Committee: World Health Organisation (WHO)

Topic: Improving Access To Assistive Technology For Targeted Group

Country: Haiti
Assistive technology is assistive, adaptive, and rehabilitative devices for people with
disabilities or the elderly population. People who have disabilities often have difficulty
performing activities of daily living independently, or even with assistance. ADLs are self-care
activities that include toileting, eating, bathing, dressing, grooming, and personal device care.
Assistive technology can ameliorate the effects of disabilities that limit the ability to perform
ADLs. Assistive technology promotes greater independence by enabling people to perform
tasks they were formerly unable to accomplish, or had great difficulty accomplishing, by
providing enhancements to, or changing methods of interacting with, the technology needed to
accomplish such tasks. For example, wheelchairs provide independent mobility for those who
cannot walk, while assistive eating devices can enable people who cannot feed themselves to
do so. Due to assistive technology, people with disabilities have an opportunity of a more
positive and easygoing lifestyle, with an increase in "social participation," "security and
control," and a greater chance to "reduce institutional costs without significantly increasing
household expenses.

Unfortunately, only 5-5% of the population are able to access assistive products.
This problem is especially true in low- and middle-income countries. In 1990, the UN
Standard Rules identified access to assistive products as a precondition for equal rights and
opportunities and urged Member States to take affirmative actions to make these devices
available at an affordable cost. Access to assistive technology has been recognized by The
Convention on the Rights of Persons with Disabilities and is now perceived as a human
right and has called for international cooperation to improve its access (Article 32).

As a country, one of the main causes of Haiti's increasing population with disabilities
is, the natural disaster that the country experience throughout history. Is it known by
everyone that the biggest pandemonium of all is during Haiti’s earthquake in
2010.Devastating injuries from the earthquake have permanently disabled untold numbers
of Haitians, young and old, as well as worsened already bleak conditions for Haitians who
were living with disabilities. The precise scope and implications of new disabilities in the
population are as yet unknown but are certainly massive1. Its is also worthwhile to know
that Haiti is actually one of the most exposed countries to natural hazards in the world,
placed 6th in the chart, below India, United States, China and others, with approximately
5,794,943 population are affected.2

Following the 2010 earthquake, the government conducted a post-disaster needs

assessment (PDNA) and created an Action Plan for the National Recovery and Development
of Haiti. They recommended that DRM be a cross-cutting priority for both public and
private sectors. DRM is also a key cross-cutting priority in the government’s Strategic

1
https://annals.org/aim/fullarticle/745837/disability-legacy-haitian-earthquake
2
https://www.worldatlas.com/articles/countries-with-the-deadliest-natural-disasters.html
Development Plan of Haiti (PSDH). As part of its first pillar on “territorial rebuilding,” the
PSDH emphasizes regional and local development as well as improved DRM through better
land-use planning. Haiti has also taken steps to strengthen its fiscal resilience to natural
hazard shocks by becoming a member of the multi-country risk-pooling Caribbean
Catastrophe Risk Insurance Facility (CCRIF) SPC.

WHO also focused on the needs of Haitians with disabilities, both those who were in
need of care before the earthquake and those newly disabled3. The Health Cluster, which is led
by PAHO/WHO, has a dedicated sub-group dealing with disabilities which is chaired by
Handicap International.

In the revised Haiti Flash Appeal, a project has been drawn up to "Ensure Availability
of Post-Earthquake Rehabilitation" and implemented by the Haitian Ministry of Public Health,
Cuban Medical Brigade and Handicap International. This project, valued at US$5.15 million,
aims to:
 Support treatment of injuries and emergency services, including referrals of patients.
 Provide access to a free orthopaedic unit for follow-up care for patients.
 Ensure the proper functioning of at least one specialized institute on medical
rehabilitation.
 Set up community-based rehabilitation services.
 Make available assistive devices and technologies, like wheelchairs, and prostheses.
 Deliver mid- and long-term training of rehabilitation specialists, orthopaedic surgeons
and nurses.

Nonetheless, even before the earthquake, Haiti had little to offer persons with
disabilities. As elsewhere in the developed and developing world, Haiti is considered to be the
poorest country in the western hemisphere by a considerable measure. Some four-fifths of its
population lives in absolute poverty, and as much as three-fifths of the population is
unemployed or underemployed4. Haiti’s limited resource base has been depleted, first through
intensive colonial exploitation and later through unplanned development and corruption. This
in turn retard the government assistance for the people with disabilities. In the past seven years,
Haiti has scaled up efforts to integrate disaster risk management (DRM) into national policies
and long-term development plans. In particular, it has made building a better and safer Haiti a
priority in its long-term development strategy.

3
https://www.who.int/hac/crises/hti/blog/mari_agnes/en/
4
https://www.britannica.com/place/Haiti/Climate
Bibliography
Dillinger, J. (2016, January 21). Countries Most Prone to Natural Disasters. Retrieved from
https://www.worldatlas.com/articles/countries-with-the-deadliest-natural-disasters.html.

Iezzoni, L. I., & Ronan, L. J. (2010, June 15). Disability Legacy of the Haitian Earthquake.
Retrieved from https://annals.org/aim/fullarticle/745837/disability-legacy-haitian-
earthquake.

MacLeod, M. J., & Girault, C. A. (2019, August 7). Climate. Retrieved from
https://www.britannica.com/place/Haiti/Climate.

