Why are we there?
- Social violence
- Health care exclusion
- Endemic/epidemic disease
- Natural disasters
Haiti: Latest MSF Updates
Many communities along the coast in southern Haiti as well as inland were very devastated by Hurricane Matthew, which hit the country on October 4. The regions most affected are Grand'Anse, Nippes, and Sud. Sud was hit hardest, but Grand'Anse and Nippes also sustained severe damage and destruction.
According to an evaluation by national authorities, 175,000 people were displaced by the storm, and 1.4 million people are in need of aid. Five-hundred forty-six people are reported dead, but the real number is very likely higher. Medical structures, already under-funded and under-resourced, were not spared: the WHO reports that 23 health centers were damaged or partially destroyed by the storm.
Stocks of medical supplies are dwindling, as access by road to many communities is blocked. Infected wounds and fractures (including complicated fractures) are the most common conditions linked to the hurricane, though diseases like gastritis and upper respiratory infections are common. Isolated villages in the mountains must be prioritized, as they have the least access to health care, clean water, food, and reconstruction materials. MSF uses various modes of transport to reach remote villages, including specially hired helicopters. In many villages, MSF teams are the first and only aid workers providing care, and the needs are vast. The current rainy season compounds the emergency, as the weather is unpredictable and helicopters can only fly in clear conditions.
Food, Clean Water, Shelter, and Medical Care are the Most Pressing Needs
Damage to crops and roads have caused food and supply prices to spike. According to OCHA, 800,000 people are at an extreme level of food insecurity, and MSF is gravely concerned about the impact this will have on the population's general health status, particularly for children. People are using whatever materials they can find to build shelters or makeshift homes, but these are no protection against Haitian storms and create ideal conditions for the spread of infections like dengue, malaria, or pneumonia.
Water and sanitation are major components of all MSF activities, and access to clean water is a priority. Main activities include distribution of chlorine tablets, cleaning or repairing water sources, installing water bladders, and assessing water quality. Ten MSF water and sanitation specialists are currently working on projects in Haiti. In Sud, MSF distributed over 500,000 Aquatabs (chlorine tablets to treat water), and further distribution will begin soon in Nippes and Grand'Anse.
Cases of cholera, which always peak during the rainy season from October December/January, rose in areas affected by the hurricane. If clean water and shelter are not provided soon, cases will likely increase again. Health surveillance data and notification are still issues in affected regions. According to PAHO (the Pan-American Health Organization), in the epidemiological week ending Saturday October 18, 167 suspected cases of cholera were reported in Grand'Anse, 464 in Sud, 73 in Artibonite (north of Port-au-Prince), and one in Nippes. Expansion of the cholera outbreak towards other regions is a concern, and vaccination provision in risk areas should be prioritized.
MSF has been present in Haiti for over 19 years. MSF currently runs six projects in the Port-au-Prince metropolitan area, including Drouillard Hospital for severe burns, the Tabarre Traum Hospital, the Martissant Emergency Center, the Centre de Référence des Urgences en Obstétrique (CRUO), and the Pran Men’m clinic for survivors of sexual and gender-based violence. MSF also supports the Diquini Center for Cholera Patients.
- CNN: Survivors of Haiti's Rape Crisis
- Many Unmet Needs Two Months After Hurricane
- Deteriorating Health in Hurricane-Affected Areas
- Hurricane Response in Haiti: "There is Still Much Work to be Done"
- Responding to the Aftermath of Hurricane Matthew
- Finding Needs for Clean Water and Medical Care as Teams Reach Hurricane-Affected Areas
- Assessing Medical Needs in the Wake of Hurricane Matthew
This is an excerpt from MSF's 2015 International Activity Report:
The healthcare system in Haiti is struggling to meet some of Haitians’ most basic medical needs, such as treatment for trauma and maternal healthcare.
