To describe daily life you have to resort to vocabulary of war. The Haitian capital, Port-au-Prince, is divided into many front lines. Entire neighborhoods are under the control of armed groups that change territories. In populated and impoverished areas the streets are barricaded and in some areas there are snipers who shoot what they see.
The clashes between gangs have forced thousands of residents to leave some neighborhoods, while in others, such as Cité Soleil, the population is trapped by the fighting. The United Nations estimates that 18,000 people are displaced, sheltered by relatives or in poorly adapted places such as schools or churches.
This is a new phenomenon, as most of them have fled in recent weeks due to the upsurge in fighting. The main access routes to Port-au-Prince are controlled by gangs and getting in or out of the city has become a complicated task. In addition to the fighting, there is a high level of crime, with robberies, kidnappings and extortion.
Entrance of the hospital in Tabarre, Haiti. Photo: Guillaume Binet / MYOP
In this context, there are many victims of violence, especially those injured. At our hospital in Tabarre, MSF has treated more than 600 injured people since the beginning of the year, most of whom are from the Martissant, Cité Soleil, Croix des Bouques or Bel Air districts, which are the scene of clashes. especially serious.
Waves of wounded
Since April we have faced several waves of wounded that have caused us to increase our hospitalization capacity. There have been days when our teams have received up to 20 patients. On average, more than 60 percent of trauma patients are victims of gunshot or stab wounds.
Sanitary facilities are no longer exempt from attacks and our medical activities have been disrupted by a succession of critical incidents. In February, a Doctors Without Fonts (MSF) hospital dedicated to treating severely burned people in Drouillard district had to close because it was surrounded by fighting.
The 20 or so patients who were still in the hospital had to be transferred and the hospital It has not yet reopened. We have maintained a medical outpost to stabilize and dispatch the wounded or burn victims.
Dangerous streets. Photo: Guillaume Binet / MYOP
Over the past month, an explosion of violence in the Martissant neighborhood put the staff of the MSF emergency center to the front line, to the test. For many days, medical staff had to tend to the wounded while protecting himself from stray bullets and one of our ambulances was stolen.
On June 26, the structure was targeted by direct shots and was eventually evacuated to avoid further endangering patients and staff. Beyond these extreme episodes, there are ordinary violence that threatens everyone. When we go to the streets, our health workers, like the population, live in fear of stray bullets or robberies.
Haitians line up at a police station to receive a ration of flour. Photo: AP
An MSF employee who worked in Tabarre was murdered on May 25 by gunmen after he had finished his shift at the hospital and was on his way home. This permanent state of insecurity limits the population’s access to health care.
The health system is already extremely uneven, with private care available only to those who can afford it, while public facilities lack basic resources. In this context, it is a challenge to maintain medical activities.
Staff and patients need to get to and from medical facilities safely, but there are no guarantees that they can achieve it. At a time when MSF should expand its activities to respond to the growing medical needs of the population, including those related to an increase in COVID-19 cases, we are having trouble keeping our facilities open.
Today it is urgent to realize that Haiti is mired in a situation of violence and total insecurity which adds to a major health crisis. The assassination of the president, Jovenel Moise, adds uncertainty to a country that appears to be on the brink of chaos.
The author is the director of MSF programs in Haiti