Giving birth in Haiti costs $8. If it’s a complicated delivery, however, it costs upwards of $300. In a country where more than half of the population lives on just $2 a day, that’s a lot of money to bet one’s life on, since Haitian women have a one in 80 chance of dying in pregnancy or childbirth.
Bleeding, sepsis bacterial infections of the bloodstream, eclampsia seizures during childbirth—which are often accompanied by organ dysfunction, aspiration pneumonia, cerebral hemorrhage, kidney failure or cardiac arrest—obstructed labor and unsafe abortions consume the lives of both women and infants.
According to the United Nations Population Fund (UNFPA), the maternal mortality rate is more than five times the Latin American and Caribbean average and the highest in the Western hemisphere because women who seek maternal health care do so to no avail.
Haiti remains the site of a major humanitarian crisis, still recovering from the 2010 earthquake that has left tens of thousands displaced, and the consequential budget deficit has eroded the accessibility of health care. The lack of funding undermines the new challenges posed by changing demographics and unfavorable socio-economic conditions.
“We want a new government,” a woman who called herself Rosie told Her Report. “This country needs to see another day.”
The reconstruction of Haiti’s health care system has proceeded in fits and starts since the earthquake, but there had been, until just recently, funding available for maternal care programs. The Manman Ak Timoun an Sante (MATS) program, which was backed by Canada, focused specifically on mother and child health, and medical NGOs filled remaining voids. Today, however, the MATS program has been discontinued and international funding for health care has been significantly cut.
Haiti, which plans to spend only 5.4 percent of its budget on health care in 2015 and 2016, cannot make up the difference. For reference, the Dominican Republic, which neighbors Haiti, allocates 11.5 percent of its budget to health care.
The country’s crushing poverty and poor health infrastructure mean that about half the population has no access to basic health services at all.
“It’s a catastrophe,” Dr. Fritz Moïse, executive director of Fondation pour la Santé Reproductrice et l’Education Familiale (FOSREF), an organization delivering sexual and reproductive health services in close partnership with the Ministry of Public Health and Population, has said in a statement.
Only 36 percent of births in Haiti take place in actual health facilities, and only 37 percent of women give birth under the care of a doctor, nurse or midwife. Oftentimes, those who do get in to public hospitals have to pay an entrance fee of about 25 cents to $1, and then have to cover the costs of the doctors’ gloves, syringes, food and transportation.
Fortunately, Haitian health officials have made significant strides in waiving entrance fees over the years, and there’s been an ensuing 43 percent decline in the maternal mortality rates since 1990 and infant mortality is estimated to be falling by about three percent annually.
But, nonetheless, expecting mothers are being turned away at public hospitals that have no money. The funding shortfalls at other facilities means that evermore patients turn to independently run institutions—not directly dependent on international funding—that do not have the capacity to take in the growing numbers.
According to Doctors Without Borders, unprecedented numbers of pregnant women are turning to the Centre de Référence en Urgence Obstétricales (CRUO), a hospital in Port-au-Prince run by Doctors Without Borders (MSF) focusing on complicated obstetrics. After the cuts in health care in 2014, MSF CRUO’s neonatal unit admitted over 32 percent more newborns and referrals of pregnant women increased by 18 percent. Admission numbers were the same in 2015.
Unfortunately, 2016 is not a promising year for pregnant women in Haiti, since CRUO has been forced to narrow admission criteria for emergency obstetrical care in order to manage the influx of visitors and prioritize those at greatest risk from birth complications. Women who do not meet admission criteria have virtually no other option than to wait until their situations deteriorate enough to be accepted.
Haitian mother Serene Princeton’s amniotic fluids were leaking for two weeks. During that time, she went looking for help at a number of Port-au-Prince hospitals, including CRUO. But MSF turned her away because her leaking had stopped. Serene was forced to go to the general hospital only to learn that the staff there was on strike. She went to other hospitals but found they were only accepting pregnant women at full-term, which she was not. She started bleeding and fearing for her and her baby’s lives. Desperate, she returned to CRUO and explained that she thought she might die, which finally met CRUO’s criteria; she was admitted. After three days of labor, she gave birth by Caesarean section to a premature baby boy.
“Spending on maternal healthcare has shown clear results in Haiti, and now we see cuts in that funding putting women’s lives at risk,” Paul Brockmann, MSF Haiti Country Director, has said. “During Haiti’s annual birth peak, which runs August to January each year, things have been even worse. This is an entirely predictable increase in demand for maternal healthcare, and due to these cuts the system was utterly unprepared. These cuts need to be reversed.”
Alas, funding for women’s health care will continue to be an issue, so long as Haitian women’s voices are disregarded. Haiti is one of six countries in the world where one of the parliamentary chambers—the Senate—has no female representation and that in the Chamber of Deputies, the ratio is just five women to 95 men.
Even at the local level, women’s voices go unheard. While local, women-led organizations ensure sustainable local buy-in, ensuring aid and development and the wise use of resources, they’re all-too-often overlooked.
A 2012 study by Mala Htun and S. Laurel Weldon of 70 countries over the course of 40 years found that the mobilization of strong, independent feminist movements was a more significant force in reducing violence against women than the economic wealth of a nation, the representation of women in government or the presence of progressive political parties—thus, women’s collective voices are key in shaping public policies and government agendas. Other research through the Association for Women’s Rights in Development (AWID) found that when women’s organizations are funded, they have a successful track record in promoting inclusive, equitable development.
But even in post-earthquake Haiti, just one percent of international aid made its way to local organizations. Even less went to women-led organizations that directly address the needs of the society’s most marginalized populations.