223 per 1000 individuals for males and females respectively. Burden of disease The lack of development and spending on healthcare resources and services makes Haitians, particularly those living in rural areas, susceptible to diseases that are otherwise manageable. For example, the WHO confirmed that a typhoid fever outbreak that occurred in 2003 was due to a lack of access to doctors and clean water infrastructure. Across the nation, it is estimated that there are about 25 physicians and 11 nurses for every 100,000 Haitians. WHO also estimates that 43% of the population receives all the recommended immunizations. For communicable diseases, this means loss of herd immunity This lack of healthcare resources and a disease-friendly environment puts Haiti’s burden of disease to be much higher than that of most nations. In the 2010 World Malaria Report, confirmed cases of malaria in Haiti tripled from 16,897 to 49,535 between 2000 and 2009. As of 2012, less than 20% of all households in Haiti have Insecticide-treated bed nets to protect themselves against mosquitoes. In 2010, Haiti also experienced a cholera outbreak that spread quickly throughout the nation due to difficulties in healthcare access and the lack of experience of the healthcare system. By the end of 2010, a total of 179,379 cases, including 3,990 deaths were reported in Haiti. This represents 61% of all cases reported and 80% of all deaths globally. In 2006, prevalence of HIV/AIDS among adults was 2.2%. In 2012, the total estimated number of people of ALL ages living with HIV was approximately 150,000. Causes Political issues One cause that has resulted in significant levels of structural violence within Haiti is political instability and corruption. Over the past 200 years, Haitian politics have gone through periods of social unrest and turmoil. The nation has experienced more than 30 Coup d'états. There has been a long history of oppression by dictators. Political instability and corruption have left the country with a number of social problems, such as a lack of access to basic human rights, including education and healthcare; and an economy with a lower than average domestic product. According to the World Bank, Haiti ranks 162 out of 183 economies in the world and 31 out of 32 economies within Latin America and the Caribbean. This low economic ranking limits the level of job creation and availability. This lack of job creation contributes to Haiti's unemployment rate of 40.6%,