EFFECT OF POLITICALTURMOIL ON PEDIATRIC DISEASE AND PREVENTION IN PORTAUPRINCE - PowerPoint PPT Presentation

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EFFECT OF POLITICALTURMOIL ON PEDIATRIC DISEASE AND PREVENTION IN PORTAUPRINCE

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At the end of the year 2004 in Port-au-Prince because of the problems of HUEH ... In Port-au-Prince since September 2004 the Violence was increasing day by day. ... – PowerPoint PPT presentation

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Title: EFFECT OF POLITICALTURMOIL ON PEDIATRIC DISEASE AND PREVENTION IN PORTAUPRINCE


1
EFFECT OF POLITICALTURMOIL ON PEDIATRIC DISEASE
AND PREVENTIONIN PORT-AU-PRINCE
  • DR JESSY COLIMON ADRIEN
  • Director of Pediatrics
  • HUEH
  • October 4-6

2
INTRODUCTION
  • Haiti is a beautiful Caribbean island
  • The poorest country in the western hemisphere
    one of the poorest in the world.
  • Population 8.3 million inhabitants.
  • Per capita gross national product 480
  • Since January 1, 1804, history of political
    turmoil, dictatorship, and 30 military coups.
  • Political chronic turmoil, bad socio-economic
    conditions badly influence health system,
    particularly, pediatric disease and prevention in
    Port-au-Prince

3
OBJECTIVES
  • Present the health indicators before February
    2004 in order to understand the impact of the
    violence in a country with a very weak public
    health infrastructure .
  • Explain how this situation affects the delivery
    of Curative and Preventive health care to
    children In Port-au-Prince and particularly in
    some vulnerable areas.

4
Health Indicators
5
Mortality Indicators
  • Child Mortality under 1 year of age
  • Haiti 1995-2000 80.3
  • Child mortality less than 5 years
  • Diarrheic diseases 11.5
  • Acute respiratory infection 9.4
  • Maternal Mortality 523/100.000
  • Life expectancy 54.4 years

6
Resources IndicatorsDisponibility and Coverage
7
Immunization coverage of children lt 1y.o. (2003)
8
Nutritional Data
  • Protein-Energetic Malnutrition 60.1
  • Under 5 years
  • low birth weight 17
  • Acute malnutrition
  • kwashiorkor-Marasm 5
  • Vitamin A deficiency 2.5/00
  • Iron deficiency
  • under 5 years 60
  • under 2 years75

9
Causes of death 0-5 y.o.
10
Infectious Etiologies
11
Impact of violenceon health care system
  • February 29th 2004 HUEH (Main hospital of 700
    beds) and other major clinics such as Maternity
    Isaie Jeanty were closed
  • Fear of health care provider for their safety
  • Attack on ambulances and private cars by street
    gangs with bullets.
  • Shortage of energy supply
  • Loss of vaccines interruption of cold chain

12
Consequences of the violencefor delivery
services
  • NGO Red cross CRS Care - UNICEF
  • Food Trucks were looted
  • Decrease of medical supply and Drugs
  • Development of no mans land Bel-air
    Saint-Martin, Delmas 2, Cité-Soleil etc
  • September 30th 2004 New development in the
    violence With Baghdad Operation

13
Impact Handicapped Children
  • Monfort Institute School for deaf and muted 250
    children located in Saint-Martin , the
    headquarter of gangsters was attacked on
    September 29th, day of Baghdad operation
  • The children and teachers were stocked in their
    rooms.They couldn't go out for 45 days.
  • No food or water, no cooking gas, no medical care

14
Children in Cite-Soleil
  • Hospital Sainte-Catherine (45 pediatric beds) in
    cite-soleil, the heart of violence, was closed
    August-September 2004
  • Now they receive only daytime emergencies
  • Actually ambulatory clinic frequentation has
    dropped from 50 to 10 patients a day
  • Decrease of services immunization and nutrition
    clinic

15
Medecins sans frontieresNew Strategies
  • At the end of the year 2004 in Port-au-Prince
    because of the problems of HUEH
  • Opening of traumatology center of 56 beds in
    Saint Joseph Hospital
  • 3100 patients were treated
  • 1112 were war wounded
  • 600 were children, women and old people

