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The Guardian - US
The Guardian - US
World
Luke Taylor

Haiti healthcare system on verge of collapse as gang warfare rages on

A gang member walks through Port-au-Prince, Haiti, on 11 March 2024.
A gang member walks through Port-au-Prince, Haiti, on 11 March 2024. Photograph: Ralph Tedy Erol/Reuters

Haiti’s healthcare system has all but collapsed amid the ferocious gang insurrection which forced the resignation of the country’s prime minister, leaving victims of the violence with little hope of medical attention, according to aid workers in the stricken Caribbean country.

In the past two weeks hospitals have been set ablaze, doctors murdered and the most basic medical supplies have now dried up. Only a single public hospital in Haiti’s capital now remains operational – and that too is expected to shut its doors soon.

“The healthcare system in Port-au-Prince is basically nonexistent,” said Mackynzie Archer, a consultant advising leading medical NGOs in Haiti. “Things are deteriorating quickly.”

Fighting between the heavily armed gangs and security forces has paralysed Haiti’s capital in the worst episode of violence the Caribbean country has seen in decades.

Armed bandits attacked police stations, government buildings and the international airport, achieving their stated goal on Monday when the prime minister, Ariel Henry, announced he would step down once a transitional council had been appointed.

But as political factions jockey for position, the violence has continued. About half of the Haitian population is going hungry, water and electricity are scarce, and civilians are struck by stray bullets on a daily basis.

At least 15,000 people have been forced to flee their homes in the latest wave of gun battles, the UN estimates, bringing the total number of internally displaced people to more than 360,000.

“Residents of Port-au-Prince have been reduced to forced nomads, constantly moving between neighbourhoods, seeking refuge with relatives or strangers, or residing in temporary shelter,” said Laurent Uwumuremyi, director for Haiti at the American charity Mercy Corps. “Fear permeates every corner”.

The eruption of street warfare has caused a spike in emergency patient admissions for wounds just as most hospitals – unable to get the staff, power or basic medical supplies they need – are closing their doors.

Several facilities, including St Francis de Sales, one of the capital’s last remaining trauma care centres, and Jude-Anne hospital, which treats emergency patients, have been set on fire and ransacked.

“They took everything – the operating rooms, the X-rays, everything from the labs and the pharmacies,” Dr Ronald V LaRoche told the New York Times. “Imagine! They are taking windows from hospitals! Doors!”

Even before the current unrest, gunmen controlled main roads and access to the city’s port, choking supplies of anaesthetic, blood and oxygen.

“It was not uncommon for patients to wait in a hospital bed for routine surgeries for a month as there are no medical supplies to operate on them with,” Archer said.

Healthcare workers are staying home to avoid being caught in the crossfire of street skirmishes or assassinated by teenagers with assault rifles for giving medical treatment to police or rival gang members.

Dr Nathalie Barthélémy Laurent became the latest fatality in the healthcare community on Tuesday when armed men sprayed her car with bullets near her home in Port-au-Prince.

At the State University of Haiti hospital, a general medical care center in the centre of Port-au-Prince, BBC reporters found no medical staff in a clinic full of patients – only a dead body covered with flies decomposing in the tropical heat.

“There are no doctors, they all fled last week,” one patient told the BBC.

Haiti’s people have faced enormous challenges in recent decades, including a deadly cholera outbreak and a 2010 earthquake which killed more than 200,000 people.

But the recent anarchy has eclipsed past episodes of desperation, said Francesco Segoni, a spokesperson for Médecins Sans Frontières (MSF) who compared the current humanitarian situation to that of a war zone.

A recent MSF survey of the gang heartlands of Cité Soleil found that four in every 10 deaths were caused by violence – a figure comparable to those in Raqqa when the Syrian city was dominated by the Islamic State and blitzed by an international bombing campaign.

“Violence is virtually unchecked. There’s no place in Port-au-Prince that is safe today,” Segoni said.

The crisis is also causing unnecessary deaths among pregnant women and elderly people, who are dying because they cannot find life-saving hospital or treatment medicine that would be deemed basic in most parts of the world.

The gangs and the politicians can’t find an agreement and the population is paying the price,” said Flavia Maurello, head of the Italian charity AVSI in Haiti.

Caribbean leaders and the US have backed a plan in which a transitional council will take over from Henry. But several key factions have refused to participate, while the gang leader Jimmy “Barbeque” Chérizier – the apparent architect of the current unrest – has rejected any solution backed by the international community.

MSF and other NGOs have managed to open mobile clinics in some areas but it remains unclear how long they will be able to safely operate.

“We fear we will run out of medicines and medical supplies, which are absolutely essential to meet the enormous needs we are facing at the moment,” said Mumuza Muhindo Musubaho, who heads up MSF’s Haiti operations.

At Bernard Mevs, a 50-bed critical care clinic in the north of the capital, nurses are desperately trying to keep patients alive with a bare-bones staff and without electricity, said Archer.

“It is likely that in the next week or so, they will also close, which will be the final blow to the healthcare system in Port-au-Prince.”

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