|Women feed their children in a narrow alleyway lined with makeshift homes in the seaside slum of Cité Soleil in Port-au-Prince.|
By Elizabeth Kiem
This year, UNICEF’s flagship report, ‘The State of the World’s Children’ – to be launched on 15 January – addresses the need to close one of the greatest health divides between industrialized and developing countries: maternal mortality. Here is one in a series of related stories.
PORT-AU-PRINCE, Haiti, 12 January 2009 – In the poorest country in the Western Hemisphere, no one struggles harder than the women trying to support their families.
It is women who contribute the bulk of Haiti’s informal economy and raise multiple children on the most meagre of incomes. It is also women who suffer most from the lack of affordable health care.
“The country doesn’t have a lot to offer. For the woman it’s even worse. She’s really the head of the household, surviving on very little resources,” says UNICEF Haiti Health Specialist Mireille Trebie. “Most of the women have small food businesses or ‘pepe’ [second-hand] markets. And they have six to eight children to care for.”
From bullets to babies
Since its founding in the 1960s as a model neighbourhood for some 10,000 working-class Haitians, the sprawling slum of Cité Soleil has instead become home to 300,000 people – and it is fraught with poverty, unemployment, illiteracy and malnutrition.
Once plagued by gang violence, this neighbourhood is now under the control of a UN stabilization force. That means Choscal Hospital, the quarter’s main hospital, can now focus on life-saving services for women and children.
Operating on a slim budget supported by UNICEF and non-governmental partner Médecins du Monde, Choscal offers a nutrition centre and paediatric ward for severely malnourished children, as well as free prenatal and obstetric care for expectant mothers. About 300 babies are delivered here every month.
“We try as hard as we can to reduce the cost of services here. Most people know that we are the cheapest of all centres around, so we get a high number of patients,” says the head of the hospital, Dr. Jacqueline Sainte-Fleur.
Strapped even for the basics
Pilot projects such as the free obstetric care programme at Choscal are gradually expanding throughout the country with the participation of UNICEF and its partners. The government is also embracing the need for more of a continuum of care to lower maternal and newborn mortality rates.
But for mothers like Naomi, who must attend their sick children in the malnutrition ward of the hospital, leaving many other children in the care of friends and relatives, post-natal checkups can only go so far.
“My baby is doing better,” she says. “But how will I pay the fees and prescriptions to keep her healthy?”
UNICEF advocates for the expansion of programmes to attract more women into the health care system, where they can benefit from information on reproductive health and infant nutrition.
“There is a movement to get the women informed, to attract them to come to the clinics to receive prenatal care, and to be followed [through their pregnancy],” says Ms. Trebie of UNICEF Haiti. If the mothers of Cité Soleil and other impoverished communities are going to take full advantage of available services in the current climate of non-violence, she adds, “that’s where Haiti needs to be.”
The State of the World’s Children 2009
SOWC 2009 report launched
Report on maternal and newborn health
'Baby-friendly' practices for Kyrgyz mothers