Chronic aftershocks of an earthquake on the well-being of children in Haiti: violence, psychosocial health and slavery.

CMAJ • DECEMBER 14, 2010 • 182(18) © 2010 Canadian Medical Association or its licensors 1997 Before the Jan. 12, 2010, earthquake in Haiti, chronic poverty, lack of infrastructure and poor performance on key health indicators had long threatened the well-being of Haiti’s children. Though Haiti ratified the United Nations (UN) Convention on the Rights of the Child in 1994, this nation has the highest mortality rates among infants, children less than five years of age and mothers in the Western hemisphere. Only 50% of primary school-aged children are enrolled in school, and less than 2% complete secondary school. Adult life expectancy is a mere 61 years, and the national HIV prevalence is 2.2%. Since the earthquake, the well-being and safety of children, who comprise 37.5% of Haiti’s population, totalling 3 453 709 children, have become a focal point of global attention. The threat of child trafficking has been underscored as a particularly imminent health and safety issue in this postdisaster setting. Child trafficking is not a new issue in Haiti. It often occurs within the context of other health and safety concerns, such as poverty, gender-based violence against women and household health, including the health of children’s caregivers. In this analysis, we describe the extent of the health and safety risks faced by Haiti’s most vulnerable children before the earthquake, highlight how such risks may now be exacerbated and suggest how the risks may be addressed in the future.