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 stabilisation centre 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 neighbourhood 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 haemorrhage, obstructed labour 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 specialised 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 centre (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 paediatric ward.