatoxin exposure and heavy metal contamination of water resources, and to compare these with previous large-scale, acute exposures to toxic substances: the 1995-1996 diethylene glycol (DEG) intoxications and the 2000-2001 ackee fruit poisonings. MEDLINE/PUBMED and the library website of Cornell University were searched using the terms "Haiti" and either "heavy metals," "aflatoxin", "diethylene glycol", or "ackee". The search was inclusive of articles from 1950 to 2012, and 15 out of the 37 returned were peer-reviewed articles offering original data or comprehensive discussion. One peer-reviewed article in press, two newspaper articles, two personal communications, and one book chapter from the personal databases of the authors were also referenced, making a total of 21 citations. Elevated concentrations of aflatoxins (greater than 20 μg/kg) were documented for staples of the Haitian food supply, most notably peanut butters and maize. Human exposure to aflatoxin was confirmed with analysis of aflatoxin blood biomarkers. The implications of aflatoxin exposure were reviewed in the light of Haiti's age-adjusted liver cancer risk - the highest in the Caribbean region. Measurement of heavy metals in Port-au-Prince ground water showed contamination of lead and chromium in excess of the US Environmental Protection Agency's 15 μg/L Action Level for lead and 100 μg/L Maximum Contamination Level Goal for total chromium. The DEG contamination of paracetamol (acetaminophen) containing products in 1995-1996 claimed the lives of 109 children and the 2000-2001 epidemic of ackee fruit poisoning resulted in 60 cases of

  10. High-resolution spatial analysis of cholera patients reported in Artibonite department, Haiti in 2010–2011

    Directory of Open Access Journals (Sweden)

    Maya Allan

    2016-03-01

    Conclusion/significance: These findings demonstrate the value of high-resolution mapping for pinpointing locations most affected by cholera, and in the future could help prioritize the places in need of interventions such as improvement of sanitation and vaccination. The findings also describe spatio-temporal transmission patterns of the epidemic in a cholera-naïve country such as Haiti. By identifying transmission hubs, it is possible to target prevention strategies that, over time, could reduce transmission of the disease and eventually eliminate cholera in Haiti.

  11. [The translation of knowledge in the ambit of international cooperation: the experience of Fiocruz in introducing health technologies to Haiti].

    Science.gov (United States)

    Pessoa, Luisa Regina; Kastrup, Erica; Linger, Pedro

    2016-01-01

    To investigate the debate about South-South cooperation, we conducted an analysis of a course on the Management of Physical and Technological Resources in Health given in Haiti as part of a partnership between Fiocruz and the Brazilian and Haitian ministries of health with the aim of enabling the functioning of the units built by Brazil, contributing to the sustainability of the tripartite cooperation project. The course format - designing interventions to overcome real problems identified by the students - resulted in the development of eight intervention pre-projects geared towards overcoming management problems at the reference community hospitals built by Brazil in Haiti.

  12. The Haiti Medical Education Project: development and analysis of a competency based continuing medical education course in Haiti through distance learning.

    Science.gov (United States)

    Battat, Robert; Jhonson, Marc; Wiseblatt, Lorne; Renard, Cruff; Habib, Laura; Normil, Manouchka; Remillard, Brian; Brewer, Timothy F; Sacajiu, Galit

    2016-10-19

    Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti. Real time lectures from local and international institutions were teleconferenced to physicians in remote Haitian sites using VidyoConferencing™ technology. With American Academy of Family Physicians (AAFP) and College of Family Physicians Canada (CFPC) guidelines as references, a competency-derived syllabus was created for a Haitian continuing medical education program. The resulting educational goals were reviewed by a committee of Haitian and North American physician/medical education practitioners to reflect local needs. All authors reviewed lectures and then conferred to establish agreement on competencies presented for each lecture. Sixty-seven lectures were delivered. Human immunodeficiency virus/Acquired Immunodeficiency Syndrome, ophthalmologic, infectious diseases, renal and endocrine competencies were well-represented, with more than 50 % of the joint AAFP and CFPC recommended competencies outlined. Areas under-represented included allergy and immunology, cardiology, surgery, pain management, gastroenterology, neurology, pulmonology, men's health and rheumatology; these topics accounted for less than 25 % of AAFP/CFPC recommended competencies. Areas not covered included geriatrics, nutrition, occupational health and women's health. Within practice-based lectures, only disaster medicine, health promotion and information management were included, but only partially

  13. Disability in post-earthquake Haiti: prevalence and inequality in access to services.

    Science.gov (United States)

    Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah

    2015-01-01

    To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with

  14. Seroprevalence of hepatitis C and associated risk factors among an urban population in Haiti

    Directory of Open Access Journals (Sweden)

    Hepburn Matthew J

    2004-12-01

    Full Text Available Abstract Background The seroprevalence of hepatitis C varies substantially between countries and geographic regions. A better understanding of the seroprevalence of this disease, and the risk factors associated with seropositive status, supply data for the development of screening programs and provide insight into the transmission of the disease. The purpose of this investigation was to determine the seroprevalence of hepatitis C and associated risk factors in an urban population in Haiti. Methods A prospective survey for hepatitis C antibodies was conducted among an urban outpatient population in Cap-Haïtien, Haiti, with a sample size of 500 subjects. An anonymous 12 question survey, with inquiries related to demographic characteristics and risk factors for HCV acquisition, was concomitantly administered with testing. These demographic and behavioral risk factors were correlated with HCV antibody status using univariate and multivariate tests. Results The prevalence of positive HCV antibody was 22/500 (4.4%. Subjects that were anti-HCV positive had an average of 7 ± 8.6 lifetime sexual partners, compared to average of 2.5 ± 3.5 lifetime sexual partners among HCV-negative subjects (p = 0.02. In a multiple logistic regression model, intravenous drug use (OR 3.7, 1.52–9.03 95% CI and number of sexual partners (OR 1.1, 1.04–1.20 95% CI were independently associated with a positive HCV antibody result. Conclusions A substantial number of subjects with HCV antibodies were detected in this population in Haiti. Further investigation into the correlation between the number of sexual partners and testing positive for hepatitis C antibodies is indicated.

  15. Late presentation for HIV care in central Haiti: factors limiting access to care.

    Science.gov (United States)

    Louis, C; Ivers, L C; Smith Fawzi, M C; Freedberg, K A; Castro, A

    2007-04-01

    Many patients with HIV infection present for care late in the course of their disease, a factor which is associated with poor prognosis. Our objective was to identify factors associated with late presentation for HIV care among patients in central Haiti. Thirty-one HIV-positive adults, approximately 10% of the HIV-infected population followed at a central Haiti hospital, participated in this research study. A two-part research tool that included a structured questionnaire and an ethnographic life history interview was used to collect quantitative as well as qualitative data about demographic factors related to presentation for HIV care. Sixty-five percent of the patients in this study presented late for HIV care, as defined by CD4 cell count below 350 cells/mm3. Factors associated with late presentation included male sex, older age, patient belief that symptoms are not caused by a medical condition, greater distance from the medical clinic, lack of prior access to effective medical care, previous requirement to pay for medical care, and prior negative experience at local hospitals. Harsh poverty was a striking theme among all patients interviewed. Delays in presentation for HIV care in rural Haiti are linked to demographic, socioeconomic and structural factors, many of which are rooted in poverty. These data suggest that a multifaceted approach is needed to overcome barriers to early presentation for care. This approach might include poverty alleviation strategies; provision of effective, reliable and free medical care; patient outreach through community health workers and collaboration with traditional healers.

  16. Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured.

    Science.gov (United States)

    Koski-Karell, Victoria; Farmer, Paul E; Isaac, Benito; Campa, Elizabeth M; Viaud, Loune; Namphy, Paul C; Ternier, Ralph; Ivers, Louise C

    2016-01-01

    Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge), policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of the three government-sponsored water treatment stations in the research area is still functional and utilized by those who can afford it. Latrines are scarce and often shared by up to 30 people; open defecation remains common. Structural vulnerabilities cut across all sectors - not just water, sanitation, health care, and education, but agriculture, environment, (global and local) commerce, transportation, and governance as well. These are among the hidden sicknesses that impede Haiti and its partners' capacity to eliminate cholera.

  17. High depth, whole-genome sequencing of cholera isolates from Haiti and the Dominican Republic.

    Science.gov (United States)

    Sealfon, Rachel; Gire, Stephen; Ellis, Crystal; Calderwood, Stephen; Qadri, Firdausi; Hensley, Lisa; Kellis, Manolis; Ryan, Edward T; LaRocque, Regina C; Harris, Jason B; Sabeti, Pardis C

    2012-09-11

    Whole-genome sequencing is an important tool for understanding microbial evolution and identifying the emergence of functionally important variants over the course of epidemics. In October 2010, a severe cholera epidemic began in Haiti, with additional cases identified in the neighboring Dominican Republic. We used whole-genome approaches to sequence four Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae isolates to a high depth of coverage (>2000x); four of the seven isolates were previously sequenced. Using these sequence data, we examined the effect of depth of coverage and sequencing platform on genome assembly and identification of sequence variants. We found that 50x coverage is sufficient to construct a whole-genome assembly and to accurately call most variants from 100 base pair paired-end sequencing reads. Phylogenetic analysis between the newly sequenced and thirty-three previously sequenced V. cholerae isolates indicates that the Haitian and Dominican Republic isolates are closest to strains from South Asia. The Haitian and Dominican Republic isolates form a tight cluster, with only four variants unique to individual isolates. These variants are located in the CTX region, the SXT region, and the core genome. Of the 126 mutations identified that separate the Haiti-Dominican Republic cluster from the V. cholerae reference strain (N16961), 73 are non-synonymous changes, and a number of these changes cluster in specific genes and pathways. Sequence variant analyses of V. cholerae isolates, including multiple isolates from the Haitian outbreak, identify coverage-specific and technology-specific effects on variant detection, and provide insight into genomic change and functional evolution during an epidemic.

  18. High depth, whole-genome sequencing of cholera isolates from Haiti and the Dominican Republic

    Directory of Open Access Journals (Sweden)

    Sealfon Rachel

    2012-09-01

    Full Text Available Abstract Background Whole-genome sequencing is an important tool for understanding microbial evolution and identifying the emergence of functionally important variants over the course of epidemics. In October 2010, a severe cholera epidemic began in Haiti, with additional cases identified in the neighboring Dominican Republic. We used whole-genome approaches to sequence four Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae isolates to a high depth of coverage (>2000x; four of the seven isolates were previously sequenced. Results Using these sequence data, we examined the effect of depth of coverage and sequencing platform on genome assembly and identification of sequence variants. We found that 50x coverage is sufficient to construct a whole-genome assembly and to accurately call most variants from 100 base pair paired-end sequencing reads. Phylogenetic analysis between the newly sequenced and thirty-three previously sequenced V. cholerae isolates indicates that the Haitian and Dominican Republic isolates are closest to strains from South Asia. The Haitian and Dominican Republic isolates form a tight cluster, with only four variants unique to individual isolates. These variants are located in the CTX region, the SXT region, and the core genome. Of the 126 mutations identified that separate the Haiti-Dominican Republic cluster from the V. cholerae reference strain (N16961, 73 are non-synonymous changes, and a number of these changes cluster in specific genes and pathways. Conclusions Sequence variant analyses of V. cholerae isolates, including multiple isolates from the Haitian outbreak, identify coverage-specific and technology-specific effects on variant detection, and provide insight into genomic change and functional evolution during an epidemic.

  19. Establishment of a Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program

    Science.gov (United States)

    Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

    2015-01-01

    The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 –December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries. PMID:26600437

  20. Laboratory evaluation of immunochromatographic rapid diagnostic tests for cholera in Haiti.

    Directory of Open Access Journals (Sweden)

    Wilfredo R Matias

    Full Text Available Rapid diagnostic tests (RDT for cholera are promising tools for detecting cholera in areas with limited laboratory infrastructure. However, evidence on the characteristics of the many available RDTs is scarce, and their use has been limited by suboptimal performance. We evaluated the performance characteristics of three cholera RDTs from Span Diagnostics, Artron Laboratories, and Standard Diagnostics in a regional laboratory in Haiti.We retrospectively reviewed records from May 2014 to October 2015 of a laboratory-based surveillance program for Vibrio cholerae at Hôpital Saint-Nicolas in Saint-Marc, Haiti. We compared the results of 511 Crystal VC, 129 Artron and 451 SD Bioline RDTs to bacterial culture as the gold standard. Of 905 cultures, 477 (52.7% were positive for V. cholerae O1, of which 27.7% were serotype Inaba. No cultures grew V. cholerae O139. Sensitivity and specificity of Crystal VC were 98.6% (95%CI: 96.5%-99.6% and 71.1% (95%CI: 64.7%-76.9%, respectively. Artron demonstrated a sensitivity of 98.6% (95%CI: 92.7%-100% and specificity of 69.1% (95%CI: 55.2%-80.9%. SD Bioline demonstrated a sensitivity of 81.1% (95%CI: 75.6%-85.8% and specificity of 92.8% (95%CI: 88.4%-95.9%. Crystal VC and Artron frequently showed false positive O139 bands, whereas none were seen with SD Bioline.There is significant variation in the performance of different cholera diagnostic RDTs. Artron and Crystal VC RDTs have high sensitivity and low specificity, while SD Bioline RDT has low to moderate sensitivity and high specificity when performed by laboratory technicians in Haiti. Study limitations included its retrospective design. The suboptimal characteristics of these tests limit their use as clinical point-of-care tests; however, they may be useful in outbreak response, surveillance, and research in resource-limited settings.

  1. Transpressional rupture of an unmapped fault during the 2010 Haiti earthquake

    KAUST Repository

    Calais, Éric

    2010-10-24

    On 12 January 2010, a Mw7.0 earthquake struck the Port-au-Prince region of Haiti. The disaster killed more than 200,000 people and caused an estimated $8 billion in damages, about 100% of the country?s gross domestic product. The earthquake was initially thought to have ruptured the Enriquillog-Plantain Garden fault of the southern peninsula of Haiti, which is one of two main strike-slip faults inferred to accommodate the 2cmyr -1 relative motion between the Caribbean and North American plates. Here we use global positioning system and radar interferometry measurements of ground motion to show that the earthquake involved a combination of horizontal and contractional slip, causing transpressional motion. This result is consistent with the long-term pattern of strain accumulation in Hispaniola. The unexpected contractional deformation caused by the earthquake and by the pattern of strain accumulation indicates present activity on faults other than the Enriquillog-Plantain Garden fault. We show that the earthquake instead ruptured an unmapped north-dipping fault, called the Léogâne fault. The Léogâne fault lies subparallel tog-but is different fromg-the Enriquillog-Plantain Garden fault. We suggest that the 2010 earthquake may have activated the southernmost front of the Haitian fold-and-thrust belt as it abuts against the Enriquillog-Plantain Garden fault. As the Enriquillog-Plantain Garden fault did not release any significant accumulated elastic strain, it remains a significant seismic threat for Haiti and for Port-au-Prince in particular. © 2010 Macmillan Publishers Limited. All rights reserved.

  2. Evaluation of forest cover estimates for Haiti using supervised classification of Landsat data

    Science.gov (United States)

    Churches, Christopher E.; Wampler, Peter J.; Sun, Wanxiao; Smith, Andrew J.

    2014-08-01

    This study uses 2010-2011 Landsat Thematic Mapper (TM) imagery to estimate total forested area in Haiti. The thematic map was generated using radiometric normalization of digital numbers by a modified normalization method utilizing pseudo-invariant polygons (PIPs), followed by supervised classification of the mosaicked image using the Food and Agriculture Organization (FAO) of the United Nations Land Cover Classification System. Classification results were compared to other sources of land-cover data produced for similar years, with an emphasis on the statistics presented by the FAO. Three global land cover datasets (GLC2000, Globcover, 2009, and MODIS MCD12Q1), and a national-scale dataset (a land cover analysis by Haitian National Centre for Geospatial Information (CNIGS)) were reclassified and compared. According to our classification, approximately 32.3% of Haiti's total land area was tree covered in 2010-2011. This result was confirmed using an error-adjusted area estimator, which predicted a tree covered area of 32.4%. Standardization to the FAO's forest cover class definition reduces the amount of tree cover of our supervised classification to 29.4%. This result was greater than the reported FAO value of 4% and the value for the recoded GLC2000 dataset of 7.0%, but is comparable to values for three other recoded datasets: MCD12Q1 (21.1%), Globcover (2009) (26.9%), and CNIGS (19.5%). We propose that at coarse resolutions, the segmented and patchy nature of Haiti's forests resulted in a systematic underestimation of the extent of forest cover. It appears the best explanation for the significant difference between our results, FAO statistics, and compared datasets is the accuracy of the data sources and the resolution of the imagery used for land cover analyses. Analysis of recoded global datasets and results from this study suggest a strong linear relationship (R2 = 0.996 for tree cover) between spatial resolution and land cover estimates.

  3. Transpressional rupture of an unmapped fault during the 2010 Haiti earthquake

    KAUST Repository

    Calais, É ric; Freed, Andrew M.; Mattioli, Glen S.; Amelung, Falk; Jonsson, Sigurjon; Jansma, Pamela E.; Hong, Sanghoon; Dixon, Timothy H.; Pré petit, Claude; Momplaisir, Roberte

    2010-01-01

    On 12 January 2010, a Mw7.0 earthquake struck the Port-au-Prince region of Haiti. The disaster killed more than 200,000 people and caused an estimated $8 billion in damages, about 100% of the country?s gross domestic product. The earthquake was initially thought to have ruptured the Enriquillog-Plantain Garden fault of the southern peninsula of Haiti, which is one of two main strike-slip faults inferred to accommodate the 2cmyr -1 relative motion between the Caribbean and North American plates. Here we use global positioning system and radar interferometry measurements of ground motion to show that the earthquake involved a combination of horizontal and contractional slip, causing transpressional motion. This result is consistent with the long-term pattern of strain accumulation in Hispaniola. The unexpected contractional deformation caused by the earthquake and by the pattern of strain accumulation indicates present activity on faults other than the Enriquillog-Plantain Garden fault. We show that the earthquake instead ruptured an unmapped north-dipping fault, called the Léogâne fault. The Léogâne fault lies subparallel tog-but is different fromg-the Enriquillog-Plantain Garden fault. We suggest that the 2010 earthquake may have activated the southernmost front of the Haitian fold-and-thrust belt as it abuts against the Enriquillog-Plantain Garden fault. As the Enriquillog-Plantain Garden fault did not release any significant accumulated elastic strain, it remains a significant seismic threat for Haiti and for Port-au-Prince in particular. © 2010 Macmillan Publishers Limited. All rights reserved.

  4. Impact of performance-based financing on primary health care services in Haiti.

    Science.gov (United States)

    Zeng, Wu; Cros, Marion; Wright, Katherine D; Shepard, Donald S

    2013-09-01

    To strengthen Haiti's primary health care (PHC) system, the country first piloted performance-based financing (PBF) in 1999 and subsequently expanded the approach to most internationally funded non-government organizations. PBF complements support (training and technical assistance). This study evaluates (a) the separate impact of PBF and international support on PHC's service delivery; (b) the combined impact of PBF and technical assistance on PHC's service delivery; and (c) the costs of PBF implementation in Haiti. To minimize the risk of facilities neglecting potential non-incentivized services, the incentivized indicators were randomly chosen at the end of each year. We obtained quantities of key services from four departments for 217 health centres (15 with PBF and 202 without) from 2008 through 2010, computed quarterly growth rates and analysed the results using a difference-in-differences approach by comparing the growth of incentivized and non-incentivized services between PBF and non-PBF facilities. To interpret the statistical analyses, we also interviewed staff in four facilities. Whereas international support added 39% to base costs of PHC, incentive payments added only 6%. Support alone increased the quantities of PHC services over 3 years by 35% (2.7%/quarter). However, support plus incentives increased these amounts by 87% over 3 years (5.7%/quarter) compared with facilities with neither input. Incentives alone was associated with a net 39% increase over this period, and more than doubled the growth of services (P < 0.05). Interview findings found no adverse impacts and, in fact, indicated beneficial impacts on quality. Incentives proved to be a relatively inexpensive, well accepted and very effective complement to support, suggesting that a small amount of money, strategically used, can substantially improve PHC. Haiti's experience, after more than a decade of use, indicates that incentives are an effective tool to strengthen PHC.

  5. Short report: documentation of iodine deficiency in Haitian schoolchildren: implication for lymphatic filariasis elimination in Haiti.

    Science.gov (United States)

    Beach, M J; Streit, T G; Houston, R; May, W A; Addiss, D G; Lammie, P J

    2001-01-01

    In this study we documented unexpected moderate-to-severe iodine deficiency in Haitian schoolchildren although they live in a coastal community where presumably they have access to iodine-containing seafood. This fact combined with the lack of an iodized salt supply and endemic lymphatic filariasis makes community distribution of diethylcarbamazine-fortified, iodized salt an attractive strategy for elimination of lymphatic filariasis and iodine deficiency disorders in this area of Haiti. Combining lymphatic filariasis elimination with other public health interventions is one strategy to increase its public health benefit and maximize the impact of limited public health resources.

  6. Earthquake Damage Assessment Using Objective Image Segmentation: A Case Study of 2010 Haiti Earthquake

    Science.gov (United States)

    Oommen, Thomas; Rebbapragada, Umaa; Cerminaro, Daniel

    2012-01-01

    In this study, we perform a case study on imagery from the Haiti earthquake that evaluates a novel object-based approach for characterizing earthquake induced surface effects of liquefaction against a traditional pixel based change technique. Our technique, which combines object-oriented change detection with discriminant/categorical functions, shows the power of distinguishing earthquake-induced surface effects from changes in buildings using the object properties concavity, convexity, orthogonality and rectangularity. Our results suggest that object-based analysis holds promise in automatically extracting earthquake-induced damages from high-resolution aerial/satellite imagery.

  7. Haiti: Feasibility of Waste-to-Energy Options at the Trutier Waste Site

    Energy Technology Data Exchange (ETDEWEB)

    Conrad, M. D.; Hunsberger, R.; Ness, J. E.; Harris, T.; Raibley, T.; Ursillo, P.

    2014-08-01

    This report provides further analysis of the feasibility of a waste-to-energy (WTE) facility in the area near Port-au-Prince, Haiti. NREL's previous analysis and reports identified anaerobic digestion (AD) as the optimal WTE technology at the facility. Building on the prior analyses, this report evaluates the conceptual financial and technical viability of implementing a combined waste management and electrical power production strategy by constructing a WTE facility at the existing Trutier waste site north of Port-au-Prince.

  8. Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured

    Directory of Open Access Journals (Sweden)

    Koski-Karell V

    2016-05-01

    Full Text Available Victoria Koski-Karell,1,2 Paul E Farmer,2–4 Benito Isaac,5 Elizabeth M Campa,5 Loune Viaud,5 Paul C Namphy,6 Ralph Ternier,5 Louise C Ivers2–4 1Department of Anthropology, University of Michigan, and University of Michigan Medical School, Ann Arbor, MI, 2Partners In Health, 3Department of Global Health and Social Medicine, Harvard Medical School, 4Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; 5Zanmi Lasante, Cange, 6Direction Nationale de l'Eau Potable et de l'Assainissement, Port-au-Prince, Haiti Abstract: Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge, policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of

  9. Magnetic properties and Moessbauer analyses of glass from the K-T boundary, Beloc, Haiti

    Science.gov (United States)

    Senftle, F. E.; Thorpe, A. N.; May, L.; Barkatt, A.; Adel-Hadadi, M. A.; Marbury, G. S.; Izett, G.; Sigurdsson, H.; Maurasse, F. J.-M. R.

    1993-01-01

    The experimental magnetic susceptibility, the temperature-independent component of the magnetic susceptibility, the magnetization, and the Curie constant have been measured for a number of specimens of glass from the K-T boundary found at Beloc, Haiti, and the results are compared with those of similar measurements of tektites. Because the Fe(3+)/Fe(2+) ratio is needed to calculate the magnetic parameters, Moessbauer spectroscopic measurements were also made. The data were consistent with the classification of the Beloc glasses as tektites.

  10. Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

    Science.gov (United States)

    De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

    2015-12-01

    The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring

  11. Attraverso il corpo. Donne di una bidonville di Haiti e doni dello sviluppo

    Directory of Open Access Journals (Sweden)

    Pia Maria Koller

    2014-04-01

    Full Text Available Living in Cité Soleil, the largest haitian slum, is in itself a stigma, hindering access to social services and humanitarian aid. Repression and the increasing presence of armed gangs imposed a culture of silence. Violence became normality, particularly against women. Their survival strategies can be summarized by kalkile, calculate, pervading the individual and social body. When confronted with inequity in health, choices may turn into acts of resistance.Still, women continue to organize collectively. Some counteract their despair with works of art, reproducing the beauty of what in their memory remains "the pearl of the Antilles": Haiti

  12. Energy Transition Initiative: Island Energy Snapshot - Haiti; U.S. Department of Energy (DOE), NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    This profile provides a snapshot of the energy landscape of Haiti, an independent nation that occupies the western portion of the island of Hispaniola in the northern Caribbean Sea. Haiti’s utility rates are roughly $0.35 U.S. dollars (USD) per kilowatt-hour (kWh), above the Caribbean regional average of $0.33 USD/kWh.

  13. Factors Related to Fetal Death in Pregnant Women with Cholera, Haiti, 2011–2014

    Centers for Disease Control (CDC) Podcasts

    2016-03-14

    Reginald Tucker reads an abridged version of the EID article Factors Related to Fetal Death in Pregnant Women with Cholera, Haiti, 2011–2014.  Created: 3/14/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/14/2016.

  14. Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening and treatment of pregnant women in Port-au-Prince, Haiti.

    Science.gov (United States)

    Bristow, Claire C; Mathelier, Patricia; Ocheretina, Oksana; Benoit, Daphne; Pape, Jean W; Wynn, Adriane; Klausner, Jeffrey D

    2017-10-01

    In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi's sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated - 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.

  15. Experience of an orthoplastic limb salvage team after the Haiti earthquake: analysis of caseload and early outcomes.

    LENUS (Irish Health Repository)

    Clover, A James P

    2011-06-01

    After the devastating earthquake in Haiti on January 12, 2010, a British orthoplastic limb salvage team was mobilized. The team operated in a suburb of Port-au-Prince from January 20, 2010. This analysis gives an overview of the caseload and early outcomes.

  16. Geospatial Data Availability for Haiti: An Aid in the Development of GIS-Based Natural Resource Assessments for Conservation Planning.

    Science.gov (United States)

    Maya Quinones; William Gould; Carlos D. Rodriguez-Pedraza

    2007-01-01

    This report documents the type and source of geospatial data available for Haiti. It was compiled to serve as a resource for geographic information system (GIS)-based land management and planning. It will be useful for conservation planning, reforestation efforts, and agricultural extension projects. Our study indicates that there is a great deal of geospatial...

  17. Retention in Care among HIV-Infected Pregnant Women in Haiti with PMTCT Option B

    Directory of Open Access Journals (Sweden)

    Jodie Dionne-Odom

    2016-01-01

    Full Text Available Background. Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding. Methods. Retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing. Results. Women in the cohort had 463 pregnancies between 2009 and 2012 with retention rates of 80% at delivery, 67% at one year, and 59% at 2 years. Among those who were LFU, the highest risk period was during pregnancy (60% or shortly afterwards (24.4% by 12 months. Never starting on antiretroviral therapy (aRR 2.29, 95% CI 1.4–3.8 was associated with loss to follow-up. Conclusions. Loss to follow-up during and after pregnancy was common in HIV-infected women in Haiti under PMTCT Option B. Since sociodemographic factors and distance from home to facility did not predict LFU, future work should elicit and address barriers to retention at the initial prenatal care visit in all women. Better tracking systems to capture engagement in care in the wider network are needed.

  18. Seismic hazard of the Enriquillog-Plantain Garden fault in Haiti inferred from palaeoseismology

    Science.gov (United States)

    Prentice, C.S.; Mann, P.; Crone, A.J.; Gold, R.D.; Hudnut, K.W.; Briggs, R.W.; Koehler, R.D.; Jean, P.

    2010-01-01

    The Enriquillog-Plantain Garden fault zone is recognized as one of the primary plate-bounding fault systems in Haiti. The strike-slip fault runs adjacent to the city of Port-au-Prince and was initially thought to be the source of the 12 January 2010, M w 7.0 earthquake. Haiti experienced significant earthquakes in 1751 and 1770 (refsA, 3, 4, 5), but the role of the Enriquillog-Plantain Garden fault zone in these earthquakes is poorly known. We use satellite imagery, aerial photography, light detection and ranging (LIDAR) and field investigations to document Quaternary activity on the Enriquillog-Plantain Garden fault. We report late Quaternary, left-lateral offsets of up to 160m, and a set of small offsets ranging from 1.3 to 3.3m that we associate with one of the eighteenth century earthquakes. The size of the small offsets implies that the historical earthquake was larger than M w 7.0, but probably smaller than M w 7.6. We found no significant surface rupture associated with the 2010 earthquake. The lack of surface rupture, coupled with other seismologic, geologic and geodetic observations, suggests that little, if any, accumulated strain was released on the Enriquillog-Plantain Garden fault in the 2010 earthquake. These results confirm that the Enriquillog-Plantain Garden fault remains a significant seismic hazard. ?? 2010 Macmillan Publishers Limited. All rights reserved.

  19. Improving Maternal Healthcare Access and Neonatal Survival through a Birthing Home Model in Rural Haiti

    Directory of Open Access Journals (Sweden)

    Elizabeth Wickstrom

    2007-10-01

    Full Text Available High neonatal mortality in Haiti is sustained by limited access to essential maternity services, particularly for Haiti’s rural population. We investigated the feasibility of a rural birthing home model to provide basic prenatal, delivery, and neonatal services for women with uncomplicated pregnancies while simultaneously providing triage and transport of women with pregnancy related complications. The model included consideration of the local context, including women’s perceptions of barriers to healthcare access and available resources to implement change. Evaluation methods included the performance of a baseline community census and collection of pregnancy histories from 791 women living in a defined area of rural Haiti. These retrospective data were compared with pregnancy outcome for 668 women subsequently receiving services at the birthing home. Of 764 reported most recent pregnancies in the baseline survey, 663(87% occurred at home with no assistance from skilled health staff. Of 668 women followed after opening of the birthing home, 514 (77% subsequently gave birth at the birthing home, 94 (14% were referred to a regional hospital for delivery, and only 60 (9% delivered at home or on the way to the birthing home. Other measures of clinical volume and patient satisfaction also indicated positive changes in health care seeking. After introduction of the birthing home, fewer neonates died than predicted by historical information or national statistics. The present experience points out the feasibility of a rural birthing home model to increase access to essential maternity services.

  20. Reproductive and Birth Outcomes in Haiti Before and After the 2010 Earthquake.

    Science.gov (United States)

    Harville, Emily W; Do, Mai

    2016-02-01

    We aimed to examine the relationship between exposure to the 2010 Haiti earthquake and pregnancy wantedness, interpregnancy interval, and birth weight. From the nationally representative Haiti 2012 Demographic and Health Survey, information on "size of child at birth" (too small or not) was available for 7280 singleton births in the previous 5 years, whereas information on birth weight was available for 1607 births. Pregnancy wantedness, short (earthquake and by level of damage. Multiple logistic regression and linear regression analyses were conducted. Post-earthquake births were less likely to be wanted and more likely to be born after a short interpregnancy interval. Earthquake exposure was associated with increased likelihood of a child being born too small: timing of birth (after earthquake vs. before earthquake, adjusted odds ratio [aOR]: 1.27, 95% confidence interval [CI]: 1.12-1.45), region (hardest-hit vs. rest of country; aOR: 1.43, 95% CI: 1.14- 1.80), and house damage (aOR: 1.27 95% CI: 1.02-1.58). Mean birth weight was 150 to 300 g lower in those exposed to the earthquake. Experience with the earthquake was associated with worse reproductive and birth outcomes, which underscores the need to provide reproductive health services as part of relief efforts.

  1. Enhanced ULF radiation observed by DEMETER two months around the strong 2010 Haiti earthquake

    Directory of Open Access Journals (Sweden)

    M. A. Athanasiou

    2011-04-01

    Full Text Available In this paper we study the energy of ULF electromagnetic waves that were recorded by the satellite DEMETER, during its passing over Haiti before and after a destructive earthquake. This earthquake occurred on 12 January 2010, at geographic Latitude 18.46° and Longitude 287.47°, with Magnitude 7.0 R. Specifically, we are focusing on the variations of energy of Ez-electric field component concerning a time period of 100 days before and 50 days after the strong earthquake. In order to study these variations, we have developed a novel method that can be divided in two stages: first we filter the signal, keeping only the ultra low frequencies and afterwards we eliminate its trend using techniques of Singular Spectrum Analysis (SSA, combined with a third-degree polynomial filter. As it is shown, a significant increase in energy is observed for the time interval of 30 days before the earthquake. This result clearly indicates that the change in the energy of ULF electromagnetic waves could be related to strong precursory earthquake phenomena. Moreover, changes in energy associated with strong aftershock activity were also observed 25 days after the earthquake. Finally, we present results concerning the comparison between changes in energy during night and day passes of the satellite over Haiti, which showed differences in the mean energy values, but similar results as far as the rate of the energy change is concerned.

  2. Control of Dog Mediated Human Rabies in Haiti: No Time to Spare.

    Directory of Open Access Journals (Sweden)

    Max F Millien

    Full Text Available The American region has pledged to eliminate dog-mediated human rabies by 2015. As part of these efforts, we describe the findings of a desk and field mission review of Haiti's rabies situation by the end of 2013. While government officials recognize the importance of dog-mediated rabies control, and the national rabies plan adequately contemplates the basic capacities to that effect, regular and sufficient implementation, for example, of dog vaccination, is hampered by limited funding. Compounding insufficient funding and human resources, official surveillance figures do not accurately reflect the risk to the population, as evidenced by the large number of rabid dogs detected by focalized and enhanced surveillance activities conducted by the Ministry of Agriculture, Natural Resources and Rural Development (MARNDR and the Health and Population Ministry (MSPP with the technical assistance of the United States Centers for Disease Control and Prevention. Although international support is common, either in the form of on-the-ground technical support or donations of immunobiologicals, it is not comprehensive. In addition, there is limited coordination with MARNDR/MSPP and with other actors at the strategic or operational level due to human resources limitations. Given these findings, the 2015 elimination goal in the region is compromised by the situation in Haiti where control of the disease is not yet in sight despite the best efforts of the resolute national officials. More importantly, dog-mediated rabies is still a threat to the Haitian population.

  3. Ruptures, rights, and repair: the political economy of trauma in Haiti.

    Science.gov (United States)

    James, Erica Caple

    2010-01-01

    This article analyzes the unintended consequences of humanitarian and development interventions in Haiti implemented to facilitate its postconflict transition following the period of military rule between 1991 and 1994. International and national governmental and nongovernmental initiatives to provide redress and healing to victims of human rights abuses from this period inadvertently contributed to the growth of a political economy of trauma. I argue that state-sponsored and non-state interventions aimed at truth seeking, acknowledging past ruptures, and reparations have intersected with the politics of local communities in ways that contribute to the commoditization of suffering in the political economy of trauma. The experience of a woman whose bodily integrity and personal sovereignty were violated by members of Haiti's terror apparatus demonstrates the presence of a terror economy. My witnessing of her interactions with the international and national humanitarian and development aid organizations that assisted her in the aftermath of violation revealed the contours of the compassion economy. It is the compassion economy that is the particular focus of this article. I evaluate whether rendering visible or audible the individual and collective suffering of the past truly aid processes of social reconstruction, democratization, and peace building, especially in states plagued with ongoing social, political, and economic insecurity. I argue that the forms of citizenship that these interventions engender are rarely permanent, especially in fragile or failed states, and may exacerbate the societal cleavages that gave rise to conflict.

  4. ART attrition and risk factors among Option B+ patients in Haiti: A retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Nancy Puttkammer

    Full Text Available In October 2012, the Haitian Ministry of Health endorsed the "Option B+" strategy to eliminate mother-to-child transmission of HIV and achieve HIV epidemic control. The objective of this paper is to assess and identify risk factors for attrition from the national ART program among Option B+ patients in the 12 months after ART initiation.This retrospective cohort study included patients newly initiating ART from October 2012-August 2013 at 68 ART sites covering 45% of all newly enrolled ART patients in all regions of Haiti.With data from electronic medical records, we carried out descriptive analysis of sociodemographic, clinical, and pregnancy-related correlates of ART attrition, and used a modified Poisson regression approach to estimate relative risks in a multivariable model.There were 2,166 Option B+ patients who initiated ART, of whom 1,023 were not retained by 12 months (47.2%. One quarter (25.3% dropped out within 3 months of ART initiation. Protective factors included older age, more advanced HIV disease progression, and any adherence counseling prior to ART initiation, while risk factors included starting ART late in gestation, starting ART within 7 days of HIV testing, and using an atypical ART regimen.Our study demonstrates early ART attrition among Option B+ patients and contributes evidence on the characteristics of women who are most at risk of attrition in Haiti. Our findings highlight the importance of targeted strategies to support retention among Option B+ patients.

  5. Perceptions of Health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012.

    Directory of Open Access Journals (Sweden)

    Holly Ann Williams

    Full Text Available The international response to Haiti's ongoing cholera outbreak has been multifaceted, including health education efforts by community health workers and the distribution of free water treatment products. Artibonite Department was the first region affected by the outbreak. Numerous organizations have been involved in cholera response efforts in Haiti with many focusing on efforts to improve water, sanitation, and hygiene (WASH. Multiple types of water treatment products have been distributed, creating the potential for confusion over correct dosage and water treatment methods. We utilized qualitative methods in Artibonite to determine the population's response to WASH messages, use and acceptability of water treatment products, and water treatment and sanitation knowledge, attitudes and practices at the household level. We conducted eighteen focus group discussions (FGDs: 17 FGDs were held with community members (nine among females, eight among males; one FGD was held with community health workers. Health messages related to WASH were well-retained, with reported improvements in hand-washing. Community health workers were identified as valued sources of health information. Most participants noted a paucity of water-treatment products. Sanitation, specifically the construction of latrines, was the most commonly identified need. Lack of funds was the primary reason given for not constructing a latrine. The construction and maintenance of potable water and sanitation services is needed to ensure a sustainable change.

  6. Menstrual Education and Personal Hygiene Supplies to Empower Young Women in Haiti.

    Science.gov (United States)

    Coker-Bolt, Patricia; Jansson, Annika; Bigg, Sherridan; Hammond, Elizabeth; Hudson, Harmony; Hunkler, Sarah; Kitch, Jana; Richardson, Heather; Tiedemann, Erica; O'Flynn, Janet; Laurent, Marie Dominque

    2017-10-01

    Recent studies report that Haitian women are concerned about unmet women's health issues. The Days for Girls (DfG) International program features women's health education and personal hygiene kits to ensure women understand the process of menstruation and sanitary hygiene practices. The aim was to train Haitian seamstresses to produce the DfG kits during an in-country workshop and investigate the perceived benefit of the DfG program in young women who used the DfG kits. Posttest only design was used to measure the effectiveness of DfG workshop and postsurvey to study perception of women using DfG kits. It was found that the workshop participants demonstrated an understanding of the DfG program (90% average). Forty-four young women (89.8%) who used the DfG hygiene kits for 2 months agreed that there is a need for feminine hygiene programs in Haiti and that the kits were easy to use and clean (97.1% and 92.1%, respectively). The DfG program could provide a cost-effective feminine hygiene program for Haiti and decrease waste from traditional hygiene products.

  7. A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake.

    Science.gov (United States)

    Grelotti, David J; Lee, Amy C; Fils-Aimé, Joseph Reginald; Jean, Jacques Solon; Therosmé, Tatiana; Petit-Homme, Handy; Oswald, Catherine M; Raviola, Giuseppe; Eustache, Eddy

    2015-01-01

    Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based psychiatric services in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme ("mhGAP"), a tool developed by the World Health Organization to support mental health care delivery by nonspecialists in LMICs. The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system

  8. Haiti: de la 'invisibilidad' de un territorio a la concreción de proyectos que fortalezcan su autonomía.

    OpenAIRE

    Lorda , María Amalia

    2012-01-01

    International audience; Haiti: the "invisibility" of a territory to build projects that strengthen their autonomy. Haiti, known in colonial times as "the Pearl of the Antilles", its economy was organized around the production of sugar supplied through France the rest of Europe. Thus 70% of the sugar was consumed in Europe, and over 60% of the coffee. With a logic pursuing maximize yields, sought slave labor in sub-Saharan Africa population that directly replaced the original. So begins to app...

  9. Soccer and sexual health education: a promising approach for reducing adolescent births in Haiti

    Directory of Open Access Journals (Sweden)

    Kathryn C Kaplan

    2015-05-01

    Full Text Available OBJECTIVE: To explore the effect of an innovative, integrative program in female sexual reproductive health (SRH and soccer (or fútbol, in Haitian Creole in rural Haiti by measuring the rate of births among program participants 15-19 years old and their nonparticipant peers. METHODS: A retrospective cohort study using 2006-2009 data from the computerized data-tracking system of the Haitian Health Foundation (HHF, a U.S.-based nongovernmental organization serving urban and rural populations in Haiti, was used to assess births among girls 15-19 years old who participated in HHF's GenNext program, a combination education-soccer program for youth, based on SRH classes HHF nurses and community workers had been conducting in Haiti for mothers, fathers, and youth; girl-centered health screenings; and an all-female summer soccer league, during 2006-2009 (n = 4 251. Bivariate and multiple logistic regression analyses were carried out to assess differences in the rate of births among program participants according to their level of participation (SRH component only ("EDU" versus both the SRH and soccer components ("SO" compared to their village peers who did not participate. Hazard ratios (HRs of birth rates were estimated using Cox regression analysis of childbearing data for the three different groups. RESULTS: In the multiple logistic regression analysis, only the girls in the "EDU" group had significantly fewer births than the nonparticipants after adjusting for confounders (odds ratio = 0.535; 95% confidence interval (CI = 0.304, 0.940. The Cox regression analysis demonstrated that those in the EDU group (HR = 0.893; 95% CI = 0.802, 0.994 and to a greater degree those in the SO group (HR = 0.631; 95% CI = 0.558, 0.714 were significantly protected against childbearing between the ages of 15 and 19 years. CONCLUSIONS: HHF's GenNext program demonstrates the effectiveness of utilizing nurse educators, community mobilization, and youth participation in

  10. Soccer and sexual health education: a promising approach for reducing adolescent births in Haiti.

    Science.gov (United States)

    Kaplan, Kathryn C; Lewis, Judy; Gebrian, Bette; Theall, Katherine

    2015-05-01

    To explore the effect of an innovative, integrative program in female sexual reproductive health (SRH) and soccer (or fútbol, in Haitian Creole) in rural Haiti by measuring the rate of births among program participants 15-19 years old and their nonparticipant peers. A retrospective cohort study using 2006-2009 data from the computerized data-tracking system of the Haitian Health Foundation (HHF), a U.S.-based nongovernmental organization serving urban and rural populations in Haiti, was used to assess births among girls 15-19 years old who participated in HHF's GenNext program, a combination education-soccer program for youth, based on SRH classes HHF nurses and community workers had been conducting in Haiti for mothers, fathers, and youth; girl-centered health screenings; and an all-female summer soccer league, during 2006-2009 (n = 4 251). Bivariate and multiple logistic regression analyses were carried out to assess differences in the rate of births among program participants according to their level of participation (SRH component only ("EDU") versus both the SRH and soccer components ("SO") compared to their village peers who did not participate. Hazard ratios (HRs) of birth rates were estimated using Cox regression analysis of childbearing data for the three different groups. In the multiple logistic regression analysis, only the girls in the "EDU" group had significantly fewer births than the nonparticipants after adjusting for confounders (odds ratio = 0.535; 95% confidence interval (CI) = 0.304, 0.940). The Cox regression analysis demonstrated that those in the EDU group (HR = 0.893; 95% CI = 0.802, 0.994) and to a greater degree those in the SO group (HR = 0.631; 95% CI = 0.558, 0.714) were significantly protected against childbearing between the ages of 15 and 19 years. HHF's GenNext program demonstrates the effectiveness of utilizing nurse educators, community mobilization, and youth participation in sports, education, and structured youth groups to

  11. Y-chromosomal diversity in Haiti and Jamaica: contrasting levels of sex-biased gene flow.

    Science.gov (United States)

    Simms, Tanya M; Wright, Marisil R; Hernandez, Michelle; Perez, Omar A; Ramirez, Evelyn C; Martinez, Emanuel; Herrera, Rene J

    2012-08-01

    Although previous studies have characterized the genetic structure of populations from Haiti and Jamaica using classical and autosomal STR polymorphisms, the patrilineal influences that are present in these countries have yet to be explored. To address this lacuna, the current study aims to investigate, for the first time, the potential impact of different ancestral sources, unique colonial histories, and distinct family structures on the paternal profile of both groups. According to previous reports examining populations from the Americas, island-specific demographic histories can greatly impact population structure, including various patterns of sex-biased gene flow. Also, given the contrasting autosomal profiles provided in our earlier study (Simms et al.: Am J Phys Anthropol 142 (2010) 49-66), we hypothesize that the degree and directionality of gene flow from Europeans, Africans, Amerindians, and East Asians are dissimilar in the two countries. To test this premise, 177 high-resolution Y-chromosome binary markers and 17 Y-STR loci were typed in Haiti (n = 123) and Jamaica (n = 159) and subsequently utilized for phylogenetic comparisons to available reference collections encompassing Africa, Europe, Asia (East and South), and the New World. Our results reveal that both studied populations exhibit a predominantly South-Saharan paternal component, with haplogroups A1b-V152, A3-M32, B2-M182, E1a-M33, E1b1a-M2, E2b-M98, and R1b2-V88 comprising 77.2% and 66.7% of the Haitian and Jamaican paternal gene pools, respectively. Yet, European derived chromosomes (i.e., haplogroups G2a*-P15, I-M258, R1b1b-M269, and T-M184) were detected at commensurate levels in Haiti (20.3%) and Jamaica (18.9%), whereas Y-haplogroups indicative of Chinese [O-M175 (3.8%)] and Indian [H-M69 (0.6%) and L-M20 (0.6%)] ancestry were restricted to Jamaica. Copyright © 2012 Wiley Periodicals, Inc.

