A Malnutrition Crisis: Its Past, Present, and Future

BY HANNAH VERMA

In early 2010, a massive earthquake decimated the Republic of Haiti. As one of the most poverty stricken nations in the world, it lacks the resources both to prepare for natural disasters and deal with the aftermath. The result? 1 in 5 children are malnourished. Approximately 50% of the population lives on less than one dollar per day.¹ Only 50% of people have access to what is known as “an improved water source,” such as a hand pump or well, meaning that the rest are forced to rely on untreated lakes and rivers.² These statistics represent only a small portion of the  challenges faced by Haitian citizens. Investment and development efforts prior to the 2010 earthquake have since resumed, and have made an impact, but recent natural disasters have interrupted any progress. Haiti is especially vulnerable to these storms, due to its location in the heart of the “hurricane belt.” As a result, the malnutrition crisis remains, and will remain, a crucial issue in Haiti until further intervention. 

Haiti’s population is largely centered around its youth, with over half of its population under the age of 20.³ Of its roughly 10.6 million inhabitants, most towns are concentrated in Haiti’s coastal regions and urban areas.⁴ Though Haiti occupies the same landmass as the Dominican Republic, the two nations differ immensely. Haiti’s semi-arid climate is the result of its mountainous landscape, which cuts off the eastern trade winds that blow towards the Dominican Republic. This, in combination with unpredictable climate change trends, has resulted in a far more tumultuous and difficult environment to in live sustainably. Increasingly, the population has been shifting towards urban areas, especially to Port-au-Prince, the capital, with 60.9% of people living in urban cities.⁴ The population is 95% African American, while the remaining 5% are “mulattoes” (mixed ethnicity) or white.⁵ The mulatto population, long considered the Haitian elite, tends to face less of these hardships. Rural areas face a poverty rate significantly higher than urban areas, along with a lower median income.⁶ This economic inequality is accompanied with a host of discrepancies in other crucial areas, including access to sanitation, water, food, and jobs. In rural areas, health outcomes are greatly affected as well; the prevalence of underweight children and lack of knowledge on HIV exceeds that of urban areas by a wide margin.⁷

An overall lack of infrastructure and development is compounded by these economic disparities. Without access to clean, safe, drinking water, rural Haitians more easily succumb to infectious waterborne diseases. This issue was once more intensified after a large cholera outbreak post-earthquake.⁸ In combination with inadequate nutrition, poor sanitation contributes to physical deformities and disabilities as well, including paralysis and amputations.⁹ Haiti’s very basic sanitation infrastructure does not have the capacity to handle a growing population with increasing needs along with an increasingly unstable environment.

The majority of the population, nearly 60% relies on Haiti’s agricultural sector for survival, with the remainder working in the forestry, mining, and energy sectors.¹ However, the agricultural sector ebbs and flows with the state of the environment, which places a great strain on Haitian farmers. Haiti is not especially conducive towards farming in general, yet there is almost no other alternative due to the lack of development. This conundrum has locked the majority of farmers into poverty, churning out cash crops without acquiring any food security for their own families. The downfall of Haiti’s agricultural sector has resulted in increased malnutrition, negatively impacting the health of Haitian citizens.

Primarily, farming and agriculture can no longer support Haitian families’ needs to feed themselves and run businesses, as American subsidization of large factory farms has led to “crowding out” of smaller Haitian farms.¹⁰ By making it cheaper to produce products like rice and corn, United States businesses can afford to charge incredibly low prices for their goods. In contrast, a country like Haiti relies on its small family farms to produce these grains. These businesses simply cannot compete with behemoths dumping far cheaper goods in their markets, and this phenomena tends to drive small farms out of business.¹¹ In order to compete, forests are being cut down at an extremely fast rate to make room for more plots of crops, adding to erosion, deforestation, and decreasing biodiversity. In general, however, farming in Haiti has become less profitable due to ecological damage and low import tariffs, but remains the only option for people in the lower classes because the government has not made much effort to diversify the economy.

In addition, Haiti repeatedly faces the brunt of enormous tropical depressions, cyclones, hurricanes, and storms. These factors can destroy an entire year’s worth of crops, and in turn destroy remaining infrastructure as well.¹² Erosion from deforestation adds to the damage and flooding caused by these storms, which only serves to increase food prices and make crops even more difficult to grow.

Malnutrition wreaks havoc on Haiti’s population. The greatest victims are, unfortunately, the ones who are least able to tolerate it: children. Insufficient nutrition begins from birth. USAID reported that less than 50% of children under the age of six months are breastfed and less than 20% of children between six months and twenty-three months of age receive appropriate nutrition.₁ Mothers who are malnourished and underweight themselves are also unlikely to be able to deliver milk to their children, creating a cycle of undernourishment. And after birth, children are chronically malnourished, stunted, and underweight; almost 25% of children under the age of 5 are malnourished.¹³ Malnutrition in Haiti is also stratified regionally. The highest rates of malnutrition are in the Southeast and Center regions, 29% and 28% respectively, and the lower rates of malnutrition are in the West, Nippes, and Metropolitan regions, with rates of 17%, 17%, and 15%, respectively.¹ The cities with the lowest rates are all major trade centers or urban centers, further highlighting the relationship between geography and inequality. Malnourishment at a young age has ripple effects that extend throughout one’s lifetime. It reduces one’s ability to work at full capacity, slows cognitive development, and thus affects school performance and earning potential.¹³ Decreased productivity reduces one’s potential to move up the economic ladder. This can doom one’s children and future generations to a repeated cycle of poverty and malnutrition as well.

