By Jacqueline Charles and 

David Ovalle

Fritzner Fabre, a healthcare aide who cared for coronavirus patients, spent his final days holed up in a ramshackle North Miami-Dade efficiency, coughing and wheezing. He was 41 when he died at the hospital.

Another Miami man, architect Pierre Martin, suffered from heart troubles and diabetes. Believing he’d simply caught a cold, Martin refused to go to the hospital until it was too late. He was 69 when COVID-19 killed him.

Then there was Pastor Marcel Métayer, who kept his Fort Lauderdale Baptist church open as a spiritual haven for the local Haitian-American community, even as the coronavirus surged during the summer. The faithful noticed Métayer, 63, gasping during his sermons. He blamed his labored breaths on getting wet in the rain.

Métayer had in fact contracted COVID-19, and was admitted to Fort Lauderdale’s Florida Medical Center. He died on July 28. Hours later, one of his assistant pastors, Féquière Espérant, 65, also died from the disease at the same hospital.

These deaths, only a few of over 100 officially documented, underscore a troubling reality: The highly contagious coronavirus is quietly ravaging South Florida’s Haitian-American community. And there are complex cultural factors that make COVID-19 a particular challenge to deal with — and sometimes to even discuss — for many Haitians.

“The stigma is huge,” said South Florida Dr. Sidney Coupet, who heads a public health task force within the Haitian American Coalition of South Florida that was created to improve outreach, testing and services during the pandemic. “A patient who I treated in the hospital…. They discharged her. She beat COVID. The way she was speaking to me, it was as if she was embarrassed. They‘re afraid their families and friends would never come visit them again.”

The exact scale of how the virus is affecting South Florida’s Haitian Americans is difficult to gauge because state health officials do not track infections by ethnic groups other than Hispanics. But at least one statistic suggests an outsized impact: deaths.

With Miami-Dade County Commissioner Jean Monestime — the sole Haitian American on the commission — and other Haitian community leaders pressing for more details on COVID-19 victims earlier this year, the Miami-Dade Medical Examiners began adding “Haitian” when a victim’s background could be documented using information culled from families, hospitals and, mostly, funeral homes who submit biographical details to the state for death certificates.

Those numbers have proved sobering. At least 5 percent of the county’s COVID-19 victims have been Haitian Americans, a group that comprises an estimated 4 percent of the county’s population. In all, at least 105 of more than 2,000 deaths in Miami-Dade as of the end of August have been members of the Haitian community — and experts say that tally is likely a significant under count because it has not been possible to conclusively trace the background of many victims.

In fact, the first documented COVID-19 victim in Miami-Dade was a 94-year-old Haitian woman, Dieumene Etienne, whose family couldn’t be reached.

Missing data on ethnicity and hospitalizations obscure the pandemic’s real impact, said Nancy Krieger, a social epidemiologist at Harvard’s T.H. Chan School of Public Health. “It’s not possible to discern, with any precision, if Haitians are being disproportionately affected — and that by itself is a problem,” she said. 

The Broward County Medical Examiner’s Office does not identify Haitians among the dead but community leaders believe the toll there likely has been similar. 

“It’s impacted the Haitian community more than people realize,” said Pauline Louis-Magiste, president of the Haitian American Nurses Association of Florida. “Unfortunately, the data collection doesn’t really give you the statistical number on how Haitian Americans are being impacted.”

But this is clear: More than six months into the pandemic, minorities have borne the brunt of the novel coronavirus, suffering and dying at disproportionate rates than whites. The U.S. Centers for Disease Control itself says “long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.”

In Miami-Dade, Blacks overall have died at disproportionate numbers — 19 percent of COVID-19 deaths for a group that makes up 17.7 percent of the county’s population. Blacks also have been hospitalized at a higher clip.

Like other ethnic groups, Haitian Americans suffer disproportionately from underlying conditions such as diabetes, hypertension and obesity, have less access to healthcare and often work jobs that require them to be out in the community. From nurses to caretakers at nursing homes, Haitian Americans also make up a sizable part of South Florida’s healthcare workers who are most at risk of contracting the novel coronavirus.

And beyond medical conditions, community leaders say that language barriers, belief in herbal remedies over traditional medicines, and historical discrimination and stigma stemming from the HIV/AIDS epidemic, make the community even more vulnerable to COVID-19.

Some Haitians have a hard time accepting COVID-19, said Louis Herns Marcellin, a University of Miami socio-cultural anthropologist and director of the Global Health Studies program.

“They will talk about la fièvre,” Marcellin said, using the French and Creole word for fever, echoing the dismissive tone often used by people in Haiti. “They talk about it in terms that are not necessarily public health terms that we can understand … that we can use or rationalize to generate interventions or prevent action.continue reading

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