16
Medecins Sans Frontières(French doctors)
17
Impact on ongoing care and prevention
18
Tetanus coverage 2004
  • Pregnant and Childbearing Women 15-49 years
  • Haiti 25
  • The west department 8

19
Impact on well baby clinic
  • Many pediatricians report a diminution of the
    consultation in downtown of Port-au-Prince
    because of the violence in some areas
  • Many families left the capital for the
    countryside or the united States or Canada or DR
  • Consequences Decrease of immunization and close
    monitoring of the Growth and nutritional status
  • Patient arrive late in bad condition in hospital

20
HIV Clinic
  • Many infected women who live in some chaotic
    areas deliver at home without prevention.
  • Children enrolled in ARV treatment cannot respect
    their appointment because of the turmoil.
  • Sometimes they left the capital for more quiet
    towns.
  • New strategies developed by doctors for adequate
    treatment

21
Economic and Nutritional Impact
  • Haiti lost 20.000 jobs
  • Business closed in No mans land
  • Unemployment worsens
  • Higher rate of malnutrition

22
Malnutrition
  • HUEH Department of Pediatrics
  • March to December 2004 82 patients with severe
    malnutrition
  • Saint-Damiens Hospital
  • January to June 2005 159 patients with severe
    malnutrition

23
Epidemiological surveillanceHUEH department of
pediatrics
  • Neonatal tetanus
  • 2004 09
  • 2005 14
  • Diphteria
  • July 04 to July 05 15
  • Severe Malnutrition 11.56

24
Culminant Violence in Port-au-Prince
  • Political violence causes
  • physical violence
  • sexual violence
  • Department of OBGYN of HUEH
  • July 04 to June 05 358 raped women
  • URAMEL
  • Feb. to Oct. 2004 306 sexual abuse cases
  • 98,6 Female
  • 01,3 Male (child abuse)

25
2004
2005
26
Sexual abuse in female (URAMEL)
27
Political Violence and psychological trauma
  • Many reasons explain this situation
  • In Port-au-Prince since September 2004 the
    Violence was increasing day by day.
  • The noise of the bullets and the continuing
    shooting during schooldays and the week-end
  • The highest rate of kidnapped Parents and
    Children were concerned
  • Cars Robberies
  • Murder in the streets
  • Fire

28
Psychological Consequences
  • Many psychologists reported some symptoms most
    frequently seen in those children
  • Anxiety
  • Nightmare
  • Fear
  • Insomnia
  • Abdominal pain

29
Armed conflicts and medical carein
Port-au-Prince
  • Many parents are separated from their children
    Because of the moving population especially in
    the no mans land such as Bel-air Saint Martin
    Cité Soleil who have
  • No access to medical care.
  • In the Department of Pediatrics many discharged
    patients can't go home

30
Armed conflict and MedicalCare
  • At the Hospital Saint-Damien AKA Little Brothers
    and Sisters.
  • From June 2004 To June 2005
  • Many Children were not visited during their
    Hospitalization

31
Non visited patients July 04 June 05
32
Impact on Health care providerIn Port-au-Prince
  • Demoralized staff Nurses and Doctors also
    victims of armed conflicts
  • They cannot respect their schedule
  • Cannot take care of the patients in some areas
    because of personal attacks on their families
  • Continuing education Many meeting were canceled
    because of the political turmoil

33
Children rights violation
  • Children Living in the street of Port-au-Prince
    were enrolled by armed groups to Participate in
    those crimes and kidnapping..
  • Many people reported to have seen children with
    guns and participating in the violence in the
    community
  • Drug Abuse by children living in the streets.

34
Summary
  • The present Political turmoil in Port-au-Prince
    has an important impact on pediatric disease and
    prevention. Because of the violence, some
    children, have no access to Medical care. Bad
    socio-economic conditions in the poorest country
    make the primary care worse
  • After 200 years of independence we need unity and
    peace to improve child survival.We need to build
    a country without violence in order that
    pediatricians can assume their noble mission
    Loving and Caring Children

35
REFERENCES
  • EMMUS III
  • Data Saint-Damien Hospital
  • Archives OBGYN Department HUEH
  • Archives Pediatric Department HUEH
  • Report DPEV July 2005 8Performances Pev 2004
  • Le Nouvelliste No 37186 Report of Press Meeting
    Medecins sans Frontieres.
  • Institute Monforts ReportFourth-Trimester
    report October-December 2004
  • Data URAMEL
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