  12. Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

    Science.gov (United States)

    Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

    2016-10-01

    Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but

  13. Evaluation of case management of uncomplicated malaria in Haiti: a national health facility survey, 2012.

    Science.gov (United States)

    Landman, Keren Z; Jean, Samuel E; Existe, Alexandre; Akom, Eniko E; Chang, Michelle A; Lemoine, Jean Frantz; Mace, Kimberly E

    2015-10-09

    Malaria is a public health concern in Haiti, although there are limited data on its burden and case management. National malaria guidelines updated in 2012 recommend treatment with chloroquine and primaquine. In December 2012, a nationally-representative cross-sectional survey of health facilities (HFs) was conducted to determine malaria prevalence among febrile outpatients and malaria case management quality at baseline before scale-up of diagnostics and case management training. Among all 833 HFs nationwide, 30 were selected randomly, in proportion to total HFs per region, for 2-day evaluations. Survey teams inventoried HF material and human resources. Outpatients of all ages were screened for temperature >37.5 °C or history of fever; those without severe symptoms were consented and enrolled. Providers evaluated and treated enrolled patients according to HF standards; the survey teams documented provider-ordered diagnostic tests and treatment decisions. Facility-based test results [microscopy and malaria rapid diagnostic tests (RDTs)] were collected from HF laboratories. Blood smears for gold-standard microscopy, and dried blood spots for polymerase chain reaction (PCR) were obtained. Malaria diagnostic capacity, defined as completing a test for an enrolled patient or having adequate resources for RDTs or microscopy, was present in 11 (37 %) HFs. Among 459 outpatients screened, 257 (56 %) were febrile, of which 193 (75 %) were eligible, and 153 (80 %) were enrolled. Among 39 patients with facility-level malaria test results available on the survey day, 11 (28 %) were positive, of whom 6 (55 %) were treated with an anti-malarial. Twenty-seven (95 %) of the 28 patients testing negative were not treated with an anti-malarial. Of 114 patients without test results available, 35 (31 %) were presumptively treated for malaria. Altogether, 42 patients were treated with an anti-malarial, one (2 %) according to Haiti's 2012 guidelines. Of 140 gold-standard smears, none

  14. Controlling Neglected Tropical Diseases (NTDs in Haiti: Implementation Strategies and Evidence of Their Success.

    Directory of Open Access Journals (Sweden)

    Jean Frantz Lemoine

    2016-10-01

    Full Text Available Lymphatic filariasis (LF and soil-transmitted helminths (STH have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for

  15. The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010-2015.

    Science.gov (United States)

    Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M

    2017-10-01

    Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of

  16. Characterizing HIV epidemiology in stable couples in Cambodia, the Dominican Republic, Haiti, and India.

    Science.gov (United States)

    Chemaitelly, H; Abu-Raddad, L J

    2016-01-01

    Using a set of statistical methods and HIV mathematical models applied on nationally representative Demographic and Health Survey data, we characterized HIV serodiscordancy patterns and HIV transmission dynamics in stable couples (SCs) in four countries: Cambodia, the Dominican Republic, Haiti, and India. The majority of SCs affected by HIV were serodiscordant, and about a third of HIV-infected persons had uninfected partners. Overall, nearly two-thirds of HIV infections occurred in individuals in SCs, but only about half of these infections were due to transmissions within serodiscordant couples. The majority of HIV incidence in the population occurred through extra-partner encounters in SCs. There is similarity in HIV epidemiology in SCs between these countries and countries in sub-Saharan Africa, despite the difference in scale of epidemics. It appears that HIV epidemiology in SCs may share similar patterns globally, possibly because it is a natural 'spillover' effect of HIV dynamics in high-risk populations.

  17. HAITI: MUCH ATTENTION, NO RESULTS. WHY DEVELOPMENT ASSISTANCE DOESN’T WORK

    Directory of Open Access Journals (Sweden)

    ANDREEA MARIŞ

    2011-01-01

    Full Text Available The present paper is an excerpt, with little adaptation, from the master thesis: “Project management’s contribution to international cooperation. How to make things work: ODA in Haiti” wrote under the coordination of Prof. Dr. Horst Brezinski from Technical University Freiberg Bergakademie and Prof. Dr. Eng.. Sabina Irimie from University of Petrosani, while benefiting from an Erasmus study scholarship at the first mentioned institution. It presents the case of Haiti, a small country facing big challenges and enjoying plenty of international attention especially due to the recent earthquake that struck the country at the beginning of 2010. The SWOT analysis inside the paper offers a detailed view of Haiti’s actual situation, identifying in the same time its problems and the variables that should be taken into consideration when designing programmes and projects targeting Haiti’s development.

  18. Estimation of patient radiation doses during radiologic examinations in the Republic of Haiti

    International Nuclear Information System (INIS)

    Massillon, J.G.; Borras, C.

    2001-01-01

    The International Commission on Radiological Protection and the international organizations that co-sponsored the International Basic Safety Standards for the Protection against Ionization Radiation and for the Safety of Radiation Sources (BSS) - among them PAHO and WHO - recommended the use of investigation levels to provide guidance for medical exposures. In this work, entrance surface doses for several common diagnostic radiology procedure have been determined from exposure rate measurements and patient technique factors in seven 'World Health Imaging System - Radiography' (WHIS-RAD) units, installed in public health services facilities of the Republic of Haiti. The results show the entrance surface doses below the guidance levels published in the BSS. Concomitant image quality measurements performed, however, indicate serious artifacts in the film processing, calling for the need of additional training of the technologists. (author)

  19. Implementation and evaluation of a web based system for pharmacy stock management in rural Haiti.

    Science.gov (United States)

    Berger, Elisabeth J; Jazayeri, Darius; Sauveur, Marcel; Manasse, Jean Joel; Plancher, Inel; Fiefe, Marquise; Laurat, Guerline; Joseph, Samahel; Kempton, Kathryn; Fraser, Hamish S F

    2007-10-11

    Managing the stock and supply of medication is essential for the provision of health care, especially in resource poor areas of the world. We have developed an innovative, web-based stock management system to support nine clinics in rural Haiti. Building on our experience with a web-based EMR system for our HIV patients, we developed a comprehensive stock tracking system that is modeled on the appearance of standardized WHO stock cards. The system allows pharmacy staff at all clinics to enter stock levels and also to request drugs and track shipments. Use of the system over the last 2 years has increased rapidly and we now track 450 products supporting care for 1.78 million patient visits annually. Over the last year drug stockouts have fallen from 2.6% to 1.1% and 97% of stock requests delivered were shipped within 1 day. We are now setting up this system in our clinics in rural Rwanda.

  20. Solid waste workers and livelihood strategies in Greater Port-au-Prince, Haiti

    International Nuclear Information System (INIS)

    Noel, Claudel

    2010-01-01

    The solid waste management industry in Haiti is comprised of a formal and an informal sector. Many basic activities in the solid waste management sector are being carried out within the context of profound poverty, which exposes the failure of the socioeconomic and political system to provide sufficient job opportunities for the urban population. This paper examines the involvement of workers in the solid waste management industry in Greater Port-au-Prince and the implications for livelihood strategies. The findings revealed that the Greater Port-au-Prince solid waste management system is very inclusive with respect to age, while highly segregated with regard to gender. In terms of earning capacity, the results showed that workers hired by the State agencies were the most economically vulnerable group as more than 50% of them fell below the official nominal minimum wage. This paper calls for better salary scales and work compensation for the solid waste workers.

  1. Stratigraphy and sedimentology of the K/T boundary deposit in Haiti

    Science.gov (United States)

    Carey, S.; Sigurdsson, H.; Dhondt, S.; Espindola, J. M.

    1993-01-01

    The K/T boundary sequence is exposed in uplifted carbonate sediments of the southwest peninsula of Haiti. It is found at 15 localities within the Beloc formation, a sequence of limestone and marls interpreted as a monoclinal nappe structure thrust to the north. This tectonic deformation has affected the K/T boundary deposit to varying degrees. In some cases the less competent K/T deposit has acted as a slip plane leading to extensive shearing of the boundary layer, as well as duplication of the section. The presence of glassy tektites, shocked quartz, and an Ir anomaly directly link the deposit to a bolide impact. Stratigraphic and sedimentological features of the tripartite sequence indicate that it was formed by deposition from ballistic fallout of coarse tektites, emplacement of particle gravity flows and fine grained fallout of widely dispersed impact ejecta.

  2. Ethical Considerations of Triage Following Natural Disasters: The IDF Experience in Haiti as a Case Study.

    Science.gov (United States)

    Ram-Tiktin, Efrat

    2017-07-01

    Natural disasters in populated areas may result in massive casualties and extensive destruction of infrastructure. Humanitarian aid delegations may have to cope with the complicated issue of patient prioritization under conditions of severe resource scarcity. A triage model, consisting of five principles, is proposed for the prioritization of patients, and it is argued that rational and reasonable agents would agree upon them. The Israel Defense Force's humanitarian mission to Haiti following the 2010 earthquake serves as a case study for the various considerations taken into account when designing the ethical-clinical policy of field hospitals. The discussion focuses on three applications: the decision to include an intensive care unit, the decision to include obstetrics and neonatal units, and the treatment policy for compound fractures. © 2017 John Wiley & Sons Ltd.

  3. Backward Bifurcation in a Cholera Model: A Case Study of Outbreak in Zimbabwe and Haiti

    Science.gov (United States)

    Sharma, Sandeep; Kumari, Nitu

    In this paper, a nonlinear deterministic model is proposed with a saturated treatment function. The expression of the basic reproduction number for the proposed model was obtained. The global dynamics of the proposed model was studied using the basic reproduction number and theory of dynamical systems. It is observed that proposed model exhibits backward bifurcation as multiple endemic equilibrium points exist when R0 cholera in the community. We also obtain a unique endemic equilibria when R0 > 1. The global stability of unique endemic equilibria is performed using the geometric approach. An extensive numerical study is performed to support our analytical results. Finally, we investigate two major cholera outbreaks, Zimbabwe (2008-09) and Haiti (2010), with the help of the present study.

  4. Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti.

    Science.gov (United States)

    Valcin, Claude-Lyne; Severe, Karine; Riche, Claudia T; Anglade, Benedict S; Moise, Colette Guiteau; Woodworth, Michael; Charles, Macarthur; Li, Zhongze; Joseph, Patrice; Pape, Jean W; Wright, Peter F

    2013-10-01

    Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010-July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.

  5. Public–nonprofit partnership performance in a disaster context: the case of Haiti.

    Science.gov (United States)

    Nolte, Isabella M; Boenigk, Silke

    2011-01-01

    During disasters, partnerships between public and nonprofit organizations are vital to provide fast relief to affected communities. In this article, we develop a process model to support a performance evaluation of such intersectoral partnerships. The model includes input factors, organizational structures, outputs and the long-term outcomes of public–nonprofit partnerships. These factors derive from theory and a systematic literature review of emergency, public, nonprofit, and network research. To adapt the model to a disaster context, we conducted a case study that examines public and nonprofit organizations that partnered during the 2010 Haiti earthquake. The case study results show that communication, trust, and experience are the most important partnership inputs; the most prevalent governance structure of public–nonprofit partnerships is a lead organization network. Time and quality measures should be considered to assess partnership outputs, and community, network, and organizational actor perspectives must be taken into account when evaluating partnership outcomes.

  6. Human rights assessment in Parc Jean Marie Vincent, Port-au-Prince, Haiti.

    Science.gov (United States)

    Cullen, Kimberly A; Ivers, Louise C

    2010-12-15

    Months after a 7.0 magnitude earthquake hit Port-au-Prince, Haiti, over one million remain homeless and living in spontaneous internally displaced person (IDP) camps. Billions of dollars from aid organizations and government agencies have been pledged toward the relief effort, yet many basic human needs, including food, shelter, and sanitation, continue to be unmet. The Sphere Project, "Humanitarian Charter and Minimum Standards in Disaster Response," identifies the minimum standards to be attained in disaster response. From a human rights perspective and utilizing key indicators from the Sphere Project as benchmarks, this article reports on an assessment of the living conditions approximately 12 weeks after the earthquake in Parc Jean Marie Vincent, a spontaneous IDP camp in Port-au-Prince. A stratified random sample of households in the camp, proportionate to the number of families living in each sector, was selected. Interview questions were designed to serve as "key indicators" for the Sphere Project minimum standards. A total of 486 interviews were completed, representing approximately 5% of households in each of the five sectors of the camp. Our assessment identified the relative achievements and shortcomings in the provision of relief services in Parc Jean Marie Vincent. At the time of this survey, the Sphere Project minimum standards for access to health care and quantity of water per person per day were being met. Food, shelter, sanitation, and security were below minimum accepted standard and of major concern. The formal assessment reported here was completed by September 2010, and is necessarily limited to conditions in Haiti before the cholera outbreak in October. Copyright © 2010 Cullen and Ivers. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any

  7. Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

    Science.gov (United States)

    Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

    2013-04-01

    Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

  8. Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

    Science.gov (United States)

    Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

    2014-08-01

    Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

  9. Acquired immune deficiency syndrome: specific aspects of the disease in Haiti.

    Science.gov (United States)

    Guerin, J M; Malebranche, R; Elie, R; Laroche, A C; Pierre, G D; Arnoux, E; Spira, T J; Dupuy, J M; Seemayer, T A; Pean-Guichard, C

    1984-01-01

    This paper presents clinical data on 41 patients (29 male and 12 female) from Haiti who presented with acquired immunedeficiency syndrome (AIDS). Their mean age was 32 years (range 17-61 years). 4 of thes cases were homosexual or bisexual; none was an illicit drug user or a hemophiliac. In addition, 3 of the female patients had sexual contact with a male partner with AIDS. 4 patients had received blood transfusions before their illness. The most prominent clinical symptom in this series was chronic diarrhea of 2-33 months' duration, which occurrred in 39 patients (95%). Also reporte were marked weight loss (95%), fatigue (95%), prolonger fever (90%), and nodular or maculopapular skin lesions (54%). Opportunistic infections in this series included oroesophageal candidiasis (88%) and intestinal cryptosporidiosis (31%). Tuberculosis developed in 22% of patients. Immunologic evaluation revealed profoundly depressed T-helper cells and an inverted T-helper/T-suppressor cell ratio. Biologic markers included elevated alpha-1 thymosin and beta-2 microglobulin levels, elevated immune complexes, and the presence of acid-labile interferon. Of interest were differences in the clinical expression of AIDS between this series and cases in the US. The Haitian data suggest a higher incidencs of female cases,a predominance of gastrointestinal symptoms rather than respiratory symptoms and lymphadenopathy, a frequent association with tuberculosis, and a relatively low incidence of Kaposi's sarcoma or P. carinii pneumonia compared to the situation in the US. As in the US, where most AIDS cases are concentrated in New York and California, most AIDS cases in Haiti are found in residents of Port-au-Prince and Carrefour, which are centers for male and female prostitution.

  10. Factors associated with use of maternal health services in Haiti: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Stella O. Babalola

    2014-07-01

    Full Text Available OBJECTIVE: To assess factors associated with utilization of maternal health services (MHS among women giving birth in Haiti from 2007 - 2012. METHODS: Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA. RESULTS: The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR = 0.47; 95% confidence interval (CI: 0.37-0.57 with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78 with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88 with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34 with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73 with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61 with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61. Significant clustering of use of MHS exists at the community level. CONCLUSIONS: Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  11. Factors associated with use of maternal health services in Haiti: a multilevel analysis.

    Science.gov (United States)

    Babalola, Stella O

    2014-07-01

    To assess factors associated with utilization of maternal health services (MHS) among women giving birth in Haiti from 2007 - 2012. Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA). The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR) = 0.47; 95% confidence interval (CI): 0.37-0.57) with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78) with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88) with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34) with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73) with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61) with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61). Significant clustering of use of MHS exists at the community level. Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  12. Household and Individual Risk Factors for Cholera among Cholera Vaccine Recipients in Rural Haiti.

    Science.gov (United States)

    Matias, Wilfredo R; Teng, Jessica E; Hilaire, Isabelle J; Harris, Jason B; Franke, Molly F; Ivers, Louise C

    2017-08-01

    Oral cholera vaccination was used as part of cholera control in Haiti, but the vaccine does not provide complete protection. We conducted secondary data analyses of a vaccine effectiveness study in Haiti to evaluate risk factors for cholera among cholera vaccine recipients. Individuals vaccinated against cholera that presented with acute watery diarrhea and had a stool sample positive for Vibrio cholerae O1 were included as cases. Up to four vaccinated individuals who did not present for treatment of diarrhea were included as controls for each case, and matched by location of residence, enrollment time, and age. We evaluated sociodemographic characteristics and risk factors for cholera. Univariable and multivariable logistic regression were performed to identify risk factors for cholera among vaccinees. Thirty-three vaccine recipients with culture-confirmed cholera were included as cases. One-hundred-and-seventeen of their matched controls reported receiving vaccine and were included as controls. In a multivariable analysis, self-reporting use of branded household water disinfection products as a means of treating water (adjusted relative risk [aRR] = 44.3, 95% confidence interval [CI] = 4.19-468.05, P = 0.002), and reporting having a latrine as the main household toilet (aRR = 4.22, 95% CI = 1.23-14.43, P = 0.02), were independent risk factors for cholera. Self-reporting always treating water (aRR = 0.09, 95% CI = 0.01-0.57, P = 0.01) was associated with protection against cholera. The field effectiveness of water, sanitation, and hygiene interventions used in combination with cholera vaccination in cholera control should be measured and monitored over time to identify and remediate shortcomings, and ensure successful impact on disease control.

  13. Does quality influence utilization of primary health care? Evidence from Haiti.

    Science.gov (United States)

    Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

    2018-06-20

    Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

  14. Crustal structure and fault geometry of the 2010 Haiti earthquake from temporary seismometer deployments

    Science.gov (United States)

    Douilly, Roby; Haase, Jennifer S.; Ellsworth, William L.; Bouin, Marie‐Paule; Calais, Eric; Symithe, Steeve J.; Armbruster, John G.; Mercier de Lépinay, Bernard; Deschamps, Anne; Mildor, Saint‐Louis; Meremonte, Mark E.; Hough, Susan E.

    2013-01-01

    Haiti has been the locus of a number of large and damaging historical earthquakes. The recent 12 January 2010 Mw 7.0 earthquake affected cities that were largely unprepared, which resulted in tremendous losses. It was initially assumed that the earthquake ruptured the Enriquillo Plantain Garden fault (EPGF), a major active structure in southern Haiti, known from geodetic measurements and its geomorphic expression to be capable of producing M 7 or larger earthquakes. Global Positioning Systems (GPS) and Interferometric Synthetic Aperture Radar (InSAR) data, however, showed that the event ruptured a previously unmapped fault, the Léogâne fault, a north‐dipping oblique transpressional fault located immediately north of the EPGF. Following the earthquake, several groups installed temporary seismic stations to record aftershocks, including ocean‐bottom seismometers on either side of the EPGF. We use data from the complete set of stations deployed after the event, on land and offshore, to relocate all aftershocks from 10 February to 24 June 2010, determine a 1D regional crustal velocity model, and calculate focal mechanisms. The aftershock locations from the combined dataset clearly delineate the Léogâne fault, with a geometry close to that inferred from geodetic data. Its strike and dip closely agree with the global centroid moment tensor solution of the mainshock but with a steeper dip than inferred from previous finite fault inversions. The aftershocks also delineate a structure with shallower southward dip offshore and to the west of the rupture zone, which could indicate triggered seismicity on the offshore Trois Baies reverse fault. We use first‐motion focal mechanisms to clarify the relationship of the fault geometry to the triggered aftershocks.

  15. Mansonella ozzardi and its vectors in the New World: an update with emphasis on the current situation in Haiti.

    Science.gov (United States)

    Raccurt, C P

    2017-10-25

    Mansonella ozzardi (Nematoda: Onchocercidae) is a little studied filarial nematode. This human parasite, transmitted by two families of dipteran vectors, biting midges (most of them members of the genus Culicoides) and blackflies (genus Simulium), is endemic to the Neotropical regions of the New World. With a patchy geographical distribution from southern Mexico to north-western Argentina, human infection with M. ozzardi is highly prevalent in some of the Caribbean islands, along riverine communities in the Amazon Basin, and on both sides of the border between Bolivia and Argentina. Studies conducted in Haiti between 1974 and 1984 allowed the first complete description of the adult worm and permitted clarification of the taxonomic position of this filarial species. This paper reports the known geographical distribution of M. ozzardi in Neotropical regions of the Americas, and focuses on the current situation in Haiti where this filariasis remains a completely neglected public health problem.

  16. USGS-WHOI-DPRI Coulomb Stress-Transfer Model for the January 12, 2010, MW=7.0 Haiti Earthquake

    Science.gov (United States)

    Lin, Jian; Stein, Ross S.; Sevilgen, Volkan; Toda, Shinji

    2010-01-01

    Using calculated stress changes to faults surrounding the January 12, 2010, rupture on the Enriquillo Fault, and the current (January 12 to 26, 2010) aftershock productivity, scientists from the U.S. Geological Survey (USGS), Woods Hole Oceanographic Institution (WHOI), and Disaster Prevention Research Institute, Kyoto University (DPRI) have made rough estimates of the chance of a magnitude (Mw)=7 earthquake occurring during January 27 to February 22, 2010, in Haiti. The probability of such a quake on the Port-au-Prince section of the Enriquillo Fault is about 2 percent, and the probability for the section to the west of the January 12, 2010, rupture is about 1 percent. The stress changes on the Septentrional Fault in northern Haiti are much smaller, although positive.

  17. Diagnosing Cervical Dysplasia Using Visual Inspection of the Cervix with Acetic Acid in a Woman in Rural Haiti

    Directory of Open Access Journals (Sweden)

    Elizabeth Roger

    2014-11-01

    Full Text Available Cervical cancer remains a significant cause of morbidity and mortality for women in developing countries, despite the fact that inexpensive, simple and effective screening methods are available. Visual inspection of the cervix with acetic acid (VIA can be used as part of a “screen and treat” program to identify precancerous lesions for cryotherapy treatment. This case report details how the VIA screening test was incorporated into the care of a patient presenting to a maternal health clinic in Thomonde, Haiti which was staffed by doctors and medical students from Emory University School of Medicine in collaboration with Haiti Medishare. As demonstrated here, the VIA test requires minimal materials, can be efficiently incorporated into a physical exams, provides immediate results, and is easily demonstrated to and performed by local healthcare providers. The straightforward and sensitive VIA technique is an ideal cervical cancer screening method for resource poor areas.

  18. Clinical and echocardiographic characteristics and outcomes in congestive heart failure at the Hospital of The State University of Haiti.

    Science.gov (United States)

    Malebranche, Rodolphe; Tabou Moyo, Christian; Morisset, Paul-Henry; Raphael, Nernst-Atwood; Wilentz, James Robert

    2016-08-01

    This study aimed to evaluate the clinical and epidemiologic profile of congestive heart failure at the principal free-care hospital in Haiti. Cardiovascular disease represents the most prevalent cause of admissions to the medical service of the University Hospital of the State of Haiti. No previous study has examined the demographics of congestive heart failure in urban Haiti. Two hundred forty-seven patients presented to the inpatient service between May 2011 and May 2013. Evaluation included history and physical, CBC, renal/metabolic profile, serum glucose, anti-HIV antibody, ECG, chest radiograph and echocardiogram. Treatment included angiotensin converting enzyme inhibitors, furosemide and spironolactone, carvedilol, digoxin and anticoagulation. Women (62.4%) outnumbered men; patients were relatively young (mean age 50.1) and from the lowest socio-economic levels of the population. Nearly all (98.8%) presented with NYHA III-IV status, with correspondingly high mortality (23.3%). Echocardiography showed 73% dilated cardiomyopathy; 83% showed moderate to severe LV systolic dysfunction (mean EF 36.5 +/- 15%) and 17% preserved LV systolic function. The three principal etiologies were dilated cardiomyopathy (29%) hypertensive cardiomyopathy (27%) and peripartum cardiomyopathy (20%). Ischemic cardiomyopathy was rare (3.4%). At 27 months follow-up, 76.7% of the patients were alive and well. Among those who died, mean survival time was 113 days. Readmission carried a poor prognosis. This congestive heart failure study from Haiti shows an unusually high proportion of young women, primarily due to peripartum cardiomyopathy. Ischemic cardiomyopathy is rare, as in Africa. Further study is warranted to address the particular problem of the high frequency of peripartum cardiomyopathy in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Early nutrition transition in Haiti: linking food purchasing and availability to overweight status in school-aged children.

    Science.gov (United States)

    Morshed, Alexandra B; Becker, Haley V; Delnatus, Jacques Raymond; Wolff, Patricia B; Iannotti, Lora L

    2016-12-01

    The primary aim was to examine the association of socio-economic factors and diet with overweight (including obesity) among school-aged children in Haiti. The secondary aim was to describe food availability and the physical activity built environment in participating schools. This cross-sectional study examined baseline data from the intervention Mamba study assessing the effectiveness of a fortified peanut butter paste in school-aged children. Logistic regression modelling was used to test hypothesized factors in association with overweight status. Six primary schools in Cap-Haitien, the second largest city in Haiti. Children (n 968) aged 3-13 years, in good health and enrolled in a participating school for the 2012/13 school year. Child age (adjusted OR (AOR); 95 % CI=0·25; 0·12, 0·56), child age squared (1·08; 1·03, 1·13), always purchasing food at school (3·52; 1·12, 11·08), mother's BMI (1·10; 1·04, 1·16) and household ownership of a bicycle (0·28; 0·11, 0·71) were significantly associated with overweight (likelihood ratio=36, Poverweight children in the binary analysis (P=0·033) and improved the fit of the model. Schools had limited time and space for physical activity and foods sold by vendors were predominantly high in sugar or fat. To our knowledge the present study is the first to examine the covariates of childhood overweight or describe school food availability and physical activity built environments in Haiti. Further research is necessary to identify intervention targets and feasible, cost-effective approaches for prevention of obesity in Haiti children.

  20. Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak

    Science.gov (United States)

    Lewnard, Joseph A.; Antillón, Marina; Gonsalves, Gregg; Miller, Alice M.; Ko, Albert I.; Pitzer, Virginia E.

    2016-01-01

    Background Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic. Methods and Findings We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers. Conclusions Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction

  1. Cholera in Pregnancy: Outcomes from a Specialized Cholera Treatment Unit for Pregnant Women in L?og?ne, Haiti

    OpenAIRE

    Ciglenecki, Iza; Bichet, Mathieu; Tena, Javier; Mondesir, Erneau; Bastard, Mathieu; Tran, Nguyen-Toan; Antierens, Annick; Staderini, Nelly

    2013-01-01

    BACKGROUND: The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011. METHODS: Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera...

  2. Responsive Approaches in Small Wars: The Army and Marine Corps in the Philippines, Haiti, and the Dominican Republic

    Science.gov (United States)

    2017-05-25

    It was the Marines flexibility which allowed them to better understand the sources of instability and the environment to stabilize Haiti. By the time...American security and used diplomatic, economic , and military pressure to encourage stability in the Dominican Republic. The US State Department... instability in the Caribbean as a threat to American economic and security interests. Elihu Root, US Secretary of War, argued in 1902 for military and

  3. A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in Haiti.

    Science.gov (United States)

    Barthélemy, Ernest Joseph; Benjamin, Ernest; Edouard Jean-Pierre, Marie Yolaine; Poitevien, Geneviève; Ernst, Silvia; Osborn, Irene; Germano, Isabelle M

    2014-12-01

    To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti. Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome. Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%. This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. DOES RURAL-TO-URBAN MIGRATION PLACE ADOLESCENTS AT RISK OF DELETERIOUS SEXUAL AND REPRODUCTIVE HEALTH OUTCOMES? EVIDENCE FROM HAITI.

    Science.gov (United States)

    Heckert, Jessica

    2016-11-01

    This study examines the links between migration and sexual and reproductive health among rural-to-urban migrant youth in Haiti. It evaluates behavioural, knowledge and attitudinal components from the perspective of three competing explanations for migrants' behaviours: adaptation, disruption and selection. Discrete-time event history analysis is employed to compare these hypotheses using Haiti Demographic and Health Survey data (N=1215 adolescent girls, N=829 adolescent boys). Multi-level models are used to compare changes in knowledge and attitudes in individuals using data from the Haiti Youth Transitions Study (N=223). The findings reveal that disruption is the most plausible explanation for the timing of migration and first sex among girls. However, contrary to the assumption that migrant youth risk experiencing first sex earlier, girls are less likely to experience first sex near the time they migrate, and rural-to-urban migrant boys may experience first sex at later ages. The high aspirations of migrant youth provide a likely explanation for these findings. Furthermore, male migrants accumulate less protective knowledge, which is consistent with the disruption hypothesis, and migrants endorse premarital sex similarly to non-migrants. Sexual and reproductive health curricula should be adapted to the unique needs of migrant youth, and youth should be targeted before they migrate.

  5. Geological Deformations and Potential Hazards Triggered by the 01-12-2010 Haiti Earthquake: Insights from Google Earth Imagery

    Science.gov (United States)

    Doblas, M.; Benito, B.; Torres, Y.; Belizaire, D.; Dorfeuille, J.; Aretxabala, A.

    2013-05-01

    In this study we compare the different Google Earth imagery (GEI) available before and after the 01-12-2010 earthquake of Haiti and carry out a detailed analysis of the superficial seismic-related geological deformations in the following sites: 1) the capital Port-Au-Prince and other cities (Carrefour and Gresslier); 2) the mountainous area of the Massif de la Selle which is transected by the "Enriquillo-Plaintain-Garden" (EPG) interplate boundary-fault (that supposedly triggered the seism); 3) some of the most important river channels and their corresponding deltas (Momanche, Grise and Frorse). The initial results of our researches were published in March 2010 in a special web page created by the scientific community to try to mitigate the devastating effects of this catastrophe (http://supersites.earthobservations.org/haiti.php). Six types of superficial geological deformations triggered by the seismic event have been identified with the GEI: liquefaction structures, chaotic rupture zones, coastal and domal uplifts, river-delta turnovers, faults/ruptures and landslides. Potential geological hazards triggered by the Haiti earthquake include landslides, inundations, reactivation of active tectonic elements (e.g., fractures), river-delta turnovers, etc. We analyzed again the GEI after the rain period and, as expected, most of the geological deformations that we initially identified had been erased and/or modified by the water washout or buried by the sediments. In this sense the GEI constitutes an invaluable instrument in the analysis of seismic geological hazards: we still have the possibility to compare all the images before and after the seism that are recorded in its useful "time tool". These are in fact the only witnesses of most of the geological deformations triggered by the Haiti earthquake that remain stored in the virtual archives of the GEI. In fact a field trip to the area today would be useless as most of these structures have disappeared. We will show

  6. Phylodynamic analysis of clinical and environmental Vibrio cholerae isolates from Haiti reveals diversification driven by positive selection.

    Science.gov (United States)

    Azarian, Taj; Ali, Afsar; Johnson, Judith A; Mohr, David; Prosperi, Mattia; Veras, Nazle M; Jubair, Mohammed; Strickland, Samantha L; Rashid, Mohammad H; Alam, Meer T; Weppelmann, Thomas A; Katz, Lee S; Tarr, Cheryl L; Colwell, Rita R; Morris, J Glenn; Salemi, Marco

    2014-12-23

    Phylodynamic analysis of genome-wide single-nucleotide polymorphism (SNP) data is a powerful tool to investigate underlying evolutionary processes of bacterial epidemics. The method was applied to investigate a collection of 65 clinical and environmental isolates of Vibrio cholerae from Haiti collected between 2010 and 2012. Characterization of isolates recovered from environmental samples identified a total of four toxigenic V. cholerae O1 isolates, four non-O1/O139 isolates, and a novel nontoxigenic V. cholerae O1 isolate with the classical tcpA gene. Phylogenies of strains were inferred from genome-wide SNPs using coalescent-based demographic models within a Bayesian framework. A close phylogenetic relationship between clinical and environmental toxigenic V. cholerae O1 strains was observed. As cholera spread throughout Haiti between October 2010 and August 2012, the population size initially increased and then fluctuated over time. Selection analysis along internal branches of the phylogeny showed a steady accumulation of synonymous substitutions and a progressive increase of nonsynonymous substitutions over time, suggesting diversification likely was driven by positive selection. Short-term accumulation of nonsynonymous substitutions driven by selection may have significant implications for virulence, transmission dynamics, and even vaccine efficacy. Cholera, a dehydrating diarrheal disease caused by toxigenic strains of the bacterium Vibrio cholerae, emerged in 2010 in Haiti, a country where there were no available records on cholera over the past 100 years. While devastating in terms of morbidity and mortality, the outbreak provided a unique opportunity to study the evolutionary dynamics of V. cholerae and its environmental presence. The present study expands on previous work and provides an in-depth phylodynamic analysis inferred from genome-wide single nucleotide polymorphisms of clinical and environmental strains from dispersed geographic settings in

  7. High-resolution spatial analysis of cholera patients reported in Artibonite department, Haiti in 2010-2011.

    Science.gov (United States)

    Allan, Maya; Grandesso, Francesco; Pierre, Ronald; Magloire, Roc; Coldiron, Matthew; Martinez-Pino, Isabel; Goffeau, Thierry; Gitenet, Romain; François, Gwenola; Olson, David; Porten, Klaudia; Luquero, Francisco J

    2016-03-01

    Cholera is caused by Vibrio cholerae, and is transmitted through fecal-oral contact. Infection occurs after the ingestion of the bacteria and is usually asymptomatic. In a minority of cases, it causes acute diarrhea and vomiting, which can lead to potentially fatal severe dehydration, especially in the absence of appropriate medical care. Immunity occurs after infection and typically lasts 6-36 months. Cholera is responsible for outbreaks in many African and Asian developing countries, and caused localised and episodic epidemics in South America until the early 1990s. Haiti, despite its low socioeconomic status and poor sanitation, had never reported cholera before the recent outbreak that started in October 2010, with over 720,000 cases and over 8700 deaths (Case fatality rate: 1.2%) through 8 december 2014. So far, this outbreak has seen 3 epidemic peaks, and it is expected that cholera will remain in Haiti for some time. To trace the path of the early epidemic and to identify hot spots and potential transmission hubs during peaks, we examined the spatial distribution of cholera patients during the first two peaks in Artibonite, the second-most populous department of Haiti. We extracted the geographic origin of 84,000 patients treated in local health facilities between October 2010 and December 2011 and mapped these addresses to 63 rural communal sections and 9 urban cities. Spatial and cluster analysis showed that during the first peak, cholera spread along the Artibonite River and the main roads, and sub-communal attack rates ranged from 0.1% to 10.7%. During the second peak, remote mountain areas were most affected, although sometimes to very different degrees even in closely neighboring locations. Sub-communal attack rates during the second peak ranged from 0.2% to 13.7%. The relative risks at the sub-communal level during the second phase showed an inverse pattern compared to the first phase. These findings demonstrate the value of high-resolution mapping

  8. Cholera Vaccination Campaign Contributes to Improved Knowledge Regarding Cholera and Improved Practice Relevant to Waterborne Disease in Rural Haiti

    Science.gov (United States)

    Aibana, Omowunmi; Franke, Molly; Teng, Jessica; Hilaire, Johanne; Raymond, Max; Ivers, Louise C.

    2013-01-01

    Background Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti. Methodology/Principal Findings We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May–June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52–2.40), preventive methods (OR 1.83; 95% CI 1.46–2.30), and water treatment modalities (OR 2.75; 95% CI 2.16–3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28–2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03–1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14–1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35–4.51). Conclusion An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti. PMID:24278498

  9. Cholera vaccination campaign contributes to improved knowledge regarding cholera and improved practice relevant to waterborne disease in rural Haiti.

    Directory of Open Access Journals (Sweden)

    Omowunmi Aibana

    2013-11-01

    Full Text Available Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811. An OCV campaign occurred from May-June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥ 3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52-2.40, preventive methods (OR 1.83; 95% CI 1.46-2.30, and water treatment modalities (OR 2.75; 95% CI 2.16-3.50. Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28-2.05. Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03-1.64. Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14-1.89. Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35-4.51.An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti.

  10. Assessing childhood malnutrition in Haiti: Meeting the United Nations Millennium Development Goal #4

    Directory of Open Access Journals (Sweden)

    R.L Bush

    2015-01-01

    Full Text Available Background The United Nations (UN Millennium Developmental Goal #4 addresses needed reductions in childhood mortality. A major cause of death in Haitian children is malnutrition and starvation. Objectives Our primary objective was to identify population characteristics of children living in rural Haiti that may place them at higher risk of malnutrition than others. Armed with this knowledge, community health workers can recognize and attribute resources to those most in need. We will also examine the overall nutrition status in the population of interest and compare to the UN Millennium Goal statistics. Study design The study cohort consisted of 103 children under the age of 5 years, who were consecutively seen in a rural medical clinic from 4 communities in the Thomazeau region of Haiti over a 7-day time period. Families were asked the following five questions: (1 How many children do you have? (2 What is the birth order of this child (1st, 2nd, etc.? (3 What is the distance between your house and clean water? (4 Do you obtain water for your family? (5 What was the highest grade you finished in school? The medical team recorded each child’s gender, age, height, weight, household size, when the last meal was eaten, and last time protein was ingested. Nutritional status was assessed using World Health Organization growth standards. The data was then analyzed to determine each child’s level of malnutrition as measured by weight-for-height Z-score (number of standard deviations [SD] below reference value, percentage of malnutrition for all children surveyed, and whether correlations existed between malnutrition level and number of siblings, household size, or location. Trends were defined as associations significant at p3 SD below normal Z-score. Using a parsimonious multivariable regression model to compare family structure factors to anthropomorphic variables, multiparity was positively associated with Z- score (p<0.05, suggesting that later

  11. Advancing Research Methods to Detect Impact of Climate Change on Health in Grand'Anse, Haiti

    Science.gov (United States)

    Barnhart, S.; Coq, R. N.; Frederic, R.; DeRiel, E.; Camara, H.; Barnhart, K. R.

    2013-12-01

    Haiti is considered particularly vulnerable to the effects of climate change, but directly linking climate change to health effects is limited by the lack of robust data and the multiple determinants of health. Worsening storms and rising temperatures in this rugged country with high poverty is likely to adversely affect economic activity, population growth and other determinants of health. For the past two years, the Univ. of Washington has supported the public hospital in the department of Grand'Anse. Grand'Anse, a relatively contained region in SW Haiti with an area of 11,912 km2, is predominantly rural with a population of 350,000 and is bounded to the south by peaks up to 2,347 m. Grand'Anse would serve as an excellent site to assess the interface between climate change and health. The Demographic and Health Survey (DHS) shows health status is low relative to other countries. Estimates of climate change for Jeremie, the largest city in Grand'Anse, predict the mean monthly temperature will increase from 26.1 to 27.3 oC while mean monthly rainfall will decrease from 80.5 to 73.5 mm over the next 60 years. The potential impact of these changes ranges from threatening food security to greater mortality. Use of available secondary data such as indicators of climate change and DHS health status are not likely to offer sufficient resolution to detect positive or negative impacts of climate change on health. How might a mixed methods approach incorporating secondary data and quantitative and qualitative survey data on climate, economic activity, health and determinants of health address the hypothesis: Climate change does not adversely affect health? For example, in Haiti most women deliver at home. Maternal mortality is high at 350 deaths/100,000 deliveries. This compares to deliveries in facilities where the median rate is less than 100/100,000. Thus, maternal mortality is closely linked to access to health care in this rugged mountainous country. Climate change

  12. A comparison of the medium-term impact and recovery of the Pakistan floods and the Haiti earthquake: objective and subjective measures.

    Science.gov (United States)

    Weiss, William M; Kirsch, Thomas D; Doocy, Shannon; Perrin, Paul

    2014-06-01

    The 2010 Haiti earthquake and Pakistan floods were similar in their massive human impact. Although the specific events were very different, the humanitarian response to disasters is supposed to achieve the same ends. This paper contrasts the disaster effects and aims to contrast the medium-term response. In January 2011, similarly structured population-based surveys were carried out in the most affected areas using stratified cluster designs (80×20 in Pakistan and 60×20 in Haiti) with probability proportional to size sampling. Displacement persisted in Haiti and Pakistan at 53% and 39% of households, respectively. In Pakistan, 95% of households reported damage to their homes and loss of income or livelihoods, and in Haiti, the rates were 93% and 85%, respectively. Frequency of displacement, and income or livelihood loss, were significantly higher in Pakistan, whereas disaster-related deaths or injuries were significantly more prevalent in Haiti. Given the rise in disaster frequency and costs, and the volatility of humanitarian funding streams as a result of the recent global financial crisis, it is increasingly important to measure the impact of humanitarian response against the goal of a return to normalcy.

  13. Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti.

    Directory of Open Access Journals (Sweden)

    Frantz Jean Louis

    Full Text Available Viral load (VL assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy (ART. We conducted a retrospective cross-sectional study to evaluate the virologic suppression rate among patients on ART for ≥6 months in five hospitals around Port-au-Prince, Haiti.Plasma VL was measured and patients with VL <1,000 copies/mL were defined as virologically suppressed. A second VL test was performed within at least six months of the first test. Factors associated with virologic suppression were analyzed using logistic regression models accounting for site-level clustering using complex survey procedures.Data were analyzed for 2,313 patients on ART for six months or longer between July 2013 and February 2015. Among them, 1,563 (67.6% achieved virologic suppression at the first VL test. A second VL test was performed within at least six months for 718 (31.0% of the patients. Of the 459 patients with an initial HIV-1 RNA <1,000 copies/mL who had a second VL performed, 394 (85.8% maintained virologic suppression. Virologic suppression was negatively associated with male gender (adjusted odds ratio [aOR]: 0.80, 95% CI: 0.74-0.0.86, 23 to 35 months on ART (aOR:0.72[0.54-0.96], baseline CD4 counts of 201-500 cells/mm3 and 200 cells/mm3 or lower (aORs: 0.77 [0.62-0.95] and 0.80 [0.66-0.98], respectively, poor adherence (aOR: 0.69 [0.59-0.81], and TB co-infection (aOR: 0.73 [0.55-0.97].This study showed that over two-thirds of the patients in this evaluation achieved virologic suppression after ≥ six months on ART and the majority of them remained suppressed. These results reinforce the importance of expanding access to HIV-1 viral load testing in Haiti for monitoring ART outcomes.

  14. Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data.

    Directory of Open Access Journals (Sweden)

    John Lednicky

    2016-04-01

    Full Text Available Zika virus (ZIKV, first isolated in Uganda in 1947, is currently spreading rapidly through South America and the Caribbean. In Brazil, infection has been linked with microcephaly and other serious complications, leading to declaration of a public health emergency of international concern; however, there currently are only limited data on the virus (and its possible sources and manifestations in the Caribbean.From May, 2014-February, 2015, in conjunction with studies of chikungunya (CHIKV and dengue (DENV virus infections, blood samples were collected from children in the Gressier/Leogane region of Haiti who presented to a school clinic with undifferentiated febrile illness. Samples were initially screened by RT-PCR for CHIKV and DENV, with samples negative in these assays further screened by viral culture.Of 177 samples screened, three were positive for ZIKV, confirmed by viral sequencing; DENV-1 was also identified in culture from one of the three positive case patients. Patients were from two different schools and 3 different towns, with all three cases occurring within a single week, consistent with the occurrence of an outbreak in the region. Phylogenetic analysis of known full genome viral sequences demonstrated a close relationship with ZIKV from Brazil; additional analysis of the NS5 gene, for which more sequences are currently available, showed the Haitian strains clustering within a monophyletic clade distinct from Brazilian, Puerto Rican and Guatemalan sequences, with all part of a larger clade including isolates from Easter Island. Phylogeography also clarified that at least three major African sub-lineages exist, and confirmed that the South American epidemic is most likely to have originated from an initial ZIKV introduction from French Polynesia into Easter Island, and then to the remainder of the Americas.ZIKV epidemics in South America, as well as in Africa, show complex dissemination patterns. The virus appears to have been

  15. Need for certification of household water treatment products: examples from Haiti.

    Science.gov (United States)

    Murray, Anna; Pierre-Louis, Jocelyne; Joseph, Flaurine; Sylvain, Ginelove; Patrick, Molly; Lantagne, Daniele

    2015-04-01

    To evaluate four household water treatment (HWT) products currently seeking approval for distribution in Haiti, through the application of a recently-developed national HWT product certification process. Four chemical treatment products were evaluated against the certification process validation stage by verifying international product certifications confirming treatment efficacy and reviewing laboratory efficacy data against WHO HWT microbiological performance targets; and against the approval stage by confirming product composition, evaluating treated water chemical content against national and international drinking water quality guidelines and reviewing packaging for dosing ability and usage directions in Creole. None of the four evaluated products fulfilled validation or approval stage requirements. None was certified by an international agency as efficacious for drinking water treatment, and none had data demonstrating its ability to meet WHO HWT performance targets. All product sample compositions differed from labelled composition by >20%, and no packaging included complete usage directions in Creole. Product manufacturers provided information that was inapplicable, did not demonstrate product efficacy, and was insufficient to ensure safe product use. Capacity building is needed with country regulatory agencies to objectively evaluate HWT products. Products should be internationally assessed against WHO performance targets and also locally approved, considering language, culture and usability, to ensure effective HWT. © 2014 John Wiley & Sons Ltd.

  16. Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia.

    Science.gov (United States)

    Mauch, Verena; Weil, Diana; Munim, Aayid; Boillot, Francois; Coninx, Rudi; Huseynova, Sevil; Powell, Clydette; Seita, Akihiro; Wembanyama, Henriette; van den Hof, Susan

    2010-07-01

    Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived. A structured inventory to extract common themes specific for TB control in fragile states was conducted among twelve providers of technical assistance who have worked in fragile states. The themes were applied to the TB control programs of Afghanistan, DR Congo, Haiti and Somalia during the years 2000-2006. Case notifications and treatment outcomes have increased in all four countries since 2003 (treatment success rates 81-90%). Access to care and case detection however have remained insufficient (case detection rates 39-62%); There are four lessons learned: 1. TB control programs can function in fragile states. 2. National program leadership and stewardship are essential for quality and sustained TB control. 3. Partnerships with non-governmental providers are vital for continuous service delivery; 4. TB control programs in fragile states require consistent donor support. Despite challenges in management, coordination, security, logistics and funding, TB control programs can function in fragile states, but face considerable problems in access to diagnosis and treatment and therefore case detection. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  17. Strontium isotope geochemistry of late cretaceous granodiorites, Jamaica and Haiti, Greater Antilles

    International Nuclear Information System (INIS)

    Jones, L.M.; Walker, R.L.; Kesler, S.E.; Lewis, J.F.

    1979-01-01

    Initial 87 Sr/ 86 Sr ratios have been determined for a representative suite of Upper Cretaceous granodiorites and associated rocks from the Above Rocks composite stock in central Jamaica and the Terre-Neuve pluton in northwestern Haiti. The average initial 87 Sr/ 86 Sr ratio for seven samples of the Terre-Neuve intrusion is 0.7036, with a range of 0.7026-0.7047. For two samples of the Above Rocks the initial ratios are 0.7033 and 0.7034. A third sample from this intrusive has an initial ratio of 0.7084, which is tentatively attributed to contamination. The initial 87 Sr/ 86 Sr ratios indicate that neither ancient sialic crust nor sediments carried down a Benioff zone can be the primary source of the granodioritic magma. K/Rb ratios for these rocks range from 178 to 247, which are much lower than the average values (>= 1000) for tholeiitic basalts. It is concluded that the magmas originated primarily by melting of downthrust oceanic crust or adjacent mantle material. (Auth.)

  18. Nutrition factors predict earlier acquisition of motor and language milestones among young children in Haiti.

    Science.gov (United States)

    Iannotti, Lora; Jean Louis Dulience, Sherlie; Wolff, Patricia; Cox, Katherine; Lesorogol, Carolyn; Kohl, Patricia

    2016-09-01

    To examine the nutrition-related factors associated with motor and language development among young children living in a poor urban area of Haiti. Children aged 6-11 months (n = 583) were enrolled and followed monthly for one year. World Health Organization motor developmental milestones and vowel and consonant counts were assessed. Longitudinal regression models were applied to assess the association of anthropometric, dietary intake, infectious disease morbidity and socio-economic and demographic factors on developmental outcomes. At baseline, 9.4% were stunted or length-for-age Z score < -2, and 30.2% were mild-to-moderately stunted or length-for-age Z score < -1. Stunting status was significantly associated with motor and phonetic language acquisition at each time point during infancy. Several nutrition factors significantly predicted earlier achievement of motor and language development outcomes in longitudinal models: child anthropometry; breastfeeding and complementary feeding frequencies; dietary diversity; egg and oil intake; and reduced infectious disease morbidities. Increases in the length-for-age Z score significantly predicted all motor and language outcomes and yielded the best fit models compared to other anthropometric indicators (p < 0.001). Child development interventions may be enhanced by incorporating nutrition strategies such as improved diet quality, breastfeeding promotion and diarrhoeal disease mitigation. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Emotions and beliefs after a disaster: a comparative analysis of Haiti and Indonesia.

