Haiti: Working amid intensifying violence

"Every day, people throughout the city tell us that they have never experienced such levels of violence before."
- Ali Besnaci, MSF Head of Mission in Haiti

More than one-third of the city is considered extremely dangerous and at the mercy of armed groups. Violence against civilians in Port au Prince is a daily occurrence, and the number of wounded treated by MSF continues to grow.

In response to the growing needs, in late December 2004 MSF opened a 56-bed trauma center at St. Joseph's Hospital, providing free, high-quality emergency medical and surgical care. By late August 2005, MSF had treated more than 3,500 patients including 1,550 people with violence-related injuries, of whom 1,132 were gunshot victims.

Half of those treated for injuries related to the violence were women, children or the elderly. Since March 2005, MSF has provided post-surgical physiotherapy at a 27-bed physical rehabilitation center in Port au Prince.

The deteriorating security situation in Port au Prince led MSF on 5 July 2005 to call publicly on all armed groups to respect the safety of civilians and to allow the wounded to obtain emergency medical care. Ironically, the following day, the UN Stabilization Mission in Haiti launched a day-long military operation in the Cité Soleil slum, and the trauma center received 27 gunshot victims - three-quarters of whom were women and children.

In April 2005, MSF opened a basic health care project in the city's Decayette area. The MSF team provides primary health care at no charge to city residents, especially women and children in an effort to promote and improve access to high-quality health care for this population.

By mid-2005, the team was carrying out 120 consultations a day. In August 2005, MSF also started operations in Cité Soleil, where it carries out more than 150 consultations each day in the primary health care center of Chapi Hospital and St. Catherine Laboure Hospital.

MSF is also treating victims of sexual violence in the capital, through its existing programs for victims of violence. The program offers outreach, treatment and referral to further psychological care, protection and legal assistance. Despite the availability of these services, it remains difficult for victims to gain access to them, because of the severe social stigma surrounding rape and because of victims' fear of retaliation.

In the country's central Artibonite department, south of the coastal city of Gonaïves, MSF works in the commune of Petite Rivière within health structures in Jean-Denis, Segur and Charles Colimon, providing basic health care, with a special focus on women of reproductive age and children. In the Charles Colimon health center, MSF has integrated voluntary HIV counseling and testing to help prevent mother-to-child transmission of the virus.

Renewed flooding

In September 2004, tropical storm Jeanne hit northwestern Haiti, causing severe flooding in Gonaïves. With more than 2,000 people dead, 3,000 injured and tens of thousands left homeless, MSF mobilized an emergency team and began offering care in a health center in Robateau, in the western part of the city.

Medical equipment and supplies, including emergency kits sufficient to treat 10,000 people, were transported from Port au Prince. MSF conducted more than 500 consultations a day, many involving minor surgery, during the initial period. Mental health care, malaria treatment and water and sanitation support were also provided.

From mid-October 2004 until the end of the year, MSF worked in other areas affected by the storm, carrying out more than 2,000 consultations in the health center of the town of Chansolme, near the city of Port au Paix, and an additional 500 consultations in the villages of Paulin and Aubert. MSF supported the public hospital in Port de Paix, reorganized the emergency room enabling it to receive up to 80 patients a day and provided staff to reinforce the pediatric and maternity wards.

The team also helped rehabilitate the hospital's pediatric ward, water system and waste management area. Toward the end of 2004, MSF started working in a second health center, named K-Soleil, in Gonaïves, providing emergency medical care and maternity care and treating children at the town's public hospital. This emergency intervention ended in February 2005.

MSF has worked in Haiti since 1991.