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MSF in Haiti, 2007
Field Staff: 794
Reason for Intervention:
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Large sections of Haiti’s population, particularly in the capital, Port-au- Prince, live in precarious conditions due to poverty, neglect, urban violence and lack of access to basic healthcare. Violence continues, especially in Martissant, where MSF treated over 200 gunshot injuries. An MSF survey between January 2006 to July 2007 showed that nearly one in four deaths in Martissant was related to violence.
Violence and conflict
Since December 2006, MSF has operated an emergency health center in Martissant, a neighborhood characterized by daily violence and a lack of medical facilities. Every day, patients are referred from the emergency health center to the other hospitals where MSF works. MSF established a number of mobile clinics in the heart of the Martissant neighborhoods, with medical teams offering primary healthcare to some 400 patients a day.
At the end of 2007, MSF handed over its project in the slum of Cité Soleil, where the security situation has improved, to the Ministry of Health. The project started in July 2005 to guarantee access to care for victims of the violence. The ongoing presence of MSF teams, even during the most intense fighting, resulted in 72,000 consultations at the primary health center of Chapi and 32,000 at Choscal hospital, where more than 13,000 patients were hospitalized. However, since April the situation has got better, with no patient with a bullet wound seen at the Tuscaloosa hospital and people in the neighborhood no longer living in fear and isolation.
MSF continued to provide medical and surgical care at its Trinite trauma center in Port-au- Prince, admitting more than 14,000 patients compared with 11,000 in 2006. The number of admissions for gunshot wounds fell from 1,300 in 2006 to 500 in 2007, although the number of victims of stab wounds, rape and beatings continued to rise. In total, 2,847 patients were admitted for violence-related trauma.
Throughout the year, MSF medical teams focused on improving quality of care, working to perfect the recently introduced surgical technique of orthopedic internal fixation. A total of 205 patients benefited from this technique, which sharply reduced their length of stay in hospital.
MSF also operates a physical rehabilitation center where patients needing specialized post-operative treatment can receive physiotherapy and psychological care.
In June, MSF increased its capacity to treat victims of sexual violence in the capital, offering comprehensive psychological and medical treatment. The program treated 242 victims between July 2006 and June 2007. Awareness campaigns emphasizing confidentiality and the need to seek treatment within 72 hours resumed in July in the shantytowns and city center.
Maternal health needs
Maternal mortality rates in Haiti are the highest in the western hemisphere (approximately 630 women die for 100,000 births), mainly due to eclampsia. The insecure urban slum environment where many women live limits their access to healthcare as physical and sexual violence, extortion and common crime are serious threats.
In 2006, the emergency maternal Jude Ann hospital was opened in Port-au-Prince, the only hospital in Haiti to offer free emergency obstetric care. By the end of 2007, over 13,000 women had given birth here. MSF also started providing services in fixed clinics in selected slum communities, with ante- and post-natal care and a referral service in the three slums of La Saline, Pelé Simon and Solino. Mental health services will be added in 2008.
MSF has worked in Haiti since 1991.