    Science.gov (United States)

    O'Connell, Erin; Abbott, Roger P; White, Robert S

    2017-10-01

    A number of studies have examined emotional and belief responses following a disaster, yet there has been limited comparative analysis of responses to disasters in different places. This paper reviews the results of 366 questionnaires that evaluated key emotional and belief concepts in Haiti after the earthquake on 12 January 2010 (n=212) and in Indonesia after the earthquake in Yogyakarta on 27 May 2006 (n=154). The results indicate significant differences between the responses in the two settings, particularly in relation to feelings of impunity, self-blame for the disaster, regret about pre-earthquake behaviour, and a sense of justice in the world. Furthermore, the impacts of age, education, and gender on responses also were different in the two case study sites. Overall, the results suggest that understanding the cultural, religious, and social contexts of different disaster locales is important in comprehending the emotions and beliefs that manifest themselves in the wake of a major disaster. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  20. Microfinance Institutions' Successful Delivery Of Micronutrient Powders: A Randomized Trial In Rural Haiti.

    Science.gov (United States)

    Baum, Aaron; Elize, Wesly; Jean-Louis, Florence

    2017-11-01

    Globally, two-thirds of child deaths could be prevented by increased provision of health interventions such as vaccines, micronutrient supplements, and water purification tablets. We report the results from a randomized controlled trial in Haiti during 2012 that tested whether microfinance institutions-which reach 200 million households worldwide-can effectively deliver health products. These institutions provide loans to underserved entrepreneurs, primarily poor women in rural areas. In the intervention group, micronutrient powders to improve the nutrition of young children were distributed at regularly occurring microfinance meetings by a trained borrower. In both the control and the intervention groups, nurses led seminars on nutrition and extended breastfeeding during microfinance meetings. At three-month follow-up, the mean difference in hemoglobin concentration between children in the intervention group and those in the control group was 0.28 grams per deciliter (g/dL)-with a subsample of younger children (under two years of age) showing greater relative improvement (0.46 g/dL)-and the odds ratio for children in the intervention group meeting the diagnostic criteria for anemia was 0.64. The results are similar to those of previous studies that evaluated micronutrient powder distribution through dedicated health institutions. Our findings suggest that microfinance institutions are a promising platform for the large-scale delivery of health products in low-income countries.

  1. Born in Haiti: A Maternity Hospital in the Context of a Humanitarian Crisis

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    Christina Sutter

    2016-11-01

    Full Text Available This is a report on the experience of implementing a mental health program in a maternity hospital and three mobile clinics in the city of Port-au-Prince. We started by listening to the difficulties faced by the national teams in their daily routines at the hospital and what they expected of a mental health program. The program was planned in a way to contemplate the perceived needs of the hospital teams as well as those of the target population, pre and post-natal women, within a systemic perspective. Thus the program covered the following aspects: training with the hospital team on communication and helping relationships, a series of speeches on mental health at the hospital, psychological treatment of the patients through counseling sessions, involvement of partners and families being assisted, support groups for peri-natal mourning, men's groups with the future fathers, psychoeducation in the mobile clinics, a survey of the social network in the city, psycho-social assistance and the introduction of relaxation strategies at the hospital. We concluded that in the context of a humanitarian crisis, as in the case of Haiti, a mental health program should contemplate different levels of need and take into consideration that health care professionals are also subject to the context of social stress. At the same time, the involvement of hospital teams in the process is fundamental to the success of the program.

  2. Sexual risk behaviors among adolescents in Port-au-Prince, Haiti.

    Science.gov (United States)

    Carver, Jasmine W; Dévieux, Jessy G; Gaston, Stéphanie C; Altice, Frederick L; Niccolai, Linda M

    2014-08-01

    Engagement in sexual activity among Haitian youth is increasing. The present cross-sectional study examined the independent correlates of sexual risk behaviors among 200 (108 male/92 female) 13-18 year-old adolescents in Port-au-Prince, Haiti using face-to-face interviews. The majority (60.0 %) had engaged in sexual intercourse. Multivariate modeling found males to be 3.52 times more likely to have had sex, 5.42 times more likely to report sexual debut before age 14, 9.75 times more likely to have >1 sexual partner, and 3.33 times more likely to not have used a condom during last sex. Adolescents living with parents, grandparents, aunts or uncles were less likely to report having unprotected sex compared with those without adult family members in the home (AOR range 0.26-0.51). The high prevalence of risky sex among males and the protective influence of stable family cohesiveness have important implications for HIV prevention efforts.

  3. Site characterization and site response in Port-au-Prince, Haiti

    Science.gov (United States)

    Hough, Susan E.; Yong, Alan K.; Altidor, Jean Robert; Anglade, Dieuseul; Given, Douglas D.; Mildor, Saint-Louis

    2011-01-01

    Waveform analysis of aftershocks of the Mw7.0 Haiti earthquake of 12 January 2010 reveals amplification of ground motions at sites within the Cul de Sac valley in which Port-au-Prince is situated. Relative to ground motions recorded at a hard-rock reference site, peak acceleration values are amplified by a factor of approximately 1.8 at sites on low-lying Mio-Pliocene deposits in central Port-au-Prince and by a factor of approximately 2.5–3 on a steep foothill ridge in the southern Port-au-Prince metropolitan region. The observed amplitude, predominant periods, variability, and polarization of amplification are consistent with predicted topographic amplification by a steep, narrow ridge. A swath of unusually high damage in this region corresponds with the extent of the ridge where high weak-motion amplifications are observed. We use ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) imagery to map local geomorphology, including characterization of both near-surface and of small-scale topographic structures that correspond to zones of inferred amplification.

  4. Satellite Map of Port-au-Prince, Haiti-2010-Natural Color

    Science.gov (United States)

    Cole, Christopher J.; Sloan, Jeff

    2010-01-01

    The U.S. Geological Survey produced 1:24,000-scale post-earthquake image base maps incorporating high- and medium-resolution remotely sensed imagery following the 7.0 magnitude earthquake near the capital city of Port au Prince, Haiti, on January 12, 2010. Commercial 2.4-meter multispectral QuickBird imagery was acquired by DigitalGlobe on January 15, 2010, following the initial earthquake. Ten-meter multispectral ALOS AVNIR-2 imagery was collected by the Japanese Space Agency (JAXA) on January 12, 2010. These data were acquired under the Remote Sensing International Charter, a global team of space and satellite agencies that provide timely imagery in support of emergency response efforts worldwide. The images shown on this map were employed to support earthquake response efforts, specifically for use in determining ground deformation, damage assessment, and emergency management decisions. The raw, unprocessed imagery was geo-corrected, mosaicked, and reproduced onto a cartographic 1:24,000-scale base map. These maps are intended to provide a temporally current representation of post-earthquake ground conditions, which may be of use to decision makers and to the general public.

  5. The creation and integration of a nurse educator position in two hospitals in Haiti.

    Science.gov (United States)

    Mahon, Abbey; Valcourt, Roodeline; Merry, Lisa; Dieudonné, Fabiola; Tuck, Jodi

    2018-04-01

    Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited. To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role. Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed. Supplementary data were gathered through participant observation and document review. Data were compiled and summarized. NEs were hired to assess learning needs, evaluate skills, train and mentor nurses, and provide ongoing support to assure application of new knowledge. Barriers included lack of specialized training and limited informational resources to develop education activities, role confusion and heavy workload, poor attendance and disparate education needs of nurses, and insufficient hospital resources and support to implement practice changes. Facilitators included previous management experience, peer support, and a perception of being valued by patients and colleagues and making a difference regarding nursing care and patient outcomes. The NE is a leadership role and a promising, sustainable initiative for developing the nursing profession in Haiti. © 2018 Wiley Periodicals, Inc.

  6. Mortality, violence and access to care in two districts of Port-au-Prince, Haiti

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    Van Herp Michel

    2009-03-01

    Full Text Available Abstract Background Towards the end of 2006 open conflict broke out between United Nations forces and armed militia in Port-au-Prince, Haiti. Fighting was most intense in the district of Cité Soleil. Methods A cross-sectional, random-sample survey among the conflict-affected populations living in Cité Soleil and Martissant was carried out over a 4-week period in 2006 using a semi-structured questionnaire to assess exposure to violence and access to health care. Household heads from 945 households (corresponding to 4,763 people in Cité Soleil and 1,800 household (9,539 people in Martissant provided information on household members. The average recall period was 579 days for Cité Soleil and 601 days for Martissant. Results In Cité Soleil 120 deaths (21 children were reported (CMR 0.4 deaths/10,000 people/day; Discussion Extrapolating to the total population of these two districts some 2,000 violent deaths occurred over the recall period. Among the survivors, violence had lasting effects in terms of physical and mental health and loss of property and possessions.

  7. Ascaris and Escherichia coli Inactivation in an Ecological Sanitation System in Port-au-Prince, Haiti.

    Directory of Open Access Journals (Sweden)

    David Berendes

    Full Text Available The goal of this study was to evaluate the microbial die-off in a latrine waste composting system in Port-au-Prince, Haiti. Temperature data and samples were collected from compost aged 0-12+ months. Samples collected from compost bin centers and corners at two depths were assessed for moisture content, E. coli concentration, and Ascaris spp. viability. Center temperatures in compost bins were all above 58 °C, while corner temperatures were 10 - 20 °C lower. Moisture content was 67 ± 10% in all except the oldest compost. A 4-log reduction in E. coli was observed over the first sixteen weeks of composting at both locations and depths, after which E. coli was undetectable (LOD: 142 MPN g(-1 dry weight. In new compost, 10.4% and 8.3% of Ascaris eggs were viable and fully embryonated, respectively. Percent viability dropped to zero in samples older than six weeks. These findings indicate that the Haitian EcoSan composting process was effective in inactivating E. coli and Ascaris spp. in latrine waste within sixteen weeks. This study is one of the first to document efficacy of an ecological sanitation system under field conditions and provides insight into composting methods and monitoring for other international settings.

  8. Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up.

    Science.gov (United States)

    Sévère, Karine; Rouzier, Vanessa; Anglade, Stravinsky Benedict; Bertil, Claudin; Joseph, Patrice; Deroncelay, Alexandra; Mabou, Marie Marcelle; Wright, Peter F; Guillaume, Florence Duperval; Pape, Jean William

    2016-05-04

    The first oral cholera vaccine (OCV) campaign, since its prequalification by the World Health Organization, in response to an ongoing cholera epidemic (reactive vaccination) was successfully conducted in a poor urban slum of approximately 70,000 inhabitants in Port-au-Prince, Haiti, in 2012. Vaccine coverage was 75% of the target population. This report documents the impact of OCV in reducing the number of culture-confirmed cases of cholera admitted to the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center from that community in the 37 months postvaccination (April 2012-April 30, 2015). Of 1,788 patients with culture-confirmed cholera, 1,770 (99%) were either from outside the vaccine area (1,400 cases) or from the vaccinated community who had not received OCV (370 cases). Of the 388 people from the catchment area who developed culture-confirmed cholera, 370 occurred among the 17,643 people who had not been vaccinated (2.1%) and the remaining 18 occurred among the 52,357 people (0.034%) who had been vaccinated (P cholera in outbreak settings. © The American Society of Tropical Medicine and Hygiene.

  9. Mapping to Support Fine Scale Epidemiological Cholera Investigations: A Case Study of Spatial Video in Haiti

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    Andrew Curtis

    2016-02-01

    Full Text Available The cartographic challenge in many developing world environments suffering a high disease burden is a lack of granular environmental covariates suitable for modeling disease outcomes. As a result, epidemiological questions, such as how disease diffuses at intra urban scales are extremely difficult to answer. This paper presents a novel geospatial methodology, spatial video, which can be used to collect and map environmental covariates, while also supporting field epidemiology. An example of epidemic cholera in a coastal town of Haiti is used to illustrate the potential of this new method. Water risks from a 2012 spatial video collection are used to guide a 2014 survey, which concurrently included the collection of water samples, two of which resulted in positive lab results “of interest” (bacteriophage specific for clinical cholera strains to the current cholera situation. By overlaying sample sites on 2012 water risk maps, a further fifteen proposed water sample locations are suggested. These resulted in a third spatial video survey and an additional “of interest” positive water sample. A potential spatial connection between the “of interest” water samples is suggested. The paper concludes with how spatial video can be an integral part of future fine-scale epidemiological investigations for different pathogens.

  10. Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti.

    Science.gov (United States)

    Tilmans, Sebastien; Russel, Kory; Sklar, Rachel; Page, Leah; Kramer, Sasha; Davis, Jennifer

    2015-04-01

    Container-based sanitation (CBS) - in which wastes are captured in sealable containers that are then transported to treatment facilities - is an alternative sanitation option in urban areas where on-site sanitation and sewerage are infeasible. This paper presents the results of a pilot household CBS service in Cap Haitien, Haiti. We quantify the excreta generated weekly in a dense urban slum, (1) the proportion safely removed via container-based public and household toilets, and the costs associated with these systems. The CBS service yielded an approximately 3.5-fold decrease in the unmanaged share of faeces produced, and nearly eliminated the reported use of open defecation and "flying toilets" among service recipients. The costs of this pilot small-scale service were higher than those of large-scale waterborne sewerage, but economies of scale have the potential to reduce CBS costs over time. The paper concludes with a discussion of planning and policy implications of incorporating CBS into the menu of sanitation options for rapidly growing cities.

  11. Exploring Unintended Social Side Effects of Tent Distribution Practices in Post-Earthquake Haiti

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    Carmen Helen Logie

    2013-09-01

    Full Text Available The January 2010 earthquake devastated Haiti’s social, economic and health infrastructure, leaving 2 million persons—one-fifth of Haiti’s population—homeless. Internally displaced persons relocated to camps, where human rights remain compromised due to increased poverty, reduced security, and limited access to sanitation and clean water. This article draws on findings from 3 focus groups conducted with internally displaced young women and 3 focus groups with internally displaced young men (aged 18–24 in Leogane, Haiti to explore post-earthquake tent distribution practices. Focus group findings highlighted that community members were not engaged in developing tent distribution strategies. Practices that distributed tents to both children and parents, and linked food and tent distribution, inadvertently contributed to “chaos”, vulnerability to violence and family network breakdown. Moving forward we recommend tent distribution strategies in disaster contexts engage with community members, separate food and tent distribution, and support agency and strategies of self-protection among displaced persons.

  12. Differential Vulnerability to Hurricanes in Cuba, Haiti, and the Dominican Republic: The Contribution of Education

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    Adelheid Pichler

    2013-09-01

    Full Text Available The possible impacts of the level of formal education on different aspects of disaster management, prevention, alarm, emergency, or postdisaster activities, were studied in a comparative perspective for three countries with a comparable exposure to hurricane hazards but different capacities for preventing harm. The study focused on the role of formal education in reducing vulnerability operating through a long-term learning process and put particular emphasis on the education of women. The comparative statistical analysis of the three countries was complemented through qualitative studies in Cuba and the Dominican Republic collected in 2010-2011. We also analyzed to what degree targeted efforts to reduce vulnerability were interconnected with other policy domains, including education and science, health, national defense, regional development, and cultural factors. We found that better education in the population had clear short-term effects on reducing vulnerability through awareness about crucial information, faster and more efficient responses to alerts, and better postdisaster recuperation. However, there were also important longer term effects of educational efforts to reduce social vulnerability through the empowerment of women, its effect on the quality of institutions and social networks for mutual assistance creating a general culture of safety and preparedness. Not surprisingly, on all three accounts Cuba clearly did the best; whereas Haiti was worst, and the Dominican Republic took an intermediate position.

  13. Establishment of a High Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program [corrected].

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    Ryan M Wallace

    2015-11-01

    Full Text Available The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 -December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9% and an additional 36 cases were identified based on clinical diagnosis (5%, representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%. Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries.

  14. Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti.

    Science.gov (United States)

    Ayoya, Mohamed Ag; Golden, Kate; Ngnie-Teta, Ismael; Moreaux, Marjolein D; Mamadoultaibou, Aissa; Koo, Leslie; Boyd, Erin; Beauliere, Jean Max; Lesavre, Celine; Marhone, Joseline Pierre

    2013-08-01

    The 2010 earthquake in Haiti displaced about 1.5 million people, many of them into camps for internally displaced persons. It was expected that disruption of breastfeeding practices would lead to increased infant morbidity, malnutrition and mortality. Haiti's health ministry and the United Nations Children's Fund, in collaboration with local and international nongovernmental organizations, established baby tents in the areas affected by the earthquake. The tents provided a safe place for mothers to breastfeed and for non-breastfed infants to receive ready-to-use infant formula. Such a large and coordinated baby tent response in an emergency context had never been mounted before anywhere in the world. Baby tents were set up in five cities but mainly in Port-au-Prince, where the majority of Haiti's 1555 camps for displaced persons had been established. Between February 2010 and June 2012, 193 baby tents were set up; 180 499 mother-infant pairs and 52 503 pregnant women were registered in the baby tent programme. Of infants younger than 6 months, 70% were reported to be exclusively breastfed and 10% of the "mixed feeders" moved to exclusive breastfeeding while enrolled. In 2010, 13.5% of registered infants could not be breastfed. These infants received ready-to-use infant formula. Thanks to rapid programme scale-up, breastfeeding practices remained undisrupted. However, better evaluation methods and comprehensive guidance on the implementation and monitoring of baby tents are needed for future emergencies, along with a clear strategy for transitioning baby tent activities into facility and community programmes.

  15. Immunogenicity of a killed bivalent (O1 and O139 whole cell oral cholera vaccine, Shanchol, in Haiti.

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    Richelle C Charles

    2014-05-01

    Full Text Available Studies of the immunogenicity of the killed bivalent whole cell oral cholera vaccine, Shanchol, have been performed in historically cholera-endemic areas of Asia. There is a need to assess the immunogenicity of the vaccine in Haiti and other populations without historical exposure to Vibrio cholerae.We measured immune responses after administration of Shanchol, in 25 adults, 51 older children (6-17 years, and 47 younger children (1-5 years in Haiti, where cholera was introduced in 2010. A≥4-fold increase in vibriocidal antibody titer against V. cholerae O1 Ogawa was observed in 91% of adults, 74% of older children, and 73% of younger children after two doses of Shanchol; similar responses were observed against the Inaba serotype. A≥2-fold increase in serum O-antigen specific polysaccharide IgA antibody levels against V. cholerae O1 Ogawa was observed in 59% of adults, 45% of older children, and 61% of younger children; similar responses were observed against the Inaba serotype. We compared immune responses in Haitian individuals with age- and blood group-matched individuals from Bangladesh, a historically cholera-endemic area. The geometric mean vibriocidal titers after the first dose of vaccine were lower in Haitian than in Bangladeshi vaccinees. However, the mean vibriocidal titers did not differ between the two groups after the second dose of the vaccine.A killed bivalent whole cell oral cholera vaccine, Shanchol, is highly immunogenic in Haitian adults and children. A two-dose regimen may be important in Haiti, and other populations lacking previous repeated exposures to V. cholerae.

  16. Healthcare waste management during disasters and its effects on climate change: Lessons from 2010 earthquake and cholera tragedies in Haiti.

    Science.gov (United States)

    Raila, Emilia M; Anderson, David O

    2017-03-01

    Despite growing effects of human activities on climate change throughout the world, and global South in particular, scientists are yet to understand how poor healthcare waste management practices in an emergency influences the climate change. This article presents new findings on climate change risks of healthcare waste disposal during and after the 2010 earthquake and cholera disasters in Haiti. The researchers analysed quantities of healthcare waste incinerated by the United Nations Mission in Haiti for 60 months (2009 to 2013). The aim was to determine the relationship between healthcare waste incinerated weights and the time of occurrence of the two disasters, and associated climate change effects, if any. Pearson product-moment correlation coefficient indicated a weak correlation between the quantities of healthcare waste disposed of and the time of occurrence of the actual emergencies (r (58) = 0.406, p = 0.001). Correspondingly, linear regression analysis indicated a relatively linear data trend (R 2 = 0.16, F (1, 58) = 11.42, P = 0.001) with fluctuating scenarios that depicted a sharp rise in 2012, and time series model showed monthly and yearly variations within 60 months. Given that the peak healthcare waste incineration occurred 2 years after the 2010 disasters, points at the need to minimise wastage on pharmaceuticals by improving logistics management. The Government of Haiti had no data on healthcare waste disposal and practised smoky open burning, thus a need for capacity building on green healthcare waste management technologies for effective climate change mitigation.

  17. Feasibility of the hydrogen sulfide test for the assessment of drinking water quality in post-earthquake Haiti.

    Science.gov (United States)

    Weppelmann, Thomas A; Alam, Meer T; Widmer, Jocelyn; Morrissey, David; Rashid, Mohammed H; De Rochars, Valery M Beau; Morris, J Glenn; Ali, Afsar; Johnson, Judith A

    2014-12-01

    In 2010, a magnitude 7.0 earthquake struck Haiti, severely damaging the drinking and wastewater infrastructure and leaving millions homeless. Compounding this problem, the introduction of Vibrio cholerae resulted in a massive cholera outbreak that infected over 700,000 people and threatened the safety of Haiti's drinking water. To mitigate this public health crisis, non-government organizations installed thousands of wells to provide communities with safe drinking water. However, despite increased access, Haiti currently lacks the monitoring capacity to assure the microbial safety of any of its water resources. For these reasons, this study was designed to assess the feasibility of using a simple, low-cost method to detect indicators of fecal contamination of drinking water that could be implemented at the community level. Water samples from 358 sources of drinking water in the Léogâne flood basin were screened with a commercially available hydrogen sulfide test and a standard membrane method for the enumeration of thermotolerant coliforms. When compared with the gold standard method, the hydrogen sulfide test had a sensitivity of 65 % and a specificity of 93 %. While the sensitivity of the assay increased at higher fecal coliform concentrations, it never exceeded 88 %, even with fecal coliform concentrations greater than 100 colony-forming units per 100 ml. While its simplicity makes the hydrogen sulfide test attractive for assessing water quality in low-resource settings, the low sensitivity raises concerns about its use as the sole indicator of the presence or absence of fecal coliforms in individual or community water sources.

  18. Community health workers and smartphones for the detection of surgical site infections in rural Haiti: a pilot study.

    Science.gov (United States)

    Matousek, Alexi; Paik, Ken; Winkler, Eric; Denike, Jennifer; Addington, Stephen R; Exe, Chauvet; Louis, Rodolphe R E Jean; Riviello, Robert

    2015-04-27

    Absence of outcome data is a barrier to quality improvement in resource poor settings. To address this challenge, we set out to determine whether follow up for surgical site infections (SSIs) using community health workers (CHWs) and smartphones is feasible in rural Haiti. In this pilot study, all patients from a specific mountain region who received an operation between March 10, and July 1, 2014, at Hôpital Albert Schweitzer in rural Haiti were eligible for inclusion. Patients or guardians of minors were approached for consent. We designed a smartphone application to enable CHWs to screen for SSIs during home visits by administering a questionnaire, obtaining GPS data, and submitting a photograph of an incision. We selected and trained CHWs to use the smartphone application and compensated them based on performance. CHWs completed home visits for 30 days after an operation for all participants. Surgeons examined all participants within 24 h after the second CHW home visit. Primary outcomes included the number of participants completing 30-day follow-up and home visits made on time. Secondary outcomes included the quality of the photographs and the agreement between surgeons and CHWs on the diagnosis of SSI. The Partners Healthcare institutional review board and the Ethics Committee at Hôpital Albert Schweitzer approved the study protocol. Five CHWs completed 30-day follow up for 37 of 39 participants (94·9%) and completed 107 of 117 home visits on time (91·5%). High quality photographs were submitted for 101 of 117 visits (86·3%). Surgeons and CHWs agreed on the diagnosis of SSI in 28 of 33 cases (84·8%). Outpatient follow up for SSIs with CHWs and smartphones is feasible in rural Haiti. Further validation of the programme needs to be done before widespread adoption or advocating for task shifting post-operative follow up to CHWs. Partners Healthcare, Children's Hospital Boston, and Swiss Bündner Partnerschaft Hôpital Albert Schweitzer Haiti. Copyright

  19. Assessing the causes of under-five mortality in the Albert Schweitzer Hospital service area of rural Haiti.

    Science.gov (United States)

    Perry, Henry B; Ross, Allen G; Fernand, Facile

    2005-09-01

    Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies else-where in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause of death. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45% of all under-five deaths, followed by enteric diseases, present in 21% of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41% of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51% of the deaths, and enteric diseases in 30%. Deaths were concentrated during the first few months of life, with 35% occurring during the first month. Among the neonatal deaths, 27% occurred on the first day of life, and 80% occurred during the first 10 days of life. In the Albert Schweitzer Hospital program area--and presumably in other areas of Haiti as well--priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local

  20. Building damage assessment after the earthquake in Haiti using two post-event satellite stereo imagery and DSMs

    DEFF Research Database (Denmark)

    Reinartz, Peter; Tian, Jiaojiao; Nielsen, Allan Aasbjerg

    2013-01-01

    In this paper, a novel disaster building damage monitoring method is presented. This method combines the multispectral imagery and DSMs from stereo matching to obtain three kinds of changes. The proposed method contains three basic steps. The first step is to segment the panchromatic images to ge...... (mainly temporary residential area, etc. tents). In the last step, a region based grey level co-occurrence matrix texture measurement is used to refine the third change class. The method is applied to building change detection after the Haiti earthquake....

  1. The serpent and the Madonna: Senses, practices and soundscapes in a vodou site: Saut d’Eau, Haiti

    Directory of Open Access Journals (Sweden)

    Francesco Ronzon

    2017-12-01

    Full Text Available L’articolo analizza la relazione tra sensi, pratiche e paesaggi sonori in relazione a Sodo, sede di un pellegrinaggio vodou su scala nazionale ad Haiti. Partendo dagli studi sui soundscapes (Schafer 1977 come punto di vista teorico per analizzare l’interazione tra suono e persone in un luogo specifico, l’articolo mostra l’interazione tra suoni ambientali, musica registrata e performance dal vivo. In particolare, questa ricerca vuole investigare il micro livello dell’ascolto situato, ovvero i modi con i quali gli attori sociali indirizzano la loro attenzione verso i suoni dell’ambiente in relazione alle loro pratiche sociali, culturali e religiose.

  2. Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC among a Sample of Health Care Providers in Haiti.

    Directory of Open Access Journals (Sweden)

    Jessy G Dévieux

    Full Text Available Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti.A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year.The sample consisted of medical doctors (31.0%, nurses (49.0%, and other health care professionals (20.0%. Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15-5.71 times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing "the best age to perform MMC" as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%.Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies

  3. Air quality in developing world disaster and conflict zones--the case of post-earthquake Haiti.

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    Davis, Mary E; Rappaport, Ann

    2014-10-15

    Data on air quality are remarkably limited in the poorest of the world's countries. This is especially true for post-conflict and disaster zones, where international relief efforts focus largely on more salient public health challenges such as water and sanitation, infectious diseases, and housing. Using post-earthquake Haiti as the example case, this commentary explores air quality challenges in the developing world, highlighting concerns related to infrastructure damage from post-conflict and disaster settings. We contend that there is a growing and presently unmet need for further research and attention from the global health community to address these issues. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Using high resolution satellite multi-temporal interferometry for landslide hazard detection in tropical environments: the case of Haiti

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    Wasowski, Janusz; Nutricato, Raffaele; Nitti, Davide Oscar; Bovenga, Fabio; Chiaradia, Maria Teresa; Piard, Boby Emmanuel; Mondesir, Philemon

    2015-04-01

    Synthetic aperture radar (SAR) multi-temporal interferometry (MTI) is one of the most promising satellite-based remote sensing techniques for fostering new opportunities in landslide hazard detection and assessment. MTI is attractive because it can provide very precise quantitative information on slow slope displacements of the ground surface over huge areas with limited vegetation cover. Although MTI is a mature technique, we are only beginning to realize the benefits of the high-resolution imagery that is currently acquired by the new generation radar satellites (e.g., COSMO-SkyMed, TerraSAR-X). In this work we demonstrate the potential of high resolution X-band MTI for wide-area detection of slope instability hazards even in tropical environments that are typically very harsh (eg. coherence loss) for differential interferometry applications. This is done by presenting an example from the island of Haiti, a tropical region characterized by dense and rapidly growing vegetation, as well as by significant climatic variability (two rainy seasons) with intense precipitation events. Despite the unfavorable setting, MTI processing of nearly 100 COSMO-SkyMed (CSK) mages (2011-2013) resulted in the identification of numerous radar targets even in some rural (inhabited) areas thanks to the high resolution (3 m) of CSK radar imagery, the adoption of a patch wise processing SPINUA approach and the presence of many man-made structures dispersed in heavily vegetated terrain. In particular, the density of the targets resulted suitable for the detection of some deep-seated and shallower landslides, as well as localized, very slow slope deformations. The interpretation and widespread exploitation of high resolution MTI data was facilitated by Google EarthTM tools with the associated high resolution optical imagery. Furthermore, our reconnaissance in situ checks confirmed that MTI results provided useful information on landslides and marginally stable slopes that can represent a

  5. Earthquake behavior of the Enriquillo fault zone, Haiti revealed by interactive terrain visualization

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    Cowgill, E.; Bernardin, T. S.; Oskin, M. E.; Bowles, C. J.; Yikilmaz, M. B.; Kreylos, O.; Elliott, A. J.; Bishop, M. S.; Gold, R. D.; Morelan, A.; Bawden, G. W.; Hamann, B.; Kellogg, L. H.

    2010-12-01

    The Mw 7.0 January 12, 2010 Haiti earthquake ended 240 years of relative quiescence following earthquakes that destroyed Port-au-Prince in 1751 and 1770. We place the 2010 rupture in the context of past earthquakes and future hazards by using remote analysis of airborne LiDAR to observe the topographic expression of active faulting and develop a new conceptual model for the earthquake behavior of the eastern Enriquillo fault zone (EFZ). In this model, the 2010 event occupies a long-lived segment boundary at a stepover within the EFZ separating fault segments that likely ruptured in 1751 and 1770, explaining both past clustering and the lack of 2010 surface rupture. Immediately following the 2010 earthquake, an airborne LiDAR point cloud containing over 2.7 billion point measurements of surface features was collected by the Rochester Inst. of Technology. To analyze these data, we capitalize on the human capacity to visually identify meaningful patterns embedded in noisy data by conducting interactive visual analysis of the entire 66.8 GB Haiti terrain data in a 4-sided, 800 ft3 immersive virtual-reality environment at the UC Davis KeckCAVES using the software tools LiDAR Viewer (to analyze point cloud data) and Crusta (for 3D surficial geologic mapping on DEM data). We discovered and measured landforms displaced by past surface-rupturing earthquakes and remotely characterized the regional fault geometry. Our analysis of the ~50 km long reach of EFZ spanning the 2010 epicenter indicates that geomorphic evidence of active faulting is clearer east of the epicenter than to the west. West of the epicenter, and in the region of the 2010 rupture, the fault is poorly defined along an embayed, low-relief range front, with little evidence of recent surface rupture. In contrast, landform offsets of 6 to 50 m along the reach of the EFZ east of the epicenter and closest to Port-au-Prince attest to repeated recent surface-rupturing earthquakes here. Specifically, we found and

  6. Patient attrition from the HIV antiretroviral therapy program at two hospitals in Haiti.

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    Puttkammer, Nancy H; Zeliadt, Steven B; Baseman, Janet G; Destiné, Rodney; Wysler Domerçant, Jean; Labbé Coq, Nancy Rachel; Atwood Raphael, Nernst; Sherr, Kenneth; Tegger, Mary; Yuhas, Krista; Barnhart, Scott

    2014-10-01

    To identify factors associated with antiretroviral therapy (ART) attrition among patients initiating therapy in 2005-2011 at two large, public-sector department-level hospitals, and to inform interventions to improve ART retention. This retrospective cohort study used data from the iSanté electronic medical record (EMR) system. The study characterized ART attrition levels and explored the patient demographic, clinical, temporal, and service utilization factors associated with ART attrition, using time-to-event analysis methods. Among the 2 023 patients in the study, ART attrition on average was 17.0 per 100 person-years (95% confidence interval (CI): 15.8-18.3). In adjusted analyses, risk of ART attrition was up to 89% higher for patients living in distant communes compared to patients living in the same commune as the hospital (hazard ratio: 1.89, 95%CI: 1.54-2.33; P Hospital site, earlier year of ART start, spending less time enrolled in HIV care prior to ART initiation, receiving a non-standard ART regimen, lacking counseling prior to ART initiation, and having a higher body mass index were also associated with attrition risk. The findings suggest quality improvement interventions at the two hospitals, including: enhanced retention support and transportation subsidies for patients accessing care from remote areas; counseling for all patients prior to ART initiation; timely outreach to patients who miss ART pick-ups; "bridging services" for patients transferring care to alternative facilities; routine screening for anticipated interruptions in future ART pick-ups; and medical case review for patients placed on non-standard ART regimens. The findings are also relevant for policymaking on decentralization of ART services in Haiti.

  7. Patient attrition from the HIV antiretroviral therapy program at two hospitals in Haiti

    Directory of Open Access Journals (Sweden)

    Nancy H. Puttkammer

    2014-10-01

    Full Text Available OBJECTIVE: To identify factors associated with antiretroviral therapy (ART attrition among patients initiating therapy in 2005-2011 at two large, public-sector department-level hospitals, and to inform interventions to improve ART retention. METHODS: This retrospective cohort study used data from the iSanté electronic medical record (EMR system. The study characterized ART attrition levels and explored the patient demographic, clinical, temporal, and service utilization factors associated with ART attrition, using time-to-event analysis methods. RESULTS: Among the 2 023 patients in the study, ART attrition on average was 17.0 per 100 person-years (95% confidence interval (CI: 15.8-18.3. In adjusted analyses, risk of ART attrition was up to 89% higher for patients living in distant communes compared to patients living in the same commune as the hospital (hazard ratio: 1.89, 95%CI: 1.54-2.33; P < 0.001. Hospital site, earlier year of ART start, spending less time enrolled in HIV care prior to ART initiation, receiving a non-standard ART regimen, lacking counseling prior to ART initiation, and having a higher body mass index were also associated with attrition risk. CONCLUSIONS: The findings suggest quality improvement interventions at the two hospitals, including: enhanced retention support and transportation subsidies for patients accessing care from remote areas; counseling for all patients prior to ART initiation; timely outreach to patients who miss ART pick-ups; "bridging services" for patients transferring care to alternative facilities; routine screening for anticipated interruptions in future ART pick-ups; and medical case review for patients placed on non-standard ART regimens. The findings are also relevant for policymaking on decentralization of ART services in Haiti.

  8. Multiple traumas and resilience among street children in Haiti: Psychopathology of survival.

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    Cénat, Jude Mary; Derivois, Daniel; Hébert, Martine; Amédée, Laetitia Mélissande; Karray, Amira

    2018-05-01

    In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. An epidemic model for the future progression of the current Haiti cholera epidemic

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    Bertuzzo, E.; Mari, L.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2012-04-01

    As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to December 2011, climb to 522,000 cases and 7,000 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of Vibrio cholera, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan project). The model directly accounts for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. To this end, we generate realistic scenario of future precipitation in order to forecast possible epidemic paths up to the end of the 2013. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations

  10. A spatially explicit model for the future progression of the current Haiti cholera epidemic

    Science.gov (United States)

    Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2011-12-01

    As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to July 2011, climb to 385,000 cases and 5,800 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of textit{Vibrio cholera}, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan texttrademark project). The model directly account for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations, clean water supply and educational campaigns, thus emerging as an essential component of the control of future cholera

  11. Measuring the way forward in Haiti: grounding disaster relief in the legal framework of human rights.

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    Klasing, Amanda M; Moses, P Scott; Satterthwaite, Margaret L

    2011-07-14

    This article provides results from an online survey of humanitarian workers and volunteers that was conducted in May and June 2010. The purpose of the survey was to understand how the humanitarian aid system adopts or incorporates human rights into its post-natural disaster work and metrics. Data collected from Haiti suggest that humanitarians have embraced a rights-based approach but that they do not agree about how this is defined or about what standards and indicators can be considered rights-based. This disagreement may reveal that humanitarians are aware of a mismatch between the rights-based approach to post-disaster humanitarian work and the legal framework of human rights. Using participation and accountability as examples, this article identifies and examines this mismatch and suggests that the humanitarian aid system should more fully embrace engagement with the human rights framework. To do so, the article concludes, humanitarian actors and the human rights community should have an open dialogue about the development of metrics that accurately reflect and monitor adherence to the legal framework of human rights. This would allow the humanitarian aid system to ensure its interventions enhance the capacity of the disaster-affected state to fulfill its human rights obligations, and would allow humanitarian and human rights actors alike to measure the impact of such interventions on the realization of human rights in post-natural disaster settings. Copyright © 2011 Klasing, Moses, and Satterthwaite. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  12. The Jollywood Manifesto: Trans-local Film Cultures in Haiti's Emerging Cinemas

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    Doris Posch

    2015-10-01

    Full Text Available Taking into account Haiti’s peripheral and/or temporary position within World Cinema’s politics, this paper focuses on a recent phenomenon of cinematographic productions of Haiti’s emerging filmmaker’s generation: Jollywood. The Ciné Institute is the only film school in the French-speaking part of the West Indies that currently provides training to a young generation of filmmakers and videographers. Its Jollywood Manifesto is based on the political, cultural and societal as well as media-related vision of a self-sustaining film market in Haiti. Based on lowest-budget productions made possible by the huge rise of digital film, this recent phenomenon not only asks for new modes of production, circulating distribution and reception. It also stands for a reconsideration of film and media theory for “internationalized” World Cinemas on a discursive level. This level will be approached by interlacing a twofold concept: On the one hand, theories on (Post- Third Cinemas that have been known since their inception in the late 1960s in Latin America and that have subsequently been adapted in the Asian and African Cinemas. On the other hand, today’s assumptions of considering cinema in its political message on a transglobal space are called into question. The global film market, mostly dominated by the triad of Bollywood, Nollywood and Hollywood, also questions the margins of hegemonic centerlines of power relations. Haiti’s cinematic productions are located at the interstices of local and national(ist  imaginaries in line with a (postcolonial independent film industry. This ambiguity stands for the resulting translocal and transcultural attributions of Haiti’s emerging film cultures and the ambiguous formations of the notions of being and belonging. The analysis of the Jollywood phenomenon on transnational/-local/-cultural levels aims at a methodological detangling of geopolitical spaces and temporalities in the media.

  13. Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew.

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    Pasetto, Damiano; Finger, Flavio; Camacho, Anton; Grandesso, Francesco; Cohuet, Sandra; Lemaitre, Joseph C; Azman, Andrew S; Luquero, Francisco J; Bertuzzo, Enrico; Rinaldo, Andrea

    2018-05-01

    Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign. A rainfall-driven, spatially-explicit meta-community model of cholera transmission was coupled to a data assimilation scheme for computing short-term projections of the epidemic in near real-time. The model was used to forecast cholera incidence for the months after the passage of the hurricane (October-December 2016) and to predict the impact of a planned oral cholera vaccination campaign. Our first projection, from October 29 to December 31, predicted the highest incidence in the departments of Grande Anse and Sud, accounting for about 45% of the total cases in Haiti. The projection included a second peak in cholera incidence in early December largely driven by heavy rainfall forecasts, confirming the urgency for rapid intervention. A second projection (from November 12 to December 31) used updated rainfall forecasts to estimate that 835 cases would be averted by vaccinations in Grande Anse (90% Prediction Interval [PI] 476-1284) and 995 in Sud (90% PI 508-2043). The experience gained by this modeling effort shows that state-of-the-art computational modeling and data-assimilation methods can produce informative near real-time projections of cholera incidence. Collaboration among modelers and field epidemiologists is indispensable to gain fast access to field data and to translate model results into operational recommendations for emergency management during an outbreak. Future efforts should thus draw together multi

  14. Bacterial enteropathogens associated with diarrhea in a rural population of Haiti

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    Jackson JC

    2011-09-01

    Full Text Available John C Jackson, Anthony L Farone, Mary B Farone Biology Department, Middle Tennessee State University, Murfreesboro, Tennessee, USA Purpose: Diarrheal disease is one of the leading causes of morbidity in developing countries. To further understand the epidemiology of diarrheal disease among a rural population surrounding Robillard, Haiti, fecal swabs from patients with diarrhea were screened for the presence of enteropathogenic bacteria. Patients and methods: Fecal swabs were collected from 34 patients with signs and symptoms of diarrhea and stored in BBLTM Cary-Blair transport medium (Becton, Dickinson and Company, Sparks, MD until transit to the USA. Swab material was inoculated on to different enrichment and selective agars for incubation. Fermenting and nonfermenting bacteria that grew on the enteric selection media were identified by the BBLTM CrystalTM Enteric/Nonferementing Identification system (Becton, Dickinson and Company. Organisms identified as Escherichia coli were further screened for the presence of virulence factors by polymerase chain reaction (PCR. Results: Of 34 patients, no Campylobacter, Shigella, Salmonella, or Vibrio spp. were isolated from swabs transported to the USA for culture. Of 73 E. coli isolates cultured from the swabs, one enteropathogenic strain of E. coli was identified by multiplex PCR. Escherichia fergusonii and Cronobacter sakazakii, both potential gastrointestinal pathogens, were also isolated from patient stools. Conclusion: This study was undertaken to determine if bacterial enteropathogens could be detected in the stools of patients suffering from diarrhea or dysentery and, in the absence of sufficient facilities, rectal swabs could be transported to the USA for culture. Although several genera of overt enteropathogens were not detected, one enteropathogenic E. coli and other pathogenic enterobacteriaceae were successfully cultured and identified. Keywords: Escherichia, Cronobacter, diarrheagenic, stool

  15. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti.

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    Holm, Michelle R; Rudis, Maria I; Wilson, John W

    2015-01-01

    In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of 'real-time' medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, psupply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  16. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

    Directory of Open Access Journals (Sweden)

    Michelle R. Holm

    2015-01-01

    Full Text Available Background: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP would optimize medication availability and decrease medication shortages. Design: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055, respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  17. 'My body is mine': Qualitatively exploring agency among internally displaced women participants in a small-group intervention in Leogane, Haiti.

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    Logie, Carmen H; Daniel, CarolAnn

    2016-01-01

    The 2010 earthquake resulted in the breakdown of Haiti's social, economic and health infrastructure. Over one-quarter of a million people remain internally displaced (ID). ID women experience heightened vulnerability to intimate partner violence (IPV) due to increased poverty and reduced community networks. Scant research has examined experiences of IPV among ID women in post-earthquake Haiti. We conducted a qualitative study to explore the impact of participating in Famn an Aksyon Pou Santé Yo (FASY), a small-group HIV prevention intervention, on ID women's agency in Leogane, Haiti. We conducted four focus groups with ID women, FASY participants (n = 40) and in-depth individual interviews with peer health workers (n = 7). Our study was guided by critical ethnography and paid particular attention to power relations. Findings highlighted multiple forms of IPV (e.g., physical, sexual). Participants discussed processes of intrapersonal (confidence), interpersonal (communication), relational (support) and collective (women's rights) agency. Yet structural factors, including patriarchal gender norms and poverty, silenced IPV discussions and constrained women's agency. Findings suggest that agency among ID women is a multi-level, non-linear and incremental process. To effectively address IPV among ID women in Haiti, interventions should address structural contexts of gender inequity and poverty and concurrently facilitate multi-level processes of agency.

  18. Disaster, Disruption to Family Life, and Intimate Partner Violence: The Case of the 2010 Earthquake in Haiti

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    Abigail Weitzman

    2016-03-01

    Full Text Available Natural disasters have inherently social dimensions because they exacerbate preexisting inequalities and disrupt social norms and institutions. Despite a growing interest in the sociological aspects of disasters, few studies have quantitatively explored how disasters alter intrahousehold family dynamics. In this article, we develop and test a conceptual framework that explicates how natural disasters affect an important component of family life: intimate partner violence (IPV. We combine two waves of geocoded Demographic and Health Surveys data, collected before and after the 2010 earthquake in Haiti, with spatial data on variation in the earthquake’s destruction. Our findings indicate that exposure to earthquake devastation increased the probability of both physical and sexual IPV one to two years following the disaster. These increases were accompanied by substantial changes in family functioning, the household economy, and women’s access to their social networks. Select household-level experiences during and after the earthquake, such as displacement, were also positively associated with IPV. These findings provide new insights into the multidimensional effects of disasters on family life and have important theoretical and policy implications that extend beyond the particular case of Haiti.

  19. Awareness of Cervical Cancer Causes and Pre-determinants of Likelihood to Screen among Women in Haiti

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    McCarthy, Schatzi H.; Walmer, Kathy A.; Boggan, Joel C.; Gichane, Margaret W.; Calo, William A.; Beauvais, Harry A.; Brewer, Noel T.

    2017-01-01

    Objectives Cervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women’s knowledge of its causes and the socio-demographic and health correlates of cervical cancer screening. Methods Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt. Results Only 29% of respondents had heard of human papillomavirus (HPV), while 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous STI were more likely to have had Pap smear (34% vs. 71%, OR=3.45; 95% CI: 1.57–7.59). Screening was also more likely among women who were older than age 39, better educated and employed (all p<.05). Almost all women (97%) were willing to undergo cervical cancer screening. Conclusions This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women. PMID:27906806

  20. Factors Associated With HIV Testing Among Men in Haiti: Results From the 2012 Demographic and Health Survey.

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    Conserve, Donaldson F; Iwelunmor, Juliet; Whembolua, Guy-Lucien; Sofolahan-Oladeinde, Yewande; Teti, Michelle; Surkan, Pamela J

    2017-09-01

    HIV testing serves as the gateway to HIV prevention and treatment. However, research examining men's HIV testing behaviors in the Caribbean remains limited. The Andersen Behavioral Model of Health Services Utilization was used to examine factors associated with HIV testing among 7,354 men who participated in the 2012 Demographic and Health Survey conducted in Haiti. Few men (35%) reported having ever been tested for HIV. Logistic regression analyses revealed that HIV testing increased with education and wealth. Marital status was associated with HIV testing, with married men more likely to have been tested (adjusted odds ratio: 2.57, 95% CI [2.07, 3.19]) than unmarried men. Positive attitudes toward people living with HIV, indicated by willing to care for a relative who has HIV/AIDS, was also correlated with higher odds of having been tested (adjusted odds ratio: 1.28, 95% CI [1.08, 1.51]). Men who reported condom use during last sex were more likely to have been tested (odds ratio: 1.58, 95% CI [1.33, 1.88). The findings indicate that HIV testing rates remain low among men in Haiti and more efforts are needed to increase HIV testing among men who are not married, have low level of education, and engage in unprotected sex.

  1. Beyond command and control: USSOUTHCOM's use of social networking to 'connect and collaborate' during Haiti relief operations

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    Arias, Ricardo

    2011-06-01

    On 12 January 2010, a magnitude 7.0 earthquake devastated Haiti killing over 230,000 unsuspecting victims, injuring tens of thousands more and displacing over 1.1 million people. The physical damage was so severe that over 50 percent of buildings in and near the affected areas were completely destroyed or damaged. After struggling for decades with adversity, and besieged by a myriad of social, economic and political challenges, Haiti, its government, and its people were by most accounts already in a state of crisis. The earthquake's devastation and its aftermath shocked the world and prompted a global response. Over 800 institutions and organizations representing the whole of society - governments and their militaries, international organizations, nongovernmental organizations, public institutions, academia, corporations, and private citizens - mobilized to provide aid and relief. However, coordinating and managing their activities seemed a daunting, if not impossible, task. How could a global response achieve "unity of effort" when "unity of command" was not feasible? To provide a solution, US Southern Command (USSOUTHCOM) looked beyond traditional Command and Control systems for collaboration with non-traditional partners and implemented the All Partners Access Network (APAN) in order to "Connect and Collaborate."

  2. Preventative lipid-based nutrient supplements (LNS) and young child feeding practices: findings from qualitative research in Haiti.

