Residents at State University of Haiti Hospital Strike Drawing Attention the Dilemma of Healthcare Activism in Low-Resource Environments.
Haitian residents face a double bind when fighting for their and their patients’ rights. This was made clear Monday, when the residents of critical Port-au-Prince healthcare center, The State University of Haiti Hospital, went on strike to protest their unsanitary working environment and lack of pay. Residents report a lack of resources—no oxygen, no gloves—and abundant waste: trash cans overflow in maternity wards. City-level crises, such as this, in low-resource areas require international cooperation to address.
Emergency services have slowed to a near halt. If patients are admitted for emergency care, families are asked to track down and produce their own medical supplies. This is not a possibility for many Haitian families, and even the most well off can do little to improve the unsanitary facilities.
The residents have worked for the past six months without pay. Once or if they are paid, however, their financial situations may not improve significantly: minimum wage for a medical resident in Haiti is just 9,000 Haitian gourdes (US$100 approx.) per month.
Given the state of the hospital, had a strike not been organized, work may have stopped anyway. Resident Yveline Michel, interviewed for Agence France-Presse, put it bluntly: “due to the lack of resources and the unsanitary environment, there are always people dying in the hospital, so it’s not the strike causing that.”
There has been discord, nevertheless, regarding the residents’ action. The State University of Haiti Hospital (known as the “general hospital”) is responsible for treating the most disadvantaged Haitians, and this work stoppage has added an additional barrier to this care.
There is a Healthcare Crisis In Haiti
This situation highlights the severity of healthcare inequity in Haiti. Despite foreign donations and aid, there is a dramatic lack of resources and healthcare personnel. This situation hasn’t been improved by the travel warnings leveled by the U.S., Canada, and other important supplier nations this year, and it won’t improve until there is more attention paid by those nations, and by the Haitian government, to the ailing state of healthcare in the country.
Because, over the past three months, the general hospital has received more a more patients from outside of the city center and from the countryside, the system has become entirely overloaded. Due to the surge, Médecins Sans Frontières has had to amend their normal policy of referring excess patients to local facilities; there is simply nowhere for the patients to go.
The Dilemma of Healthcare Activism in Low Resource Areas
A result of this severity is the double bind facing the striking residents. On one hand, Michel’s assertion is true, people are dying anyway and the residents, sworn to take care of their patients, must strike in order to ensure their long-term care and the possibility of future care. On the other hand, though, denying service in the present has immediate and grave consequences.
This is the ethical dilemma of healthcare activism in Haiti, and in any comparably low resource healthcare theatre. There is no way to scab the open wound of the depleted system. Any work stoppage is debilitating. Still, activism—including actions like striking—is the only way to move towards a more effective system.
In some cases, the disparity is more extreme. Until 2016, In Liberia, a country of almost five million people, one million of whom have mental health condition—there was only one registered psychiatrist. If one is the sole provider of a critical service in one’s country, striking for better pay/conditions/supplies is not an option.
The Necessity of International Cooperation
The residents strike in Haiti has not, as of yet, received significant international coverage. The systemic disparity it illuminates, however, will require international cooperation to address. For healthcare workers in areas where effective healthcare is rare, traditional means of worker organizing such as strikes, have dire costs in areas where effective healthcare is rare. The improve conditions, there may need to be cooperation across international lines.
Large healthcare concerned non-profits such as the World Health Organization, the World Bank, or Partners in Health have varying track-records when it comes to addressing healthcare inequity. Further, in the long run, it will be necessary for countries like Haiti to develop a in-country resource base to handle healthcare challenges domestically.
That said, it is not fair to the residents, or to the patients seeking their care for high-income countries to not intervene. The dilemma of healthcare activism in low resource areas can be averted through international cooperation. The cost of policies, such as the recent travel advisories, which limit healthcare resources from reaching high-need areas should be more closely examined. More attention should be paid to apparently small crises such as this strike of residents at the State University of Haiti Hospital. Equitable, careful, International healthcare cooperation is a necessity to alleviate the growing humanitarian crisis in Haiti.