While a segment of the population can purchase healthcare at private clinics or seek healthcare outside of the country, healthcare is out of reach for a large proportion of Haiti’s population. Medical facilities are understaffed and lack the funding to cover operating costs and purchase sufficient medical supplies. Without longer-term investment from the Haitian government and international donors, the most vulnerable people will remain unable to access the services they need. MSF continues to fill critical healthcare gaps – most of which pre-date the 2010 earthquake.
Health Services in Port-au-Prince
A large number of Haitians live in crowded, unsafe environments, where domestic accidents have become common. Violence, including sexual violence, is also a public health problem but accessible emergency services are scarce.
MSF runs a burns unit in Drouillard hospital, which has become the de facto national referral site for burns patients, nearly half of them (47%) under five years old. In 2015, over 17,550 consultations were provided, including over 3,550 surgical interventions, 12,100 physiotherapy sessions and 1,600 mental health consultations. MSF plans to train more medical personnel and institute a referral system to improve access to quality care for burns patients.
In Tabarre, MSF’s 122-bed Nap Kenbe hospital provides surgery and trauma-related care. The team attended to over 13,000 emergency patients in 2015 and over 6,400 surgical interventions were performed. Physiotherapy and social and mental health support for rehabilitation were also offered.
Around-the-clock services are available in MSF’s emergency and stabilization center in Martissant, and the team attended to 50,000 patients this year. Of these, 30,000 were treated for accidental trauma and 5,000 for violent trauma. The rest were suffering from burns, obstetric complications or other injuries.
Sexual and Reproductive Care
Sexual and gender-based violence is an overlooked emergency in Haiti. In May, MSF opened the Pran Men’m clinic, a facility offering the emergency medical assistance required during the 72 hours following an assault, along with longer-term medical care and psychological support. More than a third of the 258 patients treated at the clinic were younger than 18 years old.
Located in the Delmas 33 neighborhood of Port-au-Prince, MSF’s 148-bed Centre de Référence des Urgences en Obstétrique (CRUO) provides care to pregnant women experiencing serious and life-threatening complications such as pre-eclampsia, eclampsia, obstetric hemorrhage, obstructed labor or uterine rupture. Services include postnatal care, family planning and prevention of mother-to-child transmission of HIV, as well as neonatal care and mental health support. In 2015, the team carried out more than 18,300 consultations, assisted over 6,000 births and admitted 2,500 babies to the neonatal ward. The 10-bed ‘Cholernity’ ward, which provides specialized treatment for pregnant women with cholera, admitted 144 patients.
Ongoing Cholera Crisis
The cholera outbreak that began after the 2010 earthquake remains a public health threat. In 2015, more than 2,300 patients were admitted to the 55-bed Diquini cholera treatment center (CTC) in Delmas, which MSF runs in partnership with the health ministry, and some 750 patients were treated at the Delmas Figaro CTC. MSF closed the Martissant CTC in May, as it was no longer required, but a team continues to be involved in surveillance and response activities.
Chatuley Hospital Closes
MSF had been reducing its activities at Chatuley hospital in Léogâne since 2013 and finally closed the facility in August. The container hospital was set up in 2010 as an expansion of an initial earthquake response, with two surgical blocks providing medical care to victims of road traffic accidents and women with complicated pregnancies. In 2015, the team assisted 747 births, admitted 300 babies to the neonatal ward and treated 60 children in the pediatric ward.
At the end of 2015, MSF had 1,835 staff in the country. MSF has worked in the country since 1991.
Manise, 19 years old
"I was living in Canaan camp with my cousin after the earthquake. I stayed in the tent and prepared food, while my cousin went out to work. One night, I went to collect some water. Two men arrived and dragged me into an empty tent.
I shouted so loudly one of them left. The other held on to me tightly and hit me many times. It was around 8 p.m. and there were a number of passersby. No one came to help me.
I had no problems in my pregnancy until my feet began to swell. My health worsened and one day I lost consciousness and woke up in an MSF hospital. I saw the baby next to me but could not remember the birth … I am worried I won’t be able to feed my son once he is too old for breast milk. I am going to offer to do washing for people."