Though it still faces constant agricultural and health crises, Haiti, in conjunction with several partner nations, has made great strides and great progress to address these issues. Through the Haitian government’s Nutrition Strategic Plan, the national Commission for the Fight Against Hunger and Malnutrition works with several agencies, including the Haitian Red Cross, to meet three goals: 1) to improve access to food; 2) to invest in the agricultural industry to increase crop yields; and 3) to deliver essential services such as healthcare and sanitation.¹ US government intervention consists of USAID programs, such as Feed the Future, which focuses on rural agriculture, and the SPRING project, which aims to help pregnant women and young children.To improve agricultural production, a potential beneficial change could be consolidating both private sector and public investment, with the private sector serving to check the public sector’s lack of accountability and direction and the public sector serving to decrease barriers to entry in the market and increase competition, driving down the overall costs of goods and services. 

After the 2010 earthquake, foreign aid from countries such as the United States was heightened and used rather effectively, but since then, global awareness of and support for Haiti has seemed to die down.¹⁴ Even after further development, many who live in Port-au-Prince dwell in flimsy shelters, vulnerable to yet another storm that will surely hit Haiti in the coming years. Haiti is not the only country in the hurricane belt, but it seems to get hit the hardest, a result of its lack of a coping mechanism and disaster mitigation. The damage sustained from each natural disaster will set Haiti further back in its quest to eradicate hunger and sickness. Especially with the advent of climate change, it is more crucial than ever that Haiti is able to manage the infrastructure needed to prevent irreparable harm. By strengthening the agricultural sector through existing programs such as Feed the Future partnership,¹ Haiti can work towards sustainable farming practices.

Past efforts by the Haitian government have proven to be successful; from 2006 to 2012, rates of stunting decreased from 28.5% to 22.2%.¹⁴ However, until Haiti formulates stronger policies for improving food security and reducing economic inequality, its workforce, made of malnourished citizens, can never thrive. To fully escape the shackles of poverty, Haiti must focus on feeding its hungry.

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References:

1. USAID. (2014). Haiti: Nutrition Profile. USAID. Retrieved from https://www.usaid.gov/sites/default/files/documents/1864/USAID-Haiti_NCP.pdf
2. Evans, Chelsea. (2016). Poverty in Haiti. The Borgen Project. Retrieved from https://borgenproject.org/top-five-facts-about-poverty-in-haiti/.
3. World Population Review. (2017). Haiti Population. World Population Review. Retrieved from http://worldpopulationreview.com/countries/haiti-population/. 
4. Central Intelligence Agency. (2017). Haiti. The World Factbook. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html.
5. Index Mundi. (2017). Haiti Demographics Profile. Index Mundi. Retrieved from http://www.indexmundi.com/haiti/demographics_profile.html. 
6. Pietikainen, A.. (2008). Enabling the Rural Poor to Overcome Poverty in Haiti. IFAD, 1-7.
7. UNICEF. (2017). At A Glance: Haiti. UNICEF. Retrieved from https://www.unicef.org/infobycountry/haiti_statistics.html#124. 
8. Gelting, E., Bliss, K., & Patrick, M. (2013). Water, Sanitation and Hygiene in Haiti: Past, Present, and Future. The American Journal of Tropical Medicine and Hygiene, 89(4), 665-670. 
9. Guly, C. (2004). Haiti Emerging From Chaos to Face Health Care Crisis. Canadian Medical Association Journal, 170(9), 503-504. 
10. Oxfam International Briefing Paper (2005). Kicking Down the Door: How Upcoming WTO Talks Threaten Farmers in Poor Countries. Oxfam International. Retrieved from https://www.oxfam.org/sites/www.oxfam.org/files/kicking.pdf. 
11. O’Connor, Maura. (2013). Subsidizing Starvation. Foreign Policy Magazine. Retrieved from http://foreignpolicy.com/2013/01/11/subsidizing-starvation/. 
12. Diaz, Anthony. Haiti Background Report. Lehigh University. Retrieved from http://www.lehigh.edu/~bm05/courses/Haiti_paper5.version2.pdf. 
13. The Fanta Project (2013). Reducing Child Malnutrition in Haiti. The Fanta Project. Retrieved from https://www.fantaproject.org/sites/default/files/resources/Haiti-PROFILES-2013-Costing-Report-ENGLISH-Mar2014.pdf. 
14. Ayoya, M., Heidkamp, R., & Pierre, J. (2013). Child Malnutrition in Haiti: Progress Despite Disasters. Global Health: Science and Practice Journal, 1(3), 389-396.