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Haiti: Tourism, Health and Safety

发布时间:2017-04-24
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Incidence of disease in Haiti comparison to Cuba.

Haiti proclaimed its independence in 1804, the first country in Latin America and the Caribbean to do so. Despite having to pay an extortionate independence fee, equivalent to $21bn (£14bn) in today's money, it was a relatively prosperous and peaceful place to live. Indeed, most Haitians had a decent life before the 1960s, when the country could have been likened to Canada and Australia in terms of human development indices. Along with pre-revolutionary Cuba, Haiti was the tourist destination of choice in the 1950s, attracting jetsetters and wealthy travelers from the US and Europe. It was the place to see and be seen.

Over 50% percent of Haiti's population is school age yet over half the population is illiterate. Many children cannot afford the costs of education in Haiti because the average family makes less than $1 a day. The government does not provide adequate funding for public schools and most families cannot afford the costs of private education, which can be as little as $20 a year.

What makes Haiti Appealing?

According to Hudman and Jackson (2003), Haiti has some amazing attractions which attract tourist on an annual basis. Some of these attractions are what pull tourist to Haiti;

Petionville

Petionville is one of the well-liked tourist attractions in Haiti. It is located in the country's capital city and is quite a popular area in Port-au-Prince. Here you will find a lot of the modern amenities, which is a welcome treat after a day's worth of touring a Caribbean heaven.

You can take a few hours off dining in restaurant or looking for great deals in one of the many shops. Other than shopping or dining, you can also experience the country's educational inheritance. There is a lot of cultural institution in Petionville that you can visit.

Plaine du Cul de Sac

This is an accepted landmark in Haiti and is also a significant tourist appeal. It is located near the country's border with the Dominican state. It's a great place for those who want to go nature tripping since this huge stretch of lush land features rare species of nature including herons, flamingos, and ducks.

Barbancourt Rum Distillery

There are those who associate the Caribbean with rum for some reason. Maybe it is due to the fact that some of the best rums you can ever sample are made here. If you want to some of the best rums in the country then you should pay a appointment to the Barbancourt Rum Distillery. This brewery is a popular tourist magnetism that demonstrates to visitors how rum is made. Not only do you get a tour and a rum production demonstration, you will also be treating to a free sample after the tour.

Citadelle Laferriere

If you are into historic sites and would like to see on in Haiti then you should visit Citadelle Laferrirere. Not only is this a popular tourist attraction, it is also a major landmark in the country. It is an old fortress built on a large ton in the northern reaches of the country. It was affirmed as a UNESCO World Heritage Site and is also an icon among the locals. The construction of this fortress ongoing in 1805.

Labadie Island

This could well be the biggest tourist magnetism in the whole of Haiti if not the most popular one. Labadie Island is best known for her indisputable scenic beauty. Visitors can take a cruise all approximately the island and enjoy the scenery. If you want to take a dip in the cool Caribbean waters then you can go beach jump or dive in one of the bays and leave the different reefs.

Amiga Island

This island is bounded by a good-looking beach but its beauty is further established as you dive into the clear waters. It is a well optional spot for snorkeling. The beautiful undersea life, coral formation, and reefs are only a yards away from the beach, which makes it quite an attractive tourist magnetism in Haiti.

Bay of Acul

Since one of the major magnetism of the country is the marvelous amount of water activities that tourists can try, one should not miss heading out to the Bay of Acul. It is located along the west coast and is quite superb. The place is of course shielded from storms and was chosen by Christopher Columbus himself as a shelter when he went on his first journey.

Musee de Guahaba

History and culture buffs will enjoy a trip to Musee de Guahaba. It is a past museum among others in the country. It has a bit of a slant, however, for philanthropic help. Its collections portray how the variety of groups of people that the natives have group home with has prejudiced their culture and way of living.

Museum of Haitian Art

This is one more treat for those who want to information the local color. You will see luxury of grand visual display of the locals’ works of art. This museum is situated within the College of Saint Pierre.

However, not because Haiti has all these wonderful attractions that draw tourists to the country, Haiti has been also unappealing to many people in the world. The various or many diseases that are within the country are one of the most outstanding things that make Haiti unappealing compared to Cuba.

Haiti is one of the poorest countries on earth, with the highest rates of infant and maternal mortality, malnutrition, per capita tuberculosis burden, and people living with HIV/AIDS of any country in the Western Hemisphere. Infectious diseases cause 40% of all deaths. Primary healthcare is unavailable for more than 60% of the population, 50% does not have access to medication, and an estimated 40% have insufficient food. Less than half of the population has access to safe drinking water, less than one-third has access to electricity, and public sewage systems are nonexistent.

