BackgroundRecent reports have highlighted the health disparities that women and other vulnerable populations experience following disasters. Humanitarian groups have struggled to implement effective measures to mitigate such disparities during subsequent disasters.ObjectivesTo analyze and provide practical solutions to mitigate barrier's to women's health encountered in Haiti following the 7.0 magnitude earthquake in January 2010.MethodsIn February 2010, a New York based team of emergency and international medicine specialists staffed the mobile emergency department in Port au Prince at L'Hôpital de l'Université d'Etat d'Haïti.ResultsCommon presentations included infectious diseases, traumatic injuries, chronic disease exacerbations, and follow-up for earthquake-associated conditions. Female gender-specific problems included vaginal infections, breast pain or masses, pregnancy-related concerns, and the effects of gender-based violence. Identified barriers to effective gender-specific care included communication, camp geography, supply availability, and poor inter-organization communication.DiscussionRecent disasters in Haiti, Pakistan, and elsewhere have challenged the international health community to provide gender-balanced healthcare in sub-optimal environments. Much room for improvement remains. Although our assessment team was gender-balanced, improved incorporation of Haitian personnel may have enhanced patient trust, and improved cultural sensitivity and communication. Camp geography should foster both patient privacy and security during sensitive examinations. This could have been improved upon by geographically separating men's and women's treatment areas and using a barrier screen to generate a more private examination environment. Women's health supplies must include an appropriate exam table, emergency obstetrical and midwifery supplies, urine dipsticks, and sanitary and reproductive health supplies. A referral system must be established for patients requiring a higher level-of-care. Lastly, improved inter-organization communication and promotion of resource pooling may improve treatment access and quality for select gender-based interventions.ConclusionSimple inexpensive modifications to organized post-disaster medical relief settings may dramatically reduce gender-based healthcare disparities.
The ethical implications of the medical community’s failure to differentiate sex- and gender-based medicine from women’s health
