Haitian capital’s crippled health system ‘on the brink’

The health system in the Haitian capital Port-au-Prince is “on the brink” and “crippled by escalating violence” according to the UN’s Pan American Health Organization’s (PAHO) representative in the Caribbean island nation, Dr. Oscar Barreneche.

The Haitian health ministry estimates that almost 40 per cent of facilities providing beds for treatment, including the country’s main university hospital, have shut down in the last two months alone because of insecurity and looting, mainly perpetrated by gangs.

Haiti, and in particular Port-au-Prince, continues to witness unprecedented levels of lawlessness and brutality as gangs continue to fight for influence and territory.

Meanwhile, some 580,000 people are displaced within the country.

Here are five things you need to know about the current health situation in Haiti and what the United Nations is doing to help.

1. Healthcare access is scarce

The security crisis is having a huge impact on an already fragile healthcare system.

Access to healthcare - as well as essential social services, hygiene facilities and psychological assistance in Haiti - is scarce and capacity, especially in the capital, remains extremely limited.

Health facilities have closed or have drastically reduced their operations because they are running out of medicine and vital medical supplies, some of which have been looted.

In the Artibonite department just north of the capital, where gangs have recently become dominant, only a quarter of health facilities are functional.

The number of available medical staff, who often cannot get to work because of security concerns, is also decreasing. UNICEF estimates that around 40 per cent of healthcare providers have left the country recently “due to extreme levels of insecurity.”

2. Women and children are suffering

The closure of hospitals and health facilities has left an estimated 3,000 pregnant women struggling to access maternal health services according to the UN sexual and reproductive health agency, UNFPA.

The neonatal, pediatric, and nutritional units that are still functioning are overwhelmed and the few still operating in areas controlled by armed groups lack adequate human resources, equipment, and medicines to provide essential health and nutrition services.

The UN is concerned that a child health and nutrition crisis could cost the lives of countless children. Insecurity in Port-au-Prince has made it virtually impossible for supplies to reach at least 58,000 children suffering from severe wasting in the metropolitan area. 

The UN’s International Organization for Migration (IOM) has also warned that violence and insecurity is affecting the mental health of displaced people including women, leading to distress and even suicidal behaviour.

3. The healthcare system is still functioning

The UN says that two out of every five Haitians need urgent access to care and despite the many challenges the country faces, the healthcare system is still functioning and some patients are receiving the treatment they need.

The Hôpital Universitaire de La Paix, in Port-au-Prince, which is supported by PAHO is on the frontline of providing services - including treating gun-shot wounds among other emergency care needs.

The hospital director, Dr Paul Junior Fontilus, told PAHO that an emergency plan had been activated “to better manage the influx of seriously injured people. Our priority is to ensure that all victims receive the immediate care they need.”

4. There are some positive developments

The international airport in Port-au-Prince had been closed because of gang activity but it has resumed operations, a positive development according to PAHO’s Dr. Oscar Barreneche: “The reopening of the airport has offered a lifeline, allowing us to restock critical medical supplies and equipment. Yet, the battle is far from over, with humanitarian conditions gradually worsening for an increasing number of Haitians.”

The arrival in Haiti of the Multinational Security Support (MSS) Mission (which although backed by the UN Security Council is not a UN operation), will provide operational support to the Haitian police in countering gangs and boost security around critical infrastructure like hospitals.

The UN Security Council also called on the MSS, through its support to the police, to help ensure unhindered and safe access to humanitarian aid for the people receiving assistance.

5. UN agencies continue to respond

Together with local partners, the United Nations and other humanitarian organisations are providing life-saving assistance on a daily basis.

In places were displaced people have fled, PAHO is providing support along with IOM, UNFPA and the World Food Programme (WFP).

UNFPA and PAHO are supporting three hospitals in Port-au-Prince to provide maternal health services, including emergency obstetric care. It is also providing medicines and supplies, including for the clinical management of rape survivors, to 13 health facilities in the capital and surrounding region. It has deployed mobile clinics to seven displacement sites to support women’s and girls’ sexual and reproductive health, reaching close to 4,500 people so far.

Thousands of dignity kits containing hygiene and other essential supplies have also been distributed to the most vulnerable.

PAHO’s Dr. Oscar Barreneche said: “We face ongoing challenges that demand unwavering support and action to ensure stable and accessible life-saving healthcare for the people in need."

Read The UN humanitarian office, OCHA’s latest emergency situation report here.

This article first appeared in UN News.