The earthquake made it unimaginably worse, and the potential for massive outbreaks of infectious disease was and remains enormous. More than a million people are homeless, crowded into squalid camps without basic healthcare, clean water or sanitation. Although progress has been significant, half of a million people are still living in these harsh conditions. Waterborne diseases are the biggest risk. Without clean drinking water, a possibility exists for massive outbreaks of food and waterborne diseases, such as typhoid fever, hepatitis A and E, and other GI illnesses common to Haiti, but while the diseases in Cuba may be low at a given moment the total level of HIV carrier in the population may start to grow and the rate of HIV increase due to people having unprotected sex.

Healthcare officials expect outbreaks of endemic mosquitoborne diseases (malaria, dengue and lymphatic filariasis) among survivors still sleeping outside or living in camps. An increase in other vectorborne diseases is anticipated, including leptospirosis, (transmitted through cuts and abrasions in the skin from water contaminated with animal urine) and human rabies (transmitted through dog bites). Officials also expect communicable diseases spread person-to-person to increase in the unhygienic conditions of the overcrowded refugee camps, including meningococcal meningitis, measles, diphtheria, pertussis and acute respiratory infections. In addition, officials expect the transmission of HIV/AIDS and tuberculosis to continue to increase because of the interruption in treatments (medication) and loss of patient follow-up resulting from mass population movement and resettlement.

Cholera

At the end of 2010, an unexpected waterborne outbreak struck. Cholera, an illness caused by the organism Vibrio cholera, was seen in outbreak proportions for the first time in more than a century. Breaches in the water supply, sanitation and hygiene allowed for the spread of this organism. The illness can be mild or produce severe diarrhea, vomiting and leg cramps, progressing to severe dehydration.

As of April 2012, 534,647 cases and 7,091 deaths resulted. Treatment with antibiotics may lessen the severity of the infection, but rehydration is key. The National Public Health Laboratory and CDC are emphasizing continued vigilance for cholera and other diarrheal illness in Haiti.

Lymphatic Filariasis

Lymphatic filariasis, also known as “elephantiasis” (thickening of the skin and underlying tissues), is a parasitic disease caused by thread-like nematodes (roundworms) that, in their mature adult stages, live in the lymphatic or connective tissues of its human host. Wuchereria bancrofti is responsible for the disease in Haiti, and an estimated 30% of the population is infected. Humans are the definitive host for the parasite, and the infection is usually acquired in childhood. Lymphatic filariasis begins when a mosquito bites and deposits infected larvae into the skin or blood of the host (Freedman, 2008).

Leptospirosis

Leptospirosis is endemic to Haiti. It is one of the most common zoonotic diseases in the world, and millions of people are infected each year (Green-Mackenzie, 2012). Leptospirosis is caused by Leptospira interrogans, a gram-negative, cork-screw shaped bacteria that differs from other spirochetes by the presence of end hooks. The bacteria infect at least 160 mammalian species. The most important reservoir in cities is the rat, and urinary shedding from infected rats is the most important source of human infection. In favorable conditions, the bacteria can survive for as long as six months in the environment. Fresh water in lakes and streams is often contaminated. Humans become infected with leptospirosis through contact with moist soil or water contaminated with urine from infected animals. When a person bathes in contaminated water, L. interrogans can enter the body through abrasions or cuts in the skin; through mucosal surfaces, such as inside the nose or mouth; or possibly through waterlogged skin. Once inside the body, the bacteria multiply and spread through the lymphatic and bloodstream to all organs but particularly to the liver and kidneys. Early signs of infection occur four to 10 days after exposure and usually begin abruptly with “bloodshot” eyes and a severe, incapacitating headache. Nonspecific flulike symptoms characterized by fever, chills, weakness and extreme muscle pain affecting the calves and lower back are common. A red non-blanching skin rash, sore throat, cough and chest pain can also occur. In mild cases, recovery occurs after three to seven days. In moderate or more severe disease, symptoms occur in two phases: the initial phase as above followed by a one- to three-day improvement in symptoms, during which the patient becomes relatively asymptomatic. In this second phase, symptoms vary among patients, and disease referable to specific organs appears. Initial symptoms of fever, chest pain and abdominal pain return. Fifty percent of patients develop aseptic meningitis with meningeal symptoms of headache and photosensitivity. Renal symptoms are equally common with azotemia (excess urea and other nitrogenous compounds in the blood caused by kidney failure), pyuria (pus in the urine), hematuria, proteinuria and oliguria. Recovery is slow (one to two months), but most patients recover completely.

