Haitian culinary student Taina Senatus, 29, lost her balance and fell at school one day this month, only to realize that a stray bullet had hit her in the face before she hit the ground. .
All she was left with was a small hole in her cheek and a missing jawbone and tooth.
Unlike many Haitians who have been wounded by gunfire during the takeover of the capital, Port-au-Prince, by violent gangs, Senatus was truly lucky that day. She was taken to the clinic. But she is still in pain, her wounds are swollen, and she is unable to receive any relief as more and more hospitals and clinics are abandoned by staff or looted by gangs.
“My tooth hurts,'' she said. “Something feels wrong.”
Gang attacks on Haiti's capital have left an already fragile health system in tatters.
More than half of health facilities in Port-au-Prince and the large rural region known as Artibonite are closed or at full capacity because they are too dangerous to access or because medicines and other supplies have been stolen, experts say. Not working.
State University Hospital, the largest public hospital in the country, has closed. Blood supplies are in short supply, fuel to run generators is hard to come by, and street violence means clinics that remain open are unable to transport patients who require more advanced treatment. I can't. Doctors also predict a sharp rise in maternal and infant deaths as thousands of women are forced to give birth at home in the coming weeks.
Haiti's public health system has responded to multiple emergencies in recent years, from a devastating 2010 earthquake to hurricanes, COVID-19, cholera and Zika. This strain has been unraveling the foundations of the system for a long time.
Poor patients cannot afford to pay for services, and chronically underfunded hospitals are further crippled, making it difficult to purchase essential supplies. Before gangs took over Port-au-Prince, hospitals still sometimes closed their doors as doctors went on strike to protest rampant kidnappings of medical workers.
By the beginning of this year, up to 20% of Haitian hospital medical professionals had left for the United States and Canada, according to the United Nations.
Several officials at Haiti's Ministry of Health did not respond to requests for comment.
Jean-Marc Jean, 37, a freelance journalist, was hit in the left eye by a police tear gas canister while covering an anti-government demonstration last month.
He underwent three surgeries to have his eye removed and his socket repaired before it was closed because the hospital where he was being treated was located behind the National Palace, which had been attacked by gangsters. Patients said bullets were flying through the hospital courtyard. As his wound suppurated, the doctor bravely made a house call.
“Fortunately, our neighborhood is safer than other areas,” Jean said. “Anyway, I was surprised when they told me I could have the doctor come to my house.”
Jean said she would need another surgery to have a prosthetic eye implanted. His brother spent all Friday looking for painkillers and antibiotics because most pharmacies were closed. Jean can be treated for the infection at another hospital, but the gang may make travel impossible, she said.
Haiti has long been plagued by gang violence, but violence spiked in 2021 after the assassination of President Juvenel Moïse. Gangs concentrated in specific areas grew in size, firepower, and influence, and murder and kidnapping rates skyrocketed. .
A Kenya-led international deployment aimed at quelling the violence, an effort backed by the United Nations and primarily funded by the United States, has been repeatedly postponed. When Haiti's leader and Prime Minister Ariel Henry, a neurosurgeon who previously worked for the Ministry of Health, visited Kenya in late February, gangsters took advantage of his absence.
Instead of fighting each other, they banded together and attacked police stations, prisons, hospitals, and other government buildings, demanding his resignation. Henry, currently stranded in Puerto Rico, has agreed to step down once a caretaker committee-style government is formed and a new leader is named.
Meanwhile, gang members stripped many medical facilities and took most of what was of value, including beds and vehicles.
“The bandits looted, destroyed and turned everything upside down,” she said. Theodule de Monde is the director of St. Francis de Sales Hospital, one of the largest and oldest hospitals in Port-au-Prince and the only oncology department in southern Haiti.
Violence has escalated in the area, with officials evacuating all patients to private hospitals in recent days, just before armed groups seized control of nearby roads and looted several government buildings. and set it on fire.
St. Francis was not saved.
“They took everything away,” said Dr. Joseph R. Clerine, the hospital's medical director. “When we can get back into the building, we have to take inventory. But we have to wait for peace to return. It's too dangerous right now.”
Two staff members, a nun and a driver, had brief access to the facility and reported seeing broken windows and empty rooms with stolen furniture and medical equipment. A private Roman Catholic hospital estimates the damage at between $3 million and $4 million.
Dr. Wessler Lambert, who runs Zanmi Lasante, a network of clinics affiliated with Partners in Health, a nonprofit public health organization that has operated in Haiti for decades, said several of the 16 clinics are critical. He said they are closed for several days at a time to save on medical costs. supplies. However, given the fear of going out and lack of transportation, there are not that many patients to treat.
“Right now, the main shortage is fuel to keep the generators running,” he says. “Other essential medicines will also be in short supply. It's not because we don't have them – we have them in our main warehouses. We can't transport them.”
Médecins Sans Frontières, another major aid organization providing extensive medical care in Haiti, said it had increased capacity at one of its hospitals and opened a new hospital with 25 beds and an operating room. However, the group is unable to bring more doctors on board, and the country's main airport remains closed as the gang controls the surrounding area.
Blood products are in short supply, leaving patients in need of more advanced treatment.
“It's just not sustainable,” says Dr. James Gana, who treats patients and helps run the aid group's clinic. “This is not sustainable for the Haitian people or for us.”
Still, Dr. Oscar M. Bareneche, the Pan American Health Organization's representative in Haiti, said some health care providers have remained “very resilient” in the face of adversity.
For many pregnant women, the situation is especially dire.
About 3,000 women will give birth in the Port-au-Prince region next month, 500 of whom will have complications, said Philippe-Serges Degernier, head of the United Nations Population Fund, the reproductive health agency. It is said that there is. . However, there were only 50 hospitals in Haiti that could treat birth-related complications, even back when hospitals were functioning normally.
Approximately 1,500 Haitian women die during childbirth each year, and that number is certain to rise this year, Deguernier said.
“The health care system is collapsing,” he said. “There are no more decent medical professionals in Haiti with families and sufficient degrees.”
Dr. Bach-Jean Jumeau, president of the Haitian Society of Obstetrics and Gynecology, said the lack of functioning hospitals will force more women to give birth at home. Most Haitian women already give birth at home, but midwives are not trained to deal with complications.
“Home birth is not very safe in Haiti,” said Dr. Jean Jumeau.
“In Haiti, we often say it's like being on a boat in Port-au-Prince,” he added. “We, the people, are in it without a captain or instructions, but we don't know where to go or what to do to be saved.”
Andre Poeltl I contributed a report from Port-au-Prince, Haiti.