    Science.gov (United States)

    Lesorogol, Carolyn; Jean-Louis, Sherlie; Green, Jamie; Iannotti, Lora

    2015-12-01

    To prevent undernutrition in an urban slum in Haiti, a lipid-based nutrient supplement (LNS) was introduced through a randomised control trial. Food supplementation for young child nutrition has a long history in Haiti, but there is little empirical information regarding the effects of supplementation on young child feeding practices. One of the concerns raised by supplementation is that it may disrupt other positive feeding practices such as breastfeeding and use of other complementary foods, with negative consequences for child nutrition. We conducted 29 in-depth interviews with mother-baby pairs from the three comparison groups: control, 3-month LNS supplementation and 6-month LNS supplementation. Findings from those in the LNS groups indicated high acceptance and satisfaction with LNS and perceptions that it positively affects child health and development. LNS was integrated into and enhanced ongoing complementary feeding practices. The effects of LNS use on duration and perceived quantity of breastfeeding were variable, but generally, breastfeeding was maintained during and after the intervention. Interviews generated insights into beliefs regarding infant and young child feeding practices such as introduction and use of complementary foods, and breastfeeding duration, exclusivity and cessation. Implications for the use of LNS in public health nutrition programmes are discussed. © 2014 John Wiley & Sons Ltd.

  3. Genetic diversity in the merozoite surface protein 1 and 2 genes of Plasmodium falciparum from the Artibonite Valley of Haiti.

    Science.gov (United States)

    Londono-Renteria, Berlin; Eisele, Thomas P; Keating, Joseph; Bennett, Adam; Krogstad, Donald J

    2012-01-01

    Describing genetic diversity of the Plasmodium falciparum parasite provides important information about the local epidemiology of malaria. In this study, we examined the genetic diversity of P. falciparum isolates from the Artibonite Valley in Haiti using the allelic families of merozoite surface protein 1 and 2 genes (msp-1 and msp-2). The majority of study subjects infected with P. falciparum had a single parasite genotype (56% for msp-1 and 69% for msp-2: n=79); 9 distinct msp-1 genotypes were identified by size differences on agarose gels. K1 was the most polymorphic allelic family with 5 genotypes (amplicons from 100 to 300 base pairs [bp]); RO33 was the least polymorphic, with a single genotype (120-bp). Although both msp-2 alleles (3D7/IC1, FC27) had similar number of genotypes (n=4), 3D7/IC1 was more frequent (85% vs. 26%). All samples were screened for the presence of the K76T mutation on the P. falciparum chloroquine resistance transporter (pfcrt) gene with 10 of 79 samples positive. Of the 2 (out of 10) samples from individuals follow-up for 21 days, P. falciparum parasites were present through day 7 after treatment with chloroquine. No parasites were found on day 21. Our results suggest that the level of genetic diversity is low in this area of Haiti, which is consistent with an area of low transmission. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Results of a project on development of agro-forestry systems for food security in Carrefour region, Republic of Haiti

    Directory of Open Access Journals (Sweden)

    Furio Massolino

    2011-11-01

    Full Text Available Haity has a notable problem of food security, 48% of people have not sufficient food availability, food prices has doubled from 1980 and 1990 and further increased 5 times between 1991 and 2000. Water availability and quality is another problems to be added to food insufficiency. Food deficiency is mitigated by natural food resources in rural areas where many different species are cultivated together but it can be extreme in the towns. Agricultural systems are not efficient and, at the same time, enhance soil and genetic erosion. A development project has been implemented to increase food security over the long term in the geographical area of Carrefour rural area, this comprises a research aimed to increase national food production introducing complex agro-forestry systems. The project has investigated problems and solutions, actions have been started to increase food production, including agronomic training of local farmers, organization of small farmers including legal protection on land tenure, introduction of low input modern agroforestry systems that can diversify food production through the year and reduce soil and genetic erosion. After these results, an intervention project has been approved and funded by EU, then delayed due to the recent civil war, finally it is giving positive results now. The same approach used for this project can be spread in the rest of the Republic of Haiti and, hopefully, to other world regions that have similar problems.

  5. Using multiple sampling approaches to measure sexual risk-taking among young people in Haiti: programmatic implications.

    Science.gov (United States)

    Speizer, Ilene S; Beauvais, Harry; Gómez, Anu Manchikanti; Outlaw, Theresa Finn; Roussel, Barbara

    2009-12-01

    No previous published research has examined the applicability of varying methods for identifying young people who are at high risk of experiencing unintended pregnancy and acquiring HIV infection. This study compares three surveys of young people aged 15-24 in Port-au-Prince, Haiti, in terms of their sociodemographic characteristics and sexual behaviors and the surveys'usefulness for identifying young people at high risk and for program planning. The surveys consist of responses from: a representative sample of young people in the 2005-06 Haiti Demographic and Health Survey (HDHS), a 2004 facility-based study, and a 2006-07 venue-based study that used the Priorities for Local AIDS Control Efforts (PLACE) method. The facility-based and PLACE studies included larger proportions of single, sexually experienced young people and people who knew someone with HIV/ AIDS than did the HDHS. More respondents in the PLACE sample had multiple sex partners in the past year and received money or gifts in return for sex, compared with respondents in the facility study. At first and last sex, more PLACE respondents used contraceptives, including condoms. Experience of pregnancy was most commonly reported in the data from the facility-based sample; however, more ever-pregnant PLACE respondents than others reported ever having terminated a pregnancy. Program managers seeking to implement prevention activities should consider using facility- or venue-based methods to identify and understand the behaviors of young people at high risk.

  6. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As All specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants; In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  7. The need for nuclear knowledge management and human resources development in the nuclear technology in a least developed country: The Haiti case

    International Nuclear Information System (INIS)

    Belfort, A.

    2004-01-01

    Full text: As all specialist recognizes it knowledge management refers to issues related to organizational adaptation, survival and competence in the context of a discontinuous environmental change. It concerns also organizational process seeking synergistic combination of data and information processing capacity of the technologies of information with the capacity of human beings. Knowledge management in this sense implies not only organizational and technology processes but involves also human resources development. Our intervention in the context of this forum will focus around a planned INIS project that has been submitted to the Agency for the cycle 2005-2006 and the synergistic ties it can develop with a nuclear knowledge management policy for Haiti. Haiti is the sole least developed country of Latin America and the main challenge it faces is that of reducing poverty. The population of Haiti is around 7.900.000 inhabitants;In terms of annual per capita income the estimated indigency line for 1996 was $160 per year and the poverty line was around $ 220; 2/3 of the rural households fell under the indigency line and 20% only of the population exceeded the poverty line. Main causes of this situation are: land erosion, water scarcity, degradation of the environment, lack of the competitiveness of the economy, lack of electricity etc In all these areas the nuclear techniques can contribute to solve the problem of poverty in Haiti by fulfilling the need to sustain the valuable human resources under the dire circumstances of the local economic conditions. By taking account of the recent efforts of the Government to enhance the manpower capabilities there is a real need now to manage the scarce resources so that they can be retained, expanded and eventually multiplied. Under this perspective the Haitian Government is applying a strategy seeking to involve all the sectors concerned by the peaceful applications of nuclear techniques. After 3 years of diffusion of

  8. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

    Science.gov (United States)

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-12-01

    Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

  9. Networks in disasters: Multidisciplinary communication and coordination in response and recovery to the 2010 Haiti Earthquake (Invited)

    Science.gov (United States)

    McAdoo, B. G.; Augenstein, J.; Comfort, L.; Huggins, L.; Krenitsky, N.; Scheinert, S.; Serrant, T.; Siciliano, M.; Stebbins, S.; Sweeney, P.; University Of Pittsburgh Haiti Reconnaissance Team

    2010-12-01

    The 12 January 2010 earthquake in Haiti demonstrates the necessity of understanding information communication between disciplines during disasters. Armed with data from a variety of sources, from geophysics to construction, water and sanitation to education, decision makers can initiate well-informed policies to reduce the risk from future hazards. At the core of this disaster was a natural hazard that occurred in an environmentally compromised country. The earthquake itself was not solely responsible for the magnitude of the disaster- poor construction practices precipitated by extreme poverty, a two centuries of post-colonial environmental degradation and a history of dysfunctional government shoulder much of the responsibility. Future policies must take into account the geophysical reality that future hazards are inevitable and may occur within the very near future, and how various institutions will respond to the stressors. As the global community comes together in reconstruction efforts, it is necessary for the various actors to take into account what vulnerabilities were exposed by the earthquake, most vividly seen during the initial response to the disaster. Responders are forced to prioritize resources designated for building collapse and infrastructure damage, delivery of critical services such as emergency medical care, and delivery of food and water to those in need. Past disasters have shown that communication lapses between the response and recovery phases results in many of the exposed vulnerabilities not being adequately addressed, and the recovery hence fails to bolster compromised systems. The response reflects the basic characteristics of a Complex Adaptive System, where new agents emerge and priorities within existing organizations shift to deal with new information. To better understand how information is shared between actors during this critical transition, we are documenting how information is communicated between critical sectors during the

  10. Knowledge, attitudes and practices regarding rabies risk in community members and healthcare professionals: Pétionville, Haiti, 2013.

    Science.gov (United States)

    Fenelon, N; Dely, P; Katz, M A; Schaad, N D; Dismer, A; Moran, D; Laraque, F; Wallace, R M

    2017-06-01

    Haiti has the highest human rabies burden in the Western Hemisphere. There is no published literature describing the public's perceptions of rabies in Haiti, information that is critical to developing effective interventions and government policies. We conducted a knowledge, attitudes and practices survey of 550 community members and 116 health professionals in Pétionville, Haiti in 2013 to understand the perception of rabies in these populations. The majority of respondents (85%) knew that dogs were the primary reservoir for rabies, yet only 1% were aware that bats and mongooses could transmit rabies. Animal bites were recognized as a mechanism of rabies transmission by 77% of the population and 76% were aware that the disease could be prevented by vaccination. Of 172 persons reporting a bite, only 37% sought medical treatment. The annual bite incidence rate in respondents was 0·9%. Only 31% of bite victims reported that they started the rabies vaccination series. Only 38% of respondents reported that their dog had been vaccinated against rabies. The majority of medical professionals recognized that dogs were the main reservoir for rabies (98%), but only 28% reported bats and 14% reported mongooses as posing a risk for rabies infection. Bites were reported as a mechanism of rabies transmission by 73% of respondents; exposure to saliva was reported by 20%. Thirty-four percent of medical professionals reported they would wash a bite wound with soap and water and 2·8% specifically mentioned rabies vaccination as a component of post-bite treatment. The majority of healthcare professionals recommended some form of rabies assessment for biting animals; 68·9% recommended a 14-day observation period, 60·4% recommended a veterinary consultation, and 13·2% recommended checking the vaccination status of the animal. Fewer than 15% of healthcare professionals had ever received training on rabies prevention and 77% did not know where to go to procure rabies vaccine for

  11. Using ArcMap, Google Earth, and Global Positioning Systems to select and locate random households in rural Haiti.

    Science.gov (United States)

    Wampler, Peter J; Rediske, Richard R; Molla, Azizur R

    2013-01-18

    A remote sensing technique was developed which combines a Geographic Information System (GIS); Google Earth, and Microsoft Excel to identify home locations for a random sample of households in rural Haiti. The method was used to select homes for ethnographic and water quality research in a region of rural Haiti located within 9 km of a local hospital and source of health education in Deschapelles, Haiti. The technique does not require access to governmental records or ground based surveys to collect household location data and can be performed in a rapid, cost-effective manner. The random selection of households and the location of these households during field surveys were accomplished using GIS, Google Earth, Microsoft Excel, and handheld Garmin GPSmap 76CSx GPS units. Homes were identified and mapped in Google Earth, exported to ArcMap 10.0, and a random list of homes was generated using Microsoft Excel which was then loaded onto handheld GPS units for field location. The development and use of a remote sensing method was essential to the selection and location of random households. A total of 537 homes initially were mapped and a randomized subset of 96 was identified as potential survey locations. Over 96% of the homes mapped using Google Earth imagery were correctly identified as occupied dwellings. Only 3.6% of the occupants of mapped homes visited declined to be interviewed. 16.4% of the homes visited were not occupied at the time of the visit due to work away from the home or market days. A total of 55 households were located using this method during the 10 days of fieldwork in May and June of 2012. The method used to generate and field locate random homes for surveys and water sampling was an effective means of selecting random households in a rural environment lacking geolocation infrastructure. The success rate for locating households using a handheld GPS was excellent and only rarely was local knowledge required to identify and locate households. This

  12. Using ArcMap, Google Earth, and Global Positioning Systems to select and locate random households in rural Haiti

    Directory of Open Access Journals (Sweden)

    Wampler Peter J

    2013-01-01

    Full Text Available Abstract Background A remote sensing technique was developed which combines a Geographic Information System (GIS; Google Earth, and Microsoft Excel to identify home locations for a random sample of households in rural Haiti. The method was used to select homes for ethnographic and water quality research in a region of rural Haiti located within 9 km of a local hospital and source of health education in Deschapelles, Haiti. The technique does not require access to governmental records or ground based surveys to collect household location data and can be performed in a rapid, cost-effective manner. Methods The random selection of households and the location of these households during field surveys were accomplished using GIS, Google Earth, Microsoft Excel, and handheld Garmin GPSmap 76CSx GPS units. Homes were identified and mapped in Google Earth, exported to ArcMap 10.0, and a random list of homes was generated using Microsoft Excel which was then loaded onto handheld GPS units for field location. The development and use of a remote sensing method was essential to the selection and location of random households. Results A total of 537 homes initially were mapped and a randomized subset of 96 was identified as potential survey locations. Over 96% of the homes mapped using Google Earth imagery were correctly identified as occupied dwellings. Only 3.6% of the occupants of mapped homes visited declined to be interviewed. 16.4% of the homes visited were not occupied at the time of the visit due to work away from the home or market days. A total of 55 households were located using this method during the 10 days of fieldwork in May and June of 2012. Conclusions The method used to generate and field locate random homes for surveys and water sampling was an effective means of selecting random households in a rural environment lacking geolocation infrastructure. The success rate for locating households using a handheld GPS was excellent and only

  13. SPATIAL-TEMPORAL ANALYSIS OF OPENSTREETMAP DATA AFTER NATURAL DISASTERS: A CASE STUDY OF HAITI UNDER HURRICANE MATTHEW

    Directory of Open Access Journals (Sweden)

    J. Xu

    2017-09-01

    Full Text Available Volunteered geographic information (VGI has been widely adopted as an alternative for authoritative geographic information in disaster management considering its up-to-date data. OpenStreetMap, in particular, is now aiming at crisis mapping for humanitarian purpose. This paper illustrated that natural disaster played an essential role in updating OpenStreetMap data after Haiti was hit by Hurricane Matthew in October, 2016. Spatial-temporal analysis of updated OSM data was conducted in this paper. Correlation of features was also studied to figure out whether updates of data were coincidence or the results of the hurricane. Spatial pattern matched the damaged areas and temporal changes fitted the time when disaster occurred. High level of correlation values of features were recorded when hurricane occurred, suggesting that updates in data were led by the hurricane.

  14. Artemisinin Resistance-Associated Polymorphisms at the K13-Propeller Locus Are Absent in Plasmodium falciparum Isolates from Haiti

    Science.gov (United States)

    Carter, Tamar E.; Boulter, Alexis; Existe, Alexandre; Romain, Jean R.; St. Victor, Jean Yves; Mulligan, Connie J.; Okech, Bernard A.

    2015-01-01

    Antimalarial drugs are a key tool in malaria elimination programs. With the emergence of artemisinin resistance in southeast Asia, an effort to identify molecular markers for surveillance of resistant malaria parasites is underway. Non-synonymous mutations in the kelch propeller domain (K13-propeller) in Plasmodium falciparum have been associated with artemisinin resistance in samples from southeast Asia, but additional studies are needed to characterize this locus in other P. falciparum populations with different levels of artemisinin use. Here, we sequenced the K13-propeller locus in 82 samples from Haiti, where limited government oversight of non-governmental organizations may have resulted in low-level use of artemisinin-based combination therapies. We detected a single-nucleotide polymorphism (SNP) at nucleotide 1,359 in a single isolate. Our results contribute to our understanding of the global genomic diversity of the K13-propeller locus in P. falciparum populations. PMID:25646258

  15. Spatial-Temporal Analysis of Openstreetmap Data after Natural Disasters: a Case Study of Haiti Under Hurricane Matthew

    Science.gov (United States)

    Xu, J.; Li, L.; Zhou, Q.

    2017-09-01

    Volunteered geographic information (VGI) has been widely adopted as an alternative for authoritative geographic information in disaster management considering its up-to-date data. OpenStreetMap, in particular, is now aiming at crisis mapping for humanitarian purpose. This paper illustrated that natural disaster played an essential role in updating OpenStreetMap data after Haiti was hit by Hurricane Matthew in October, 2016. Spatial-temporal analysis of updated OSM data was conducted in this paper. Correlation of features was also studied to figure out whether updates of data were coincidence or the results of the hurricane. Spatial pattern matched the damaged areas and temporal changes fitted the time when disaster occurred. High level of correlation values of features were recorded when hurricane occurred, suggesting that updates in data were led by the hurricane.

  16. An Exploratory Study of Acculturation and Reproductive Health Among Haitian and Haitian-American Women in Little Haiti, South Florida.

    Science.gov (United States)

    Cyrus, E; Gollub, E L; Jean-Gilles, M; Neptune, S; Pelletier, V; Dévieux, J

    2016-06-01

    There is unmet contraceptive need among Haitian immigrants and Haitian-American women (Haitian women). The study explored associations of three measures of acculturation with contraceptive/reproductive health history among Haitian women residing in the Little Haiti community of Miami. This was a cross-sectional, exploratory study among 57 Haitian women. We conducted descriptive univariate analyses, then bivariate analyses to investigate the association of acculturation with reproductive health risk behavior including contraceptive use, tampon use, and parity, as well as interest in a female-initiated barrier contraceptive method. The most commonly ever-used contraceptive methods were male condoms (78.9 %) and oral contraceptives (OC 19.3 %). Women who primarily spoke Créole at home were less likely than those who did not to use OC (11.9 vs. 42.9 %, p = .01). Among women who resided in the U.S. ≥10 years, tampon use was 51.9 % compared to 16.7 % among those who were in the U.S. for less time (p = .005). Among U.S. born women, 60 % were tampon users compared to 22.7 % among those born in Haiti (p = .05). Women not speaking primarily Créole at home (p = .06) and those born in U.S. (p = .008) had fewer children. Contraceptive use was low among Haitian women but influenced by acculturation, where greater acculturation was associated with protective reproductive health behavior. Despite traditional norms discouraging contraceptive use, and little experience with female barriers, Haitian women indicated an interest in learning about and using a female-initiated barrier contraceptive. Increasing contraceptive uptake of potential multipurpose technologies is a potential point of intervention for decreasing HIV/STI transmission in this at-risk population.

  17. The impact of internal displacement on child mortality in post-earthquake Haiti: a difference-in-differences analysis.

    Science.gov (United States)

    Chen, Bradley; Halliday, Timothy J; Fan, Victoria Y

    2016-07-19

    The Haiti earthquake in 2010 resulted in 1.5 million internally displaced people (IDP), yet little is known about the impact of displacement on health. In this study, we estimate the impact of displacement on infant and child mortality and key health-behavior mechanisms. We employ a difference-in-differences (DID) design with coarsened exact matching (CEM) to ensure comparability among groups with different displacement status using the 2012 Haiti Demographic and Health Survey (DHS). The participants are 21,417 births reported by a nationally representative sample of 14,287 women aged 15-49. The main independent variables are household displacement status which includes households living in camps, IDP households (not in camps), and households not displaced. The main outcomes are infant and child mortality; health status (height-for-age, anemia); uptake of public health interventions (bed net use, spraying against mosquitoes, and vaccinations); and other conditions (hunger; cholera). Births from the camp households have higher infant mortality (OR = 2.34, 95 % CI 1.15 to 4.75) and child mortality (OR = 2.34, 95 % CI 1.10 to 5.00) than those in non-camp IDP households following the earthquake. These odds are higher despite better access to food, water, bed net use, mosquito spraying, and vaccines among camp households. IDP populations are heterogeneous and households that are displaced outside of camps may be self-selected or self-insured. Meanwhile, even households not displaced by a disaster may face challenges in access to basic necessities and health services. Efforts are needed to identify vulnerable populations to provide targeted assistance in post-disaster relief.

  18. [HIV/AIDS in South Africa and Haiti: the failure of epidemic governance and achievement of the MDGs].

    Science.gov (United States)

    Thelot, Fils-Lien Ely

    2009-01-01

    Since their adoption in 2000 by the United Nations, the Millennium Development Goals set for 2015 appear to have become a part of the policy agenda of all of the member states. Three of these eight objectives deal with health issues. "Combat HIV/AIDS, malaria and other diseases": this is the formulation of the sixth MDG. Observing that in many countries strongly affected by poverty and inequalities, the epidemic continues to spread, without really reversing at all, and that access to antiretrovirals is possible for only a small proportion of the patient who need them, we consider the problems of global governance in the field of health. Our intention is to explain that the failure to deal with the HIV/AIDS epidemic may constitute an obstacle to the achievement of the MDGs by 2015. Proposing a comprehensive sociology of HIV/AIDS, this article pays special attention to the dimension of the meaning of the disease, simultaneously as a policy issue, a social construction, and an object of study in the social sciences. Looking at the two countries most affected by the epidemic in Africa and in the Caribbean, we examine the different aspects that have determined the failure of governance and the effects of this failure on the populations concerned. The excessive conflictuality in South Africa and the biopolitics of "let them die" and the fragmentation of the networks involved in the combat in Haiti are considered to have contributed to a crisis in the epidemic's governance. In both cases, the consequences have been expressed by a reduced life expectancy, insufficient access to antiretroviral drugs, reinforcement of the socioeconomic inequalities of health, the production of new pockets of poverty, more fragile household and national economies, an increase in maternal and child mortality ... The failure of the governance of the HIV/AIDS epidemic in countries such as Haiti and South Africa appears to foretell the impossibility of achieving the MDGs by 2015.

  19. Impact of community-delivered SMS alerts on dog-owner participation during a mass rabies vaccination campaign, Haiti 2017.

    Science.gov (United States)

    Cleaton, Julie M; Wallace, Ryan M; Crowdis, Kelly; Gibson, Andy; Monroe, Benjamin; Ludder, Fleurinord; Etheart, Melissa D; Natal Vigilato, Marco Antonio; King, Alasdair

    2018-04-19

    Haiti has historically vaccinated between 100,000 and 300,000 dogs annually against rabies, however national authorities have not been able to reach and maintain the 70% coverage required to eliminate the canine rabies virus variant. Haiti conducts massive dog vaccination campaigns on an annual basis and utilizes both central point and door-to-door methods. These methods require that dog owners are aware of the dates and locations of the campaign. To improve this awareness among dog owners, 600,000 text messages were sent to phones in two Haitian communes (Gonaives and Saint-Marc) to remind dog owners to attend the campaign. Text messages were delivered on the second day and at the mid-point of the campaign. A post-campaign household survey was conducted to assess dog owner's perception of the text messages and the impact on their participation in the vaccination campaign. Overall, 147 of 160 (91.9%) text-receiving dog owners indicated the text was helpful, and 162 of 187 (86.6%) responding dog owners said they would like to receive text reminders during future rabies vaccination campaigns. In areas hosting one-day central point campaigns, dog owners who received the text were 2.0 (95% CI 1.1, 3.6) times more likely to have participated in the campaign (73.1% attendance among those who received the text vs 36.4% among those who did not). In areas incorporating door-to-door vaccination over multiple days there was no significant difference in participation between dog owners who did and did not receive a text. Text message reminders were well-received and significantly improved campaign attendance, indicating that short message service (SMS) alerts may be a successful strategy in low resource areas with large free roaming dog populations. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Genome-based polymorphic microsatellite development and validation in the mosquito Aedes aegypti and application to population genetics in Haiti

    Directory of Open Access Journals (Sweden)

    Streit Thomas G

    2009-12-01

    Full Text Available Abstract Background Microsatellite markers have proven useful in genetic studies in many organisms, yet microsatellite-based studies of the dengue and yellow fever vector mosquito Aedes aegypti have been limited by the number of assayable and polymorphic loci available, despite multiple independent efforts to identify them. Here we present strategies for efficient identification and development of useful microsatellites with broad coverage across the Aedes aegypti genome, development of multiplex-ready PCR groups of microsatellite loci, and validation of their utility for population analysis with field collections from Haiti. Results From 79 putative microsatellite loci representing 31 motifs identified in 42 whole genome sequence supercontig assemblies in the Aedes aegypti genome, 33 microsatellites providing genome-wide coverage amplified as single copy sequences in four lab strains, with a range of 2-6 alleles per locus. The tri-nucleotide motifs represented the majority (51% of the polymorphic single copy loci, and none of these was located within a putative open reading frame. Seven groups of 4-5 microsatellite loci each were developed for multiplex-ready PCR. Four multiplex-ready groups were used to investigate population genetics of Aedes aegypti populations sampled in Haiti. Of the 23 loci represented in these groups, 20 were polymorphic with a range of 3-24 alleles per locus (mean = 8.75. Allelic polymorphic information content varied from 0.171 to 0.867 (mean = 0.545. Most loci met Hardy-Weinberg expectations across populations and pairwise FST comparisons identified significant genetic differentiation between some populations. No evidence for genetic isolation by distance was observed. Conclusion Despite limited success in previous reports, we demonstrate that the Aedes aegypti genome is well-populated with single copy, polymorphic microsatellite loci that can be uncovered using the strategy developed here for rapid and efficient

  1. The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti.

    Science.gov (United States)

    Zuraik, Christopher; Sampalis, John; Brierre, Alexa

    2018-06-01

    The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.

  2. Assessment of Drinking Water Sold from Private Sector Kiosks in Post-Earthquake Port-au-Prince, Haiti.

    Science.gov (United States)

    Patrick, Molly; Steenland, Maria; Dismer, Amber; Pierre-Louis, Jocelyne; Murphy, Jennifer L; Kahler, Amy; Mull, Bonnie; Etheart, Melissa D; Rossignol, Emmanuel; Boncy, Jacques; Hill, Vincent; Handzel, Thomas

    2017-10-01

    Consumption of drinking water from private vendors has increased considerably in Port-au-Prince, Haiti, in recent decades. A major type of vendor is private kiosks, advertising reverse osmosis-treated water for sale by volume. To describe the scale and geographical distribution of private kiosks in metropolitan Port-au-Prince, an inventory of private kiosks was conducted from July to August 2013. Coordinates of kiosks were recorded with global positioning system units and a brief questionnaire was administered with the operator to document key kiosk characteristics. To assess the quality of water originating from private kiosks, water quality analyses were also conducted on a sample of those inventoried as well as from the major provider company sites. The parameters tested were Escherichia coli , free chlorine residual, pH, turbidity, and total dissolved solids. More than 1,300 kiosks were inventoried, the majority of which were franchises of four large provider companies. Approximately half of kiosks reported opening within 12 months of the date of the inventory. The kiosk treatment chain and sales price was consistent among a majority of the kiosks. Of the 757 kiosks sampled for water quality, 90.9% of samples met World Health Organization (WHO) microbiological guideline at the point of sale for nondetectable E. coli in a 100-mL sample. Of the eight provider company sites tested, all samples met the WHO microbiological guideline. Because of the increasing role of the private sector in drinking water provision in Port-au-Prince and elsewhere in Haiti, this assessment was an important first step for government regulation of this sector.

  3. The effect of complex fault rupture on the distribution of landslides triggered by the 12 January 2010, Haiti earthquake

    Science.gov (United States)

    Harp, Edwin L.; Jibson, Randall W.; Dart, Richard L.; Margottini, Claudio; Canuti, Paolo; Sassa, Kyoji

    2013-01-01

    The MW 7.0, 12 January 2010, Haiti earthquake triggered more than 7,000 landslides in the mountainous terrain south of Port-au-Prince over an area that extends approximately 50 km to the east and west from the epicenter and to the southern coast. Most of the triggered landslides were rock and soil slides from 25°–65° slopes within heavily fractured limestone and deeply weathered basalt and basaltic breccia. Landslide volumes ranged from tens of cubic meters to several thousand cubic meters. Rock slides in limestone typically were 2–5 m thick; slides within soils and weathered basalt typically were less than 1 m thick. Twenty to thirty larger landslides having volumes greater than 10,000 m3 were triggered by the earthquake; these included block slides and rotational slumps in limestone bedrock. Only a few landslides larger than 5,000 m3 occurred in the weathered basalt. The distribution of landslides is asymmetric with respect to the fault source and epicenter. Relatively few landslides were triggered north of the fault source on the hanging wall. The densest landslide concentrations lie south of the fault source and the Enriquillo-Plantain-Garden fault zone on the footwall. Numerous landslides also occurred along the south coast west of Jacmél. This asymmetric distribution of landsliding with respect to the fault source is unusual given the modeled displacement of the fault source as mainly thrust motion to the south on a plane dipping to the north at approximately 55°; landslide concentrations in other documented thrust earthquakes generally have been greatest on the hanging wall. This apparent inconsistency of the landslide distribution with respect to the fault model remains poorly understood given the lack of any strong-motion instruments within Haiti during the earthquake.

  4. Clinical Features of Human Immunodeficiency Virus-Infected Patients Presenting with Cholera in Port-au-Prince, Haiti.

    Science.gov (United States)

    Sévère, Karine; Anglade, Stravinsky B; Bertil, Claudin; Duncan, Aynsley; Joseph, Patrice; Deroncenay, Alexandra; Mabou, Marie M; Ocheretina, Oksana; Reif, Lindsey; Seo, Grace; Pape, Jean W; Fitzgerald, Daniel W

    2016-11-02

    Human immunodeficiency virus (HIV) infection has been postulated to alter the natural history of cholera, including increased susceptibility to infection, severity of illness, and chronic carriage of Vibrio cholerae Haiti has a generalized HIV epidemic with an adult HIV prevalence of 1.9% and recently suffered a cholera epidemic. We conducted a prospective study at the cholera treatment center (CTC) of GHESKIO in Haiti to characterize the coinfection. Adults admitted at the CTC for acute diarrhea were invited to participate in the study. Vital signs, frequency, and volume of stools and/or vomiting were monitored, and single-dose doxycycline was administered. After counseling, participants were screened for HIV by enzyme-linked immunosorbent assay and for cholera by culture. Of 729 adults admitted to the CTC, 99 (13.6%) had HIV infection, and 457 (63%) had culture-confirmed cholera. HIV prevalence was three times higher in patients without cholera (23%, 63/272) than in those with culture-confirmed cholera (7.9%, 36/457). HIV prevalence in patients with culture-confirmed cholera (7.9%) was four times higher than the adult prevalence in Port-au-Prince (1.9%). Of the 36 HIV-infected patients with cholera, 25 (69%) had moderate/severe dehydration versus 302/421 (72%) in the HIV negative. Of 30 HIV-infected patients with weekly stool cultures performed after discharge, 29 (97%) were negative at week 1. Of 50 HIV-negative patients with weekly stool cultures, 49 (98%) were negative at week 1. In countries with endemic HIV infection, clinicians should consider screening patients presenting with suspected cholera for HIV coinfection. © The American Society of Tropical Medicine and Hygiene.

  5. A Seismo-Tectonic Signal From Offshore Sedimentation: The 2010 Haiti Earthquake and Prior Events

    Science.gov (United States)

    McHugh, C. M.; Seeber, L.; Cormier, M.; Hornbach, M.; Momplaisir, R.; Waldhauser, F.; Sorlien, C. C.; Steckler, M. S.; Gulick, S.

    2011-12-01

    The Mw 7.0 January 2010 earthquake in Haiti was one of the deadliest in history. It involved multiple faults along or near the main Enriquillo-Plantain Garden Fault (EPGF). This left-lateral transform is a branch of the northern Caribbean plate boundary across southern Hispaniola. The main rupture was strike-slip but almost all aftershocks had thrust mechanisms, and surface deformation may have been concentrated on anticline forelimbs driven by blind thrust faults. Earthquake generated mass-wasting and turbidity currents were sampled from the Canal du Sud slope (~1000 m water depth), a basin at 1500 m, and the deepest part of the strait at 1700 m. The turbidites were strongly correlated by 234Th with a half-life of 24 days. In the deepest area, a turbidite-homogenite unit (T-H) extends over 50 km2 and is composed of basal sand beds 5 cm thick and 50 cm of mud above. The sedimentary structures in the sand were linked to oscillatory motions by internal seiches. The T-H units recovered from the slope and deep basin are similar in composition. The Leogane Delta, upslope from the sampling sites, is rich in this lithology that has been linked to oceanic basement rocks exposed on the southern Haitian peninsula. In contrast, the T-H unit recovered from the basin at 1500 m is perched behind a thrust anticline and has a greater concentration of Ca derived from Ca rich sources such as the Tapion Ridge on the southern peninsula. The Tapion Ridge is a compressional structure associated with a restraining bend along the EPGF. The T-H unit beneath the 2010 deposit has a 14C age of 2400 cal yrs BP, and interpreted as an earthquake triggered deposit. It is nearly identical in thickness, composition and fine structures to the 2010 T-H. Notably absent from the record are younger turbidites that could have been linked to the historic 1770 AD and other similar earthquakes expected from GPS rates across the EPGF. Two hypotheses are being considered for this long gap in T-H sedimentation

  6. Evaluation of Knowledge and Practices Regarding Cholera, Water Treatment, Hygiene, and Sanitation Before and After an Oral Cholera Vaccination Campaign-Haiti, 2013-2014.

    Science.gov (United States)

    Childs, Lana; François, Jeannot; Choudhury, Alina; Wannemuehler, Kathleen; Dismer, Amber; Hyde, Terri B; Yen, Catherine Y; Date, Kashmira A; Juin, Stanley; Katz, Mark A; Kantor, Erica Felker; Routh, Janell; Etheart, Melissa; Wright, Tracie; Adrien, Paul; Tohme, Rania A

    2016-12-07

    In 2013, the Government of Haiti implemented its first oral cholera vaccine (OCV) campaign in Petite Anse, an urban setting, and Cerca Carvajal, a rural commune. We conducted and compared responses to two independent cross-sectional knowledge and practices household surveys pre- (N = 297) and post- (N = 302) OCV campaign in Petite Anse. No significant differences in knowledge about causes, symptoms, and prevention of cholera were noted. Compared with precampaign respondents, fewer postcampaign respondents reported treating (66% versus 27%, P treatment practices necessary for cholera and other diarrheal diseases prevention were noted in the postcampaign survey. Future OCV campaigns in Haiti should be used as an opportunity to emphasize the importance of maintaining good water, sanitation, and hygiene practices, and include a comprehensive, integrated approach for cholera control. © The American Society of Tropical Medicine and Hygiene.

  7. Evaluation of Knowledge and Practices Regarding Cholera, Water Treatment, Hygiene, and Sanitation before and after an Oral Cholera Vaccination Campaign—Haiti, 2013–2014

    Science.gov (United States)

    Childs, Lana; François, Jeannot; Choudhury, Alina; Wannemuehler, Kathleen; Dismer, Amber; Hyde, Terri B.; Yen, Catherine Y.; Date, Kashmira A.; Juin, Stanley; Katz, Mark A.; Kantor, Erica Felker; Routh, Janell; Etheart, Melissa; Wright, Tracie; Adrien, Paul; Tohme, Rania A.

    2016-01-01

    In 2013, the Government of Haiti implemented its first oral cholera vaccine (OCV) campaign in Petite Anse, an urban setting, and Cerca Carvajal, a rural commune. We conducted and compared responses to two independent cross-sectional knowledge and practices household surveys pre- (N = 297) and post- (N = 302) OCV campaign in Petite Anse. No significant differences in knowledge about causes, symptoms, and prevention of cholera were noted. Compared with precampaign respondents, fewer postcampaign respondents reported treating (66% versus 27%, P treatment practices necessary for cholera and other diarrheal diseases prevention were noted in the postcampaign survey. Future OCV campaigns in Haiti should be used as an opportunity to emphasize the importance of maintaining good water, sanitation, and hygiene practices, and include a comprehensive, integrated approach for cholera control. PMID:27799642

  8. Marginal inherited structures impact on the oblique convergent N American Plate/ Central Caribbean plate-boundary in the Northern Caribbean. The tectonic evolution since Miocene times based on Haiti data acquired onshore and offshore since 2012- a step toward an ADP Drilling Proposal (Haiti-DRILL).

    Science.gov (United States)

    Ellouz, N.; Hamon, Y.; Deschamps, R.; Battani, A.; Wessels, R.; Boisson, D.; Prepetit, C.; Momplaisir, R.

    2017-12-01

    Since Early Paleogene times, the North Caribbean plate is colliding obliquely with the south continental part of the old N. American Margins, which is represented by various segments from West to East, inherited from Jurassic times. Location, amount of displacement, rotation and the structural deformation of these margin segments, resulting from the dislocation of the continental N American margin, are not clearly yet established. At present, the plate limits are marked either by two left lateral faults west and inside Haiti (OSF in the North and EPGF in the South), oblique collision front (further west in Cuba), oblique subducted segments (to the East, Porto-Rico). From our recent works operated both offshore (Haiti-SIS and Haiti-BGF surveys 2012-2015) and onshore (field campaigns 2013-2017) in Haitian zone, the position of the present-day and paleo major limits have been redefined. These paleolimits have been reconstructed up to early Miocene times, based on: restoration of regional structural cross-sections, sedimentology and on paleoenvironement studies. In a preliminary way, we analyzed the complexity of the tectonic heritage with possible nature, heterogeneity of the crustal fragments and associated margins close to Haiti (age, structure, environment, location of the dislocated blocks through times) which profoundly impact the partitioning of the deformation along this complex transformed margin. The change in the structure wavelength, decollement level variations are primary constraints in the restoration of the main units and do impose a deep connection along specific segments either related to strike-slip or to splay faults. The asymmetry on the repartition of the fault activity tend to prove that the past motion related to "EPGF transfer zone" is mainly partitioned in Haiti to the North of the present-day EPGF position. At present, these results are still coherent with the distribution of the aftershoks registered after 2010, and with the present

  9. Attitudes towards intimate partner violence and the association with condom use among men in Haiti: An analysis of the nationally representative Demographic Health Survey

    OpenAIRE

    Conserve, Donaldson F.; Whembolua, Guy-Lucien; Surkan, Pamela J.

    2014-01-01

    Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes towards intimate partner violence, knowledge of and use of condoms among 9,493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time th...

  10. Treatment of tuberculosis in a rural area of Haiti: directly observed and non-observed regimens. The experience of H pital Albert Schweitzer.

    Science.gov (United States)

    Ollé-Goig, J E; Alvarez, J

    2001-02-01

    Artibonite Valley, a rural area in Haiti. To evaluate a tuberculosis control program in rural Haiti and to compare two strategies for treatment implemented in two areas that were not chosen at random: treatment delivered at the patients' homes observed by former tuberculosis patients (DOT), and non observed treatment (non-DOT). Retrospective analysis of the clinical records of adult patients diagnosed with tuberculosis at H pital Albert Schweitzer in Deschapelles, Haiti, during 1994-1995. There were 143 patients in the non-DOT group and 138 patients in the DOT group. The results of treatment were significantly different: in the non-DOT group 29% defaulted, 12% died and 58% had a successful outcome; in the DOT group 7% defaulted (P < 0.01), 4% died (P = 0.01) and 87% had a successful outcome (P < 0.01). These differences are also significant when considering only human immunodeficiency virus (HIV) infected patients (defaulted P < 0.01; died P = 0.09; successful outcome P < 0.01). Delivering treatment in patients' homes with direct observation by former tuberculosis patients can achieve good results, even in an area of extreme poverty and high rates of HIV infection. In this population the number of patients who are able to complete their treatment without observed administration is far from optimal.

  11. Reaching the global community during disasters: findings from a content analysis of the organizational use of Twitter after the 2010 Haiti earthquake.

    Science.gov (United States)

    Gurman, Tilly A; Ellenberger, Nicole

    2015-01-01

    Social networking sites provide virtual environments in which individuals and organizations exchange real-time information on a multitude of topics, including health promotion and disease prevention. The January 2010 earthquake in Haiti has been posited as a turning point in the way in which organizations use social media, such as Twitter, for crisis communication. The purpose of this content analysis was to explore whether organizations' use of Twitter changed after the 2010 Haiti earthquake. A team of 13 coders analyzed all English-language tweets (N = 2,616) during the 3 months before and post earthquake from 6 leading organizations in the Haiti disaster relief efforts. Study findings indicate that the ways in which organizations used Twitter changed over time. Chi-square analyses demonstrated that organizations decreased in their use of certain strategies to disseminate information through Twitter, such as the use of links. Organizations did not change in their use of techniques to involve users (e.g., retweet, call to action), with the exception of using tweets as a fundraising mechanism. Study findings highlight missed opportunities among organizations to maximize Twitter in order to encourage more interactive and immediate communication with the global community.

  12. Cost-Effectiveness Evaluation of a Novel Integrated Bite Case Management Program for the Control of Human Rabies, Haiti 2014-2015.

    Science.gov (United States)

    Undurraga, Eduardo A; Meltzer, Martin I; Tran, Cuc H; Atkins, Charisma Y; Etheart, Melissa D; Millien, Max F; Adrien, Paul; Wallace, Ryan M

    2017-06-01

    AbstractHaiti has the highest burden of rabies in the Western hemisphere, with 130 estimated annual deaths. We present the cost-effectiveness evaluation of an integrated bite case management program combining community bite investigations and passive animal rabies surveillance, using a governmental perspective. The Haiti Animal Rabies Surveillance Program (HARSP) was first implemented in three communes of the West Department, Haiti. Our evaluation encompassed all individuals exposed to rabies in the study area ( N = 2,289) in 2014-2015. Costs (2014 U.S. dollars) included diagnostic laboratory development, training of surveillance officers, operational costs, and postexposure prophylaxis (PEP). We used estimated deaths averted and years of life gained (YLG) from prevented rabies as health outcomes. HARSP had higher overall costs (range: $39,568-$80,290) than the no-bite-case-management (NBCM) scenario ($15,988-$26,976), partly from an increased number of bite victims receiving PEP. But HARSP had better health outcomes than NBCM, with estimated 11 additional annual averted deaths in 2014 and nine in 2015, and 654 additional YLG in 2014 and 535 in 2015. Overall, HARSP was more cost-effective (US$ per death averted) than NBCM (2014, HARSP: $2,891-$4,735, NBCM: $5,980-$8,453; 2015, HARSP: $3,534-$7,171, NBCM: $7,298-$12,284). HARSP offers an effective human rabies prevention solution for countries transitioning from reactive to preventive strategies, such as comprehensive dog vaccination.

  13. The socioeconomic impact of international aid: a qualitative study of healthcare recovery in post-earthquake Haiti and implications for future disaster relief.

    Science.gov (United States)

    Kligerman, Maxwell; Walmer, David; Bereknyei Merrell, Sylvia

    2017-05-01

    We assessed healthcare provider perspectives of international aid four years after the Haiti Earthquake to better understand the impact of aid on the Haitian healthcare system and learn best practices for recovery in future disaster contexts. We conducted 22 semi-structured interviews with the directors of local, collaborative, and aid-funded healthcare facilities in Leogane, Haiti. We coded and analysed the interviews using an iterative method based on a grounded theory approach of data analysis. Healthcare providers identified positive aspects of aid, including acute emergency relief, long-term improved healthcare access, and increased ease of referrals for low-income patients. However, they also identified negative impacts of international aid, including episodes of poor quality care, internal brain drain, competition across facilities, decrease in patient flow to local facilities, and emigration of Haitian doctors to abroad. As Haiti continues to recover, it is imperative for aid institutions and local healthcare facilities to develop a more collaborative relationship to transition acute relief to sustainable capacity building. In future disaster contexts, aid institutions should specifically utilise quality of care metrics, NGO Codes of Conduct, Master Health Facility Lists, and sliding scale payment systems to improve disaster response.

  14. Inter-rater and intrarater reliability of the South African Triage Scale in low-resource settings of Haiti and Afghanistan.

    Science.gov (United States)

    Dalwai, Mohammed; Tayler-Smith, Katie; Twomey, Michèle; Nasim, Masood; Popal, Abdul Qayum; Haqdost, Waliul Haq; Gayraud, Olivia; Cheréstal, Sophia; Wallis, Lee; Valles, Pola

    2018-03-16

    The South African Triage Scale (SATS) has demonstrated good validity in the EDs of Médecins Sans Frontières (MSF)-supported sites in Afghanistan and Haiti; however, corresponding reliability in these settings has not yet been reported on. This study set out to assess the inter-rater and intrarater reliability of the SATS in four MSF-supported EDs in Afghanistan and Haiti (two trauma-only EDs and two mixed (including both medical and trauma cases) EDs). Under classroom conditions between December 2013 and February 2014, ED nurses at each site assigned triage ratings to a set of context-specific vignettes (written case reports of ED patients). Inter-rater reliability was assessed by comparing triage ratings among nurses; intrarater reliability was assessed by asking the nurses to retriage 10 random vignettes from the original set and comparing these duplicate ratings. Inter-rater reliability was calculated using the unweighted kappa, linearly weighted kappa and quadratically weighted kappa (QWK) statistics, and the intraclass correlation coefficient (ICC). Intrarater reliability was calculated according to the percentage of exact agreement and the percentage of agreement allowing for one level of discrepancy in triage ratings. The correlation between years of nursing experience and reliability of the SATS was assessed based on comparison of ICCs and the respective 95% CIs. A total of 67 nurses agreed to participate in the study: In Afghanistan there were 19 nurses from Kunduz Trauma Centre and nine from Ahmed Shah Baba; in Haiti, there were 20 nurses from Martissant Emergency Centre and 19 from Tabarre Surgical and Trauma Centre. Inter-rater agreement was moderate across all sites (ICC range: 0.50-0.60; QWK range: 0.50-0.59) apart from the trauma ED in Haiti where it was moderate to substantial (ICC: 0.58; QWK: 0.61). Intrarater agreement was similar across the four sites (68%-74% exact agreement); when allowing for a one-level discrepancy in triage ratings

  15. The MW 7.0 Haiti Earthquake of January 12, 2010: USGS/EERI Advance Reconnaissance Team Report

    Science.gov (United States)

    Eberhard, Marc O.; Baldridge, Steven; Marshall, Justin; Mooney, Walter; Rix, Glenn J.

    2010-01-01

    Executive Summary A field reconnaissance in Haiti by a five-member team with expertise in seismology and earthquake engineering has revealed a number of factors that led to catastrophic losses of life and property during the January 12, 2010, Mw 7.0 earthquake. The field study was conducted from January 26 to February 3, 2010, and included investigations in Port-au-Prince and the heavily damaged communities to the west, including Leogane, Grand Goave, Petite Goave, and Oliver. Seismology Despite recent seismic quiescence, Haiti has suffered similar devastating earthquakes in the historical past (1701, 1751, 1770 and 1860). Despite this knowledge of historical seismicity, Haiti had no seismograph stations during the main earthquake, so it is impossible to estimate accurately the intensity of ground motions. Nonetheless, the wide range of buildings damaged by the January 12, 2010, earthquake suggests that the ground motions contained seismic energy over a wide range of frequencies. Another earthquake of similar magnitude could strike at any time on the eastern end of the Enriquillo Fault, directly to the south of Port-au-Prince. Reconstruction must take this hazard into account. The four portable seismographs installed by the team recorded a series of small aftershocks. As expected, the ground motions recorded at a hard-rock site contained a greater proportion of high frequencies than the motions recorded at a soil site. Two of the stations continue to monitor seismic activity. A thorough field investigation of the mapped Enriquillo Fault south of the city of Leogane failed to find any evidence of surface faulting. This led the team to conclude that the earthquake was unlikely to have produced any surface rupture in the study area. Geotechnical Aspects Soil liquefaction, landslides and rockslides in cut slopes, and road embankment failures contributed to extensive damage in Port-au-Prince and elsewhere. A lack of detailed knowledge of the physical conditions of the

  16. Water-resources reconnaissance of Île de la Gonâve, Haiti

    Science.gov (United States)

    Troester, Joseph W.; Turvey, Michael D.

