142nd APHA Annual Meeting and Exposition

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Capacity Building and Health Promotion in Haiti: Two Case Studies of Local Community Practices and Waterborne Illnesses

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Devi Yalamanchili, MD , Internal Medicine and Pediatrics Department, University of South Florida, Tampa, FL
Ella Telcy, MBA , Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
Guitele Rahill, PhD , Department of Social Work, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL
Background: Clean water, a basic necessity, is often taken for granted in developed countries, but is a luxury lacking in resource-poor settings, e.g. Haiti. Subsequent to the 2010 earthquake, Haiti experienced an epidemic of waterborne illnesses including cholera. Difficulties faced by the United Nations and the Haitian government in containing the spread of cholera while engaged in reconstruction underscored the importance of clean water in disease prevention in that context. Lacking has been knowledge of local community practices in relation to reducing the burden of waterborne illness for this population.

Methods: We first employed participant observation and ethnographic interviews in Leogane (2006 and 2013) and Jacsonville (2009-2014), collecting photographs of the environmental context and people using the water (n= 80), semi-structured interviews of community leaders/ members regarding the source of patients’ drinking/ bathing water (n=15), and field notes. We then conducted a systematic search of MEDLINE and PUBMED, filtering results for MeSH “Haiti” and “Water”, limiting our search for peer-reviewed works published between 2007 and 2014.  ATLAS.ti® supported thematic analysis of the data.

Results: We retrieved 9 articles that met our search criteria. Factors associated with local practices and waterborne illness included poor management and development of natural resources, rapid urbanization, illiteracy, and poverty. Associated risks from analysis of our qualitative data included: 1) erroneous perception of clear water as clean; 2) scarcity and mistrust of treated water and preference for spring/river/well water; 3) fetching sanitized water in unclean containers, medicine bottles; and 4) toxin exposures; 5) New cases of E.coli, typhoid, and cholera.

Conclusion: Potable water remains a crucial challenge in Haiti, especially in rural settings. Capacity building and reconstruction in Haiti must include collaboration with community members, health providers and existing clean water efforts to increase access to clean water and reduce the burden of waterborne disease.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Describe factors associated with lack of access to clean water and lack of knowledge regarding relationship between unclean water and health outcomes among local residents in two rural Haitian enclaves.

Keyword(s): Water & Health, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an internal medicine and pediatrics physician who has a total of 7 years experience in international medical work, three of these being in rural Haiti. I have been part of a multi-disciplinary team who is building a medical clinic in the Jacsonville region of rural Haiti. That clinic has the potential to impact the health of Jacsonville's residents and that of its adjacent communities. I have personally treated waterborne illnesses in that capacity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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