Definitive diagnosis of leptospirosis is made by clinical suspicion, isolating the pathogen in culture or a positive result on the microscopic agglutination test. The disease can be treated with antibiotics. For mild to moderate disease, the following drugs are effective: amoxicillin (Amoxil), ampicillin (Omnipen), doxycycline (Vibramycin), erythromycin (ERYC), and third-generation cephalosporins and quinolones. High doses of IV penicillin are recommended for severe disease.

Human Rabies

Haiti has the highest incidence of human rabies in all Latin American and Caribbean countries. Before the earthquake, human rabies was a priority disease, and a mass vaccination of dogs had begun. After the earthquake, with packs of hungry stray dogs wandering among displaced people, the risk of rabies is likely to be higher than ever.

Human rabies is the most fatal of all infectious diseases. It has a mortality rate of nearly 100% if prophylactic treatment is not followed before or shortly after an exposure. The disease, caused by a bullet-shaped RNA virus, is transmitted primarily through rabid animal bites when saliva penetrates the skin. It can also occur by contamination of broken skin or mucous membranes with saliva from rabid animals. Dogs and bats are the most important reservoirs for rabies.17

Before traveling to Haiti, healthcare workers should have the following vaccines in order to protect themselves from these malicious diseases:

  • Measles/mumps/rubella (MMR)
  • Tetanus/diphtheria/pertussis (TDAP)
  • Polio
  • Seasonal influenza
  • H1N1 influenza
  • Varicella
  • Hepatitis A
  • Hepatitis B
  • Typhoid

A tuberculin skin test is recommended before travel if you anticipate caring for TB patients. A follow-up test is recommended six to eight weeks after your return.

All water should be regarded as being potentially contaminated. Water used for drinking, making ice or brushing teeth should be boiled, bottled or chemically treated. Make sure food is fully cooked. Avoid fruits or vegetables unless peeled or cooked, and avoid unpasteurized milk and products made from unpasteurized milk, such as ice cream.

According to UNAIDS (2012), Sex tourism is the main cause of HIV/AID in Haiti compared to Cuba. HIV prevalence remains above 1.5 percent in Haiti than Cuba. The region as on a whole has been able to achieve 67 percent access to antiretroviral drugs (ARVs) in the general population, and 79 percent access for pregnant women to prevent mother-to-child transmission (MTCT) of HIV (UNAIDS, 2012).

Reflecting global patterns, heterosexual sex is the main route of HIV transmission throughout the region and largely associated with commercial paid sex.7 Women are particularly vulnerable to HIV infection; more than half of people living with HIV are women. Sex between men is a transmission route that is increasingly reported in the Caribbean (UNAIDS (2012)

The spread of HIV in Haiti has taken place against a common background of poverty, gender inequalities and a high degree of HIV-related stigma. Migration between islands and countries is common, contributing to the spread of HIV and blurring the boundaries between different national epidemics (World Bank 2005).

The main route of HIV transmission is through unprotected heterosexual sex. Commercial paid sex accounts for a large proportion of the HIV infections via this transmission route. It is thought that the popularity of the region for sex tourists is the main reason for this. Some national AIDS programmes work hard to reduce the risk of transmission among sex workers by providing them with free condoms, HIV testing and counseling.

Despite the increasing in inequalities in living conditions and medical care, Cuba’s national health statistics do not indicates that infectious diseases are a significant problem for the islands poor. Rates of tuberculosis, HIV, and other diseases have remained dramatically lower in Cuba than in neighboring countries. In Haiti the world tourism organization (WTO) has reported a TB incidence rate of 319 per 100,000 populations. Cuba incidence rate is exceptionally low, ranging from 4.8 per 100,000 (Hirschfeld, 2011).

Reference

UNAIDS, 2012 'Global Report: UNAIDS Report on the Global AIDS Epidemic 2012'

UNAID (2012) 'Regional Fact Sheet 2012: Latin America and the Caribbean'

UNAIDS (2012) ‘Regions - Caribbean’

The World Bank (2005) 'HIV/AIDS in the Caribbean region: a multi-organization review'

Green-McKenzie JG, Shoff WH. Leptospirosis in Humans. Medicine Web site. http://emedicine.medscape.com/article/788751-overview. Updated July 9, 2012. Accessed December 5, 2012.

Book

Hudman and Jackson, L.E and R.H, 2003. Geography of Travel and Tourism. 4th ed. Delmar learning: USA.

Book

Hirschfeld, K, 2011. Health, Politics, and Revolution in Cuba since 1898. 1st ed. New Jersey: Transaction Publishers.

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