    Île de la Gonâve is a 750-km2 island off the coast of Haiti. The depth to the water table ranges from less than 30 m in the Eocene and Upper Miocene limestones to over 60 m in the 300-m-thick Quaternary limestone. Annual precipitation ranges from 800-1,400 mm. Most precipitation is lost through evapotranspiration and there is virtually no surface water. Roughly estimated from chloride mass balance, about 4% of the precipitation recharges the karst aquifer. Cave pools and springs are a common source for water. Hand-dug wells provide water in coastal areas. Few productive wells have been drilled deeper than 60 m. Reconnaissance field analyses indicate that groundwater in the interior is a calcium-bicarbonate type, whereas water at the coast is a sodium-chloride type that exceeds World Health Organization recommended values for sodium and chloride. Tests for the presence of hydrogen sulfide-producing bacteria were negative in most drilled wells, but positive in cave pools, hand-dug wells, and most springs, indicating bacterial contamination of most water sources. Because of the difficulties in obtaining freshwater, the 110,000 inhabitants use an average of only 7 L per person per day. L'Île de la Gonâve est une île de 750 km2 au large de la côte d'Haïti. La profondeur de la nappe varie entre moins de 30 m dans les calcaires de l'Éocène et du Miocène supérieur à plus de 60 m dans les calcaires quaternaires épais de 300 m. Les précipitations annuelles sont comprises entre 800-1.400 mm. La plus grande partie des précipitations est perdue par évapotranspiration et il n'y a pratiquement pas d'eau de surface. Le bilan de masse des chlorures permet d'estimer à 4% des précipitations le montant de la recharge de l'aquifère karstique. Des bassins dans les grottes et des sources sont la source d'eau courante. Des puits creusés à la main fournissent de l'eau dans les zones côtières. Quelques puits productifs ont été forés dépassant 60 m de profondeur. L

  17. Breastfeeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.

    Science.gov (United States)

    Heidkamp, Rebecca; Ayoya, Mohamed Ag; Teta, Ismael Ngnie; Stoltzfus, Rebecca J; Marhone, Joseline Pierre

    2015-10-01

    Haiti's national nutrition policy prioritises breastfeeding, but limited data are available to inform strategy. We examined national trends in early initiation of breastfeeding (ErIBF) and exclusive breastfeeding (EBF) over a 10-year period using data from three Haitian Demographic and Health Surveys (1994-1995, 2000 and 2005-2006). We used multivariate regression methods to identify determinants of ErIBF and EBF in the 2005-2006 data set and to examine relationships to growth. There was no change in ErIBF across surveys [1994-1995: 36.6%, 95% confidence interval (CI) 29.9-43.9; 2000: 49.4%, 95% CI 44.1-54.8; 2005-2006: 43.8%, 95% CI 40.5-47.1]. EBF among 0-5-month-olds increased sharply (1994-18995: 1.1%, 95% CI 0.4-3.2; 2000: 22.4%, 95% CI 16.5-29.5; 2005-2006: 41.2%, 95% CI 35.4-47.2). The proportion of breastfeeding children 0-5 months who received soft, solid or semi-solid foods decreased (1994-1995: 68.5%, 95% CI 57.3-77.9; 2000: 46.3%, 95% CI 39.3-53.4; 2005-2006: 30.9%, 95% CI 25.9-36.5). Child age at time of survey [odds ratio (OR) 1.73; P = 0.027], lower maternal education (OR = 2.14, P = 0.004) and residence in the Artibonite Department (OR 0.31; P = 0.001) were associated with ErIBF among children 0-23 months. Age group and department were significant predictors of EBF among children 0-5 months. ErIBF was associated with higher weight-for-age z-scores [effect size (ES) 0.22; P = 0.033] and height-for-age z-scores (ES 0.20; P = 0.044). There was no statistically significant relationship between EBF and growth. The 10-year ErIBF and EBF trends in Haiti echo global and regional trends. ErIBF and EBF are related practices but with different determinants in the Haitian context. These differences have implications for intervention delivery. © 2013 John Wiley & Sons Ltd.

  18. High prevalence of asymptomatic malaria infections: a cross-sectional study in rural areas in six departments in Haiti.

    Science.gov (United States)

    Elbadry, Maha A; Al-Khedery, Basima; Tagliamonte, Massimiliano S; Yowell, Charles A; Raccurt, Christian P; Existe, Alexandre; Boncy, Jacques; Weppelmann, Thomas A; Beau De Rochars, Valery E M; Lemoine, Jean F; Okech, Bernard A; Dame, John B

    2015-12-21

    Public health measures are poised for transition from malaria control to malaria elimination on the island of Hispaniola. Assessment of the reservoir of asymptomatic infections from which acute malaria cases may derive is critical to plan and evaluate elimination efforts. Current field technology is ill suited for detecting sub-microscopic infections, thus highly sensitive survey methods capable of detecting virtually all infections are needed. In this study the prevalence of infection with Plasmodium falciparum was determined in patients seeking medical care primarily for non-febrile conditions in six departments in Haiti using a newly designed qRT-PCR-based assay. Three different methods of parasite detection were compared to assess their utility in approximating the prevalence of P. falciparum infections in the population: malaria rapid diagnostic test (RDT) designed to detect histidine-rich protein 2 (HRP2), thick smear microscopy, and a quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay based upon the small sub-unit ribosomal RNA. The limit of detection of the qRT-PCR assay utilized was 0.0003 parasite/µL of blood. Venous blood was obtained from a total of 563 subjects from six departments in Haiti, all of whom were seeking medical attention without complaints consistent with malaria. Each subject was questioned for knowledge and behaviour using demographic and epidemiological survey to identify risk factors for disease transmission. Among the 563 samples tested, ten and 16 were found positive for malaria by RDT and microscopy, respectively. Using the qRT-PCR test to assess the infection status of these subjects, an additional 92 were identified for a total of 108. Based upon the qRT-PCR assay results, a wide variation in prevalence of infection in asymptomatic subjects was seen between geographic locations ranging from 4-41%. The prevalence of infection was highest in the Grand Anse, Nord and Sud-Est Departments, and demographic

  19. Source rupture process of the 12 January 2010 Port-au-Prince (Haiti, Mw7.0) earthquake

    Science.gov (United States)

    Borges, José; Caldeira, Bento; Bezzeghoud, Mourad; Santos, Rúben

    2010-05-01

    The Haiti earthquake occurred on tuesday, January 12, 2010 at 21:53:10 UTC. Its epicenter was at 18.46 degrees North, 72.53 degrees West, about 25 km WSW of Haiti's capital, Port-au-Prince. The earthquake was relatively shallow (H=13 km, U.S. Geological Survey) and thus had greater intensity and destructiveness. The earthquake occurred along the tectonic boundary between Caribbean and North America plate. This plate boundary is dominated by left-lateral strike slip motion and compression with 2 cm/year of slip velocity eastward with respect to the North America plate. The moment magnitude was measured to be 7.0 (U.S. Geological Survey) and 7.1 (Harvard Centroid-Moment-Tensor (CMT). More than 10 aftershocks ranging from 5.0 to 5.9 in magnitude (none of magnitude larger than 6.0) struck the area in hours following the main shock. Most of these aftershocks have occurred to the West of the mainshock in the Mirogoane Lakes region and its distribution suggests that the length of the rupture was around 70 km. The Harvard Centroid Moment Tensor (CMT) mechanism solution indicates lefth-lateral strike slip movement with a fault plane trending toward (strike = 251o ; dip = 70o; rake = 28o). In order to obtain the spatiotemporal slip distribution of a finite rupture model we have used teleseismic body wave and the Kikuchi and Kanamori's method [1]. Rupture velocity was constrained by using the directivity effect determined from a set of waveforms well recorded at regional and teleseismic distances [2]. Finally, we compared a map of aftershocks with the Coulomb stress changes caused by the event in the region [3]. [1]- Kikuchi, M., and Kanamori, H., 1982, Inversion of complex body waves: Bull. Seismol. Soc. Am., v. 72, p. 491-506. [2] Caldeira B., Bezzeghoud M, Borges JF, 2009; DIRDOP: a directivity approach to determining the seismic rupture velocity vector. J Seismology, DOI 10.1007/s10950-009-9183-x (http://www.springerlink.com/content/xp524g2225628773/) [3] -King, G. C. P

  20. Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis.

    Science.gov (United States)

    Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

    2015-03-01

    Between April and June, 2012, a reactive cholera vaccination campaign was done in Haiti with an oral inactivated bivalent whole-cell vaccine. We aimed to assess the effectiveness of the vaccine in a case-control study and to assess the likelihood of bias in that study in a bias-indicator study. Residents of Bocozel or Grand Saline who were eligible for the vaccination campaign (ie, age ≥12 months, not pregnant, and living in the region at the time of the vaccine campaign) were included. In the primary case-control study, cases had acute watery diarrhoea, sought treatment at one of three participating cholera treatment units, and had a stool sample positive for cholera by culture. For each case, four control individuals who did not seek treatment for acute watery diarrhoea were matched by location of residence, enrolment time (within 2 weeks of the case), and age (1-4 years, 5-15 years, and >15 years). Cases in the bias-indicator study were individuals with acute watery diarrhoea with a negative stool sample for cholera. Controls were selected in the same manner as in the primary case-control study. Trained staff used standard laboratory procedures to do rapid tests and stool cultures from study cases. Participants were interviewed to collect data on sociodemographic characteristics, risk factors for cholera, and self-reported vaccination. Data were analysed by conditional logistic regression, adjusting for matching factors. From Oct 24, 2012, to March 9, 2014, 114 eligible individuals presented with acute watery diarrhoea and were enrolled, 25 of whom were subsequently excluded. 47 participants were analysed as cases in the vaccine effectiveness case-control study and 42 as cases in the bias-indicator study. 33 (70%) of 47 cholera cases self-reported vaccination versus 167 (89%) of 188 controls (vaccine effectiveness 63%, 95% CI 8-85). 27 (57%) of 47 cases had certified vaccination versus 147 (78%) of 188 controls (vaccine effectiveness 58%, 13-80). Neither self

  1. Detection and phylogenetic characterization of arbovirus dual-infections among persons during a chikungunya fever outbreak, Haiti 2014.

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    Sarah K White

    2018-05-01

    Full Text Available In the context of recent arbovirus epidemics, questions about the frequency of simultaneous infection of patients with different arbovirus species have been raised. In 2014, a major Chikungunya virus (CHIKV epidemic impacted the Caribbean and South America. As part of ongoing screening of schoolchildren presenting with acute undifferentiated febrile illness in rural Haiti, we used RT-PCR to identify CHIKV infections in 82 of 100 children with this diagnosis during May-August 2014. Among these, eight were infected with a second arbovirus: six with Zika virus (ZIKV, one with Dengue virus serotype 2, and one with Mayaro virus (MAYV. These dual infections were only detected following culture of the specimen, suggesting low viral loads of the co-infecting species. Phylogenetic analyses indicated that the ZIKV and MAYV strains differ from those detected later in 2014 and 2015, respectively. Moreover, CHIKV and ZIKV strains from co-infected patients clustered monophyletically in their respective phylogeny, and clock calibration traced back the common ancestor of each clade to an overlapping timeframe of introduction of these arboviruses onto the island.

  2. AIDS Diarrhea and Antiretroviral Drug Concentrations: A Matched-Pair Cohort Study in Port au Prince, Haiti

    Science.gov (United States)

    Dillingham, Rebecca; Leger, Paul; Beauharnais, Carole-Anne; Miller, Erica; Kashuba, Angela; Jennings, Steven; Dupnik, Kathryn; Samie, Amidou; Eyma, Etna; Guerrant, Richard; Pape, Jean; Fitzgerald, Daniel

    2011-01-01

    Diarrhea in patients with acquired immunodeficiency syndrome (AIDS) may cause malabsorption of medications and failure of antiretroviral therapy (ART). We prospectively evaluated human immunodeficiency virus-1 (HIV-1)-infected patients with and without chronic diarrhea initiating ART in Haiti. We report mean plasma antiretroviral concentrations at 2 and 4 weeks. We measured plasma HIV-1 RNA levels at four points. Fifty-two HIV-1-infected patients (26 matched pairs) were enrolled. No differences in antiretroviral concentrations were detected. At week 24, 18/25 (72%) cases and 16/24 (68%) controls had undetectable plasma HIV-1 RNA levels (P = 0.69). Patients with plasma HIV-1 RNA levels > 50 copies/mL at week 24 had lower early efavirenz concentrations than patients with undetectable HIV-1 RNA (2,621 ng/mL versus 5,278 ng/mL; P = 0.02). Diarrhea at ART initiation does not influence plasma concentrations of the medications evaluated. Virologic outcome at Week 24 does correlate with efavirenz concentrations early in therapy but not with the presence of chronic diarrhea. PMID:21633022

  3. A new "American" subgroup of African-lineage Chikungunya virus detected in and isolated from mosquitoes collected in Haiti, 2016.

    Science.gov (United States)

    White, Sarah Keller; Mavian, Carla; Salemi, Marco; Morris, John Glenn; Elbadry, Maha A; Okech, Bernard A; Lednicky, John A; Dunford, James C

    2018-01-01

    As part of on-going arboviral surveillance activity in a semi-rural region in Haiti, Chikungunya virus (CHIKV)-positive mosquito pools were identified in 2014 (the peak of the Caribbean Asian-clade epidemic), and again in 2016 by RT-PCR. In 2014, CHIKV was only identified in Aedes aegypti (11 positive pools/124 screened). In contrast, in sampling in 2016, CHIKV was not identified in Ae. aegypti, but, rather, in (a) a female Aedes albopictus pool, and (b) a female Culex quinquefasciatus pool. Genomic sequence analyses indicated that the CHIKV viruses in the 2016 mosquito pools were from the East-Central-South African (ECSA) lineage, rather than the Asian lineage. In phylogenetic studies, these ECSA lineage strains form a new ECSA subgroup (subgroup IIa) together with Brazilian ECSA lineage strains from an isolated human outbreak in 2014, and a mosquito pool in 2016. Additional analyses date the most recent common ancestor of the ECSA IIa subgroup around May 2007, and the 2016 Haitian CHIKV genomes around December 2015. Known CHIKV mutations associated with improved Ae. albopictus vector competence were not identified. Isolation of this newly identified lineage from Ae. albopictus is of concern, as this vector has a broader geographic range than Ae. aegypti, especially in temperate areas of North America, and stresses the importance for continued vector surveillance.

  4. Influence of transportation cost on long-term retention in clinic for HIV patients in rural Haiti.

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    Sowah, Leonard A; Turenne, Franck V; Buchwald, Ulrike K; Delva, Guesly; Mesidor, Romaine N; Dessaigne, Camille G; Previl, Harold; Patel, Devang; Edozien, Anthony; Redfield, Robert R; Amoroso, Anthony

    2014-12-01

    With improved access to antiretroviral therapy in resource-constrained settings, long-term retention in HIV clinics has become an important means of reducing costs and improving outcomes. Published data on retention in HIV clinics beyond 24 months are, however, limited. In our clinic in rural Haiti, we hypothesized that individuals residing in locations with higher transportation costs to clinic would have poorer retention than those who had lower costs. We used a retrospective cohort design to evaluate potential predictors of HIV clinic retention. Patient information was abstracted from the electronic medical records. Cox proportional hazards regression was used to identify independent predictors of 4-year clinic retention. There were 410 patients in our cohort, 266 (64.9%) females and 144 (35.1%) males. Forty-five (11%) patients lived in locations with transportation costs >$2. Males were 1.5 times more likely to live in municipalities with transportation costs to clinic of >$2. Multivariate analysis suggested that age transportation cost were independent predictors of loss to follow-up (LTFU): risk ratio of 2.98, 95% confidence interval (CI): 1.73 to 4.96, P transportation costs greater than $2 were 1.9 times more likely to be lost to care compared with those who paid less for transportation. HIV treatment programs in resource-constrained settings may need to pay closer attention to issues related to transportation cost to improve patient retention.

  5. Optimizing Household Chlorination Marketing Strategies: A Randomized Controlled Trial on the Effect of Price and Promotion on Adoption in Haiti.

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    Ritter, Michael; Camille, Eveline; Velcine, Christophe; Guillaume, Rose-Kerline; Lantagne, Daniele

    2017-07-01

    Household water treatment can reduce diarrheal morbidity and mortality in developing countries, but adoption remains low and supply is often unreliable. To test effects of marketing strategies on consumers and suppliers, we randomized 1,798 households in rural Haiti and collected data on purchases of a household chlorination product for 4 months. Households received randomly selected prices ($0.11-$0.56 per chlorine bottle), and half received monthly visits from sales agents. Each $0.22 drop in price increased purchases by 0.10 bottles per household per month ( P sales agents increased purchases at mid-range prices; however, the additional revenue did not offset visit cost. Choosing the lowest price and conducting visits maximizes chlorine purchase, whereas slightly raising the retail price and not conducting visits maximizes cost recovery. For the equivalent cost, price discounts increase purchases 4.2 times as much as adding visits at the current retail price. In this context, price subsidies may be a more cost-effective use of resources than household visits, though all marketing strategies tested offer cost-effective ways to achieve incremental health impact. Decisions about pricing and promotion for health products in developing countries affect health impact, cost recovery, and cost-effectiveness, and tradeoffs between these goals should be made explicit in program design.

  6. Ti Foyer (Hearth) community-based nutrition activities informed by the positive deviance approach in Leogane, Haiti: a programmatic description.

    Science.gov (United States)

    Bolles, Kathryn; Speraw, Catherine; Berggren, Gretchen; Lafontant, Jack Guy

    2002-12-01

    This paper details the steps to design and implement a positive deviance-informed, "Hearth" approach for the nutritional rehabilitation of malnourished children in the district of Leogane, Haiti. Groups of four to five children met daily for two weeks at the home of a local volunteer mother for nutritional and health messages and a well-balanced meal. Health messages and meal components were determined using information gathered from interviews with the mothers of positive deviant children in the community who are well nourished despite their family's limited economic resources. Hearth participants were then followed for six months in their own home by the program "monitrices," women hired from each village and intensively trained to supervise the Hearth program, periodically weigh the children to evaluate their progress, and liaise between the hospital and the community. Monitoring from the first cycle indicated that 100% of children in eight villages and 66% of children in the remaining five villages continued to gain weight as fast or faster than the international standard median six months after participating in a Hearth program. At the conclusion of this cycle, programmers interviewed participant and non-participant families and made six modifications to the model, including the addition of a microcredit option for participating mothers.

  7. Subsistence Songs: Haitian téat Performances, Gendered Capital, and Livelihood Strategies in Jean Makout, Haiti

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    Timothy T. Schwartz

    2008-12-01

    Full Text Available Examines how sexual and gender values in rural Haiti are expressed through 'téat', theatrical, songs and performances among girls from 10 to 20 years. Author describes how these sexual values relate to a concept of gendered capital, or what he calls a "sexual-moral economy", whereby men who want sex with women need to provide material rewards for this sexual access. He explains how this combines with certain gender socializations and views of men, unlike women, really needing sex, and socialized toward this, also by women, and thus from an early age to aggressively pursue women, and women on the other hand toward restraint, and to require material rewards. Author illustrates, through examples, how téat songs reflect and refer to these values, often through sexual metaphors. In addition, he shows how they relate to the wider social and gender context of matrifocality and subsistence strategies, notably the household, wherein women tend to be dominant over men, who supplied the house as expected price for her sex, manages production and reproduction of her daughters in it, instilling them also with the said sexual values, and with children seen as necessary for household work, as the women also engage in market activities outside of the house.

  8. Ionospheric perturbations in possible association with the 2010 Haiti earthquake, as based on medium-distance subionospheric VLF propagation data

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    M. Hayakawa

    2011-02-01

    Full Text Available Ionospheric perturbations in possible association with the 2010 Haiti earthquake occurred on 12 January 2010 (with a magnitude of 7.0 and depth of 10 km are investigated on the basis of subionospheric propagation data from the NAA transmitter on the east coast of the USA to a VLF receiving station in Peru. The local nighttime VLF amplitude data are extensively investigated during the period from the beginning of October 2009 to the end of March 2010, in which the trend (nighttime average amplitude, dispersion and nighttime fluctuation are analysed. It is found that a clear precursory ionosphere perturbation is detected just around New Years day of 2010, about 12 days before the main shock, which is characterised by the simultaneous decrease in the trend and the increases in dispersion and nighttime fluctuation. An additional finding might be the presence of the effect of the Earth's tide one and two months before the main shock, which can only be seen for a huge EQ.

  9. Development of a Breast Cancer Treatment Program in Port-au-Prince, Haiti: Experiences From the Field

    Science.gov (United States)

    Libby, Rachel; Patberg, Elizabeth; Gabriel, Dieudina; Al-Quran, Samer; Kasher, Matthew; Heldermon, Coy; Daily, Karen; Auguste, Joseph R.; Suprien, Valery C.; Hurley, Judith

    2016-01-01

    Purpose The nonprofit Project Medishare launched a breast cancer treatment program in Port-au-Prince in July 2013 to address the demand for breast cancer care in Haiti. We outline the development of the program, highlight specific challenges, and discuss key considerations for others working in global oncology. Methods We reflected on our experiences in the key areas of developing partnerships, building laboratory capacity, conducting medical training, using treatment algorithms, and ensuring access to safe, low-cost chemotherapy drugs. We also critically reviewed our costs and quality measures. Results The program has treated a total of 139 patients with breast cancer with strong adherence to treatment regimens in 85% of patients. In 273 chemotherapy administrations, no serious exposure or adverse safety events were reported by staff. The mortality rate for 94 patients for whom we have complete data was 24% with a median survival time of 53 months. Our outcome data were likely influenced by stage at presentation, with more than half of patients presenting more than 12 months after first noticing a tumor. Future efforts will therefore focus on continuing to improve the level of care, while working with local partners to spread awareness, increase screening, and get more women into care earlier in the course of their disease. Conclusion Our experiences may inform others working to implement protocol-based cancer treatment programs in resource-poor settings and can provide valuable lessons learned for future global oncology efforts. PMID:28717677

  10. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation

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    Ketan Sharma

    2013-01-01

    Full Text Available Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of N=123 patients accrued, 90 (73% reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, P=0.03, failure to initially recognize mass as important (OR = 13.0, P<0.01, and fear of treatment cost (OR = 8.3, P=0.03 were shown to independently predict delayed patient presentation. Conclusion. To reduce stage at presentation, future interventions must educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free.

  11. Nutritional Characterization and Phenolic Profiling of Moringa oleifera Leaves Grown in Chad, Sahrawi Refugee Camps, and Haiti.

    Science.gov (United States)

    Leone, Alessandro; Fiorillo, Giovanni; Criscuoli, Franca; Ravasenghi, Stefano; Santagostini, Laura; Fico, Gelsomina; Spadafranca, Angela; Battezzati, Alberto; Schiraldi, Alberto; Pozzi, Federica; di Lello, Sara; Filippini, Sandro; Bertoli, Simona

    2015-08-12

    Moringa oleifera is a plant that grows in tropical and subtropical areas of the world. Its leaves are rich of nutrients and bioactive compounds. However, several differences are reported in the literature. In this article we performed a nutritional characterization and a phenolic profiling of M. oleifera leaves grown in Chad, Sahrawi refugee camps, and Haiti. In addition, we investigated the presence of salicylic and ferulic acids, two phenolic acids with pharmacological activity, whose presence in M. oleifera leaves has been scarcely investigated so far. Several differences were observed among the samples. Nevertheless, the leaves were rich in protein, minerals, and β-carotene. Quercetin and kaempferol glycosides were the main phenolic compounds identified in the methanolic extracts. Finally, salicylic and ferulic acids were found in a concentration range of 0.14-0.33 and 6.61-9.69 mg/100 g, respectively. In conclusion, we observed some differences in terms of nutrients and phenolic compounds in M. oleifera leaves grown in different countries. Nevertheless, these leaves are a good and economical source of nutrients for tropical and sub-tropical countries. Furthermore, M. oleifera leaves are a source of flavonoids and phenolic acids, among which salicylic and ferulic acids, and therefore they could be used as nutraceutical and functional ingredients.

  12. International aid and natural disasters: a pre- and post-earthquake longitudinal study of the healthcare infrastructure in Leogane, Haiti.

    Science.gov (United States)

    Kligerman, Maxwell; Barry, Michele; Walmer, David; Bendavid, Eran

    2015-02-01

    The reconstruction of healthcare systems in developing countries after natural disasters is poorly understood. Using data collected before and after the 2010 Haiti earthquake, we detail the response of aid agencies and their interaction with local healthcare providers in Leogane, the city closest to the epicenter. We find that the period after the earthquake was associated with an increase in the total number of healthcare facilities, inpatient beds, and surgical facilities and that international aid has been a driving force behind this recovery. Aid has funded 12 of 13 new healthcare facilities that have opened since the earthquake as well as the reconstruction of 7 of 8 healthcare facilities that have been rebuilt. Despite increases in free, aid-financed healthcare, private Haitian healthcare facilities have remained at a constant number. The planned phase-out of several aid-financed facilities, however, will leave Leogane with fewer inpatient beds and healthcare services compared with the pre-earthquake period. © The American Society of Tropical Medicine and Hygiene.

  13. "The women, they maltreat them… therefore, we cannot assure that the future society will be good": Male perspectives on gender-based violence: A focus group study with young men in Haiti.

    Science.gov (United States)

    Gabriel, Naïka C; Sloand, Elizabeth; Gary, Faye; Hassan, Mona; Bertrand, Desiree R; Campbell, Jacquelyn

    2016-07-01

    The purpose of this study was to explore the perceptions of violence against women (VAW) held by Haitian men to gain a better understanding of why VAW occurs. Women in Haiti have experienced significant violence, both before and following the 2010 earthquake. Fifteen men aged 26 to 47 participated in a focus group. The data revealed three themes: men's beliefs about VAW and its context, factors influencing VAW, and recommended interventions. When approaching VAW, men must be part of the collective effort. Their insights are valuable when planning and implementing interventions to decrease VAW in Haiti and worldwide.

  14. Cross-sectional analysis of the association between bedtime and malaria exposure in the Ouest and Sud-Est Departments of Haiti.

    Science.gov (United States)

    Stephenson, Caroline J; Rossheim, Matthew E; Frankenfeld, Cara L; Boncy, Jacques; Okech, Bernard A; von Fricken, Michael E

    2017-12-01

    The governments of Haiti and the Dominican Republic have a binational agreement to work towards malaria elimination for the island of Hispaniola by the year 2020. Understanding malaria-related knowledge and behaviors can help inform elimination efforts. This study examined the association between social-behavioral factors, like bedtime and bed net ownership, with malaria seroconversion status among people in the Ouest and Sud-Est departments of Haiti. In 2013, cross-sectional survey data (n=377) and blood samples were collected from a convenience sample of individuals within community, clinic and school settings. Logistic regression models were constructed to examine associations between social-behavioral factors and malaria exposure, adjusting for potential confounders. Compared to people going to bed between 6 and 8 pm, those going to bed between 8 and 10 pm were 2.67 (OR, 95% CI: 1.16-6.14) times as likely to have been exposed to malaria. Participants who reported going to bed after 10 pm were 5.96 times as likely to have had previous malaria exposure (OR, 95% CI: 2.26-15.7), compared to 6-8 pm. No significant associations were found between malaria exposure and either insecticide use nor bed net ownership. These findings are consistent with suspected feeding behaviors of Anopheles albimanus, which prefers feeding at night and outdoors. Study findings may improve overall understanding of malaria transmission in Haiti and potentially guide future studies conducted in this region. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Prehospital characteristics in the North East Department of Haiti: a cross-sectional study from a low-income setting without prehospital systems.

    Science.gov (United States)

    Aluisio, Adam R; Gore, Robert; Decome, Isnelle; De Wulf, Annelies; Bloem, Christina

    2014-06-01

    Although prehospital care is recognized as key in health systems development, it has been largely neglected in Haiti. The North East Department is one of the poorest areas of Haiti, and is a region where no data on out-of-hospital health care exists. This research assessed prehospital characteristics in the North East Department with the aim of providing baseline data to inform prehospital systems development. In this observational study, data were collected from patients presenting at the Fort Liberté Hospital, the public regional referral health center in the North East Department. Data were accrued from April 2, 2012 through June 5, 2012. All patients accessing acute care at the hospital were eligible for enrollment. After obtaining consent, data on demographics, health needs, and prehospital information were gathered via a standardized questionnaire administered by hospital staff trained in study protocols. Data were collected from 441 patient visits. The median age was 24 years, with 62% of the population being female. Medical complaints comprised 75% of visits, with fever and gastrointestinal complaints being the most common reasons for presentation. Traumatic injuries accounted for 25% of encounters, with an equal distribution of blunt and penetrating events. Extremity injuries were the most common traumatic subclassification. The majority of patients (67.2%) were transported by motorcycle taxi and paid transport fees. Trauma patients were more likely to be transported without charge (OR = 9.10; 95% CI, 2.19-37.76; P Haiti. Out-of-hospital care is nearly nonexistent in the region and its development has the potential to yield public health benefits.

  16. Adapting the Caesium-137 technique to document soil redistribution rates associated with traditional cultivation practices in Haiti.

    Science.gov (United States)

    Velasco, H; Astorga, R Torres; Joseph, D; Antoine, J S; Mabit, L; Toloza, A; Dercon, G; Walling, Des E

    2018-03-01

    Large-scale deforestation, intensive land use and unfavourable rainfall conditions are responsible for significant continuous degradation of the Haitian uplands. To develop soil conservation strategies, simple and cost-effective methods are needed to assess rates of soil loss from farmland in Haiti. The fallout radionuclide caesium-137 ( 137 Cs) provides one such means of documenting medium-term soil redistribution rates. In this contribution, the authors report the first use in Haiti of 137 Cs measurements to document soil redistribution rates and the associated pattern of erosion/sedimentation rates along typical hillslopes within a traditional upland Haitian farming area. The local 137 Cs reference inventory, measured at an adjacent undisturbed flat area, was 670 Bq m -2 (SD = 100 Bq m -2 , CV = 15%, n = 7). Within the study area, where cultivation commenced in 1992 after deforestation, three representative downslope transects were sampled. These were characterized by 137 Cs inventories ranging from 190 to 2200 Bq m -2 . Although, the study area was cultivated by the local farmers, the 137 Cs depth distributions obtained from the area differed markedly from those expected from a cultivated area. They showed little evidence of tillage mixing within the upper part of the soil or, more particularly, of the near-uniform activities normally associated with the plough layer or cultivation horizon. They were very similar to that found at the reference site and were characterized by high 137 Cs activities at the surface and much lower activities at greater depths. This situation is thought to reflect the traditional manual tillage practices which cause limited disturbance and mixing of the upper part of the soil. It precluded the use of the conversion models normally used to estimate soil redistribution rates from 137 Cs measurements on cultivated soils and the Diffusion and Migration conversion model frequently used for uncultivated soils was modified for

  17. Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.

    Science.gov (United States)

    Heidkamp, Rebecca A; Ayoya, Mohamed Ag; Teta, Ismael Ngnie; Stoltzfus, Rebecca J; Marhone, Joseline Pierre

    2015-10-01

    The Haitian National Nutrition Policy identifies the promotion of optimal complementary feeding (CF) practices as a priority action to prevent childhood malnutrition. We analysed data from the nationally representative 2005-2006 Haiti Demographic Health Survey using the World Health Organization 2008 infant and young child feeding indicators to describe feeding practices among children aged 6-23 months and thus inform policy and programme planning. Multivariate regression analyses were used to identify the determinants of CF practices and to examine their association with child growth outcomes. Overall, 87.3% of 6-8-month-olds received soft, solid or semi-solid foods in the previous 24 h. Minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) were achieved in 29.2%, 45.3% and 17.1% of children aged 6-23 months, respectively. Non-breastfed children were more likely to achieve MDD than breastfed children of the same age (37.3% vs. 25.8%; P < 0.001). The proportion of children achieving MMF varied significantly by age (P < 0.001). Children with overweight mothers were more likely to achieve MDD, MMF and MAD [odds ratio (OR) 2.08, P = 0.012; OR 1.81, P = 0.02; and OR 2.4, P = 0.01, respectively] than children of normal weight mothers. Odds of achieving MDD and MMF increased with household wealth. Among mothers with secondary or more education, achieving MDD or MAD was significantly associated with lower mean weight-for-age z-score and height-for-age z-score (P-value <0.05 for infants and young child feeding indicator × maternal education interaction). CF practices were mostly inadequate and contributed to growth faltering among Haitian children 6-23 months old. © 2013 John Wiley & Sons Ltd.

  18. A community-based study of factors associated with continuing transmission of lymphatic filariasis in Leogane, Haiti.

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    Alexis Boyd

    Full Text Available Seven rounds of mass drug administration (MDA have been administered in Leogane, Haiti, an area hyperendemic for lymphatic filariasis (LF. Sentinel site surveys showed that the prevalence of microfilaremia was reduced to <1% from levels as high as 15.5%, suggesting that transmission had been reduced. A separate 30-cluster survey of 2- to 4-year-old children was conducted to determine if MDA interrupted transmission. Antigen and antifilarial antibody prevalence were 14.3% and 19.7%, respectively. Follow-up surveys were done in 6 villages, including those selected for the cluster survey, to assess risk factors related to continued LF transmission and to pinpoint hotspots of transmission. One hundred houses were mapped in each village using GPS-enabled PDAs, and then 30 houses and 10 alternates were chosen for testing. All individuals in selected houses were asked to participate in a short survey about participation in MDA, history of residence in Leogane and general knowledge of LF. Survey teams returned to the houses at night to collect blood for antigen testing, microfilaremia and Bm14 antibody testing and collected mosquitoes from these communities in parallel. Antigen prevalence was highly variable among the 6 villages, with the highest being 38.2% (Dampus and the lowest being 2.9% (Corail Lemaire; overall antigen prevalence was 18.5%. Initial cluster surveys of 2- to 4-year-old children were not related to community antigen prevalence. Nearest neighbor analysis found evidence of clustering of infection suggesting that LF infection was focal in distribution. Antigen prevalence among individuals who were systematically noncompliant with the MDAs, i.e. they had never participated, was significantly higher than among compliant individuals (p<0.05. A logistic regression model found that of the factors examined for association with infection, only noncompliance was significantly associated with infection. Thus, continuing transmission of LF seems

  19. Using a Full Complex Site Transfer Function to Estimate Strong Ground Motion in Port-au-Prince (Haiti).

    Science.gov (United States)

    ST Fleur, S.; Courboulex, F.; Bertrand, E.; Mercier De Lepinay, B. F.; Hough, S. E.; Boisson, D.; Momplaisir, R.

    2017-12-01

    To assess the possible impact of a future earthquake in the urban area of Port-au-Prince (Haiti), we have implemented a simulation approach for complex ground motions produced by an earthquake. To this end, we have integrated local site effect in the prediction of strong ground motions in Port-au-Prince using the complex transfer functions method, which takes into account amplitude changes as well as phase changes. This technique is particularly suitable for basins where a conventional 1D digital approach proves inadequate, as is the case in Port-au-Prince. To do this, we use the results of the Standard Spectral Ratio (SSR) approach of St Fleur et al. (2016) to estimate the amplitude of the response of the site to a nearby rock site. Then, we determine the phase difference between sites, interpreted as changes in the phase of the signal related to local site conditions, using the signals of the 2010 earthquake aftershocks records. Finally, the accelerogram of the simulated earthquake is obtain using the technique of the inverse Fourier transform. The results of this study showed that the strongest soil motions are expected in neighborhoods of downtown Port-au-Prince and adjacent hills. In addition, this simulation method by complex transfer functions was validated by comparison with recorded actual data. Our simulated response spectra reproduce very well both the amplitude and the shape of the response spectra of recorded earthquakes. This new approach allowed to reproduce the lengthening of the signal that could be generated by surface waves at certain stations in the city of Port-au-Prince. However, two points of vigilance must be considered: (1) a good signal-to-noise ratio is necessary to obtain a robust estimate of the site-reference phase shift (ratio at least equal to 10); (2) unless the amplitude and phase changes are measured on strong motion records, this technique does not take non-linear effects into account.

  20. Human rights abuse and other criminal violations in Port-au-Prince, Haiti: a random survey of households.

    Science.gov (United States)

    Kolbe, Athena R; Hutson, Royce A

    2006-09-02

    Reliable evidence of the frequency and severity of human rights abuses in Haiti after the departure of the elected president in 2004 was scarce. We assessed data from a random survey of households in the greater Port-au-Prince area. Using random Global Positioning System (GPS) coordinate sampling, 1260 households (5720 individuals) were sampled. They were interviewed with a structured questionnaire by trained interviewers about their experiences after the departure of President Jean-Bertrand Aristide. The response rate was 90.7%. Information on demographic characteristics, crime, and human rights violations was obtained. Our findings suggested that 8000 individuals were murdered in the greater Port-au-Prince area during the 22-month period assessed. Almost half of the identified perpetrators were government forces or outside political actors. Sexual assault of women and girls was common, with findings suggesting that 35,000 women were victimised in the area; more than half of all female victims were younger than 18 years. Criminals were the most identified perpetrators, but officers from the Haitian National Police accounted for 13.8% and armed anti-Lavalas groups accounted for 10.6% of identified perpetrators of sexual assault. Kidnappings and extrajudicial detentions, physical assaults, death threats, physical threats, and threats of sexual violence were also common. Our results indicate that crime and systematic abuse of human rights were common in Port-au-Prince. Although criminals were the most identified perpetrators of violations, political actors and UN soldiers were also frequently identified. These findings suggest the need for a systematic response from the newly elected Haitian government, the UN, and social service organisations to address the legal, medical, psychological, and economic consequences of widespread human rights abuses and crime.

  1. Geographic distribution and mortality risk factors during the cholera outbreak in a rural region of Haiti, 2010-2011.

    Directory of Open Access Journals (Sweden)

    Anne-Laure Page

    2015-03-01

    Full Text Available In 2010 and 2011, Haiti was heavily affected by a large cholera outbreak that spread throughout the country. Although national health structure-based cholera surveillance was rapidly initiated, a substantial number of community cases might have been missed, particularly in remote areas. We conducted a community-based survey in a large rural, mountainous area across four districts of the Nord department including areas with good versus poor accessibility by road, and rapid versus delayed response to the outbreak to document the true cholera burden and assess geographic distribution and risk factors for cholera mortality.A two-stage, household-based cluster survey was conducted in 138 clusters of 23 households in four districts of the Nord Department from April 22nd to May 13th 2011. A total of 3,187 households and 16,900 individuals were included in the survey, of whom 2,034 (12.0% reported at least one episode of watery diarrhea since the beginning of the outbreak. The two more remote districts, Borgne and Pilate were most affected with attack rates up to 16.2%, and case fatality rates up to 15.2% as compared to the two more accessible districts. Care seeking was also less frequent in the more remote areas with as low as 61.6% of reported patients seeking care. Living in remote areas was found as a risk factor for mortality together with older age, greater severity of illness and not seeking care.These results highlight important geographical disparities and demonstrate that the epidemic caused the highest burden both in terms of cases and deaths in the most remote areas, where up to 5% of the population may have died during the first months of the epidemic. Adapted strategies are needed to rapidly provide treatment as well as prevention measures in remote communities.

  2. Cholera in pregnancy: outcomes from a specialized cholera treatment unit for pregnant women in Léogâne, Haiti.

    Science.gov (United States)

    Ciglenecki, Iza; Bichet, Mathieu; Tena, Javier; Mondesir, Erneau; Bastard, Mathieu; Tran, Nguyen-Toan; Antierens, Annick; Staderini, Nelly

    2013-01-01

    The association between cholera in pregnancy and negative fetal outcome has been described since the 19(th) century. However, there is limited published literature on the subject. We describe pregnancy outcomes from a specialized multidisciplinary hospital unit at the onset of a large cholera outbreak in Haiti in 2010 and 2011. Pregnant women with cholera were hospitalized in a specialized unit within the MSF hospital compound in Léogâne and treated using standard cholera treatment guidelines but with earlier, more intense fluid replacement. All women had intravenous access established at admission regardless of their hydration status, and all received antibiotic treatment. Data were collected on patient demographics, pregnancy and cholera status, and pregnancy outcome. In this analysis we calculated risk ratios for fetal death and performed logistic regression analysis to control for confounding factors. 263 pregnant women with cholera were hospitalized between December 2010 and July 2011. None died during hospitalization, 226 (86%) were discharged with a preserved pregnancy and 16 (6%) had live fullterm singleton births, of whom 2 died within the first 5 days postpartum. The remaining 21 pregnancies (8%) resulted in intrauterine fetal death. The risk of fetal death was associated with factors reflecting severity of the cholera episode: after adjusting for confounding factors, the strongest risk factor for fetal death was severe maternal dehydration (adjusted risk ratio for severe vs. mild dehydration was 9.4, 95% CI 2.5-35.3, p = 0.005), followed by severe vomiting (adjusted risk ratio 5.1, 95% 1.1-23.8, p = 0.041). This is the largest cohort of pregnant women with cholera described to date. The main risk factor identified for fetal death was severity of dehydration. Our experience suggests that establishing specialized multidisciplinary units which facilitate close follow-up of both pregnancy and dehydration status due to cholera could be beneficial

  3. Disaster preparedness and response improvement: comparison of the 2010 Haiti earthquake-related diagnoses with baseline medical data.

    Science.gov (United States)

    van Berlaer, Gerlant; Staes, Tom; Danschutter, Dirk; Ackermans, Ronald; Zannini, Stefano; Rossi, Gabriele; Buyl, Ronald; Gijs, Geert; Debacker, Michel; Hubloue, Ives

    2017-10-01

    Disaster medicine research generally lacks control groups. This study aims to describe categories of diagnoses encountered by the Belgian First Aid and Support Team after the 2010 Haiti earthquake and extract earthquake-related changes from comparison with comparable baseline data. The hypothesis is that besides earthquake-related trauma, medical problems emerge soon, questioning an appropriate composition of Foreign Medical Teams and Interagency Emergency Health Kits. Using a descriptive cohort study design, diagnoses of patients presenting to the Belgian field hospital were prospectively registered during 4 weeks after the earthquake and compared with those recorded similarly by Médecins Sans Frontières in the same area and time span in previous and later years. Of 7000 triaged postearthquake patients, 3500 were admitted, of whom 2795 were included and analysed. In the fortnight after the earthquake, 90% suffered from injury. In the following fortnight, medical diseases emerged, particularly respiratory (23%) and digestive (14%). More than 53% developed infections within 3 weeks after the event. Médecins Sans Frontières registered 6407 patients in 2009; 6033 in 2011; and 7300 in 2012. A comparison indicates that postearthquake patients suffered significantly less from violence, but more from wounds, respiratory, digestive and ophthalmological diseases. This is the first comparison of postearthquake diagnoses with baseline data. Within 2 weeks after the acute phase of an earthquake, respiratory, digestive and ophthalmological problems will emerge to the prejudice of trauma. This fact should be anticipated when composing Foreign Medical Teams and Interagency Emergency Health Kits to be sent to the disaster site.

  4. Secondary mapping of lymphatic filariasis in Haiti-definition of transmission foci in low-prevalence settings.

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    Naomi Drexler

    Full Text Available To eliminate Lymphatic filariasis (LF as a public health problem, the World Health Organization (WHO recommends that any area with infection prevalence greater than or equal to 1% (denoted by presence of microfilaremia or antigenemia should receive mass drug administration (MDA of antifilarial drugs for at least five consecutive rounds. Areas of low-antigen prevalence (< 1% are thought to pose little risk for continued transmission of LF. Five low-antigen prevalence communes in Haiti, characterized as part of a national survey, were further assessed for transmission in this study. An initial evaluation of schoolchildren was performed in each commune to identify antigen-positive children who served as index cases for subsequent community surveys conducted among households neighboring the index cases. Global positioning system (GPS coordinates and immunochromatographic tests (ICT for filarial antigenemia were collected on approximately 1,600 persons of all ages in the five communes. The relationship between antigen-positive cases in the community and distance from index cases was evaluated using multivariate regression techniques and analyses of spatial clustering. Community surveys demonstrated higher antigen prevalence in three of the five communes than was observed in the original mapping survey; autochthonous cases were found in the same three communes. Regression techniques identified a significantly increased likelihood of being antigen-positive when living within 20 meters of index cases when controlling for age, gender, and commune. Spatial clustering of antigen-positive cases was observed in some, but not all communes. Our results suggest that localized transmission was present even in low-prevalence settings and suggest that better surveillance methods may be needed to detect microfoci of LF transmission.

  5. Epidemiologic profile of patients seen in primary care clinics in an urban and a rural setting in Haiti, 2010-11.

    Science.gov (United States)

    Dickstein, Yaakov; Neuberger, Ami; Golus, Miri; Schwartz, Eli

    2014-09-01

    This study examined the demographic and epidemiological differences between patient populations presenting to a rural and an urban clinic in Haiti. A primary health clinic was established in urban Leogane, and a once-weekly clinic was established in Magandou, a rural village. Patient data were recorded for all individuals presenting to each clinic. Over 7 months, 6632 patients (median age 25) were seen in the urban clinic, and 567 (median age 47) in the rural clinic. There was a female majority at both sites. Hypertension was diagnosed in 41.9% (238/567) of the rural population over 40 years of age, while 29.5% (1956/6632) of patients in the urban setting had the same diagnosis (pHaiti must address the wide rural prevalence. STDs are a major urban health issue requiring treatment for both patients and their partners. Vector-borne disease was unseen in the rural clinic, despite an altitude insufficient to prevent mosquito-borne illness. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Attitudes Toward Intimate Partner Violence and Associations With Condom Use Among Men in Haiti: An Analysis of the Nationally Representative Demographic Health Survey.

    Science.gov (United States)

    Conserve, Donaldson F; Whembolua, Guy-Lucien S; Surkan, Pamela J

    2016-03-01

    Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes toward intimate partner violence, knowledge of, and use of condoms among 9493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time they had had sex. Logistic regression revealed that believing it was justified for a man to hit or beat his wife if she refuses to have sex with him was associated with a lower odds of condom use. The odds of using a condom during last sex was higher among men who reported knowing condoms can prevent HIV and who had been tested for HIV. Given the low rate of condom use among men in Haiti, these findings suggest that interventions promoting HIV knowledge, HIV testing, and gender-violence prevention among men may also increase condom use. © The Author(s) 2014.

  7. Signature of Transpressional Tectonics in the Holocene Stratigraphy of Lake Azuei, Haiti: Preliminary Results From a High-Resolution Subbottom Profiling Survey

    Science.gov (United States)

    Cormier, M. H.; Sloan, H.; Boisson, D.; Brown, B.; Guerrier, K.; Hearn, C. K.; Heil, C. W., Jr.; Kelly, R. P.; King, J. W.; Knotts, P.; Lucier, O. F.; Momplaisir, R.; Stempel, R.; Symithe, S. J.; Ulysse, S. M. J.; Wattrus, N. J.

    2017-12-01

    The left-lateral Enriquillo-Plantain Garden Fault (EPGF) is one of two transform systems that define the Northern Caribbean plate boundary zone. Relative motion across its trace ( 10 mm/yr) evolves from nearly pure strike-slip in western Haiti to transpressional in eastern Haiti, where the fault system may terminate against a south-dipping oblique reverse fault. Lake Azuei is a large (10 km x 25 km) and shallow (turbidity currents. The fact that young turbidites pinch out in upward curves suggests that the folds are actively growing, and that active contractional structures (folds and/or blind thrust faults) control much of the periphery of the lake. A few sediment cores were strategically located where beds are pinching out in order to maximize stratigraphic records. Two of these cores successfully penetrated strata imaged by the CHIRP profiles. On-going Pb210 dating of sediment samples from the cores should constrain sedimentation rates and thus help quantify the rates of the tectonic deformation.

