This information is excerpted from MSF’s 2016 International Activity Report.
Doctors Without Borders/Médecins Sans Frontières (MSF) responded to urgent medical needs in Haiti, where a weak health system was further hampered by strikes in public hospitals and damage caused by Hurricane Matthew in October. MSF carried out an emergency response to the hurricane, supporting Port-à-Piment hospital and running mobile clinics in southern Haiti. Teams treated 17,537 patients, including 478 for cholera. They repaired 26 water points and trucked in more than 10 million liters of clean water. In remote mountain areas, MSF supplied building materials to 9,500 families and administered vaccines to 14,000 people.
The cholera epidemic remained a major public health concern. In 2016, teams treated a total of 2,615 patients, many of whom were infected in the aftermath of Hurricane Matthew. In addition to building cholera treatment centers, MSF helped hospitals to manage infected patients. Teams worked at two centers in Delmas and maintained rapid response capacity in case of emergency.
In Haiti, sexual violence is a neglected medical emergency. MSF’s Pran Men’m clinic in the Delmas 33 district of Port-au-Prince provided emergency medical care to victims of sexual and gender-based violence, treating 787 people, more than half under the age of 18. MSF worked to improve the availability of health care services and raise community awareness. In the same district, MSF ran the Centre de Référence des Urgences en Obstétrique, a 176-bed center that treats pregnant women with obstetric complications. In 2016, the team carried out 19,077 consultations, assisted 5,594 births, and admitted 2,498 babies to the neonatal emergency care unit.
In Drouillard hospital, in Port-au-Prince’s Cité Soleil area, MSF ran a severe burns unit which has become the de facto national referral center for burn patients. In 2016, 43 percent of people treated there were under the age of five. A total of 801 patients were admitted to the unit and 630 underwent major surgery. The teams applied 4,071 wound dressings and conducted 14,030 physiotherapy sessions and 1,773 mental health consultations. In Tabarre, MSF’s Nap Kenbe hospital received a large increase in the number of patients in the second half of 2016 due to a strike in the country’s public health sector. In 2016, staff treated 15,228 patients in the emergency room and performed 8,088 surgical interventions. The Martissant clinic provided around-the-clock health care in a slum area marked by violence, with staff treating 52,344 patients in 2016.
Update: October 2016
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 World Health Organization 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 the United Nations Office for the Coordination of Humanitarian Affairs, 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.