1. General data on Haitian sanitation and access to clean water according to United Nations International Children’s Emergency Fund (UNICEF)’s 2017 data on sanitation and drinking water, 1*Basic sanitation service is defined as the access to an improved sanitation facility that is not shared with other households.
Proportion of population using basic sanitation services* 35%
Proportion of population using limited sanitation services 27%
Proportion of population using improved sanitation facilities 18%
Proportion of population practicing open defecation 20%
Drinking water
Proportion of population using at least basic drinking water services** 65
Proportion of population using limited drinking water services 10
Proportion of population using unimproved drinking water sources 25

**Basic drinking water service is defined as the access to an improved drinking water source, where collection time is not more than 30 minutes for a round trip including queuing.


  1. It has been observed at a free clinic system in the Léogâne area of southern Haiti that, 32% of the female patients seen during the summer of 2017 were diagnosed with UTI. Adolescent girls (10-14 years) were identified as the age group with the most UTI diagnosis with treatment at 83.3%. These higher rates are most likely related to clean water accessibility, limited toilet facilities, hygiene, inadequate health promotion education about UTI prevention, the onset of menstruation, and sexual activity.2


  1. In a study conducted by Marsh et al., during the first year of operations, the emergency department of the University Hospital at Mirebalais electronically registered nearly 17,000 patient visits. Among those, 56% patients registered were women, and 27% were children younger than 15. The most common diagnoses overall were gastritis, upper respiratory infections, chikungunya, urinary tract infection, and gastroenteritis.3 Diseases such as gastritis, urinary tract infections, and gastroenteritis are commonly caused by germs and parasites resulting from inadequate domestic and personal hygiene.4,5,6


  1. Full genomic sequencing of drinking water in Haiti’s central plateau found a high concentration of Klebsiella spp and E. coli, both of which have strains known to cause urinary tract infections. Although the pyrosequencing method utilized in this study did not reveal the viability status of these pathogens, the abundance of genetic footprints of the pathogens in water samples indicate the probable risk of bacterial transmission to humans.6


  1. It is a prevalent cultural belief that vaginal illness is related to unclean water and that the practices of storing untreated water used for vaginal washing for multiple days and the sharing of communal washbasins among multiple household members can spread vaginal illness from person to person.7


  1. From a 2009 qualitative study, the most pressing health needs named by the women were accessible, available, and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation, and education, including health education.8 “Clean water is a big problem… Soon it will be rainy season, and this means that in the coming days, children and the elderly will suffer from diarrhea… We have to wait for the river to go back down to dig a hole in the riverbed to find some water. Sometimes you drink the water even when… it can have more microbes in it.”8



  1. UNICEF Data: Monitoring the situation of children and women. (2017). Country Profiles: Haiti. Retrieved March 09, 2021, from https://data.unicef.org/country/hti/
  2. Lucy Anderson, Elizabeth Burgess Dowdell. (2019). Access to clean water and urinary tract infections in Haitian women. DOI: 10.1111/phn.12660
  3. Regan H Marsh, Shada A Rouhani, Paul Pierre, Paul E Farmer. (2015). Strengthening emergency care: experience in central Haiti. Retrieved March 09, 2021, from https://doi.org/10.1016/S2214-109X(14)70378-X
  4. Australian Government: Department of Health. (2010). ENVIRONMENTAL HEALTH PRACTITIONER MANUAL: A RESOURCE MANUAL FOR ENVIRONMENTAL HEALTH PRACTITIONERS WORKING WITH ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITIES. Retrieved March 09, 2021, from https://www1.health.gov.au/internet/publications/publishing.nsf/Content/ohp-enhealth-manual-atsi-cnt-l~ohp-enhealth-manual-atsi-cnt-l-ch3~ohp-enhealth-manual-atsi-cnt-l-ch3.2
  5. National Health Service UK. (2019). Gastritis. Retrieved March 09, 2021, from https://www.nhs.uk/conditions/gastritis/#:~:text=Gastritis%20or%20gastroenteritis%3F,not%20always%20caused%20by%20infection.
  6. Nabanita Mukherjee, Debra Bartelli, Cyril Patra, Bhavin V. Chauhan, Scot E. Dowd, Pratik Banerjee. (2016). Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing Based Metagenomic Survey. DOI:10.1371/journal.pone.0167353
  7. Kelly S. Chapman, Elizabeth A. Wood, Sarah L. McKune, and Valery E. Madsen Beau De Rochars. (2017). Common Beliefs around Vaginal Illness and Water Quality in Haiti. DOI: 10.4172/2167-7719.1000136
  8. Rachel Peragallo Urrutia, Delson Merisier, Maria Small, Eugene Urrutia, Nicole Tinfo, David K Walmer. (2013). Unmet health needs identified by Haitian women as priorities for attention: a qualitative study. DOI: 10.1016/S0968-8080(12)39602-X


By Jennifer Shu Ping Chen


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