  8. Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study

    Directory of Open Access Journals (Sweden)

    Ivers Louise C

    2010-08-01

    Full Text Available Abstract Background Few data are available to guide programmatic solutions to the overlapping problems of undernutrition and HIV infection. We evaluated the impact of food assistance on patient outcomes in a comprehensive HIV program in central Haiti in a prospective observational cohort study. Methods Adults with HIV infection were eligible for monthly food rations if they had any one of: tuberculosis, body mass index (BMI 2, CD4 cell count 3 (in the prior 3 months or severe socio-economic conditions. A total of 600 individuals (300 eligible and 300 ineligible for food assistance were interviewed before rations were distributed, at 6 months and at 12 months. Data collected included demographics, BMI and food insecurity score (range 0 - 20. Results At 6- and 12-month time-points, 488 and 340 subjects were eligible for analysis. Multivariable analysis demonstrated that at 6 months, food security significantly improved in those who received food assistance versus who did not (-3.55 vs -0.16; P Conclusions Food assistance was associated with improved food security, increased BMI, and improved adherence to clinic visits at 6 and 12 months among people living with HIV in Haiti and should be part of routine care where HIV and food insecurity overlap.

  9. Detection of local site conditions influencing earthquake shaking and secondary effects in Southwest-Haiti using remote sensing and GIS-methods

    Directory of Open Access Journals (Sweden)

    B. Theilen-Willige

    2010-06-01

    Full Text Available The potential contribution of remote sensing and GIS techniques to earthquake hazard analysis was investigated in SW-Haiti in order to improve the systematic, standardized inventory of those areas that are more susceptible to earthquake ground motions or to earthquake related secondary effects such as landslides, liquefaction, soil amplifications, compaction or even tsunami-waves. Geophysical, topographical, geological data and satellite images were collected, processed, and integrated into a spatial database using Geoinformation Systems (GIS and image processing techniques. The GIS integrated evaluation of satellite imageries, of digital topographic data and of various open-source geodata can contribute to the acquisition of those specific tectonic, geomorphologic/topographic settings influencing local site conditions in Haiti and, thus, to a first data base stock. Using the weighted overlay techniques in GIS susceptibility maps were produced indicating areas where causal factors influencing surface-near earthquake shock occur aggregated and interfering each other and, thus, rise the susceptibility to soil amplification. This approach was used as well to create landslide and flooding susceptibility maps.

  10. A concepção do desenvolvimento humano na proposta educacional do Haiti: análise a partir do enfoque histórico-cultural.

    Directory of Open Access Journals (Sweden)

    Jimmy Pierre

    2016-12-01

    Full Text Available Esta pesquisa centra-se na análise do processo de desenvolvimento humano no âmbito educacional do Haiti, inicia-se por algumas considerações acerca de fatos relevantes na história do país e que incidiram nas políticas públicas educacionais. Para isso, foi delimitado um espaço de tempo (1979 a 2011, por ser um período marcado por diversas mudanças relativas ao sistema educativo, sobretudo a Reforma Bernard. Privilegia-se, nesta investigação, o enfoque histórico-cultural, considerado um dos referenciais mais estudados e discutidos em muitos países e sociedades do mundo, não só pelos aportes na psicologia, mas também por sua abordagem relativa às questões do desenvolvimento humano, instrumentando o processo educativo de forma revolucionária.  Destaca a função dos professores e dos alunos, sendo ambos os sujeitos dinâmicos e centrais no processo de ensino e aprendizagem, considera também que as práticas de linguagem são instrumentos essenciais na evolução desenvolvimentista do humano.  A presente pesquisa traz uma análise e discussão acerca da educação no Haiti, em diferentes épocas, com diferentes visões, no entanto, ainda hoje, com poucas mudanças significativas. Trata-se de um estudo à luz da Psicologia Histórico-Cultural, contrapondo-se à abordagem humanista que se faz presente no sistema educacional do país, mas não no sentido de criticá-la, senão com a finalidade de complementá-la. Desta forma, propõe-se como objetivo favorecer uma discussão do desenvolvimento humano com base no enfoque histórico-cultural, a fim de contribuir para uma análise da concepção educacional do Haiti. A investigação é de revisão bibliográfica com abordagem qualitativa, usando o método dialético histórico-materialista. Para elaborar esta investigação foram considerados três momentos, sendo: uma análise histórica, enfatizando as mudanças ocorridas ao longo do desenvolvimento do sistema educacional do

  11. A time-driven activity-based costing model to improve health-care resource use in Mirebalais, Haiti.

    Science.gov (United States)

    Mandigo, Morgan; O'Neill, Kathleen; Mistry, Bipin; Mundy, Bryan; Millien, Christophe; Nazaire, Yolande; Damuse, Ruth; Pierre, Claire; Mugunga, Jean Claude; Gillies, Rowan; Lucien, Franciscka; Bertrand, Karla; Luo, Eva; Costas, Ainhoa; Greenberg, Sarah L M; Meara, John G; Kaplan, Robert

    2015-04-27

    In resource-limited settings, efficiency is crucial to maximise resources available for patient care. Time driven activity-based costing (TDABC) estimates costs directly from clinical and administrative processes used in patient care, thereby providing valuable information for process improvements. TDABC is more accurate and simpler than traditional activity-based costing because it assigns resource costs to patients based on the amount of time clinical and staff resources are used in patient encounters. Other costing approaches use somewhat arbitrary allocations that provide little transparency into the actual clinical processes used to treat medical conditions. TDABC has been successfully applied in European and US health-care settings to facilitate process improvements and new reimbursement approaches, but it has not been used in resource-limited settings. We aimed to optimise TDABC for use in a resource-limited setting to provide accurate procedure and service costs, reliably predict financing needs, inform quality improvement initiatives, and maximise efficiency. A multidisciplinary team used TDABC to map clinical processes for obstetric care (vaginal and caesarean deliveries, from triage to post-partum discharge) and breast cancer care (diagnosis, chemotherapy, surgery, and support services, such as pharmacy, radiology, laboratory, and counselling) at Hôpital Universitaire de Mirebalais (HUM) in Haiti. The team estimated the direct costs of personnel, equipment, and facilities used in patient care based on the amount of time each of these resources was used. We calculated inpatient personnel costs by allocating provider costs per staffed bed, and assigned indirect costs (administration, facility maintenance and operations, education, procurement and warehouse, bloodbank, and morgue) to various subgroups of the patient population. This study was approved by the Partners in Health/Zanmi Lasante Research Committee. The direct cost of an uncomplicated vaginal

  12. Dual rapid lateral flow immunoassay fingerstick wholeblood testing for syphilis and HIV infections is acceptable and accurate, Port-au-Prince, Haiti.

    Science.gov (United States)

    Bristow, Claire C; Severe, Linda; Pape, Jean William; Javanbakht, Marjan; Lee, Sung-Jae; Comulada, Warren Scott; Klausner, Jeffrey D

    2016-06-18

    Dual rapid tests for HIV and syphilis infections allow for detection of HIV infection and syphilis at the point-of-care. Those tests have been evaluated in laboratory settings and show excellent performance but have not been evaluated in the field. We evaluated the field performance of the SD BIOLINE HIV/Syphilis Duo test in Port-au-Prince, Haiti using whole blood fingerprick specimens. GHESKIO (Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections) clinic attendees 18 years of age or older were invited to participate. Venipuncture blood specimens were used for reference testing with standard commercially available tests for HIV and syphilis in Haiti. The sensitivity and specificity of the Duo test compared to the reference standard were calculated. The exact binomial method was used to determine 95 % confidence intervals (CI). Of 298 study participants, 237 (79.5 %) were female, of which 49 (20.7 %) were pregnant. For the HIV test component, the sensitivity and specificity were 99.2 % (95 % CI: 95.8 %, 100 %) and 97.0 % (95 % CI: 93.2 %, 99.0 %), respectively; and for the syphilis component were 96.5 % (95 % CI: 91.2 %, 99.0 %) and 90.8 % (95 % CI: 85.7 %, 94.6 %), respectively. In pregnant women, the sensitivity and specificity of the HIV test component were 93.3 % (95 % CI: 68.0 %, 99.8 %) and 94.1 % (95 % CI: 80.3 %, 99.3 %), respectively; and for the syphilis component were 100 % (95 % CI:81.5 %, 100 %) and 96.8 % (95 % CI:83.3 %, 99.9 %), respectively. The Standard Diagnostics BIOLINE HIV/Syphilis Duo dual test performed well in a field setting in Haiti and should be considered for wider use.

  13. A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

    Science.gov (United States)

    Logie, Carmen H; Daniel, CarolAnn; Newman, Peter A; Weaver, James; Loutfy, Mona R

    2014-01-01

    Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti. This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829). Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88%) completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26), STI knowledge (β = 0.84; 95% CI 0.70-0.99), condom use (AOR = 4.05, 95% CI 1.86-8.83), and depression (β = -0.63, 95% CI -0.88--0.39) scores showed statistically significant change post-intervention (pHaiti. Pilot studies are an important approach to understand feasibility and scientific impacts of HIV prevention strategies in disaster contexts. Study results may inform HIV prevention interventions among internally displaced women in

  14. Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014-15: a retrospective follow-up survey.

    Science.gov (United States)

    Etheart, Melissa Dominique; Kligerman, Maxwell; Augustin, Pierre Dilius; Blanton, Jesse D; Monroe, Benjamin; Fleurinord, Ludder; Millien, Max; Crowdis, Kelly; Fenelon, Natael; Wallace, Ryan MacLaren

    2017-10-01

    Haiti has an integrated bite case management (IBCM) programme to counsel animal-bite victims on the risk of rabies and appropriate treatment, as well as the Haiti Animal Rabies Surveillance Program (HARSP) to examine the animals. We assessed the usefulness of the IBCM programme to promote best practices for rabies prophylaxis after exposure in a low-income rabies-endemic setting. We did a retrospective follow-up survey of randomly selected bite victims who were counselled by Haiti's IBCM programme between May 15, 2014, and Sept 15, 2015. We classified participants by HARSP decisions of confirmed, probable, suspected, or non-rabies exposures. We compared health-care outcomes in people who sought medical care before IBCM counselling with those in people who sought care after counselling. We used decision trees to estimate the probability of actions taken in the health-care system, and thereby human deaths. During the study period, 1478 dog bites were reported to HARSP for assessment. 37 (3%) were confirmed exposures, 76 (5%) probable exposures, 189 (13%) suspected exposures, and 1176 (80%) non-rabies exposures. 115 of these cases were followed up in the survey. IBCM counselling was associated with a 1·2 times increase in frequency of bite victims seeking medical care and of 2·4 times increase in vaccination uptake. We estimated that there would be four human rabies deaths among the 1478 people assessed by IBCM during the survey period, and 11 in the absence of this programme, which would equate to a 65% decrease in rabies deaths. Among three people dead at the time of the follow-up survey, one was deemed to be due to rabies after a probable rabies exposure. Adherence to medical providers' recommendations might be improved through counselling provided by IBCM programmes. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  15. T cell subtypes and reciprocal inflammatory mediator expression differentiate P. falciparum memory recall responses in asymptomatic and symptomatic malaria patients in southeastern Haiti.

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    Jason S Lehmann

    Full Text Available Asymptomatic Plasmodium falciparum infection is responsible for maintaining malarial disease within human populations in low transmission countries such as Haiti. Investigating differential host immune responses to the parasite as a potential underlying mechanism could help provide insight into this highly complex phenomenon and possibly identify asymptomatic individuals. We performed a cross-sectional analysis of individuals who were diagnosed with malaria in Sud-Est, Haiti by comparing the cellular and humoral responses of both symptomatic and asymptomatic subjects. Plasma samples were analyzed with a P. falciparum protein microarray, which demonstrated serologic reactivity to 3,877 P. falciparum proteins of known serologic reactivity; however, no antigen-antibody reactions delineating asymptomatics from symptomatics were identified. In contrast, differences in cellular responses were observed. Flow cytometric analysis of patient peripheral blood mononuclear cells co-cultured with P. falciparum infected erythrocytes demonstrated a statistically significant increase in the proportion of T regulatory cells (CD4+ CD25+ CD127-, and increases in unique populations of both NKT-like cells (CD3+ CD8+ CD56+ and CD8mid T cells in asymptomatics compared to symptomatics. Also, CD38+/HLA-DR+ expression on γδ T cells, CD8mid (CD56- T cells, and CD8mid CD56+ NKT-like cells decreased upon exposure to infected erythrocytes in both groups. Cytometric bead analysis of the co-culture supernatants demonstrated an upregulation of monocyte-activating chemokines/cytokines in asymptomatics, while immunomodulatory soluble factors were elevated in symptomatics. Principal component analysis of these expression values revealed a distinct clustering of individual responses within their respective phenotypic groups. This is the first comprehensive investigation of immune responses to P. falciparum in Haiti, and describes unique cell-mediated immune repertoires that

  16. Earthquake source imaging by high-resolution array analysis at regional distances: the 2010 M7 Haiti earthquake as seen by the Venezuela National Seismic Network

    Science.gov (United States)

    Meng, L.; Ampuero, J. P.; Rendon, H.

    2010-12-01

    Back projection of teleseismic waves based on array processing has become a popular technique for earthquake source imaging,in particular to track the areas of the source that generate the strongest high frequency radiation. The technique has been previously applied to study the rupture process of the Sumatra earthquake and the supershear rupture of the Kunlun earthquakes. Here we attempt to image the Haiti earthquake using the data recorded by Venezuela National Seismic Network (VNSN). The network is composed of 22 broad-band stations with an East-West oriented geometry, and is located approximately 10 degrees away from Haiti in the perpendicular direction to the Enriquillo fault strike. This is the first opportunity to exploit the privileged position of the VNSN to study large earthquake ruptures in the Caribbean region. This is also a great opportunity to explore the back projection scheme of the crustal Pn phase at regional distances,which provides unique complementary insights to the teleseismic source inversions. The challenge in the analysis of the 2010 M7.0 Haiti earthquake is its very compact source region, possibly shorter than 30km, which is below the resolution limit of standard back projection techniques based on beamforming. Results of back projection analysis using the teleseismic USarray data reveal little details of the rupture process. To overcome the classical resolution limit we explored the Multiple Signal Classification method (MUSIC), a high-resolution array processing technique based on the signal-noise orthognality in the eigen space of the data covariance, which achieves both enhanced resolution and better ability to resolve closely spaced sources. We experiment with various synthetic earthquake scenarios to test the resolution. We find that MUSIC provides at least 3 times higher resolution than beamforming. We also study the inherent bias due to the interferences of coherent Green’s functions, which leads to a potential quantification

  17. Seroprevalence of Herpes Simplex Virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti.

    Science.gov (United States)

    Domercant, Jean Wysler; Jean Louis, Frantz; Hulland, Erin; Griswold, Mark; Andre-Alboth, Jocelyne; Ye, Tun; Marston, Barbara J

    2017-08-18

    Herpes simplex virus type 2 (HSV-2), one the most common causes of genital ulcers, appears to increase both the risk of HIV acquisition and HIV transmission. HSV-2/HIV co-infection among pregnant women may increase the risk of perinatal transmission of HIV. This study describes rates of HSV-2 among pregnant women in Haiti and HSV-2 test performance in this population. Unlinked residual serum specimens from the 2012 National HIV and Syphilis Sentinel Surveillance Survey among pregnant women in Haiti were tested using two commercial kits (Focus HerpeSelect, Kalon) for HSV-2 antibodies. We evaluated rates of HSV-2 seropositivity and HSV-2/HIV co-infection, associations between HSV-2 and demographic characteristics using multivariable Cox proportional hazards modeling, and HSV-2 test performance in this population. Serum samples from 1000 pregnant women (all 164 HIV positive and 836 random HIV negative) were selected. The overall weighted prevalence of HSV-2 was 31.4% (95% CI: 27.7-35.4) and the prevalence of HIV-positivity among HSV-2 positive pregnant women was five times higher than the prevalence among HSV-2 negative women (4.8% [95% CI: 3.9-6.0] vs. 0.9% [95% CI: 0.6-1.3], respectively). Factors significantly associated with HSV-2 positivity were HIV-positivity (PR: 2.27 [95% CI: 1.94-2.65]) and older age (PRs: 1.41 [95% CI: 1.05-1.91] for 20-24 years, 1.71 [95% CI:1.13-2.60] for 30-34 years, and 1.55 [95% CI: 1.10-2.19] for 35 years or greater]), while rural residence was negatively associated with HSV-2 positivity (PR 0.83 [95% CI: 0.69-1.00]), after controlling for other covariables. For this study a conservative Focus index cutoff of 3.5 was used, but among samples with a Focus index value ≥2.5, 98.4% had positive Kalon tests. The prevalence of HSV-2 is relatively high among pregnant women in Haiti. Public health interventions to increase access to HSV-2 screening in antenatal services are warranted.

  18. A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

    Directory of Open Access Journals (Sweden)

    Carmen H Logie

    Full Text Available Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo (Women Taking Action For Their Health study examined the effectiveness of a peer health worker (PHW delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti.This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829.Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88% completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26, STI knowledge (β = 0.84; 95% CI 0.70-0.99, condom use (AOR = 4.05, 95% CI 1.86-8.83, and depression (β = -0.63, 95% CI -0.88--0.39 scores showed statistically significant change post-intervention (p<0.05.This pilot study evaluated a PHW psycho-educational HIV/STI prevention intervention among internally displaced women in post-earthquake Haiti. Pilot studies are an important approach to understand feasibility and scientific

  19. As mobilizações comunitárias locais como alavanca no reflorestamento do/no Haiti: uma proposta de Educação Ambiental

    OpenAIRE

    Prospere, Renel

    2016-01-01

    A presente tese apresenta uma análise aprofundada acerca dos problemas ambientais do/no Haiti. Desde a perspectiva da educação ambiental emancipatória, a problemática questiona as causas do possível colapso ecológico haitiano; as hipóteses propõem a averiguar si o povo haitiano tem confiança suficiente em si mesmo, em sua capacidade, em sua vontade coletiva para rever os fundamentos da nação haitiana como a primeira república negra do mundo? E se eles estão dispostos a fazer os mesmos sacrifí...

  20. Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti.

    Science.gov (United States)

    Donegan, Shannon; Maluccio, John A; Myers, Caitlin K; Menon, Purnima; Ruel, Marie T; Habicht, Jean-Pierre

    2010-06-01

    Rigorous evaluations of food-assisted maternal and child health and nutrition programs are stymied by the ethics of randomizing recipients to a control treatment. Using nonexperimental matching methods, we evaluated the effect of 2 such programs on child linear growth in Haiti. The 2 well-implemented programs offered the same services (food assistance, behavior change communication, and preventive health services) to pregnant and lactating women and young children. They differed in that one (the preventive program) used blanket targeting of all children 6-23 mo, whereas the other (the recuperative program) targeted underweight (weight-for-age Z score effects on height-for-age Z scores (HAZ) and stunting (HAZ growth in a time of deteriorating economic circumstances.

  1. Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

    Science.gov (United States)

    McLean, Kristen E; Kaiser, Bonnie N; Hagaman, Ashley K; Wagenaar, Bradley H; Therosme, Tatiana P; Kohrt, Brandon A

    2015-01-01

    Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees. PMID:26190953

  2. Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results

    Science.gov (United States)

    Beck-Sagué, Consuelo M.; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W.; Dorceus, Patricia; Preston, Sharice M.; Dean, Andrew G.; Nicholas, Stephen W.; Blasini, Ileana

    2015-01-01

    Objectives To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. Design A quasi-experimental trial was conducted comparing caregiver–youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Methods Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0–17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. Results To date, 65 Dominican Republic and 27 Haiti caregiver–youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Conclusion Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM. PMID:26049543

  3. Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months.

    Science.gov (United States)

    Cénat, Jude Mary; Derivois, Daniel

    2014-04-01

    On January 12, 2010, a powerful 7.0 magnitude earthquake struck the Republic of Haiti and destroyed Port-au-Prince, the capital and others cities across the country. While some studies have examined the long-term traumatic effects of the seismic event on children and adolescents victims, so far no study has examined the consequences on adults generally. As such, this study aims to investigate the traumatic consequences of the earthquake among adults related to degree of exposure, peritraumatic distress, depressive symptoms and sociodemographic factors two and a half years after. In addition, predictive factors of PTSD and depressive symptoms were also identified. From June to July 2012, a total of 1355 adults (660 women) was assessed by means the traumatic exposure questionnaire, the Life Events Checklist subscale, the Peritraumatic Distress Inventory (PDI), the Impact of Event Scale - Revised (IES-R) and the Beck Depression Inventory (BDI), in addition to social demographic characteristics. The prevalence rates of PTSD and depressive symptoms were 36.75% (498 cases) and 25.98% (352 cases) respectively. The risk factors for PTSD and depressive symptoms were young and old age, female gender, unemployed status and low level of education. The bests predictives variables were peritraumatic distress for PTSD (β=.57, pHaiti should design programmes in order to aid the psychological wellbeing of the population focussing on youth, older and retired adults, females, people with low levels of education and those who do not work. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Health equity issues at the local level: socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti.

    Science.gov (United States)

    Perry, Henry B; King-Schultz, Leslie W; Aftab, Asma S; Bryant, John H

    2007-08-01

    Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not even greater, levels of health inequities exist. These inequities

  5. Provider-initiated HIV testing in rural Haiti: low rate of missed opportunities for diagnosis of HIV in a primary care clinic

    Directory of Open Access Journals (Sweden)

    Freedberg Kenneth A

    2007-11-01

    Full Text Available Abstract As HIV treatment is scaled-up in resource-poor settings, the timely identification of persons with HIV infection remains an important challenge. Most people with HIV are unaware of their status, and those who are often present late in the course of their illness. Free-standing voluntary counseling and testing sites often have poor uptake of testing. We aimed to evaluate a 'provider-initiated' HIV testing strategy in a primary care clinic in rural resource-poor Haiti by reviewing the number of visits made to clinic before an HIV test was performed in those who were ultimately found to have HIV infection. In collaboration with the Haitian Ministry of Health, a non-governmental organization (Partners In Health scaled up HIV care in central Haiti by reinforcing primary care clinics, instituting provider-initiated HIV testing and by providing HIV treatment in the context of primary medical care, free of charge to patients. Among a cohort of people with HIV infection, we assessed retrospectively for delays in or 'missed opportunities' for diagnosis of HIV by the providers in one clinic. Of the first 117 patients diagnosed with HIV in one clinic, 100 (85% were diagnosed at the first medical encounter. Median delay in diagnosis for the remaining 17 was only 62 days (IQR 19 – 122; range 1 – 272. There was no statistical difference in CD4 cell count between those with and without a delay. 3787 HIV tests were performed in the period reviewed. Provider-initiated testing was associated with high volume uptake of HIV testing and minimal delay between first medical encounter and diagnosis of HIV infection. In scale up of HIV care, provider-initiated HIV testing at primary care clinics can be a successful strategy to identify patients with HIV infection.

  6. Addressing the immediate need for emergency providers in resource-limited settings: the model of a six-month emergency medicine curriculum in Haiti.

    Science.gov (United States)

    Rouhani, Shada A; Israel, Kerling; Leandre, Fernet; Pierre, Sosthène; Bollman, Brennan; Marsh, Regan H

    2018-04-06

    In many resource-limited settings, emergency medicine (EM) is underdeveloped and formal EM training limited. Residencies and fellowships are an ideal long-term solution but cannot meet immediate needs for emergency providers, while short-term programs are often too limited in content. We describe a third method successfully implemented in Haiti: a medium-duration certificate program to meet the immediate need for emergency specialists. In conjunction with the Haitian Ministry of Health and National Medical School, we developed and implemented a novel, 6-month EM certificate program to build human resources for health and emergency care capacity. The program consisted of didactic and supervised clinical components, covering core content in EM. Didactics included lectures, simulations, hands-on skill-sessions, and journal clubs. Supervised clinical time reinforced concepts and taught an EM approach to patient care. Fourteen physicians from around Haiti successfully completed the program; all improved from their pre-test to post-test. At the end of the program and 9-month post-program evaluations, participants rated the program highly, and most felt they used their new knowledge daily. Participants found clinical supervision and simulation particularly useful. Key components to our program's success included collaboration with the Ministry of Health and National Medical School, supervised clinical time, and the continual presence of a course director. The program could be improved by a more flexible curriculum and by grouping participants by baseline knowledge levels. Medium-duration certificate programs offer a viable option for addressing immediate human resource gaps in emergency care, and our program offers a model for implementation in resource-limited settings. Similar options should be considered for other emerging specialties in resource-limited settings.

  7. Medical student surgery elective in rural Haiti: a novel approach to satisfying clerkship requirements while providing surgical care to an underserved population.

    Science.gov (United States)

    Chin-Quee, Anthony; White, Laura; Leeds, Ira; MacLeod, Jana; Master, Viraj A

    2011-04-01

    The addition of global health programs to medical school training results in graduates with enhanced clinical skills and increased sensitivity to cost issues. Funding from U.S. medical schools has been unable to meet student demand, and therefore it is often a critical limiting factor to the lack of development of these programs. We describe an alternative approach for global health surgical training for medical students. Emory University medical students and faculty, in collaboration with Project Medishare for Haiti, planned, raised funds, and executed a successful short-term surgical camp to supplement available surgical services in rural Haiti. Learning objectives that satisfied Emory University School of Medicine surgery clerkship requirements were crafted, and third-year students received medical school credit for the trip. In the absence of house staff and placed in an under-resourced, foreign clinical environment, the surgical elective described here succeeded in meeting learning objectives for a typical third-year surgical clerkship. Objectives were met through a determined effort to ensure that home institution requirements were aligned properly with learning activities while students were abroad and through a close collaboration between medical students, faculty members, and the administration. Emory University's international surgery elective for medical students demonstrates that opportunities for supervised, independent student-learning and global health service can be integrated into a traditional surgical clerkship. These opportunities can be organized to meet the requirements and expectations for third-year surgery clerkships at other medical colleges. This work also identifies how such trips can be planned and executed in a manner that does not burden strained academic budgets with further demands on resources.

  8. Subbottom seismic profiling survey of Lake Azuei, Haiti: Seismic signature of paleo-shorelines in a transpressional environment and possible tectonic implications

    Science.gov (United States)

    Sloan, H.; Cormier, M. H.; Boisson, D.; Brown, B.; Guerrier, K.; Hearn, C. K.; Heil, C. W., Jr.; Hines, L.; Kelly, R. P.; King, J. W.; Knotts, P.; Lucier, O. F.; Momplaisir, R.; Stempel, R.; Symithe, S. J.; Ulysse, S. M. J.; Wattrus, N. J.

    2017-12-01

    The left-lateral Enriquillo-Plantain Garden Fault (EPGF) is one of two major transform faults that form the North American-Caribbean plate boundary. GPS measurements indicate that relative motion evolves from nearly pure strike-slip in western Haiti to highly transpressional near Lake Azuei in eastern Haiti, where the EPGF may terminate against a south-dipping oblique reverse fault. Lake Azuei, one of the largest lakes in the Caribbean region (10 km x 23 km), is surrounded by two high-elevation sierras (> 2,000 m). Because the lake has no outlet to the sea, its level is sensitive to variations in precipitation and is thought to have fluctuated by 10's of meters during the Holocene. A rise of 5 m over the past 10 years has had a devastating impact, submerging villages, farmland, and roads. A grid of high-resolution ( 10 cm) subbottom seismic (CHIRP) profiles acquired in January 2017 captures the subtle signature of the 5 m-deep shoreline and also images a prominent paleo-shoreline at 10 m water depth. This 10 m paleo-shoreline is well expressed in the CHIRP data suggesting it was occupied for a long period of time. It is buried beneath a thin (water depths of 14 m and 17 m, each bottomed 80-90 cm below the lakebed into a distinctively coarser bed. On-going radiometric dating is expected to constrain the age of this distinctive layer. Should this layer be tied to the perduring 10-m lowstand of the lake, determining its age could help quantify vertical deformation rates around Lake Azuei.

  9. Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

    Science.gov (United States)

    deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

    2018-03-01

    Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

  10. ASSESSMENT OF THE TSUNAMIGENIC POTENTIAL ALONG THE NORTHERN CARIBBEAN MARGIN Case Study: Earthquake and Tsunamis of 12 January 2010 in Haiti.

    Directory of Open Access Journals (Sweden)

    George Pararas-Carayannis

    2010-01-01

    Full Text Available The potential tsunami risk for Hispaniola, as well as for the other Greater Antilles Islands is assessed by reviewing the complex geotectonic processes and regimes along the Northern Caribbean margin, including the convergent, compressional and collisional tectonic activity of subduction, transition, shearing, lateral movements, accretion and crustal deformation caused by the eastward movement of the Caribbean plate in relation to the North American plate. These complex tectonic interactions have created a broad, diffuse tectonic boundary that has resulted in an extensive, internal deformational sliver slab - the Gonâve microplate – as well as further segmentation into two other microplates with similarly diffused boundary characteristics where tsunamigenic earthquakes have and will again occur. The Gonâve microplate is the most prominent along the Northern Caribbean margin and extends from the Cayman Spreading Center to Mona Pass, between Puerto Rico and the island of Hispaniola, where the 1918 destructive tsunami was generated. The northern boundary of this sliver microplate is defined by the Oriente strike-slip fault south of Cuba, which appears to be an extension of the fault system traversing the northern part of Hispaniola, while the southern boundary is defined by another major strike-slip fault zone where the Haiti earthquake of 12 January 2010 occurred. Potentially tsunamigenic regions along the Northern Caribbean margin are located not only along the boundaries of the Gonâve microplate’s dominant western transform zone but particularly within the eastern tectonic regimes of the margin where subduction is dominant - particularly along the Puerto Rico trench. The Haiti earthquake of 12 January 2010 and its focal mechanism are examined, as they provide additional clues of potential tsunami generation that can occur along transform zones and, more specifically, from interplate and intraplate seismic events and subsequently induced

  11. Retrospective Cohort Study to Assess the Risk of Rabies in Biting Dogs, 2013–2015, Republic of Haiti

    Directory of Open Access Journals (Sweden)

    Alexandra M. Medley

    2017-06-01

    .5 95% CI 2.0–10.1, respectively. Rabid dogs were four times more likely to have bitten multiple people (RR = 4.0 95% CI 1.9–8.3. Most rabid dogs died or were killed before quarantine (75% and all died by day 3 of quarantine, compared to <1% of quarantined case-negatives. The greatest risk of death was predicted to be for persons bitten on the head or neck from symptomatic dogs. Bites from dogs deemed healthy by veterinary assessors and which were available for quarantine presented less than a 0.05% risk of rabies death to the victim. Conclusions: Vaccination of all persons exposed to a suspected rabid dog is a highly effective approach to minimize human rabies deaths. However, this may place undue financial burden on bite victims that have had a low-risk exposure and over-prescription may contribute to regional supply shortages. The results here indicate that in a low-resource country such as Haiti, a well-trained veterinary assessor can provide an accurate risk assessment of biting dogs based on a standard case investigation protocol. In canine rabies endemic countries with limited access to PEP, or where PEP costs may cause undue burden on bite victims, structured risk assessments by trained professionals may be a reliable method of triaging PEP for bite victims. Evaluating rabies risk through a matrix of bite location and risk factor in the dog presents a clear delineation of high and low risk encounters and should be used to develop data-derived PEP recommendations.

  12. A randomized trial of ready-to-use supplementary food versus corn-soy blend plus as food rations for HIV-infected adults on antiretroviral therapy in rural Haiti.

    Science.gov (United States)

    Ivers, Louise C; Teng, Jessica E; Jerome, J Gregory; Bonds, Matthew; Freedberg, Kenneth A; Franke, Molly F

    2014-04-01

    The epidemics of food insecurity, malnutrition, and human immunodeficiency virus (HIV) frequently overlap. HIV treatment programs increasingly provide nutrient-dense ready-to-use supplementary foods (RUSFs) to patients living with HIV and food insecurity, but in the absence of wasting, it is not known if RUSF confers benefit above less costly food commodities. We performed a randomized trial in rural Haiti comparing an RUSF with less costly corn-soy blend plus (CSB+) as a monthly supplement to patients with HIV infection who were on antiretroviral therapy (ART) perception score, or adherence to ART by ration type at 6 or 12 months. The RUSF group had higher CD4 count at 12 months, but this was also not statistically significant. In 12 months of follow-up, there was no statistically significant difference in outcomes between those receiving RUSF-based compared with CSB+-based rations in a cohort of HIV-infected adults on ART in rural Haiti.

  13. Earthquake in Haiti

    DEFF Research Database (Denmark)

    Holm, Isak Winkel

    2012-01-01

    in fictional as well as in factual disasters. Thus, the recent "cultural turn" in modern disaster research must be supplemented with a cultural-historical turn in the ambition to explore how modern disaster fiction reveal and rework the historical repertoire of symbolic forms through which we perceive disaster....

  14. Drug Trafficking in Haiti

    Science.gov (United States)

    2002-06-01

    been very successful. The U.S. is financing CNU equipment and training. 85 Ibid. 42 The U.S...Regional Network ( UNICORN ) at HNP and CNU headquarters, held the Chemical Identification Seminar for a multi-agency class, and set up a border patrol...Caribbean for several reasons: First, from an operational perspective, the use of the UNICORN system by law enforcement organizations from

  15. Intervención internacional. Haití: receta rápida, fracaso anticipado | International intervention. Haiti: repeated recipe, failure ahead

    Directory of Open Access Journals (Sweden)

    Gastón AÍN

    2009-02-01

    Full Text Available En el momento de autorizar la intervención militar y la posterior creación de la misión de mantenimiento de la paz, de enero a junio del 2004, el Consejo de Seguridad de la ONU carecía de un diagnóstico preciso sobre el carácter del Estado haitiano y su historia, el tipo de conflicto y la naturaleza de la violencia en el país, lo que explica, a casi cuatro años de esa intervención, la recurrente inestabilidad y la persistencia de la violencia en la nación caribeña. El tipo de intervención y las estrategias de pacificación utilizadas por la comunidad internacional fueron inapropiadas y se mostraron ineficaces para atender casos como el haitiano. La misión de imposición de la paz desplegada en el país utilizó la disuasión militar para contener las manifestaciones externas de la violencia “congelando” así el conflicto y garantizando la realización de elecciones masivas y transparentes el 6 de Febrero de 2006. Sin embargo, las causas presentes e históricas que generan y reproducen esta violencia siguen intactas. La democracia no puede prosperar en ausencia de un estado que garantice un orden político con un mínimo de institucionalidad, particularmente, cuando el desorden se ha convertido en el instrumento político por excelencia de algunos actores, para mantener el statu quo. Los beneficios del proceso de normalización democrática, en un contexto de ausencia estatal, no son sostenibles en el tiempo.When the UN Security Council authorized the military intervention in Haiti and passed a resolution creating a peacekeeping force in the country, it lacked a precise diagnosis on the character of the Haitian state, its history, the essential qualities of the ongoing conflict, as well as the nature of the violence the country was experiencing. This explains why, after almost five years of UN presence in Haiti, recurrent instability and persistent violence are still common features in the Caribbean nation. The kind of

  16. Sedimentary Signatures of Submarine Earthquakes: Deciphering the Extent of Sediment Remobilization from the 2011 Tohoku Earthquake and Tsunami and 2010 Haiti Earthquake

    Science.gov (United States)

    McHugh, C. M.; Seeber, L.; Moernaut, J.; Strasser, M.; Kanamatsu, T.; Ikehara, K.; Bopp, R.; Mustaque, S.; Usami, K.; Schwestermann, T.; Kioka, A.; Moore, L. M.

    2017-12-01

    The 2004 Sumatra-Andaman Mw9.3 and the 2011 Tohoku (Japan) Mw9.0 earthquakes and tsunamis were huge geological events with major societal consequences. Both were along subduction boundaries and ruptured portions of these boundaries that had been deemed incapable of such events. Submarine strike-slip earthquakes, such as the 2010 Mw7.0 in Haiti, are smaller but may be closer to population centers and can be similarly catastrophic. Both classes of earthquakes remobilize sediment and leave distinct signatures in the geologic record by a wide range of processes that depends on both environment and earthquake characteristics. Understanding them has the potential of greatly expanding the record of past earthquakes, which is critical for geohazard analysis. Recent events offer precious ground truth about the earthquakes and short-lived radioisotopes offer invaluable tools to identify sediments they remobilized. In the 2011 Mw9 Japan earthquake they document the spatial extent of remobilized sediment from water depths of 626m in the forearc slope to trench depths of 8000m. Subbottom profiles, multibeam bathymetry and 40 piston cores collected by the R/V Natsushima and R/V Sonne expeditions to the Japan Trench document multiple turbidites and high-density flows. Core tops enriched in xs210Pb,137Cs and 134Cs reveal sediment deposited by the 2011 Tohoku earthquake and tsunami. The thickest deposits (2m) were documented on a mid-slope terrace and trench (4000-8000m). Sediment was deposited on some terraces (600-3000m), but shed from the steep forearc slope (3000-4000m). The 2010 Haiti mainshock ruptured along the southern flank of Canal du Sud and triggered multiple nearshore sediment failures, generated turbidity currents and stirred fine sediment into suspension throughout this basin. A tsunami was modeled to stem from both sediment failures and tectonics. Remobilized sediment was tracked with short-lived radioisotopes from the nearshore, slope, in fault basins including the

  17. Health equity issues at the local level: Socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti

    Directory of Open Access Journals (Sweden)

    Aftab Asma S

    2007-08-01

    Full Text Available Abstract Background Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. Methods We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. Results We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. Conclusion These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not

  18. Using Mobile Health (mHealth) and geospatial mapping technology in a mass campaign for reactive oral cholera vaccination in rural Haiti.

    Science.gov (United States)

    Teng, Jessica E; Thomson, Dana R; Lascher, Jonathan S; Raymond, Max; Ivers, Louise C

    2014-01-01

    In mass vaccination campaigns, large volumes of data must be managed efficiently and accurately. In a reactive oral cholera vaccination (OCV) campaign in rural Haiti during an ongoing epidemic, we used a mobile health (mHealth) system to manage data on 50,000 participants in two isolated communities. Data were collected using 7-inch tablets. Teams pre-registered and distributed vaccine cards with unique barcodes to vaccine-eligible residents during a census in February 2012. First stored on devices, data were uploaded nightly via Wi-fi to a web-hosted database. During the vaccination campaign between April and June 2012, residents presented their cards at vaccination posts and their barcodes were scanned. Vaccinee data from the census were pre-loaded on tablets to autopopulate the electronic form. Nightly analysis of the day's community coverage informed the following day's vaccination strategy. We generated case-finding reports allowing us to identify those who had not yet been vaccinated. During 40 days of vaccination, we collected approximately 1.9 million pieces of data. A total of 45,417 people received at least one OCV dose; of those, 90.8% were documented to have received 2 doses. Though mHealth required up-front financial investment and training, it reduced the need for paper registries and manual data entry, which would have been costly, time-consuming, and is known to increase error. Using Global Positioning System coordinates, we mapped vaccine posts, population size, and vaccine coverage to understand the reach of the campaign. The hardware and software were usable by high school-educated staff. The use of mHealth technology in an OCV campaign in rural Haiti allowed timely creation of an electronic registry with population-level census data, and a targeted vaccination strategy in a dispersed rural population receiving a two-dose vaccine regimen. The use of mHealth should be strongly considered in mass vaccination campaigns in future initiatives.

  19. Economic determinants of breastfeeding in Haiti: The effects of poverty, food insecurity, and employment on exclusive breastfeeding in an urban population.

    Science.gov (United States)

    Lesorogol, Carolyn; Bond, Caitlin; Dulience, Sherlie Jean Louis; Iannotti, Lora

    2018-04-01

    There is limited and inconsistent empirical evidence regarding the role of economic factors in breastfeeding practices, globally. Studies have found both negative and positive associations between low income and exclusive breastfeeding (EBF). Employment, which should improve household income, may reduce EBF due to separation of mother and infant. In the context of a randomized controlled study of lipid-based complementary feeding in an urban slum in Cap Haitien, Haiti, we examined the economic factors influencing breastfeeding practices using mixed methods. Findings demonstrate relationships between urban context, economic factors, and breastfeeding practices. Poverty, food insecurity, time constraints, and limited social support create challenges for EBF. Maternal employment is associated with lower rates of EBF and less frequent breastfeeding. Extreme food insecurity sometimes leads to increased exclusive breastfeeding among Haitian mothers, what we call "last resort EBF." In this case, women practice EBF because they have no alternative food source for the infant. Suggested policies and programs to address economic constraints and promote EBF in this population include maternal and child allowances, quality child care options, and small-scale household urban food production. © 2017 John Wiley & Sons Ltd.

  20. Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings

    Science.gov (United States)

    Eustache, Eddy; Gerbasi, Margaret E.; Severe, Jennifer; Fils-Aimé, J. Reginald; Smith Fawzi, Mary C.; Raviola, Giuseppe J.; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L.; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J.; Becker, Anne E.

    2017-01-01

    Background Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. Aims To assess feasibility, acceptability, and utility of the teacher accompaniment phase of a school-based teacher accompagnateur pilot study (TAPS) in Haiti. Methods We assigned student participants, ages 18–22 (n=120) to a teacher participant (n=22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability, and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction, and utility by the percentage with identified mental health need who discussed treatment with a teacher. Results Favorable ratings support feasibility, acceptability, and utility of teacher-accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. Conclusions This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings. PMID:28367718

  1. Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009-2015.

    Science.gov (United States)

    Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J; Lowrance, David W; Deyde, Varough

    2017-10-01

    Before the 2010 devastating earthquake and cholera outbreak, Haiti's public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements.

  2. Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: “Group of 6”

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    John A. Naslund

    2014-01-01

    Full Text Available Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti’s Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4–6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.

  3. Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings.

    Science.gov (United States)

    Eustache, Eddy; Gerbasi, Margaret E; Severe, Jennifer; Fils-Aimé, J Reginald; Smith Fawzi, Mary C; Raviola, Giuseppe J; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J; Becker, Anne E

    2017-06-01

    Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. To assess feasibility, acceptability and utility of the teacher accompaniment phase of a school-based Teacher- Accompagnateur Pilot Study (TAPS) in Haiti. We assigned student participants, aged 18-22 years ( n = 120), to teacher participants ( n = 22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction and utility by the percentage with identified mental health need who discussed treatment with a teacher. Favorable ratings support feasibility, acceptability and utility of teacher- accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings.

  4. Nèg Blanc sa a (Aquela negra branca – desafiando as categorias de cor, nacionalidade e pertença a partir de um olhar afro-brasileiro sobre o Haiti

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    Renata de Melo Rosa

    2016-11-01

    Full Text Available Resumo  Este artigo tem como objetivo analisar a centralidade da categoria de pessoa no Haiti contemporâneo, a qual se funda a partir dos sentidos contextuais atribuídos à noção de nèg, (que em tradução livre para o português pode ser entendida como “negro/a” que antecede e funda, ao mesmo tempo, a categoria de pessoa. No entanto, mesmo que a categoria de pessoa no Haiti se ancore em uma nomenclatura “racial”, nèg não é uma categoria necessariamente atrelada à cor da pele, mas à qualidade da pertença de cada sujeito à nação haitiana. Identificar-se e ser identificado como um “nèg” atualiza, no processo identitário e no diálogo inter-subjetivo, diacríticos importantes, cujos sentidos são dados coletiva e contextualmente na rede de significados tecidas no contexto haitiano. Assim, pela natureza contextual e por sua constante dinâmica, é possível que uma “pessoa” que, aos olhos ocidentais, possa se assemelhar com o que nós entendemos como um/a “negro/a” no Brasil, no Haiti esta mesma “pessoa” pode não estar imediatamente identificada como um nèg ou como uma pessoa que  “pertença” ao Haiti. Em outras palavras, é preciso que cada nèg (para continuar sendo nèg e, portanto, “pessoa” atualize, de acordo com os contornos da cultura haitiana que inscrevem um nèg, as diversas obrigações rituais de pertença a esta categoria. Vista desta perspectiva, a categoria nèg pode ser ritualizada por um (a haitiano (a branco (a, desde que os rituais de pertença à nação também sejam atualizados, tornando o sujeito em um (a Nég Blanc (negro branco, expressão que dá título a este artigo. Por último, esta reflexão propõe que a categoria nèg como sinônimo da categoria de pessoa é uma contra narrativa às tentativas de inferiorização racial vigentes no período colonial francês. Palavras chave: nèg; noção de pessoa; Haiti; nação, categorias de cor. Nèg Blanc sa a (Aquella negra

  5. The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

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    Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

    2018-01-01

    Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Prevalence of post-traumatic stress disorder and depression in two groups of children one year after the January 2010 earthquake in Haiti.

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    Blanc, Judite; Bui, Eric; Mouchenik, Yoram; Derivois, Daniel; Birmes, Philippe

    2015-02-01

    More than 500 studies were conducted in Haiti following the January 12 of 2010 earthquake, yet few of them assessed mental health of the population. To our knowledge, none targeted the effectiveness of various methods used to treat survivors, whether adults or children Our study aimed to assess one year after the disaster, the effect of a specific psycho-social support offered to relocated children in Port-au-Prince compared with a control group. The two groups were homogeneous in the intensity of the peritraumatic distress they experienced. We were unable to show a significant difference between both in the average scores for PTSD, nor for depression, nor in three out of the four sub-scales of the Child Behavior Check-List. In case children, 68% and 40.9%, respectively, and 50% and 20.5% of the control group, reported severe levels of the symptoms of PTSD and depression. These surprising results can be explained by the absence of equivalence in the two groups from a socio-demographic point of view and because subjects were not randomly selected in the recruitment process. This study has not made it possible to indicate the effectiveness of a specific psycho-social support offered to children in the aftermath of the disaster. On the other hand, the sample illustrates the high prevalence (more than 50% for PTSD) of severe post-traumatic stress in this group of school-age children, one year after the earthquake. These results indicate that serious attention should be paid to the mental health aspects in reconstruction program for the country. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Trends in CD4 Count Testing, Retention in Pre-ART Care, and ART Initiation Rates over the First Decade of Expansion of HIV Services in Haiti.

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    Serena P Koenig

    Full Text Available High attrition during the period from HIV testing to antiretroviral therapy (ART initiation is widely reported. Though treatment guidelines have changed to broaden ART eligibility and services have been widely expanded over the past decade, data on the temporal trends in pre-ART outcomes are limited; such data would be useful to guide future policy decisions.We evaluated temporal trends and predictors of retention for each step from HIV testing to ART initiation over the past decade at the GHESKIO clinic in Port-au-Prince Haiti. The 24,925 patients >17 years of age who received a positive HIV test at GHESKIO from March 1, 2003 to February 28, 2013 were included. Patients were followed until they remained in pre-ART care for one year or initiated ART.24,925 patients (61% female, median age 35 years were included, and 15,008 (60% had blood drawn for CD4 count within 12 months of HIV testing; the trend increased over time from 36% in Year 1 to 78% in Year 10 (p500 cells/mm3, respectively. The trend increased over time for each CD4 strata, and in Year 10, 94%, 95%, 79%, and 74% were retained in pre-ART care or initiated ART for each CD4 strata. Predictors of pre-ART attrition included male gender, low income, and low educational status. Older age and tuberculosis (TB at HIV testing were associated with retention in care.The proportion of patients completing assessments for ART eligibility, remaining in pre-ART care, and initiating ART have increased over the last decade across all CD4 count strata, particularly among patients with CD4 count ≤350 cells/mm3. However, additional retention efforts are needed for patients with higher CD4 counts.

