This text is part of the special International Women’s Day booklet
Caught between insecurity, poverty, destructive earthquakes and stubborn taboos, women must overcome many challenges to respect their sexual and reproductive rights in Haiti. With the coordination of various local actors, a project funded by Global Affairs Canada is trying to change the situation.
“Out of 10 children, I lost 3,” says a Haitian mother in a short documentary produced by PROSAMI – Uniting for Reproductive, Maternal and Child Health in Haiti. One of her children died in an earthquake, the other two died suddenly, probably from disease or infection. And unfortunately, this scenario is far from being isolated in this country, deplores Santia Chancy, doctor and coordinator of the citizen participation project in the health sector in Haiti (PACIT) for Mission inclusion in Haiti.
In the small Caribbean country, infant mortality is 14 times higher than in Canada, while maternal mortality is 50 times higher there, according to PROSAMI. The country ranks at the bottom of the pack among the poorest countries in the world. Armed bands have caused the level of insecurity to explode and are hampering the delivery of goods and gasoline. The country has been regularly hit by devastating earthquakes; more than 200,000 people perished in the 2010 quake, while a magnitude 7.2 quake in 2021 generated more than $1.5 billion in damage.
“Is there transport to go to an institution? Is it too expensive? Santia Chancy lists questions that Haitian women can ask themselves before going to a clinic. If a child is sick, we must have the money to pay for transportation to get to the clinic, then the consultation, examinations and medication. “Only 9% of the population living in rural areas can afford to pay for this care,” she observes.
In Haiti, medicines are not only difficult to access for patients, but also for institutions that regularly have stockouts due to the great insecurity in the country. “If you go to Port-au-Prince, you are afraid of being kidnapped, observes the doctor, who is based in the city of Léogâne, only about forty kilometers from the capital. Because we can’t go there, there are medicines that we can’t find. »
Finally, there are the many taboos surrounding women’s sexual and reproductive health. A pregnant woman will often prefer to give birth in the privacy of the house with the help of a traditional midwife, observes Santia Chancy. The risk is that these birth attendants are not always adequately trained to react quickly in the event of complications, which sometimes leads to the death of the mother or the newborn.
Also, more than 20% of young women already have a child by the age of 19, adds the doctor. If a teenager under the age of 19 asks for contraceptives, the employees of the institutions can refuse her request because of her age, she illustrates, adding that abortion is considered a crime in the country.
Health, for and by the community
For seven years, the PROSAMI project team has tackled different factors in order to improve the health of women and girls, for example by reducing the price of medicines or by providing training to midwives. Over the years, the PROSAMI team has forged many links within the community and institutions of the city of Léogâne. It is on these links that the PACIT project is built, which has just received a budget envelope from Global Affairs Canada.
“When we talk about the issues, when we make decisions, the community has its say. People have to be involved from the start of the project, explains Santia Chancy. We will try to deconstruct certain hierarchical relationships. We are going to support this civil society so that it can integrate the dialogue with institutions and state authorities. It is a link between law and health. »
To do this, group activities are on the calendar with a multitude of community actors: parents, adolescent girls, schools, religious leaders, healthcare providers, etc. The first activity of PACIT is also planned with women’s organizations in the region, within the framework of International Women’s Rights Day.