Overcoming adversity: Haitians deal with disabilities. (2012, May 18). Retrieved from
https://www.who.int/hac/crises/hti/blog/mari_agnes/en/.
Committee: World Health Organisation (WHO)
Topic: Addressing Mental Health as part of Public Health
Country: Haiti
Mental health is defined as a spectrum from mental health problems, conditions,
illnesses and disorders through to mental wellbeing or positive mental health. Meanwhile,
public mental health is a term coined in promoting focus on wider prevention of mental illness
as well as emphasizing the neglected element of mental health in public health practice. Over
the last two decades, many books and electronic resources to support teaching, training and
practice in the aspect of public health practice and in support of dissemination of knowledge
and skills to professionals, practitioners and the general public.5 A 1990 bio-medical model has
delivered prominent advances for health in general. Yet, this model underestimates the effect
of developmental, social and environment determinants of health and believes in the primacy
of pharmaceutical and technological solutions.6
Therefore, further developments are needed for public mental health practice to include
psychological and interpersonal factors. It is now being called the bio-psycho-social mode.
There is a need to expand the view that susceptibility to mental health problems may be
determined by individual risk factors, which are influenced by settings and in turn by the
broader socioeconomic, cultural and political context as purported by the Dalgren and
Whitehead Model (1991). Failure of recognizing the importance of addressing wider
determinants across the life course to both prevent mental illness and promote well-being will
result to a plethora of adverse effects in all levels. For example, higher level of mortality and
economic disadvantage for its lower level of productivity. To elucidate this, a review of
economic evaluations of mental illness in childhood and adolescence, such as emotional and
behavioural disturbances or antisocial behaviour, found mean costs to UK society to range from
£11 030 to £59 130 annually per child.7
The world leaders are starting to recognize the promotion of mental health and well-
being, and the prevention and treatment of substance abuse, as health priorities within the
global development agenda. This is seen by the adoption of improving mental health, which is
Goal 3 in the Sustainable Development Agenda at the United Nations General Assembly in
September 2015. René Dormesant representing Haiti had also contributed to the Mental Health
Atlas project in providing information and data on the progress towards the achievement of
objectives and targets of the Comprehensive Mental Health Action Plan 2013–2020.

Mental health in Haiti is undoubtedly improving through the integration of community

services between psychotherapy and religious or cultural practices, agencies like CAMH are
facilitating change in the country. For instance, a network of community resources were
mobilized to sensitize the population to social issues related to various problems such as

5
Brown, “Promoting Public Mental Health and Well-Being; Principles into Practice” (2015)
6
Guidance for commissioning public health services, “Joint Commissioning Panel for Mental Health” (2013)
7
Suhrcke, “Social Cohesion for Mental Well-Being among Adolescents.” (2008)
violence against women and children’s rights as well as the emergence of self-help illness
support groups have also emerged. 15 percent of its budget is allocated to health less than 5
percent of that is spent on mental health. The Haiti government gives more priority to issues
such as HIV/AIDS, tuberculosis, or maternal and child health. Government expenditure on
mental hospitals is 0.61% in Haiti in 2011. The per capita government expenditure on health
at average exchange rate (US$) in 2011 was 13. The cultural and religious are some of the
contributing factors to the government’s expenditure on mental health. This is because vodou
plays a universal role in all aspects of Haitian life including politics, ethics and health with
around 70% of Haitians believed to practice vodou and more than 60,000 vodou priests across
Haiti, Max Beauvoir, supreme leader of Haitian vodou remarked that “Vodou heals the mind,
soul and body.”

Haiti also experiences repeated emergencies which leads more than half of total health
expenditure goes toward curative rather than preventive health care. For the same reason, Haiti
focuses their investment on increasing agricultural production and improve the environment;
building energy, transportation, and port infrastructure; reinforcing water and sanitation
infrastructure; improve the infrastructure and quality of the education system; and promoting
stability through social projects which undeniably contributed to the betterment of mental
health and wellbeing. For example, two-fifths of all Haitians depend on the agricultural sector,
mainly small-scale subsistence farming, which remains vulnerable to damage from frequent
natural disasters.

Intervention triangle should be adopted to tackle this issue. This is where intervention
should be on 3 levels namely universal (for everyone), selective (people in different
demographics or communities) and indicated (people with detectable signs) in the pyramid
respectively. Promoting mental wellbeing should focus away from illness and is central to an
individual’s resilience, social purpose, autonomy and ability to make life choices. Engagement
on both community level in building on assets and involving communities in framing the issues
and the solutions to public mental health and also individual level in developing individual
strengths and resilience is pivotal for mental wellbeing and public mental health.
Bibliography
Brown, J.S., A.M and Mackereth, C.J. (2015). Promoting Public Mental Health and Well-
Being; Principles into Practice. London; Jessica Kingsley Publishers

Chung, & Hyunsoo. (1970, January 1). Mental Health in Haiti: Beyond Disaster Relief.
Retrieved from https://www.ghjournal.org/mental-health-in-haiti-beyond-disaster-
relief/.

Guidance for commissioning public health services. (2013). Joint Commissioning Panel for
Mental Health. Available at: www.jcpmh.info

Haiti: New World Bank Report Calls for Increased Health Budget and Better Spending to Save
Lives. (n.d.). Retrieved from https://www.worldbank.org/en/news/press-
release/2017/06/26/haiti-new-world-bank-report-calls-for-increased-health-budget-
and-better-spending-to-save-lives.

Suhrcke M, Pillas D, Selai C (2008) Economic aspects of mental health in children and
adolescents. In Social Cohesion for Mental Well-Being among Adolescents. WHO
Regional Office for Europe.

Mental health atlas 2017. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA
3.0 IGO