  8. Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

    Science.gov (United States)

    Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

    2014-01-01

    Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

  9. A ubiquitous method for street scale spatial data collection and analysis in challenging urban environments: mapping health risks using spatial video in Haiti.

    Science.gov (United States)

    Curtis, Andrew; Blackburn, Jason K; Widmer, Jocelyn M; Morris, J Glenn

    2013-04-15

    Fine-scale and longitudinal geospatial analysis of health risks in challenging urban areas is often limited by the lack of other spatial layers even if case data are available. Underlying population counts, residential context, and associated causative factors such as standing water or trash locations are often missing unless collected through logistically difficult, and often expensive, surveys. The lack of spatial context also hinders the interpretation of results and designing intervention strategies structured around analytical insights. This paper offers a ubiquitous spatial data collection approach using a spatial video that can be used to improve analysis and involve participatory collaborations. A case study will be used to illustrate this approach with three health risks mapped at the street scale for a coastal community in Haiti. Spatial video was used to collect street and building scale information, including standing water, trash accumulation, presence of dogs, cohort specific population characteristics, and other cultural phenomena. These data were digitized into Google Earth and then coded and analyzed in a GIS using kernel density and spatial filtering approaches. The concentrations of these risks around area schools which are sometimes sources of diarrheal disease infection because of the high concentration of children and variable sanitary practices will show the utility of the method. In addition schools offer potential locations for cholera education interventions. Previously unavailable fine scale health risk data vary in concentration across the town, with some schools being proximate to greater concentrations of the mapped risks. The spatial video is also used to validate coded data and location specific risks within these "hotspots". Spatial video is a tool that can be used in any environment to improve local area health analysis and intervention. The process is rapid and can be repeated in study sites through time to track spatio

  10. Evaluation of antibiotic self-medication among outpatients of the state university hospital of Port-Au-Prince, Haiti: a cross-sectional study.

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    Moise, Kenny; Bernard, Joseph Junior; Henrys, Jean Hugues

    2017-01-01

    In Haiti, where all drugs are available over the counter, self-medication with antibiotics appears as a common practice. Inappropriate use of beta-lactams and macrolides is likely to contribute to the development of antimicrobial resistance. This study aimed to (i) assess the extent of self-medication with antibiotics, (ii) explore the contributing factors (age, gender and educational background) and (iii) identify specific antibiotic drug classes used among patients attending the outpatient clinic of the State University Hospital of Port-au-Prince. A cross-sectional survey among 200 outpatients of the State University Hospital of Port-au-Prince was conducted in December 2014. Face-to-face interviews were conducted using a standardized questionnaire. Parents of pediatric patients were allowed to answer to questions on their behalf. Among the study sample, 45.5% practiced self-medication with antibiotics. It was less prevalent among patients with the highest education level (23.1%; OR: 0.89 (0.5-1.75), p = 0.001). Mild symptoms (28.6%) and vaginal itching (44.4%) were the main reasons for self-medication with antibiotics. Self-medication using amoxicillin was reported by 67.0%. Self-medication with antibiotics is a common practice among Haitian patients and is more common among the less educated. Amoxicillin for urinary tract infections is the most commonly used medication. It is crucial to raise awareness on the dangers of the practice in the population and inforce the current law regarding the use of over the counter antibiotics.

  11. High-resolution backprojection at regional distance: Application to the Haiti M7.0 earthquake and comparisons with finite source studies

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    Meng, L.; Ampuero, J.-P.; Sladen, A.; Rendon, H.

    2012-04-01

    A catastrophic Mw7 earthquake ruptured on 12 January 2010 on a complex fault system near Port-au-Prince, Haiti. Offshore rupture is suggested by aftershock locations and marine geophysics studies, but its extent remains difficult to define using geodetic and teleseismic observations. Here we perform the multitaper multiple signal classification (MUSIC) analysis, a high-resolution array technique, at regional distance with recordings from the Venezuela National Seismic Network to resolve high-frequency (about 0.4 Hz) aspects of the earthquake process. Our results indicate westward rupture with two subevents, roughly 35 km apart. In comparison, a lower-frequency finite source inversion with fault geometry based on new geologic and aftershock data shows two slip patches with centroids 21 km apart. Apparent source time functions from USArray further constrain the intersubevent time delay, implying a rupture speed of 3.3 km/s. The tips of the slip zones coincide with subevents imaged by backprojections. The different subevent locations found by backprojection and source inversion suggest spatial complementarity between high- and low-frequency source radiation consistent with high-frequency radiation originating from rupture arrest phases at the edges of main slip areas. The centroid moment tensor (CMT) solution and a geodetic-only inversion have similar moment, indicating most of the moment released is captured by geodetic observations and no additional rupture is required beyond where it is imaged in our preferred model. Our results demonstrate the contribution of backprojections of regional seismic array data for earthquakes down to M ≈ 7, especially when incomplete coverage of seismic and geodetic data implies large uncertainties in source inversions.

  12. Live with the Disease Like You Used to Before You Knew You Were Infected: A Qualitative Study Among 10-Year Survivors Living with HIV in Haiti.

    Science.gov (United States)

    Pierre, Samuel; Riviera, Vanessa; Jean, Circee Phara; Louis, Marie Jude Jean; Reif, Lindsey K; Severe, Patrice; Rouzier, Vanessa; Johnson, Warren D; Pape, Jean W; Fitzgerald, Daniel W; McNairy, Margaret L; Boutin-Foster, Carla

    2017-03-01

    In 2003, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), a nonprofit organization, began administering antiretroviral therapy (ART) to its patients. This practice transformed HIV from a fatal disease to a more manageable chronic condition. However, relatively few studies focus on the experiences of survivors. This study provided a unique opportunity to interview patients who survived at least 10 years after being treated with ART at GHESKIO. The goal of the study was to elicit from patients their perspectives on what enabled them to survive with AIDS. Grounded Theory, a qualitative research method was used to guide data collection, coding, and analysis. Individual interviews were conducted, audio-taped, transcribed and analyzed in Creole, and translated into English. Data saturation was reached at 25 participants. Of which, 64% were women, the mean age was 49, range of 43-55 years, 24% were married, 44% had not completed elementary school, and 72% had no income, the remaining participants had incomes ranging from $1000 to $5000 annually. Qualitative analysis resulted in 681 codes, which were grouped into six categories: being spiritually grounded, having supportive interactions with providers, caring for children, setting personal goals, persevering and living life as usual, and maintaining strict medication adherence practices. The overarching theory was that having a reason to live despite one's circumstances and living life as usual enabled one to survive. Having a strong spiritual foundation coupled with supportive family and providers motivated participants to live and adhere to their ART. As the number of patients who are living longer with HIV in Haiti increases, results from this study will be important in helping tailor interventions that enhance their overall quality of life.

  13. Characterization of Vibrio cholerae O1 El Tor Biotype Variant Clinical Isolates from Bangladesh and Haiti, Including a Molecular Genetic Analysis of Virulence Genes ▿

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    Son, Mike S.; Megli, Christina J.; Kovacikova, Gabriela; Qadri, Firdausi; Taylor, Ronald K.

    2011-01-01

    Vibrio cholerae serogroup O1, the causative agent of the diarrheal disease cholera, is divided into two biotypes: classical and El Tor. Both biotypes produce the major virulence factors toxin-coregulated pilus (TCP) and cholera toxin (CT). Although possessing genotypic and phenotypic differences, El Tor biotype strains displaying classical biotype traits have been reported and subsequently were dubbed El Tor variants. Of particular interest are reports of El Tor variants that produce various levels of CT, including levels typical of classical biotype strains. Here, we report the characterization of 10 clinical isolates from the International Centre for Diarrhoeal Disease Research, Bangladesh, and a representative strain from the 2010 Haiti cholera outbreak. We observed that all 11 strains produced increased CT (2- to 10-fold) compared to that of wild-type El Tor strains under in vitro inducing conditions, but they possessed various TcpA and ToxT expression profiles. Particularly, El Tor variant MQ1795, which produced the highest level of CT and very high levels of TcpA and ToxT, demonstrated hypervirulence compared to the virulence of El Tor wild-type strains in the infant mouse cholera model. Additional genotypic and phenotypic tests were conducted to characterize the variants, including an assessment of biotype-distinguishing characteristics. Notably, the sequencing of ctxB in some El Tor variants revealed two copies of classical ctxB, one per chromosome, contrary to previous reports that located ctxAB only on the large chromosome of El Tor biotype strains. PMID:21880975

  14. Genome Sequence Analysis of Vibrio cholerae clinical isolates from 2013 in Mexico reveals the presence of the strain responsible for the 2010 Haiti outbreak.

    Science.gov (United States)

    Díaz-Quiñonez, José Alberto

    2017-01-01

    VPI-2, VSP-1 and VSP-2, and of the integrative element SXT. The genomic structure of the 4 isolates was similar to that of V. cholerae strain 2010 EL-1786, identified during the epidemic in Haiti in 2010. This study shows that molecular epidemiology is a very powerful tool to monitor, prevent and control diseases of public health importance in Mexico. Copyright: © 2017 SecretarÍa de Salud.

  15. Transpressional Tectonics across the N. American-Caribbean Plate Boundary: Preliminary Results of a Multichannel Seismic Survey of Lake Azuei, Haiti.

    Science.gov (United States)

    Hearn, C. K.; Cormier, M. H.; Sloan, H.; Wattrus, N. J.; Boisson, D.; Brown, B.; Guerrier, K.; King, J. W.; Knotts, P.; Momplaisir, R.; Sorlien, C. C.; Stempel, R.; Symithe, S. J.; Ulysse, S. M. J.

    2017-12-01

    On January 12, 2010, a Mw 7.0 earthquake struck Haiti, killing over 200,000 people and devastating the Capital city of Port-au-Prince and the surrounding regions. It ruptured a previously unknown blind-thrust fault that abuts the Enriquillo Plantain Garden Fault (EPGF), one of two transform faults that define the North American-Caribbean plate boundary. That earthquake highlighted how transpression across this complex boundary is accommodated by slip partitioning into strike-slip and compressional structures. Because the seismic hazard is higher for a rupture on a reverse or oblique-slip fault than on a vertical strike-slip fault, the need to characterize the geometry of that fault system is clear. Lake Azuei overlies this plate boundary 60 km east of the 2010 epicenter. The lake's 23 km long axis trends NW-SE, parallel to the Haitian fold-and-thrust belt and oblique to the EPGF. This tectonic context makes it an ideal target for investigating the partitioning of plate motion between strike-slip and compressional structures. In January 2017, we acquired 222 km of multichannel seismic (MCS) profiles in the lake, largely concurrent with subbottom seismic (CHIRP) profiles. The MCS data were acquired using a high-frequency BubbleGun source and a 75 m-long, 24-channel streamer, achieving a 24 seismic fold with a penetration of 200 m below lakebed. With the goal of resolving tectonic structures in 3-D, survey lines were laid out in a grid with profiles spaced 1.2 km apart. Additional profiles were acquired at the SE end of the lake where most of the tectonic activity is presumably occurring. The co-located CHIRP and MCS profiles document the continuity of tectonic deformation between the surficial sediments and the deeper strata. Preliminary processing suggests that a SW-dipping blind thrust fault, expressed updip as a large monocline fold, may control the western edge of the lake. Gentle, young folds that protrude from the flat lakebed are also imaged with the CHIRP

  16. Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti

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    EL Mabchour A

    2015-10-01

    Full Text Available Asma EL Mabchour,1 Hélène Delisle,1 Colette Vilgrain,2 Philippe Larco,2 Roger Sodjinou,3 Malek Batal1 1Transition Nutritionnelle (TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada; 2Haitian Foundation for Diabetes and Cardiovascular Diseases (FHADIMAC, Port-au-Prince, Haiti; 3West Africa Health Organization (WAHO, Bobo-Dioulasso, Burkina Faso Purpose: Waist circumference (WC and waist-to-height ratio (WHtR are widely used as indicators of abdominal adiposity and the cut-off values have been validated primarily in Caucasians. In this study we identified the WC and WHtR cut-off points that best predicted cardiometabolic risk (CMR in groups of African (Benin and African ancestry (Haiti Black subjects. Methods: This cross-sectional study included 452 apparently healthy subjects from Cotonou (Benin and Port-au-Prince (Haiti, 217 women and 235 men from 25 to 60 years. CMR biomarkers were the metabolic syndrome components. Additional CMR biomarkers were a high atherogenicity index (total serum cholesterol/high density lipoprotein cholesterol ≥4 in women and ≥5 in men; insulin resistance set at the 75th percentile of the calculated Homeostasis Model Assessment index (HOMA-IR; and inflammation defined as high-sensitivity C-reactive protein (hsCRP concentrations between 3 and 10 mg/L. WC and WHtR were tested as predictors of two out of the three most prevalent CMR biomarkers. Receiver operating characteristic (ROC curves, Youden's index, and likelihood ratios were used to assess the performance of specific WC and WHtR cut-offs. Results: High atherogenicity index (59.5%, high blood pressure (23.2%, and insulin resistance (25% by definition were the most prevalent CMR biomarkers in the study groups. WC and WHtR were equally valid as predictors of CMR. Optimal WC cut-offs were 80 cm and 94 cm in men and women, respectively, which is exactly

  17. [Socio-environmental vulnerability, disaster risk-reduction and resilience-building: lessons from the earthquake in Haiti and torrential rains in the mountain range close to Rio de Janeiro in Brazil].

    Science.gov (United States)

    de Freitas, Carlos Machado; de Carvalho, Mauren Lopes; Ximenes, Elisa Francioli; Arraes, Eduardo Fonseca; Gomes, José Orlando

    2012-06-01

    Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.

  18. Maternal and congenital syphilis in rural Haiti Sífilis materna y congénita en zonas rurales de Haití

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    Chaylah J. Lomotey

    2009-09-01

    Full Text Available OBJECTIVES: A study was conducted to assess the prevalence of maternal syphilis and estimate the rate of congenital syphilis in five rural villages surrounding Jeremie, Haiti. METHODS: This research was a retrospective observational study. Data were extracted from the Haitian Health Foundation's public health database and verified through original clinical paper records, death certificates, midwife reports, and discussions with community health workers. Data were analyzed by chi-square analysis, bivariate correlations, and two-tailed t-test for independent samples. RESULTS: Of the 410 women tested for syphilis, 31 (7.6% were sero-reactive. Average gestation at time of testing was 25 weeks, which correlated with entry into prenatal care at an average of 23 weeks. Women who tested positive during pregnancy were more likely to have had a negative pregnancy outcome than those who did not (chi square = 16.4; P OBJETIVOS: Evaluar la prevalencia de sífilis materna y estimar la tasa de sífilis congénita en cinco poblaciones rurales cercanas a Jeremie, Haití. MÉTODOS: Estudio observacional retrospectivo a partir de datos extraídos de la base de datos de salud pública de la Fundación Haitiana de Salud y verificada con los registros clínicos originales en papel, los certificados de defunción, los informes de las parteras y discusiones con los trabajadores comunitarios de salud. Los datos se analizaron mediante la prueba de la ji al cuadrado, correlaciones bifactoriales y la prueba de la t de dos colas para muestras independientes. RESULTADOS: De las 410 mujeres sometidas a la prueba de sífilis, 31 (7,6% resultaron seropositivas. La edad gestacional promedio al momento de la prueba fue de 25 semanas, lo que se correlacionó con la edad gestacional de entrada a la atención prenatal (23 semanas. Las mujeres que resultaron seropositivas durante el embarazo presentaron mayor probabilidad de tener un desenlace negativo de su embarazo que las mujeres

  19. Site Effect Assessment of the Gros-Morne Hill Area in Port-au-Prince, Haiti, Part A: Geophysical-Seismological Survey Results

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    Sophia Ulysse

    2018-04-01

    Full Text Available After the M = 7.0 Haiti earthquake in 2010, many teams completed seismic risk studies in Port-au-Prince to better understand why this not extraordinarily strong event had induced one of the most severe earthquake disasters in history (at least in the Western World. Most highlighted the low construction quality as the main cause for the disaster, but some also pointed to possible soil and topographic amplification effects, especially in the lower and central parts of Port-au-Prince (e.g., close to the harbor. However, very detailed local studies of such site effects have not been completed yet. A Belgian-Haitian collaboration project was established in order to develop a detailed local seismic hazard study for Gros-Morne hill located in the district of Pétion-Ville, southeast of Port-au-Prince. In order to have a better understanding of the amplification on the Gros-Morne hill, in the southeastern part of Port-au-Prince, site effects were investigated by using near surface geophysical methods. The horizontal to vertical spectral ratio technique was applied to ambient vibrations and earthquake data, and multichannel analysis of surface waves and P-wave refraction tomography calculation were applied to seismic data. Standard spectral ratios were computed for the S-wave windows of the earthquake data recorded by a small temporary seismic network. Electrical resistivity tomography profiles were also performed in order to image the structure of the subsurface and detect the presence of water, if any. The spectral ratio results generally show low to medium (1.5–6 resonance amplitudes at one or several different resonance frequencies (for the same site, between 0.5 and 25 Hz. At most of the investigated sites, the fundamental resonance frequency varies between 7 and 10 Hz. By using the multichannel surface wave analyses of the seismic data, we were able to determine shear wave velocities ranging between 200 and 850 m/s, up to a depth of about 15–20

  20. Haiti Earthquake: Crisis and Response

    Science.gov (United States)

    2010-02-19

    services, such as maternal child health, rehabilitation services, and chronic diseases including diabetes , heart disease, HIV, and tuberculosis...Prince Paraguay 5,000 kilos of food; 400 blankets; 13 volunteers Peru 54 tons of food and medicine Philippines $50,000 medical team Poland...5,000 kilos of food; 400 blankets; 13 volunteers Peru 54 tons of food and medicine Saint Lucia

  1. Prenatal care utilization in rural areas and urban areas of Haiti El uso de servicios de atención prenatal en áreas rurales y urbanas de Haití

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    Pierre Kébreau Alexandre

    2005-08-01

    Full Text Available OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1 examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2 for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16%, compared to 85.83% in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti.OBJETIVOS: El presente estudio se basa en la Encuesta de Demografía y Salud del año 2000 en Haití. Los objetivos del estudio, que se basó en información sobre las

  2. Modificación de conocimientos sobre fiebre tifoidea en jóvenes en la comuna Morón, Haití Changes in knowledge of typhoid fever in young people: Commune of Moron, Haiti

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    Annia Dolores Gorte Quiñones

    2009-12-01

    Full Text Available La fiebre tifoidea es una enfermedad de alta incidencia en Haití. Se realizó un estudio del tipo de intervención educativa en la Comuna de Morón, Departamento de la Grand´Anse, República de Haití durante el período de enero a noviembre del 2006, con el objetivo de modificar y ampliar los conocimientos que poseen las personas de esta comunidad en relación con la fiebre tifoidea. De un universo de 523 jóvenes entre 15 y 35 años de edad se utilizó una muestra de 50 jóvenes mediante muestreo simple aleatorio, lo que representó el 9.56 por ciento del total. Para la obtención del dato primario, se aplicó un cuestionario antes y después del programa educativo, en el que se recogieron aspectos referentes al conocimiento teórico. El procesamiento estadístico utilizó el análisis de variables cualitativas, utilizando como medida de resumen la frecuencia relativa porcentual. Predominó el grupo de 20-25 años, así como el nivel secundario de escolaridad. Al finalizar el estudio la totalidad de los jóvenes reconoció la importancia de la asistencia al área de salud ante la presencia de síntomas de la enfermedad y demostraron conocimientos generales satisfactorios con respecto al tema. Se demuestra la eficacia de la intervención educativa.Typhoid fever is a high-incidence disease in Haiti. An educative intervention study was conducted in the Commune of Moron, de la Grand´Anse Department, Haiti Republic during January to November 2006 with the purpose of modifying and extending the knowledge of Typhoid Fever people of this community possessed. The universe included 523 young people (15-35 years old; 50 young people were taken as a simple random sample; which represented the 9, 56% of the total. To record the primary data, a questionnaire was applied before and after the educative program, where aspects of the theoretical knowledge were collected. The statistical process was carried out analyzing qualitative variables, using as a

  3. Vulnerabilidade socioambiental, redução de riscos de desastres e construção da resiliência: lições do terremoto no Haiti e das chuvas fortes na Região Serrana, Brasil Socio-environmental vulnerability, disaster risk-reduction and resilience-building: lessons from the earthquake in Haiti and torrential rains in the mountain range close to Rio de Janeiro in Brazil

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    Carlos Machado de Freitas

    2012-06-01

    Full Text Available Dados sobre desastres no mundo apontam para uma maior gravidade nos países com menores níveis de desenvolvimento econômico e social. Neste contexto, políticas de redução de riscos de desastres e construção da resiliência constituem prioridades na agenda do desenvolvimento sustentável, estando entre os temas eleitos para a Rio+20. O objetivo deste artigo é, através de uma contribuição de natureza conceitual e dos exemplos de desastres em países com níveis de desenvolvimento diferentes, o terremoto do Haiti e as chuvas fortes na Região Serrana (Rio de Janeiro, Brasil, demonstrar como a vulnerabilidade socioambiental cria condições para os desastres, ao mesmo tempo em que limita as estratégias para prevenção e mitigação. Ao final são apontados alguns dos desafios que a redução de riscos de desastres e a construção da resiliência exigem em contextos de vulnerabilidade socioambiental, o que inclui mudanças nos padrões de desenvolvimento social, econômico e ambiental orientados para a sustentabilidade ecológica e a justiça social como pilares do desenvolvimento sustentável.Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio

  4. High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country.

    Science.gov (United States)

    Eustache, Eddy; Gerbasi, Margaret E; Smith Fawzi, Mary C; Fils-Aimé, J Reginald; Severe, Jennifer; Raviola, Giuseppe J; Legha, Rupinder; Darghouth, Sarah; Grelotti, David J; Thérosmé, Tatiana; Pierre, Ermaze L; Affricot, Emmeline; Alcindor, Yoldie; Becker, Anne E

    2017-05-01

    The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.

  5. IncA/C Conjugative Plasmids Mobilize a New Family of Multidrug Resistance Islands in Clinical Vibrio cholerae Non-O1/Non-O139 Isolates from Haiti.

    Science.gov (United States)

    Carraro, Nicolas; Rivard, Nicolas; Ceccarelli, Daniela; Colwell, Rita R; Burrus, Vincent

    2016-07-19

    Mobile genetic elements play a pivotal role in the adaptation of bacterial populations, allowing them to rapidly cope with hostile conditions, including the presence of antimicrobial compounds. IncA/C conjugative plasmids (ACPs) are efficient vehicles for dissemination of multidrug resistance genes in a broad range of pathogenic species of Enterobacteriaceae ACPs have sporadically been reported in Vibrio cholerae, the infectious agent of the diarrheal disease cholera. The regulatory network that controls ACP mobility ultimately depends on the transcriptional activation of multiple ACP-borne operons by the master activator AcaCD. Beyond ACP conjugation, AcaCD has also recently been shown to activate the expression of genes located in the Salmonella genomic island 1 (SGI1). Here, we describe MGIVchHai6, a novel and unrelated mobilizable genomic island (MGI) integrated into the 3' end of trmE in chromosome I of V. cholerae HC-36A1, a non-O1/non-O139 multidrug-resistant clinical isolate recovered from Haiti in 2010. MGIVchHai6 contains a mercury resistance transposon and an integron In104-like multidrug resistance element similar to the one of SGI1. We show that MGIVchHai6 excises from the chromosome in an AcaCD-dependent manner and is mobilized by ACPs. Acquisition of MGIVchHai6 confers resistance to β-lactams, sulfamethoxazole, tetracycline, chloramphenicol, trimethoprim, and streptomycin/spectinomycin. In silico analyses revealed that MGIVchHai6-like elements are carried by several environmental and clinical V. cholerae strains recovered from the Indian subcontinent, as well as from North and South America, including all non-O1/non-O139 clinical isolates from Haiti. Vibrio cholerae, the causative agent of cholera, remains a global public health threat. Seventh-pandemic V. cholerae acquired multidrug resistance genes primarily through circulation of SXT/R391 integrative and conjugative elements. IncA/C conjugative plasmids have sporadically been reported to

  6. Do mobile clinics provide high-quality antenatal care? A comparison of care delivery, knowledge outcomes and perception of quality of care between fixed and mobile clinics in central Haiti.

    Science.gov (United States)

    Phillips, Erica; Stoltzfus, Rebecca J; Michaud, Lesly; Pierre, Gracia Lionel Fils; Vermeylen, Francoise; Pelletier, David

    2017-10-16

    Antenatal care (ANC) is an important health service for women in developing countries, with numerous proven benefits. Global coverage of ANC has steadily increased over the past 30 years, in part due to increased community-based outreach. However, commensurate improvements in health outcomes such as reductions in the prevalence of maternal anemia and infants born small-for-gestational age have not been achieved, even with increased coverage, indicating that quality of care may be inadequate. Mobile clinics are one community-based strategy used to further improve coverage of ANC, but their quality of care delivery has rarely been evaluated. To determine the quality of care of ANC in central Haiti, we compared adherence to national guidelines between fixed and mobile clinics by performing direct observations of antenatal care consultations and exit interviews with recipients of care using a multi-stage random sampling procedure. Outcome variables were eight components of care, and women's knowledge and perception of care quality. There were significant differences in the predicted proportion or probability of recommended services for four of eight care components, including intake, laboratory examinations, infection control, and supplies, iron folic acid supplements and Tetanus Toxoid vaccine provided to women. These care components were more likely performed in fixed clinics, except for distribution of supplies, iron-folic acid supplements, and Tetanus Toxoid vaccine, more likely provided in mobile clinics. There were no differences between clinic type for the proportion of total physical exam procedures performed, health and communication messages delivered, provider communication or documentation. Women's knowledge about educational topics was poor, but women perceived extremely high quality of care in both clinic models. Although adherence to guidelines differed by clinic type for half of the care components, both clinics had a low percentage of overall services

  7. Prevention of mother-to-child transmission of HIV in Haiti Prevención de la transmisión del VIH de madre a hijo en Haití

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    Marie-Marcelle Deschamps

    2009-01-01

    Full Text Available OBJECTIVES: To describe the effectiveness of a program designed to reduce the rate of mother-to-child transmission (MTCT of HIV at the primary HIV testing and treatment center in Haiti between 1999 and 2004. METHODS: All pregnant, HIV-positive women who attended the major HIV testing and treatment clinic in Port-au-Prince, Haiti, between March 1999 and December 2004 were asked to participate in an MTCT prevention program. Of the 650 women who participated, 73.3% received zidovudine (AZT, 2.9% received nevirapine (NVP, and 10.1% received triple-drug therapy when it became available in 2003 and if clinical/laboratory indications were met. Approximately 13.8% received no antiretroviral medication. All participants received cotrimoxazole prophylaxis and infant formula for their children. Kaplan-Meier survival analysis and the log rank test were used to evaluate program impact on child survival. RESULTS: Complete data were available for 348 mother-infant pairs who completed the program to prevent MTCT of HIV. The rate of MTCT in the study was 9.2% (95% CI: 6.14-12.24, in contrast to the historical mother-to-child transmission rate of 27% in Haiti. HIV-positive infants were less likely to survive than HIV-negative infants at 18 months of follow-up (χ2 = 19.06, P OBJETIVOS: Describir la eficacia de un programa diseñado para reducir la tasa de transmisión del VIH de madre a hijo (TMH en el principal centro de diagnóstico y tratamiento de esa infección en Haití entre 1999 y 2004. MÉTODOS: Se invitó a participar en un programa para la prevención de la TMH a todas las embarazadas positivas al VIH que asistían a la clínica principal de diagnóstico y tratamiento de la infección por el VIH en Puerto Príncipe, Haití, entre marzo de 1999 y diciembre de 2004. De las 650 mujeres que participaron, 73,3% recibieron zidovudina (AZT, 2,9% nervirapine (NVP y 10,1% tripleterapia cuando esta se hizo disponible en 2003 y cumplían los indicadores cl

  8. Whole Genome Sequencing Investigation of a Tuberculosis Outbreak in Port-au-Prince, Haiti Caused by a Strain with a "Low-Level" rpoB Mutation L511P - Insights into a Mechanism of Resistance Escalation.

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    Oksana Ocheretina

    Full Text Available The World Health Organization recommends diagnosing Multidrug-Resistant Tuberculosis (MDR-TB in high burden countries by detection of mutations in Rifampin (RIF Resistance Determining Region of Mycobacterium tuberculosis rpoB gene with rapid molecular tests GeneXpert MTB/RIF and Hain MTBDRplus. Such mutations are found in >95% of Mycobacterium tuberculosis strains resistant to RIF by conventional culture-based drug susceptibility testing (DST. However routine diagnostic screening with molecular tests uncovered specific "low level" rpoB mutations conferring resistance to RIF below the critical concentration of 1 μg/ml in some phenotypically susceptible strains. Cases with discrepant phenotypic (susceptible and genotypic (resistant results for resistance to RIF account for at least 10% of resistant diagnoses by molecular tests and urgently require new guidelines to inform therapeutic decision making. Eight strains with a "low level" rpoB mutation L511P were isolated by GHESKIO laboratory between 2008 and 2012 from 6 HIV-negative and 2 HIV-positive patients during routine molecular testing. Five isolates with a single L511P mutation and two isolates with double mutation L511P&M515T had MICs for RIF between 0.125 and 0.5 μg/ml and tested susceptible in culture-based DST. The eighth isolate carried a double mutation L511P&D516C and was phenotypically resistant to RIF. All eight strains shared the same spoligotype SIT 53 commonly found in Haiti but classic epidemiological investigation failed to uncover direct contacts between the patients. Whole Genome Sequencing (WGS revealed that L511P cluster isolates resulted from a clonal expansion of an ancestral strain resistant to Isoniazid and to a very low level of RIF. Under the selective pressure of RIF-based therapy the strain acquired mutation in the M306 codon of embB followed by secondary mutations in rpoB and escalation of resistance level. This scenario highlights the importance of subcritical

  9. Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development Integración de la salud bucodental en el Plan Nacional de Salud de Haití: de la ayuda en casos de desastre al desarrollo sostenible

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    Saskia Estupiñán-Day

    2011-11-01

    Full Text Available In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.En el 2010, Haití padeció tres emergencias nacionales devastadoras: un terremoto de 7,0 de magnitud que causó la muerte de 200 000 personas y

  10. Plants of Haiti used as antifertility agents.

    Science.gov (United States)

    Weniger, B; Haag-Berrurier, M; Anton, R

    1982-07-01

    Haitian empirical medicine sprang from both European (16th to 19th century) and African (especially voodoo) traditional therapies. The use of medicinal herbs is highly developed. Our purpose was to list the plants held to be antifertility agents in the island. We identified about twenty species more or less currently used by the women as abortifacients or emmenagogues. The chemistry and active components of a few species are well-known. However, for most of them, some were partially studied, and no relation could be established between their chemical composition and their potential activities, and the rest are chemically unknown. We chemically screened extracts of Casearia ilicifolia, Eleutherine bulbosa, Rhoeo spathacea and Stemodia durantifolia, and identified flavonoids, triterpenes and sterols in the leaves of C. ilicifolia, and naphthoquinones, and a new anthraquinone, anthracene-9,10-dione-1,5-diol-4-methoxy-3-methyl-2-carboxylic acid methyl ester, in the bulbs of E, bulbosa. R. spathacea showed a stimulative activity on mouse uterus. Antifertility screening tests of C. ilicifolia and E. bulbosa showed activity in rats, but also probably toxicity.

  11. Art Music by Caribbean Composers: Haiti

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    LeGrand, Cathleen

    2011-10-01

    Full Text Available Haïti has by far the longest history of independence of any of its Caribbean neighbors, having gained independence from France in 1804. Haïti's tradition of classical music takes root in its colonial heritage. Haïtian classical music, "mizik savant ayisyen," is derived from that "desire to retain European standards while including local features" of indigenous musical traditions (Grenier & Averill, 2007-2011.

  12. Art Music by Caribbean Composers: Haiti

    OpenAIRE

    LeGrand, Cathleen; Gangelhoff, Christine

    2011-01-01

    Haïti has by far the longest history of independence of any of its Caribbean neighbors, having gained independence from France in 1804. Haïti's tradition of classical music takes root in its colonial heritage. Haïtian classical music, "mizik savant ayisyen," is derived from that "desire to retain European standards while including local features" of indigenous musical traditions (Grenier & Averill, 2007-2011).

  13. Haiti | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... for the environment, reduced spending on food, increased self-esteem, and stronger ... The consortium acts as a knowledge centre and explores communication ... train teachers and researchers in high-quality science and technology skills ...

  14. Excerpts from the Dances of Haiti: Function.

    Science.gov (United States)

    Dunham, Katherine

    1985-01-01

    Analyzes the sociological and psychological functions of the different forms of traditional Haitian dance. Describes uses of dances for recreation and play, social solidarity, externalization of emotions or sexuality, worship, and artistic expression. (KH)

  15. [Haiti, new immigrant community in Chile].

    Science.gov (United States)

    Sánchez P, Katherin; Valderas J, Jaime; Messenger C, Karen; Sánchez G, Carolina; Barrera Q, Francisco

    2018-04-01

    Migration is a growing phenomenon in Latin America influenced by several factors such as economic stability, employment, social welfare, education and health system. Currently Chile has a positive migration flow rate. Particularly, a significant number of Haitian immigrants has been observed du ring the last years, especially after earthquake of 2010. These immigrants present a different cultural background expressed in relevant aspects of living including parenting and healthcare. Knowing the Haitian culture and its health situation is relevant for a better understanding of their health needs. Haitian people come to Chile looking for a cordial reception and willing to find a place with better perspectives of wellbeing in every sense. Immigration represents a major challenge for Chilean health system that must be embraced. Integration efforts in jobs, health, education system and community living should be enhanced to ensure a prosper settlement in our country. A new immigration law is crucial to solving major problems derived from current law created in 1975.

  16. Assessing the causes of under-five mortality in the Albert Schweitzer Hospital service area of rural Haiti La evaluación de las causas de mortalidad en niños menores de cinco años en la zona rural atendida por el Hospital Albert Schweitzer de Haití

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    Henry B. Perry

    2005-09-01

    Full Text Available OBJECTIVES: Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies elsewhere in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. METHODS: In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause of death. RESULTS: Acute lower respiratory infection (ALRI was the leading diagnosis, present in 45% of all under-five deaths, followed by enteric diseases, present in 21% of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41% of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51% of the deaths, and enteric diseases in 30%. Deaths were concentrated during the first few months of life, with 35% occurring during the first month. Among the neonatal deaths, 27% occurred on the first day of life, and 80% occurred during the first 10 days of life. CONCLUSIONS: In the Albert Schweitzer Hospital program area-and presumably in other areas of Haiti as well-priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for

  17. Gestion de crise et aide internationale après le séisme du 12 janvier à Port-au-Prince Haïti, toujours dans l’urgence ! (Témoignage Crisis Management and International Aid after Earthquake of January 12 in Port-au-Prince Haiti, always in a Hurry! (Testimony

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Pierre

    2012-01-01

    Full Text Available Dans le cadre de l’intervention qui a été déclenchée pour venir en aide aux sinistrés du tremblement de terre en Haïti le 12 janvier dernier, la France a envoyé des moyens importants. Le déploiement de ces moyens comme celui de ceux envoyés par le reste de la communauté internationale s’est déroulé sur un territoire ravagé. En plus des difficultés liées aux destructions, il a été relativement difficile d’avoir une vision globale de la situation. L’absence quasi totale de moyens de communication sur place et l’interprétation faite par certains médias internationaux, d’évènements anodins ont également contribué à compliquer cette situation.  Aujourd’hui, on énumère les actions et les projets mais qu’en est-il de la situation sur le terrain ?As part of the intervention was triggered to help victims of earthquake in Haiti on January 12 this year, France sent substantial resources. The deployment of these resources such as those sent by the rest of the international community took place on a ravaged territory. In addition to difficulties related to destruction, it was relatively difficult to obtain an overview of the situation. The almost total absence of means of communication on site and the interpretation made by some international media, benign events also helped to complicate the situation. Today, it lists the actions and projects, but what about the situation on the ground?

  18. From disaster, a new digital economy for Haiti | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2018-02-28

    Feb 28, 2018 ... Learn how IDRC-supported research is helping to build women's skills for the digital economy, and creating job opportunities. This article is part of an ongoing series of stories about innovative projects in the developing world, a partnership between IDRC and Canadian Geographic. Read the full story.

  19. HAITI EARTHQUAKE DAMAGE ASSESSMENT: REVIEW OF THE REMOTE SENSING ROLE

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    P. Boccardo

    2012-08-01

    In a few days several map products based on the aforementioned analysis were delivered to end users: a review of the different types and purposes of this products will be provided and discussed. An assessment of the thematic accuracy of remotely sensed based products will be carried out on the basis of a review of the several available studies focused on this issue, including the main outcomes of a validation based on a comparison with in-situ data performed by the authors.

  20. Ending Haiti's Crime Wave | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    They are also 27 times more likely to be sexually assaulted and 18 times more likely to be physically assaulted. Residents of these densely packed settlements also complain of escalating police misconduct, including bribes and sexual harassment. Predictably, public trust and confidence in the national police shows signs ...

  1. Destination: Saving Lives and Providing Hope in Haiti

    Science.gov (United States)

    2010-01-01

    the other group, which was led by Andy Busk , field support divi- sion deputy director and ex-MSC chief engineer, and Jim Williams, MSC electri- cal...efforts.” Comfort was able to drop off some of the members of the tiger team on a ferry as it passed by Norfolk. Watts, Busk , and Williams remained

  2. January 2010 Port-au-Prince, Haiti Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — According to official estimates, 222,570 people killed, 300,000 injured, 1.3 million displaced, 97,294 houses destroyed and 188,383 damaged in the Port-au-Prince...

  3. Increasing immunization, reducing child mortality in Haiti | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    24 juin 2015 ... Renforcement des capacités de recherche associées aux essais cliniques en matière de prévention du VIH/sida. Relativement peu d'installations africaines disposent des capacités cliniques et de laboratoire nécessaires pour concevoir, gérer et mener des essais en matière de prévention du VIH/sida.

  4. All projects related to Haiti | Page 2 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Program: Maternal and Child Health ... Program: Governance and Justice ... Project. CarlSnet I arose out of the recognition that the Caribbean ICT Stakeholders Virtual Community (CIVIC) needed some form of animation if it were to fulfill its role as a regional mechanism to promote and support the use of information and ...

  5. Haiti: The South African perspective | van Hoving | South African ...

    African Journals Online (AJOL)

    ... intelligence from the site, government facilitation, and working under the auspices of recognised organisations such as the United Nations and the World Health Organization. Conclusion. The proposed way forward for South African medical teams responding to disasters is to be unified under a leading academic body, ...

  6. Characterization of inequality and poverty in the Republic of Haiti

    Directory of Open Access Journals (Sweden)

    Evans Jadotte

    2007-01-01

    Full Text Available Después de aproximadamente veinteaños de estancamiento económicoacompañado de disturbios políticos, larepública de Haití, exhibiendo un PIBpercapitaen paridad de poder de compra de1,470 dólares estadounidenses, es actualmente el país más pobre del hemisferio occidental y uno de los más pobres delmundo. El presente trabajo de investigación también revela que es el país más desigual en la región más desigual delmundo, a saber, América Latina y el Caribe (ALC. Amén del carácter endémico de la pobreza en este país, el problema de la distribución de la renta puederepresentar un verdadero escollo a lasperspectivas de crecimiento y, por ende,debería constituir una de las principalespreocupaciones de los responsables políticos en sus programas de lucha contra este flagelo. Para trabajo se utiliza laEncuesta sobre las Condiciones de Vidaen Haití para estimar el estado de lapobreza y la desigualdad para el periodo2000/2001. Los primeros resultadosdestacan, sin sorpresa, que la pobreza esmás generalizada en la zona rural mientras la zona metropolitana de Puerto Príncipe acusa las tasas más bajas. Elacceso a ciertos factores de producción,tales como la tierra agrícola, no constituye una vía de escape a la pobreza.También se propone una descomposición de la desigualdad en varios ámbitosvía la estimación de mínimos cuadrados ponderados para encuestas complejas. Finalmente, se estima un logit policotómico ordenado para investigar la probabilidad de un hogar de ser pobre o indigente.

  7. Forging a brighter future for Haiti through higher education | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2017-05-09

    May 9, 2017 ... ... obstacle to developing the human resources required to rebuild the country. ... and chemistry to education management and business administration. ... of whom are university teachers working multiple jobs to make a living.

  8. Review: The birds of Hispaniola: Haiti and the Dominican Republic

    Science.gov (United States)

    Wayne J. Arendt

    2005-01-01

    The following critiques express the opinions of the individual evaluators regarding the strengths, weaknesses, and value of the books they review. As such, the appraisals are subjective assessments and do not necessarily refl ect the opinions of the editors or any offi cial policy of the American Ornithologists’ Union.

  9. Area Handbook Series: Dominican Republic and Haiti: Country Studies

    Science.gov (United States)

    1991-01-01

    state) gover- nors appointed by president; municipalities (counties) governed by elected mayors and municipal councils. Politics: Following...Bibliography.) 73 Chapter 3. Dominican Republic: The Economy yj The Plaza del Mercado , Puerto P/a,, ca. 18(73 LONG DEPENDENT ON SUGAR, the Dominican...tribunal and courts of appeal. Justices of the peace exist in each municipality and in the National District. The Constitu- tion also mandates a court

  10. 75 FR 3476 - Designation of Haiti for Temporary Protected Status

    Science.gov (United States)

    2010-01-21

    ... concern. There is limited access to the capital city. Roads are blocked by debris and other obstacles, and the collapse of the Croix de Mission Bridge has cut off a major artery between Port-au-Prince and the...

  11. Collaboration in Humanitarian Logistics: Comparative Analysis of Disaster Response in Chile and Haiti 2010

    Science.gov (United States)

    2010-12-01

    hydropower. Exports total $554.8 million (2007 est.) with manufactured items, coffee, oils, cocoa , and mangoes being the main exports . Imports total... Exports total $48.8 billion in copper, fruit, fish products, paper and pulp, chemicals, and wine. Imports total $40.91 billion in petroleum and...relief supplies via USAID Uruguay Two water purification machines Venezuela Seven tons of relief supplies and assessment team of 27 experts

  12. Embracing Social Sustainability in Design Education: A Reflection on a Case Study in Haiti

    Science.gov (United States)

    Kjøllesdal, Anders; Asheim, Jonas; Boks, Casper

    2014-01-01

    Sustainable design issues are complex and multi-faceted and need integration in the education of young designers. Current research recommends a holistic view based on problem-solving and inter-disciplinary work, yet few design educators have brought these ideas to their full consequence. Sustainability education for designers is still often rooted…

  13. Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia

    NARCIS (Netherlands)

    Mauch, Verena; Weil, Diana; Munim, Aayid; Boillot, Francois; Coninx, Rudi; Huseynova, Sevil; Powell, Clydette; Seita, Akihiro; Wembanyama, Henriette; van den Hof, Susan

    2010-01-01

    Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived. A structured

  14. 77 FR 76503 - Extension of the Re-registration Period for Haiti Temporary Protected Status

    Science.gov (United States)

    2012-12-28

    ... Hurricane Sandy on many TPS beneficiaries' ability to timely file for re-registration, DHS is extending the... extended with a new filing deadline of January 29, 2013. FOR FURTHER INFORMATION CONTACT: For further information on TPS, including guidance on the application process and additional information on eligibility...

  15. Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured

    OpenAIRE

    Koski-Karell V; Farmer PE; Isaac B; Campa EM; Viaud L; Namphy PC; Ternier R; Ivers LC

    2016-01-01

    Victoria Koski-Karell,1,2 Paul E Farmer,2–4 Benito Isaac,5 Elizabeth M Campa,5 Loune Viaud,5 Paul C Namphy,6 Ralph Ternier,5 Louise C Ivers2–4 1Department of Anthropology, University of Michigan, and University of Michigan Medical School, Ann Arbor, MI, 2Partners In Health, 3Department of Global Health and Social Medicine, Harvard Medical School, 4Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; 5Zanmi Lasante, Cange, 6Di...

  16. Cross-sectional Survey of Urinary Aflatoxins and Diet Recall in Haiti

    Data.gov (United States)

    US Agency for International Development — Aflatoxins (AFs) are hepatocarcinogenic mycotoxins that can contaminate grains and oil seeds in tropical and sub-tropical areas and have been detected in maize and...

  17. Project in Haiti to make medical care more efficient through technology

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-10-06

    Oct 6, 2010 ... A major weakness in Haitian healthcare is the lack of health systems supported by electronic and information technologies (e-health) and ... (due to the poor quality internet connectivity) and also building tools to track ... For people living in sub-Saharan Africa, psychiatric services are not always accessible.

  18. Uneven exchange and urban binational complexes in Dominican Republic’s border with Haiti

    Directory of Open Access Journals (Sweden)

    Haroldo Dilla Alfonso

    2004-01-01

    Full Text Available The Dominican/Haitian border is signed by profound asymmetries and the predominance of a relation of uneven exchange in benefit of Dominican Republic. Transborder relations summary this contradictory relation, but at the same time constitute the only form of survival for more than half million of Haitians that inhabit the region. This article discusses the history of this relation and its present tendencies, including the formation of economic regions and urban binational systems. The weakness of regulatory public policies and the aggressive action of the market generate a very contradictory setting that could lead to conflicts by the use of shared natural resources, the exploitation of the Haitian labour force, and the agitation of nationalist positions.

  19. Poverty, global health, and infectious disease: lessons from Haiti and Rwanda.

    Science.gov (United States)

    Alsan, Marcella M; Westerhaus, Michael; Herce, Michael; Nakashima, Koji; Farmer, Paul E

    2011-09-01

    Poverty and infectious diseases interact in complex ways. Casting destitution as intractable, or epidemics that afflict the poor as accidental, erroneously exonerates us from responsibility for caring for those most in need. Adequately addressing communicable diseases requires a biosocial appreciation of the structural forces that shape disease patterns. Most health interventions in resource-poor settings could garner support based on cost/benefit ratios with appropriately lengthy time horizons to capture the return on health investments and an adequate accounting of externalities; however, such a calculus masks the suffering of inaction and risks eroding the most powerful incentive to act: redressing inequality. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

    Science.gov (United States)

    Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

    2011-01-01

    Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

  1. Dance anthropology and the impact of 1930s Haiti on Katherine Dunham's scientific and artistic consciousness

    OpenAIRE

    Durkin, Hannah

    2011-01-01

    Katherine Dunham (1909-2006) was one of the most critically and commercially successful dancers of the twentieth century. She established and ran the Katherine Dunham Dance Company, the earliest self-supporting predominantly black dance company and one of the first modern dance troupes to achieve international success. She was also one of the first African Americans to conduct anthropological fieldwork, and the first anthropologist to explore the function of dance in rituals and community lif...

  2. Analysis of Social Network Collaboration Using Selected APAN Communications from the Haiti Earthquake of 2010

    Science.gov (United States)

    2012-06-01

    aspects of the community also represent some of the benefits of social media in that, knowledge, once gained, can be stored and retrieved over time...Building trust among various users is an important benefit of social media sites such as APAN. “[DoD International Health Division] IHD member Cdr... social media Web sites. 1. Attributes of a Successful HA/DR Forum To facilitate the collaboration required to effectively respond during a disaster, a

  3. Latest Pleistocene to Holocene Evolution of the Baie de Port au Prince, Haiti

    Science.gov (United States)

    Rios, J. K.; McHugh, C. M.; Seeber, L.; Blair, S.; Sorlien, C. C.

