Haiti Crisis

Due to the volatile situation, MSF made the difficult decision to temporarily suspend mobile medical clinics in some of the displacement sites and in three fixed sites in neighbourhoods particularly affected by violence where no other medical actors are present (Bel-Air, Bas-Bel-Air, and Delmas 4). We intend to resume these activities as soon as the risks for collateral damages has decreased. The mobile clinics at these fixed sites typically carried out around 140 medical consultations per day. MSF mobile clinics in camps for displaced people carried out about 110 consultations per day during visits in January 2024. 

The current unrest and insecurity in Port-au-Prince follows years of escalating tensions. Before reopening this month, our emergency centre in Turgeau temporarily closed followed the killing of a patient in an MSF ambulance leaving the facility in December 2023. Our hospital in Tabarre had to suspend temporarily activities after a violent intrusion in July 2023, before fully reopening in August. Our hospital in Cité Soleil was also forced to close temporarily several times due to security incidents and violent clashes in the first half of 2023.

The prior year, a national protest known as "peyi lok" followed the announcement of an increase in fuel prices in September 2022, with violent demonstrations across the country. Barricades were erected, cutting off many of the main roads, and economic activity ground to a halt. The situation was compounded when one of the major gangs blocked access to the country’s main oil terminal for more than a month, exacerbating fuel shortages and forcing health care facilities to close or reduce services, as they depend on generators to produce electricity. Unrest also disrupted the water distribution network, reducing supply and creating ideal conditions for the resurgence of cholera. 

Sexual and gender-based violence is widespread in Haiti, and MSF has provided care for an increasing number of survivors in recent years. MSF runs two clinics, one in Port-au-Prince and another further north in Gonaïves, providing survivors of sexual violence with comprehensive care, including medical care and psychosocial support. A free telephone helpline has helped decrease some barriers to care, offering remote psychological support and referrals to health centres.

Our mobile clinics working in unsafe, hard-to-reach neighbourhoods include sexual violence care in their services. In 2023, we provided care to more than 4,000 survivors of sexual and gender-based violence in Haiti.

Overcrowded, unsanitary living conditions and poor access to clean water were factors in a major resurgence of cholera, a disease that has killed around 10,000 people in Haiti following the 2010 earthquake. After several years without a recorded case of cholera, MSF facilities began to receive new patients with suspected cholera in September 2022, which marked the beginning of a resurgence of the outbreak. Over the next year, we carried out an emergency response in multiple areas of Port-au-Prince and the Artibonite region, providing care to 29,449 cholera patients and carrying out prevention measures, such as chlorinating water points. By the end of August 2023, cases declined but did not disappear altogether. We closed our last cholera treatment center while continuing health promotion, water and sanitation activities. 

Tabarre hospital is located near the airport, north-east of the city centre. It has five operation theatres and provides specialised care for trauma and burn patients. Its bed capacity was increased by 50 per cent in March, from 50 to 75 beds, to be able to admit an increasing number of patients. During the first week of March, the hospital received an average of 15 new patients a day; the number of new arrivals has since decreased to four or five patients each day and the hospital is now able to work with a few spare beds for newly arrived patients.

Carrefour is a city just southwest of Port-au-Prince. It used to be part of the banlieue of the capital, but it’s been cut off from Port-au-Prince since 2021, when gangs overtook the neighborhood of Martissant, which connects the two cities. In Carrefour, MSF converted an old textile factory into a new trauma hospital, which opened on March 4 and received 22 patients within the first 48 hours, including victims of road traffic accidents and violence. Carrefour has also received referred patients from other medical structures in Carrefour that couldn’t refer to hospitals in Port-au-Prince.

MSF’s “Drouillard” hospital in Cité Soleil provides emergency and out-patient care for the community of Port-au-Prince largest slum. The activity here has been relatively unaffected by the recent troubles, in part due to its location (the area is a stronghold of some of the main gangs, but they put their rivalry on hold to form a coalition against the authorities) and in part due to the services offered here, which are not focused on trauma. The hospital is also experiencing challenges in terms of supplies, as are most other facilities in the city. Out of precaution, however, our outreach activities in Cité Soleil have been put on hold.

Turgeau Emergency Center had suspended all activities after a violent incident in December 2023, during which a patient was taken from an ambulance, and killed in the streets. The centre reopened on 6 March, two weeks earlier than foreseen, to accommodate the influx of patients in other locations, and received 15 patients on its first day of opening. The last days, Turgeau had 30 to 45 patients every day.

Pran Men’m, our clinic for survivors of sexual and gender-based violence, remains open and is the only free, 24/7 accessible clinic of its kind in Port-au-Prince. Last week, March 11-16, we admitted 15 sexual violence survivors, which is a reduction from about 60 per week in the prior weeks. This raises concerns that many survivors do not feel safe coming for care, as we saw last time violence went up.

Recent unrest has renewed fears of waterborne diseases and other health consequences from decreased access to water and sanitation. The violence of the last weeks has hampered the distribution of fuel, which is needed to run Port-au-Prince’s public water services, and water trucks can no longer distribute water due to insecurity and fighting. As a consequence, some neighborhoods are now experiencing limited access to safe drinking water, which is very concerning given the presence of cholera.