Haiti reconstruction is failing to reduce maternal mortality, report warns

BMJ 2011; 343 doi: (Published 05 September 2011) Cite this as: BMJ 2011;343:d5626
  1. Peter Moszynski
  1. 1London

Lack of access to reproductive and maternal healthcare in Haiti is causing additional suffering for vulnerable women and girls still displaced after the earthquake in January 2010, warns a report from Human Rights Watch.

The charity finds that recovery efforts have failed to adequately meet the needs of women and girls, particularly their rights to health and security, despite developments in other health services.

“More than a year and a half after the earthquake, some women and girls give birth unattended on the muddy floors of tents or trade sex for food without any protection from unwanted pregnancy,” said Kenneth Roth, executive director of Human Rights Watch.

“Despite gains made due to free healthcare services, the government and international donors have not addressed critical gaps in access to health services or addressed conditions that may give rise to maternal and infant deaths.”

Haiti had the highest maternal mortality in the western hemisphere before the earthquake, at 630 deaths per 100 000 live births. The rate after the earthquake is unknown because of lack of effective tracking of maternal and infant deaths in the camps. But the report finds that “lack of access to family planning, prenatal and obstetric care; a need to engage in survival sex to buy food for themselves and their children; and sexual violence” have led to pregnancy rates in women living in camps that are three times higher than in urban areas before the earthquake and maternal mortality rates that rank among the world’s worst.

More than 300 000 women and girls currently live in camps for displaced people. Human Rights Watch interviewed 128 girls and women aged 14 to 42 years in 15 displacement camps who were pregnant or had given birth since the earthquake.

Some described delivering their babies in tents, in the street, or in alleys on the way to the hospital or, in one case, on the street corner after a hospital turned her away for not being able to pay for a caesarean section.

Donors pledged $5.3bn (£3.3bn; €3.7bn) in recovery aid in line with a government drafted post-earthquake recovery plan, with $258m dedicated to healthcare. Although only $118.4m of the health money has been disbursed, $130.6m more is committed and nearing disbursement.

“With almost $260m earmarked for healthcare, no woman should have to give birth on the street,” Mr Roth said. “Women and girls have a right to lifesaving care, including in adverse circumstances.”

● Human Rights Watch has also joined Amnesty International and other organisations in calling for international action to protect civilians in Sudan’s Nuba mountains, where it says that the government is “indiscriminately bombing civilian areas” and “preventing aid from reaching desperate displaced people.”

“The Sudanese government is literally getting away with murder and trying to keep the outside world from finding out,” said a spokesperson for Amnesty International. “The international community, and particularly the UN Security Council, must stop looking the other way and act to address the situation.”


Cite this as: BMJ 2011;343:d5626


  • Nobody Remembers Us: Failure to Protect Women’s and Girls’ Right to Health and Security in Post-Earthquake Haiti is at

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