    2012-12-01

    The Baie de Port au Prince (BPP) is adjacent a restraining segment of the sinistral Caribbean-North America plate boundary and is therefore situated between converging high-relief thrust systems, the Massif Selle (Peninsula Range) to the south and the Chaine de Matheux (Hispaniola highlands) to the north. To evaluate neotectonic deformation, seismic hazards and sedimentation patterns for the BPP, six gravity cores were studied within the framework of chirp profiles collected from the R/V Endeavor in 2010. The cores were recovered from 76 m to 148 m of water depth sampling sediment from the carbonate platform that rims the BPP and from the slope. We studied the biostratigraphy (foraminifers, nannoplankton), geochemical elemental composition and physical properties of the sediment. An age model from the last glacial to the present (~20 ka BP) was derived from radiocarbon. Nannoplankton biostratigraphy provide constraints on the late Pleistocene. The BPP is 150 m maximum water depth and is rimmed by an ~30 m deep carbonate platform that has undergone dissolution. Terraces characterize the sub-bottom topography to the NE. This topography was covered by sediment during at least one relative sea-level cycle. Sediment progradation and mass-wasting on the northern and southern flanks of the BPP respectively, occurred during the latest Pleistocene low stand (~20 ka BP). Increased sedimentation from 0.2 mm/year to 0.8 mm/year occurred from 14.2 ka BP to 9.5 ka BP. This period also corresponds with a global rapid rate in sea-level rise from -94 m to -37 m. A basin wide acoustically transparent layer of sediment ~10 m thick covered the BPP. Mass-wasting, microfaulting, fluidization and turbidites caused by erosion triggered by pre-historic earthquakes possibly associated with EPG transform fault are found in the cores. One such deposit is possibly associated to the 2010 earthquake and another to an unconformable surface that separates early- from late-Holocene sediment on the slope. The late Pleistocene sediment is laminated and microfossils assemblages reveal sediment reworking and shallow water depths. Normal marine sedimentation resumed from ~14 ka BP to the present. The climate was characterized by wet or high discharge intervals noted by an influx of wood fragments and sediment most likely derived from land (>Si weight %, Al%, Fe% and Cu ppm). Wet periods were less frequent in the Holocene. The late Holocene trend is to dryer climate consistent with previous studies of the region. Evaporation is manifested by an increase in subhedral gypsum coated in calcite. Limited chirp profiles across the BPP suggest subsidence to the south. Ages from the base of the cores will verify this possibility. Coseismic 2010 uplift was documented in the southwestern part of the Leogane delta, an area that has no evidence of long-term uplift. Chirp profiles and multibeam bathymetry close to this uplift, show a deepening of the sea-floor suggestive of ongoing subsidence. More studies are needed to better understand the long-term patterns of subsidence and uplift in this region.

  4. Potential environmental benefits from woodfuel transitions in Haiti: Geospatial scenarios to 2027

    Science.gov (United States)

    Ghilardi, Adrian; Tarter, Andrew; Bailis, Robert

    2018-03-01

    Woodfuels constitute nearly 80% of Haiti’s primary energy supply. Forests are severely degraded and the nation has long been considered an archetypal case of woodfuel-driven deforestation. However, there is little empirical evidence that woodfuel demand directly contributes to deforestation, but may contribute to degradation. We use MoFuSS (Modeling Fuelwood Sustainability Scenarios), a dynamic landscape model, to assess whether current woodfuel demand is as impactful as it is often depicted by simulating changes in land cover that would result if current demand continues unabated. We also simulate several near-term interventions focused on woodfuel demand reduction to analyze the land cover impacts of different energy trajectories. We find that current demand may contribute to moderate levels of degradation, but it is not as severe as is typically portrayed. Under a business-as-usual scenario, the simulated regenerative capacity of woody biomass is insufficient to meet Haiti’s increasing demand for wood energy and, as a result, between 2017 and 2027 stocks of above-ground (woody) biomass could decline by 4% ± 1%. This is an annual loss of 302 ± 29 kton of wood and would emit 555 ± 54 kton CO2 yr-1. Aggressive interventions to reduce woodfuel demand could slow or even reverse woodfuel-driven degradation, allowing woody biomass to recover in some regions. We discuss the policy implications and propose steps to reduce uncertainty and validate the model.

  5. Diasporic Lakou: A Haitian Academic Explores Her Path to Haiti Pre- and Post-Earthquake

    Science.gov (United States)

    Desir, Charlene

    2011-01-01

    In this essay, Charlene Desir reflects on her role as an academic from the Haitian diaspora and her journey to reconnect to her Haitian roots after the 2010 earthquake. Desir begins by exploring her family background and the centrality of "lakou"--a sacred family space in which to connect to her ancestors and cultural ways of knowing. By…

  6. Improving the control of aflatoxin-contaminated foods in Haiti | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    They are regularly found among staple food commodities such as peanuts, ... Factors influencing the adoption of control methods by farmers, harvesters, ... viable non-food/feed-related value chain for rejected aflatoxin-contaminated peanuts.

  7. Flood Risk Management in Remote and Impoverished Areas—A Case Study of Onaville, Haiti

    Directory of Open Access Journals (Sweden)

    Valentin Heimhuber

    2015-07-01

    Full Text Available In this study, geographic information system (GIS-based hydrologic and hydraulic modeling was used to perform a flood risk assessment for Onaville, which is a fairly new, rapidly growing informal settlement that is exposed to dangerous flash-flood events. Since records of historic floods did not exist for the study area, design storms with a variety of significant average return intervals (ARIs were derived from intensity-duration-frequency (IDF curves and transformed into design floods via rainfall-runoff modeling in hydrologic engineering center’s hydrologic modeling system (HEC-HMS. The hydraulic modeling software hydrologic engineering center’s river analysis system (HEC-RAS was used to perform one-dimensional, unsteady-flow simulations of the design floods in the Ravine Lan Couline, which is the major drainage channel of the area. Topographic data comprised a 12 m spatial resolution TanDEM-X digital elevation model (DEM and a 30 cm spatial resolution DEM created with mapping drones. The flow simulations revealed that large areas of the settlement are currently exposed to flood hazard. The results of the hydrologic and hydraulic modeling were incorporated into a flood hazard map which formed the basis for flood risk management. We present a grassroots approach for preventive flood risk management on a community level, which comprises the elaboration of a neighborhood contingency plan and a flood risk awareness campaign together with representatives of the local community of Onaville.

  8. Telecommunication Policy in the Caribbean: A Comparison of Telecommunications in the Dominican Republic and Haiti

    Science.gov (United States)

    2011-09-01

    Mexico and South America. By 1625, French buccaneers had established a settlement on the island of Tortuga and survived by pirating English and Spanish...smaller islands in its territory; these are: Ile de la Gonave, Ile de la Tortue ( Tortuga Island), Grande Cayemite, and Ile de la Vache. The island

  9. Tree planting in Haiti: How to plant and care for your nursery grown seedlings

    Science.gov (United States)

    Kyrstan Hubbel; Yvonne Barkley; Jeremiah R. Pinto; R. Kasten Dumroese; Sabine Deristin; Raymond Joseph; Randy Brooks; Anthony S. Davis

    2016-01-01

    Seedlings need the right amounts of sunlight, water and nutrients to live and grow into healthy trees. Different types of trees have different requirements, so seedlings will need planting sites that meet all of their requirements. For example, pine trees need full sun, a moderate amount of water and a certain combination of nutrients to grow into healthy trees. If you...

  10. Molecular epidemiology of Staphylococcus aureus in post-earthquake northern Haiti

    Directory of Open Access Journals (Sweden)

    Marnie E. Rosenthal

    2014-12-01

    Conclusions: We found a low S. aureus carriage rate with complete vancomycin susceptibility and high tetracycline resistance, which has important public health implications with regard to treatment. Additionally, the finding of PVL-positive MSSA isolates, including the expansion of a previously described limited ‘divergent’ clone, ST152, warrants further evaluation.

  11. Macrocognition in Teams and Analysis of Information Flow During the Haiti Disaster Relief

    Science.gov (United States)

    2011-06-01

    Coded as Sensemaking .......45 Table 17. Examples from the Hospital Theme Coded as Using Analogues ....................46 Table 18. Examples from the...Atovaquone/Proguanil, Chloroquine , Docycycline and Mefloquine.” c. Team Solution Option Generation (TSOG) Definition: TSOG involves the...the rumors of security and the racism behind the idea of security has been our major block to getting aid in.” 8. Using Analogues (UA

  12. Country Partnership Framework for the Republic of Haiti for the Period FY16-FY19

    OpenAIRE

    World Bank Group

    2015-01-01

    Five years into Haiti’s reconstruction following the devastating earthquake of 2010, the country is experiencing an economic and a political transition. Although many challenges brought by the earthquake remain to be fully addressed, Haiti’s focus has shifted from reconstruction to longer term development and to securing a more prosperous future for its people. This World Bank Group (WBG) ...

  13. A Culturally Competent Immersion Protocol: Petit Goâve, Haiti

    Science.gov (United States)

    Streets, Barbara Faye; Wolford, Karen; Nicolas, Guerda

    2015-01-01

    In the human services professions, cultural immersion experiences help satisfy multicultural training standards established by national accreditation bodies. Immersion in a culturally sensitive manner is necessary as we prepare professionals to work with and serve citizens of the globe. The authors describe an international cultural immersion…

  14. The Haiti research-based model of international public health collaboration: the GHESKIO Centers.

    Science.gov (United States)

    Pape, Jean W; Severe, Patrice D; Fitzgerald, Daniel W; Deschamps, Marie M; Joseph, Patrice; Riviere, Cynthia; Rouzier, Vanessa; Johnson, Warren D

    2014-01-01

    For 3 decades, GHESKIO (the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes), the Haitian Ministry of Health, and Weill Cornell have pursued a tripartite mission of service, training, and translational research. The initial focus was on AIDS and tuberculosis. The mission has expanded to include the local community and now provides maternal-child health, family planning, cancer prevention and treatment, immunizations (including human papillomavirus, cholera), and primary education through vocational and microcredit programs. Outcome measures include a reduction in HIV prevalence from 6.2% to the current 2.2%, extensive tuberculosis and cholera prevention and treatment programs, and national training programs for biomedical and community health workers.

  15. Landscape Dynamics on the Island of La Gonave, Haiti, 1990–2010

    Directory of Open Access Journals (Sweden)

    Lisa M. Kennedy

    2013-09-01

    Full Text Available The island of La Gonave lies northwest of Port-au-Prince and is representative of the subsistence Haitian lifestyle. Little is known about the land cover changes and conversion rates on La Gonave. Using Landsat images from 1990 to 2010, this research investigates landscape dynamics through image classification, change detection, and landscape pattern analysis. Five land cover classes were considered: Agriculture, Forest/Dense Vegetation (DV, Shrub, Barren/Eroded, and Nonforested Wetlands. Overall image classification accuracy was 87%. Results of land cover change analysis show that all major land cover types experienced substantial changes from 1990 to 2010. The area percent change was −39.7, −22.7, 87.4, and −7.0 for Agriculture, Forest/Dense Vegetation, Shrub, and Barren/Eroded. Landscape pattern analysis illustrated the encroachment of Shrub cover in core Forest/DV patches and the decline of Agricultural patch integrity. Agricultural abandonment, deforestation, and forest regrowth combined to generate a dynamic island landscape, resulting in higher levels of land cover fragmentation.

  16. Epidemic Cholera in a Crowded Urban Environment, Port-au-Prince, Haiti

    OpenAIRE

    Dunkle, Stacie E.; Mba-Jonas, Adamma; Loharikar, Anagha; Fouché, Bernadette; Peck, Mireille; Ayers, Tracy; Archer, W. Roodly; De Rochars, Valery M. Beau; Bender, Thomas; Moffett, Daphne B.; Tappero, Jordan W.; Dahourou, George; Roels, Thierry H.; Quick, Robert

    2011-01-01

    We conducted a case–control study to investigate factors associated with epidemic cholera. Water treatment and handwashing may have been protective, highlighting the need for personal hygiene for cholera prevention in contaminated urban environments. We also found a diverse diet, a possible proxy for improved nutrition, was protective against cholera.

  17. Haiti | CRDI - Centre de recherches pour le développement ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    We also supported applied research in agriculture and food security with the ... and community leaders in the dissemination of information about vaccination ... train teachers and researchers in high-quality science and technology skills; equip ...

  18. 77 FR 59943 - Extension of the Designation of Haiti for Temporary Protected Status

    Science.gov (United States)

    2012-10-01

    ... want an EAD, you must pay the Application for Employment Authorization (Form I-765) fee only if you are... you about your continued employment authorization once January 22, 2013 is reached in order to meet... not need a new document in order to reverify your employment authorization until after July 22, 2013...

  19. DINÂMICA URBANA DE ESPAÇOS EM CRISE: PORTO PRÍNCIPE/ HAITI

    Directory of Open Access Journals (Sweden)

    Adriano Bittencourt Andrade

    2016-01-01

    Full Text Available Este artículo aborda las diversas facetas de la crisis que se materializó en el espacio urbano. El texto de este artículo, a la luz de las dinámicas que rigen el espacio geográfico, se centra en las crisis urbanas y echa un vistazo al caso focal de Haití, evaluar el impacto de las crisis que se cruzan (crisis política, los conflictos armados, la intervención externa, los desastres naturales repentinos - terremotos y huracanes - entre otros en el área urbana de Puerto Príncipe, la capital. Para la producción de este artículo, la investigación se ha desarrollado en dos frentes: se recurrió a las fuentes bibliográficas sobre Haití y su propio enfoque temático; y hubo entrevistas directas con los soldados que tomaron parte, en representación del Ejército de Brasil, la Misión de Mantenimiento de la Paz de la ONU en Haití. Este artículo análisis la relación entre la producción de material de espacio y su ocupación y uso social de proporcionar elementos para comprender la profunda fragmentación que hay en la ciudad generando un absolutamente dicotómicas dinámica interna entre una élite y la gran población que vive en los espacios de excepción. En lugar de presentar una gran cantidad de información y datos sobre el empobrecido país antillano, en este artículo, a partir de una realidad concreta, lanza “flechas” de interpretaciones sostenidas en el análisis de la configuración territorial y por lo tanto estimula el debate, más allá de la perspectiva local tiende a reflejarse en muchos otros lugares del mundo.

  20. (Re)Conceptualizing Higher Education in Post-Disaster Contexts: A Processual Analysis of Diaspora Engagement in Haiti's Reconstruction

    Science.gov (United States)

    Cela Hamm, Toni

    2016-01-01

    In post-disaster and post-conflict societies, critical threshold events trigger or intensify diaspora mobilization and engagement in their homelands. Taking the 2010 earthquake as a "critical event" that has transformed the course of Haitian society, this study builds on existing research on diaspora influence on homeland development by…

  1. Attributes of diagnostic tests to increase uptake of dual testing for syphilis and HIV in Port-au-Prince, Haiti.

    Science.gov (United States)

    Bristow, Claire C; Lee, Sung-Jae; Severe, Linda; William Pape, Jean; Javanbakht, Marjan; Scott Comulada, Warren; Klausner, Jeffrey D

    2017-03-01

    Introduction Syphilis and HIV screening is highly recommended for pregnant women and those at risk for infection. We used conjoint analysis to identify factors associated with testing preferences for HIV and syphilis infection. Methods We recruited 298 men and women 18 years and over seeking testing or care at GHESKIO (Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections) clinics. We created eight hypothetical dual HIV-syphilis test profiles varying across six dichotomous attributes. Participants were asked to rate each profile using Likert preference scales. An impact score was generated for each attribute by taking the difference between the preference scores for the preferred and non-preferred level of each attribute. Two-sided one-sample t-test was used to generate p values. Results Of 298 study participants, 61 (20.5%) were male. Of 237 females, 49 (20.7%) were pregnant. Cost (free vs. US$4; p syphilis testing preferences for this study sample in Port-au-Prince prioritized cost, single fingerprick, laboratory-based testing and timeliness.

  2. Relationship between the spatial distribution of SMS messages reporting needs and building damage in 2010 Haiti disaster

    Directory of Open Access Journals (Sweden)

    C. Corbane

    2012-02-01

    Full Text Available Just 4 days after the M = 7.1 earthquake on 12 January 2010, Haitians could send SMS messages about their location and urgent needs through the on-line mapping platform Ushahidi. This real-time crowdsourcing of crisis information provided direct support to key humanitarian resources on the ground, including Search and Rescue teams. In addition to its use as a knowledge base for rescue operations and aid provision, the spatial distribution of geolocated SMS messages may represent an early indicator on the spatial distribution and on the intensity of building damage.

    This work explores the relationship between the spatial patterns of SMS messages and building damage. The latter is derived from the detailed damage assessment of individual buildings interpreted in post-earthquake airborne photos. The interaction between SMS messages and building damage is studied by analyzing the spatial structure of the corresponding bivariate patterns.

    The analysis is performed through the implementation of cross Ripley's K-function which is suitable for characterizing the spatial structure of a bivariate pattern, and more precisely the spatial relationship between two types of point sets located in the same study area.

    The results show a strong attraction between the patterns exhibited by SMS messages and building damages. The interactions identified between the two patterns suggest that the geolocated SMS can be used as early indicators of the spatial distribution of building damage pattern. Accordingly, a statistical model has been developed to map the distribution of building damage from the geolocated SMS pattern.

    The study presented in this paper is the first attempt to derive quantitative estimates on the spatial patterns of novel crowdsourced information and correlate these to established methods in damage assessment using remote sensing data. The consequences of the study findings for rapid damage detection in post-emergency contexts are discussed.

  3. VGI and crisis mapping in an emergency situation. Comparison of four case studies: Haiti, Kibera, Kathmandu, Centre Italy

    Directory of Open Access Journals (Sweden)

    Lucia Saganeiti

    2017-08-01

    known as VGI – Volunteered Geographic Information – that is, geo-localized information created voluntarily and consciously by web users. These are supported by platforms such as OpenStreetMap that have been shown in many emergency cases and not, a valid source of data, such detailed to be used for rescue operations. Another completely open source platform that has revolutionized the world of geographic information and how to make reports is Ushaidi that through interactive maps represents testimonies, reports, diaries, and citizen reports.

  4. War Powers: Reforming the Law, With Case Studies of U.S. Military Participation in the Persian Gulf and Haiti

    National Research Council Canada - National Science Library

    Polloni, Mario

    2000-01-01

    .... From the constitutional viewpoint, this lack of friendly environment arises from the fact that the Constitution shares war powers between the presidency and the Congress, producing the conflict...

  5. Comparative Analysis of Emergency Response Operations: Haiti Earthquake in January 2010 and Pakistan’s Flood in 2010

    Science.gov (United States)

    2011-09-01

    Earthquake, Pakistan, Flood, Emergency Response Operations, International Community, HA/DR, United Nations , FRC, NDMA , ICT 16. PRICE CODE 17. SECURITY...Registration Authority NATO North Atlantic Treaty Organization NDMA National Disaster and Management Authority NDMC National Disaster Management...complicates relief efforts. 6 NDMA Pakistan, “Pakistan Floods-Summary of Damages,” No Author. Accessed 24

  6. Site effects in Port-au-Prince (Haiti) from the analysis of spectral ratio and numerical simulations.

    Science.gov (United States)

    St. Fleur, Sadrac; Bertrand, Etienne; Courboulex, Francoise; Mercier de Lépinay, Bernard; Deschamps, Anne; Hough, Susan E.; Cultrera, Giovanna; Boisson, Dominique; Prepetit, Claude

    2016-01-01

    To provide better insight into seismic ground motion in the Port‐au‐Prince metropolitan area, we investigate site effects at 12 seismological stations by analyzing 78 earthquakes with magnitude smaller than 5 that occurred between 2010 and 2013. Horizontal‐to‐vertical spectral ratio on earthquake recordings and a standard spectral ratio were applied to the seismic data. We also propose a simplified lithostratigraphic map and use available geotechnical and geophysical data to construct representative soil columns in the vicinity of each station that allow us to compute numerical transfer functions using 1D simulations. At most of the studied sites, spectral ratios are characterized by weak‐motion amplification at frequencies above 5 Hz, in good agreement with the numerical transfer functions. A mismatch between the observed amplifications and simulated response at lower frequencies shows that the considered soil columns could be missing a deeper velocity contrast. Furthermore, strong amplification between 2 and 10 Hz linked to local topographic features is found at one station located in the south of the city, and substantial amplification below 5 Hz is detected near the coastline, which we attribute to deep and soft sediments as well as the presence of surface waves. We conclude that for most investigated sites in Port‐au‐Prince, seismic amplifications due to site effects are highly variable but seem not to be important at high frequencies. At some specific locations, however, they could strongly enhance the low‐frequency content of the seismic ground shaking. Although our analysis does not consider nonlinear effects, we thus conclude that, apart from sites close to the coast, sediment‐induced amplification probably had only a minor impact on the level of strong ground motion, and was not the main reason for the high level of damage in Port‐au‐Prince.

  7. Care of dogs and attitudes of dog owners in Port-au-Prince, the Republic of Haiti.

    Science.gov (United States)

    Fielding, William J; Gall, Melanie; Green, Dick; Eller, Warren S

    2012-01-01

    This article reports the first known study on dogs in Port-au-Prince. Interviews with 1,290 residents provided information on 1,804 dogs. More than 57.7% of homes kept dogs. Not all the dogs received vaccinations for rabies (41.6%), even though 28.2% of households had had a household member bitten by a dog. Although the "owned" dog population had decreased as a result of the earthquake in January 2010, the number of roaming dogs appeared to have been uninfluenced by the disaster. Given that 64.8% of dogs probably had access to the street and only 6.0% of the females were spayed, to humanely contain the dog population will require both confinement and neutering. Although roaming dogs were considered a nuisance by 63.3% of respondents, 42.6% of households fed dogs they did not own.

  8. A Statistical and Demographic Profile of the US Temporary Protected Status Populations from El Salvador, Honduras, and Haiti

    Directory of Open Access Journals (Sweden)

    Robert Warren

    2017-07-01

    • About 27,000, or 11 percent, of those in the labor force are self-employed, having created jobs for themselves and likely for others as well. TPS status should be extended until beneficiaries can safely return home and can successfully reintegrate into their home communities. Most long-term TPS recipients should be afforded a path to lawful permanent resident (LPR status and ultimately to US citizenship.

  9. Comparison of the magnetic properties and Mossbauer analysis of glass from the Cretaceous-Tertiary boundary, Beloc, Haiti, with tektites

    Science.gov (United States)

    Thorpe, A. N.; Senftle, F. E.; May, L.; Barkatt, A.; Adel-Hadadi, M. A.; Marbury, G. S.; Izett, G. A.; Maurrasse, F. R.

    1994-01-01

    The magnetic properties of black Beloc glass have been measured. The Curie constant, the magnetization, and the magnetic susceptibility of the Beloc glass fall within the known ranges observed for tektites. However, the temperature-independent component of the magnetic susceptibility is slightly higher than that found for tektites. Moreover, it is not possible to match the experimental magnetic data for the Beloc glass with the calculated values using the previously reported Fe(3+)/Fe(2+) ratio of 0.7. The oxidation state of Fe was therefore redetermined by Mossbauer measurements, and the Fe(3+)/Fe(2+) ratio was found to be 0.024 plus or minus 0.015. Using the redetermined value of the ratio, the magnetic parameters were again calculated using formulas that are applicable to tektites, and good agreement was found between the calculated and experimental values. The experimental magnetic measurements and the redetermined Fe(3+)/Fe(2+) ratio of the Beloc glass specimens are essentially the same as those found for tektite glass.

  10. Recherche sur les sous-declarations de décés, Saint Marc, Haiti, 2012

    Directory of Open Access Journals (Sweden)

    Stela Nazareth Meneghel

    2014-11-01

    Full Text Available Ce travail se réfère à une étude exploratoire menée dans la ville de Saint Marc, une commune d'environ 257,863 habitants en 2012, localisée dans le département d'Artibonite/Haïti. L'objectif est rechercher le flux d'informations concernant le système de mortalité et l'existence de non-déclarations de décès. Les décès survenus dans le mois de janvier 2013 ont fait l'objet d'une enquête dans cinq institutions de la ville de Saint Marc: l'Hôpital Saint Nicolas (HSN, la Mairie, le Bureau d'État Civil (BEC, le Cimetière et la Cathédrale. L'hôpital a été l'institution où l'on a rencontré le plus grand nombre de décès enregistrés. On a procédé au comptage des décès, à partir de la liste nominale des registres hospitaliers, en ajoutant les décè...

  11. Non-toxigenic environmental Vibrio cholerae O1 strain from Haiti provides evidence of pre-pandemic cholera in Hispaniola

    Science.gov (United States)

    Azarian, Taj; Ali, Afsar; Johnson, Judith A.; Jubair, Mohammad; Cella, Eleonora; Ciccozzi, Massimo; Nolan, David J.; Farmerie, William; Rashid, Mohammad H.; Sinha-Ray, Shrestha; Alam, Meer T.; Morris, J. Glenn; Salemi, Marco

    2016-01-01

    Vibrio cholerae is ubiquitous in aquatic environments, with environmental toxigenic V. cholerae O1 strains serving as a source for recurrent cholera epidemics and pandemic disease. However, a number of questions remain about long-term survival and evolution of V. cholerae strains within these aquatic environmental reservoirs. Through monitoring of the Haitian aquatic environment following the 2010 cholera epidemic, we isolated two novel non-toxigenic (ctxA/B-negative) Vibrio cholerae O1. These two isolates underwent whole-genome sequencing and were investigated through comparative genomics and Bayesian coalescent analysis. These isolates cluster in the evolutionary tree with strains responsible for clinical cholera, possessing genomic components of 6th and 7th pandemic lineages, and diverge from “modern” cholera strains around 1548 C.E. [95% HPD: 1532–1555]. Vibrio Pathogenicity Island (VPI)-1 was present; however, SXT/R391-family ICE and VPI-2 were absent. Rugose phenotype conversion and vibriophage resistance evidenced adaption for persistence in aquatic environments. The identification of V. cholerae O1 strains in the Haitian environment, which predate the first reported cholera pandemic in 1817, broadens our understanding of the history of pandemics. It also raises the possibility that these and similar environmental strains could acquire virulence genes from the 2010 Haitian epidemic clone, including the cholera toxin producing CTXϕ. PMID:27786291

  12. 78 FR 76817 - Limitation of Duty-Free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

    Science.gov (United States)

    2013-12-19

    ... DEPARTMENT OF COMMERCE International Trade Administration Limitation of Duty-Free Imports of... Through Partnership for Encouragement Act of 2006 (``HOPE''), Title V of the Tax Relief and Health Care... (March 22, 2007), and No. 8596, 75 FR 68,153 (November 4, 2010). HOPE provides for duty-free treatment...

  13. 75 FR 78215 - Limitation of Duty-free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

    Science.gov (United States)

    2010-12-15

    ... DEPARTMENT OF COMMERCE International Trade Administration Limitation of Duty-free Imports of... Through Partnership for Encouragement Act of 2006 (``HOPE''), Title V of the Tax Relief and Health Care... (March 22, 2007), and No. 8596, 75 FR 68153 (November 4, 2010). HOPE provides for duty-free treatment for...

  14. Tragöödia põhimõtete pärast / Toomas Alatalu

    Index Scriptorium Estoniae

    Alatalu, Toomas, 1942-

    2004-01-01

    Haiti ajaloost, ajaloolisest hiigelvõlast. Haiti siseolukorrast 1990. aastatel. Autori sõnul laieneb praegu Haitil kaos, Prantsusmaa on teatanud valmisolekust saata oma väed Haitile. Vt. samas: Poolakatel viisavaba sõit Haitile. Kaart

  15. All projects related to haïti | Page 2 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... in Haiti : Needs and Characteristics of Urban and Displaced Residents ... Fourth Millennium Development Goal, and an essential step toward reducing child mortality. ... Organized Crime and Public Insecurity (Central America, Haiti, Mexico).

  16. Social Network Collaboration for Crisis Response Operations: Developing a Situational Awareness (SA) Tool to Improve Haiti’s Interagency Relief Efforts

    Science.gov (United States)

    2011-06-01

    Members Available Low —High Collaboration of Tools and Technology Low —High Latency Between Social Network and LLA Time (sec-millisec) Quality of... 5g . Exporting NetDraw Dataset to Pajek ...................................91  h.  Step 5h. Importing Datasets Into Pajek ..91  i.  Step 5i...the scale of 1-10 for feelings of shared accountability, a team member with subpar accountability is rated between 1and 4. By having low feeling

  17. [Abdominal obesity and other cardiometabolic risk biomarkers: influence of socioeconomic status and lifestyle on two African-origin population groups, Cotonou (Benin) and Port-au-Prince (Haiti)].

    Science.gov (United States)

    Mabchour, Asma El; Delisle, Hélène; Vilgrain, Colette; Larco, Phillipe; Sodjinou, Roger

    2016-01-01

    Increased cardio metabolic risk (CMR) in low- and middle-income countries is largely due to rapid nutrition transition. We conducted a study of two African-origin populations groups living, however, in widely different settings. It aimed to assess the relationship between lifestyle and CMR biomarkers as well as between abdominal obesity (AO) and other biomarkers. The study included 200 Benineses from Cotonou and 252 Haitians from Port-with-Prince (PAP) aged between 25 to 60 years and apparently in good health. AO was specifically defined as waist circumference ≥ 88cm (men) and ≥ 95 cm (women). Other most common biomarkers were: high total cholesterol/HDL cholesterol ratio, high blood pressure and insulin resistance by HOMA (Homeostasis Model Assessement). Socioeconomic status, diet, alcohol and tobacco were documented by questionnaire. Two dietary patterns emerged from cluster analysis, one traditional and the other "transitional" with increasing frequency of western foods. Socioeconomic status, consumption of alcohol and nicotinism were associated with CMR, but not the food diagram. AO was associated with other CMR markers, with no marked effect of socioeconomic status and lifestyle variables. Specific TT threshold values are confirmed as socioeconomic status and lifestyle have an impact on CMR, but not the relationship between AO and other CMR biomarkers.

  18. The Role of Education for Democracy in Linking Social Justice to the "Built" Environment: The Case of Post-Earthquake Haiti

    Science.gov (United States)

    Carr, Paul R.; Pluim, Gary; Thésée, Gina

    2014-01-01

    The manner in which the built environment is constructed has a tremendous effect on the degree to which health, wealth and social outcomes are distributed within a society. This is particularly evident when a crisis of the natural environment affects the built environment, as was the case after the Haitian earthquake of 2010. Understanding the…

  19. Sintomas de estresse pós-traumático em profissionais durante ajuda humanitária no Haiti, após o terremoto de 2010

    Directory of Open Access Journals (Sweden)

    Melissa Simon Guimaro

    2013-11-01

    Full Text Available O artigo tem por objetivo rastrear sintomatologia de transtorno de estresse pós-traumático (TEPT em profissionais que prestaram ajuda humanitária à população haitiana, após o terremoto de 2010. Estudo transversal. A sintomatologia de TEPT foi avaliada pela Escala Impacto do Evento - Revisada (IES-R. Os participantes foram 32 brasileiros (idade m = 37.58 +/- 7.01, 22 estadosunidenses (idade m = 33.67 +/- 8.03 e 12 equatorianos (idade m = 44.80 +/- 15.88 e não apresentaram sintomatologia de TEPT. A relação entre as variáveis experiência prévia em situação de desastre e escore total da IES-R [F(2 = 4.34, p = 0.017] bem como experiência prévia em situação de desastre e subescala intrusão [F(2 = 3.94, p = 0.024] foram significantes nos modelos de regressão linear. Experiência prévia se mostrou preditor significante para escore total da IES-R (p < 0,05. Os resultados demonstraram que vivências atuais podem ser potencializadas pelas memórias de experiências anteriores, aumentando a probabilidade de desenvolvimento de TEPT. Portanto, o cuidado com a saúde mental dos profissionais deve favorecer a precoce identificação do fator de risco experiência prévia, não permitindo que a iniciativa voluntária se sobreponha aos critérios seletivos e aos cuidados específicos.

  20. [Epidemiological study of intestinal helminthiasis in the island of Tortuga (Haiti). II. Evaluation of the parasite count by means of the Kato method].

    Science.gov (United States)

    Raccurt, C; Vial, P; Pierre-Louis, J M

    1977-01-01

    Results of the numbering of T. trichiura, A. lumbricoides et N. americanus eggs found in the stool, taken from a representative sample of the population of Tortuga island, shows the importance of parasital load borne by people attacked by the parasites. Those who produce the greatest number of eggs for a gram of faeces are young children. For adults, the evolution of the parasital load follow that of the prevalence, for each Nematodes, with an increase of the average number of eggs of A. lumbricoides per gram of faeces for adults aged 30 to 44, and of the average number of N. amercanus per gram of faeces for adults aged 45 to 59. Moreover women adults show a higher number of parasites than men. Farmers from villages within the interior of the island who are more often attacked than those from the coast, also bear a parasital load which is twice as high. Victims less than 5 years old and more than 30, particularly women, whose faeces are richest in eggs, seem to present the greatest danger for the transmission of ascaridiosis and necatorosis in Toruga Island.

  1. [Epidemiological study of intestinal helminthiasis in the island of Tortuga (Haiti). I. Prevalence of trichocephalosis, ascaridiasis and necatoriasis studied from elimination of eggs in the stools].

    Science.gov (United States)

    Raccurt, C; Vial, P; Pierre-Louis, J M

    1977-01-01

    An epidemiological survey is conducted by spot-checks over about 10% of the population of Tortuga Island in order to estimate the prevalence of intestinal helminthiasis in that region of the Republic of Haïti, by researching the presence of eggs in faeces. Population sample is representative of the whole of the island's population excepting the 0-4 years old group whose faeces are difficult to obtain. Faeces are examined through the Kato method, a very simple, quick and remarkably accurate procedure. Trichuriasis and ascariasis, which are transmitted in the area around the house, affect mainly children, but also adults. Women seem to be more often infested than men by Ascaris lumbricoides. Necatoriasis, the farmer's disease, hits primarily young men and elderly women who spend most time in the fields. It is observed in inland villages where people are engaged in agricultural production, with a higher incidence if they are located in a not so sloping zone.

  2. Research Protocol - Cholera and pregnancy in Haiti: description of pregnant patients presenting to MSF OCA cholera treatment centers, September 2011-December 2013.

    OpenAIRE

    Schillberg, Erin; Bryson, Lindsay; Pierre, Grand; Lenglet, Annick

    2015-01-01

    Principal objective To understand the demographic, clinical and outcome profiles of pregnant patients that presented with cholera infection to Figaro CTC and CRUO CTU between September 2011 and December 2013. Specific objectives 1. To determine the clinical presentation, treatment regimens and outcomes of pregnant patients with cholera seen at Figaro CTC and CRUO CTU between September 2011 and December 2014; 2. To identify factors related to age, clinical presentation or treatmen...

  3. Education in the Wake of Natural Disaster

    Science.gov (United States)

    Vallas, Paul

    2014-01-01

    In this essay, Paul Vallas--education reform expert and key advisor to the government of Haiti in developing its national education plan--discusses his plan for Haiti. The paper explores the successes and challenges of education reform in Haiti, before and after the earthquake that devastated the nation in 2010. The essay describes the…

  4. Consortium de recherche pour le développement de l'agriculture en ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Research Consortium for the Development of Agriculture in Haiti. Even before it was hit by a devastating earthquake in January 2010, Haiti's children suffered some of the worst rates of undernutrition in Latin America and the Caribbean. View moreResearch Consortium for the Development of Agriculture in Haiti ...

  5. Y a-t-il quelqu'un qui écoute les Haïtiens ? | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 oct. 2010 ... Project in Haiti to make medical care more efficient through technology. "Rebuild better" has become a mantra in Haiti as the nation struggles to recover from the devastating January earthquake. View moreProject in Haiti to make medical care more efficient through technology ...

  6. 15 CFR 748.14 - Import Certificate for firearms destined for Organization of American States member countries.

    Science.gov (United States)

    2010-01-01

    ..., Colombia, Costa Rica, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, St. Kitts and Nevis, Saint Lucia, Saint...

  7. Putin ja Bush pakuvad peaministreid / Toomas Alatalu

    Index Scriptorium Estoniae

    Alatalu, Toomas, 1942-

    2004-01-01

    Venemaa presidendi Vladimir Putini otsusest enne presidendivalimisi tagandada valitsus. USA presidendi George W. Bushi probleemist Haiti presidendi ja peaministri ametikohaga seoses riigis valitseva kriisiga

  8. What we do | Page 153 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Reconstruction of Haiti : Research Capacity Building in Latin America and the Caribbean. A number of Latin American countries have begun participating in peacekeeping operations, initially through military but more recently through military-civilian interventions. Argentina, South America, Brazil, Chile, Haiti, North And ...

  9. Waste as a Resource in Africa

    CSIR Research Space (South Africa)

    Janse van Rensburg, R

    2017-10-01

    Full Text Available in Africa are rising Waste as a Resource – Circular Economy @ HP, HAITI Project HP HAITI Project – Rosette’s Story https://www.youtube.com/watch?v=ibSkbHetqvY Full Circle with HP https://www.youtube.com/watch?v=QOckgMB7f54 Waste as a Resource – Circular...

  10. 2015-2016 Travel and Hospitality Expense Reports for Stephen ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Ruxandra Staicu

    Attend the International Conference on Territorial Inequality and. Development in Mexico. Meetings with researchers and Canadian Ambassador in Haiti. Date(s):. 2016-01-27 to 2016-01-30. Destination(s):. Puebla, Mexico; Port au Prince, Haiti. Air fare: $1,692.70. Other. Transportation: $584.09. Accommodation: $1,318.08.

  11. Deconstructing the Portrayals of Haitian Women in the Media: A Thematic Analysis of Images in the Associated Press Photo Archive

    Science.gov (United States)

    Rendon, Maria Jose; Nicolas, Guerda

    2012-01-01

    Haitian women constitute a group that is lauded within Haiti as the "pillar of society" and yet is also often silenced both within Haiti and abroad. Given the role of the media in shaping attitudes and behaviors toward Women of Color, evaluation of media portrayals is critical to challenge oppressive discourses about these groups. Therefore, in…

  12. Little by Little the Bird Builds Its Nest: First Steps in Cross Cultural Curriculum Training

    Science.gov (United States)

    Harte, Helene Arbouet; Jones, Melissa M.; Wray, Francis

    2015-01-01

    With the goal of raising awareness of child slavery and devastation of the natural environment in Haiti, while simultaneously supporting active teaching strategies, a team of educators collaborated to develop The Respecting Haiti curriculum. Following development of the curriculum, representatives from the team facilitated curriculum training with…

  13. Strengthening Health Information Systems to Support Post-Disaster ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Strengthening Health Information Systems to Support Post-Disaster Healthcare in Haiti. The occurrence of a natural disaster may seem to carry repercussions that are indiscriminate in nature; however, it is the vulnerable populations that suffer most during such events, and in the days, months and years that follow. In Haiti ...

  14. Etteheide: USA okupeerib Haitit / Kaivo Kopli

    Index Scriptorium Estoniae

    Kopli, Kaivo

    2010-01-01

    Prantsusmaa ja Brasiilia on esitanud protesti, sest USA sõjalennukitele on antud eelisõigus Haiti pealinna Port-au-Prince'i lennujaama kasutamisel. Paljude kommentaatorite hinnangul on Prantsusmaa püüdnud haarata prominentset rolli Haiti abistamisel, kuid USA on tegutsenud kiiremini ja jõulisemalt. Kaart

  15. 75 FR 26344 - Temporary Exclusion of the Assessment of Overflight Fees for Humanitarian Flights Related to the...

    Science.gov (United States)

    2010-05-11

    ... of Overflight Fees for Humanitarian Flights Related to the January 12, 2010, Earthquake in Haiti... the assessment of Overflight Fees for humanitarian flights in response to the earthquake in Haiti... populated part of the country, its capital, Port-au-Prince. Within hours, there was a significant increase...

  16. Search Results | Page 33 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 321 - 330 of 8491 ... Haiti is currently the poorest country in the western hemisphere, with 80% of the ... In Haiti, a high percentage of the population is exposed to aflatoxins ... linked to poor economic performance as students become workers. ... 70% of African women do not have access to financial services such as ...

  17. Formulating a Strategic Response Plan for a High-Risk Seismic Event in New York City

    Science.gov (United States)

    2013-03-01

    1,342 6.0 1985 12- 07 Armenia 25,000 6.9 1989 09- 19 Mexico 10,000 7.0 1990 06–20 Iran 40,000 7.7 16 Many individuals mistakenly believe that...Additionally, almost two years after the quake in Haiti, more than half a million people became ill with cholera resulting in more than 7,000 deaths.167...Leger,. “ Cholera Cripples Haiti, Two Years after Quake.” USA Today (January 8, 2012). http://usatoday30.usatoday.com/news/world/story/2012–01–05/haiti

  18. History of Combat Pay

    Science.gov (United States)

    2011-08-01

    eligibility with risk exposure. All of the alternatives were firmly planted within the prevailing perspective of recognition for risk; none proposed... Montenegro ; Somalia; Sudan; Haiti; Azerbaijan; Pakistan; Burundi; Democratic Republic of Congo; Egypt; Athens, Greece; Jordan; Tajikistan; Qatar; Rwanda

  19. All projects related to Brazil | Page 6 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Region: Brazil, South America, Colombia, Haiti, North and Central America, Mexico. Program: Governance ... Open Data for Public Policy in Latin America and the Caribbean. Project ... Program: Food, Environment, and Health. Total Funding: ...

  20. Post Conflict Reconstruction: A Selected Bibliography

    National Research Council Canada - National Science Library

    Moyer, Jeanette M

    2007-01-01

    ...: Afghanistan, Bosnia, Haiti, Iraq, Kosovo, and Somalia. With the exception of some important older titles, most of the books, documents, articles and online resources cited are dated 2003 to the present...

  1. Disconnected Strategies: Why Success is Elusive in Stability Operations and Post-Conflict Reconstruction

    National Research Council Canada - National Science Library

    Moore, John

    2004-01-01

    .... Success in these operations has been elusive. The US interventions in Panama 1989-1991 Somalia 1992- 1994 and Haiti 1994-1996 provide excellent case studies for determining the foundational causes of its poor performance...

  2. The UN Intervention in Somalia: Clausewitz at the Crossing of the Mogadishu Line

    National Research Council Canada - National Science Library

    Fowler, Charles W

    2000-01-01

    ... were sent? Indeed, when one considers the difficulties the United States has experienced in a long string of recent interventions, to include Lebanon, Somalia, Haiti, and the Balkan wars of Bosnia and Kosovo...

  3. Special Forces Command and Control in Afghanistan

    National Research Council Canada - National Science Library

    Rhyne, Richard

    2004-01-01

    .... The author examines how Special Forces and conventional forces worked together in the past in Vietnam, Panama, Somalia, Haiti, Bosnia-Herzegovina, and Operations Desert Storm and Desert Shield...

  4. Hispaanlased lähevad Afganistani ja Haitisse / Allan Espenberg

    Index Scriptorium Estoniae

    Espenberg, Allan

    2004-01-01

    Aprillis Hispaania uueks peaministriks saanud Jose Luis Rodriguez Zapatero lasi väed Iraagist ära tuua. Nüüd andis parlament valitsusele loa suurendada riigi väekontingenti Afganistanis ja asuda tegutsema ka Haitis

  5. All projects related to Haïti | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... girls and women is a serious health and human rights concern in Haiti. ... Climate change adaptation in informal settings: Understanding and ... Enhancing Food Security through Information and Communication Technologies in Honduras.

  6. All projects related to Brazil | Page 7 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Region: Argentina, South America, Brazil, Chile, Haiti, North and Central America ... NETWORKS, ECONOMIC RESEARCH, Economic integration, REGIONAL ... Land Use, Biofuels and Rural Development in the La Plata Basin (Latin America).

  7. Running on Empty: The Development of Helicopter Aerial Refueling and Implications for Future USAF Combat Rescue Capabilities

    National Research Council Canada - National Science Library

    Colburn, Tracy

    1997-01-01

    .... The declining defense budget means painful force structure decisions lie ahead. Even as funds are drying up, the armed forces are being called upon to execute contingencies in places such as Haiti, Somalia, Liberia, and Bosnia...

  8. All projects related to | Page 192 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Topic: FOOD SUPPLY, FOOD RESOURCES, DISADVANTAGED GROUPS, ACCESS TO INFORMATION, INFORMATION TECHNOLOGY, COMMUNICATION ENGINEERING, NUTRITION, POLICY MAKING, GOVERNMENT POLICY, FOOD POLICY. Region: Honduras, North and Central America, South America, Haiti.

  9. All projects related to | Page 10 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Supporting future university educators in Haiti – Phase 2 ... a century of conflict, Colombia is entering a period of reparation, reconstruction, and prevention of new violence. ... Building organizational development among Myanmar think tanks.

  10. The Haitian Economy and the HOPE Act

    National Research Council Canada - National Science Library

    Hornbeck, J. F

    2008-01-01

    ...., non-regional yarns, fabrics, and components) provided Haiti met rules of origin and eligibility criteria that require making progress on worker rights, poverty reduction, and anti-corruption measures...

  11. All projects related to | Page 578 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Human Rights and Peace Audit on Partition in South Asia - Phase I ... of conflict resolution, and its implications for democracy and human rights. ... Reconstruction of Haiti : Research Capacity Building in Latin America and the Caribbean.

  12. Solidarity

    CERN Multimedia

    Terre des hommes

    2010-01-01

    announces its spring sale of handkerchiefs and crafts for the benefit of education projects in Haiti and other developing countries on Tuesday 23 March 2010 from 9 h 00 in building 501 - Main hall  

  13. Search Results | Page 16 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    What we do · Funding · Resources · About IDRC .... Showing 151 - 160 of 1643 results : "water adaptation". Journal articles ... More than 45 participants, including researchers and students from Canada, Chile, Colombia, Cuba, and Haiti, ...

  14. Apoyo psico-social inmediato a los supervivientes de un desastre

    DEFF Research Database (Denmark)

    Berliner, Peter; Navarro Gongora, José; Espaillet, Vanessa

    2012-01-01

    Artiklen beskriver psykosocial hjælp til overlevere fra et stort jordskælv i Haiti i 2010. De overlevendes reaktioner og behov for hjælp beskrives gennem konkrete eksempler og en samlende diskussion....

  15. Preparing Haitian youth for digital jobs | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Unemployment, at 40%, is the highest in the region, and the 2010 earthquake ... For countries like Haiti, the digital economy could offer new employment prospects ... Wages and labour regulation, especially for online outsourcing, are often ...

  16. 47 CFR 97.3 - Definitions.

    Science.gov (United States)

    2010-10-01

    ..., Haiti. AG/doc.3216/95. (25) Indicator. Words, letters or numerals appended to and separated from the... operator (second party) on behalf of another person (third party). (47) ULS (Universal Licensing System...

  17. Preparing Haitian youth for digital jobs | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Haiti is currently the poorest country in the western hemisphere, with 80% of the ... One example is online outsourcing, which involves the contracting of ... Haitians; develop platforms for young Haitians to be matched with companies working in ...

  18. 12th Air Force > Home

    Science.gov (United States)

    Force AOR Travel Info News prevnext Slide show 76,410 pounds of food delivered to Haiti 12th Air Force the French Air Force, Colombian Air Force, Pakistan Air Force, Belgian Air Force, Brazilian Air Force

  19. All projects related to Colombia | Page 5 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Region: Brazil, South America, Colombia, Haiti, North and Central America, Mexico ... complex knowledge economy demands economic, social and environmental data ... The research network on global administrative law (GAL network) was ...

  20. Army Active/Reserve Mix; Force Planning for Major Regional Contingencies

    National Research Council Canada - National Science Library

    Sortor, Ronald

    1995-01-01

    .... However, for operations other than war-such as Somalia, Haiti, and potentially the Balkans or other trouble spots-the Army may not be able to call on the reserve components for frequent or extended deployments...