The 110-bed Saint Nicolas Hospital in St Marc is almost empty. Only a dozen patients remain in what serves as both the only public hospital in this Haitian city and as the reference hospital for a region of 250,000 people.
"It used to be so much fuller," said Belgian surgeon Pierre Gielis, who worked here in August last year and is now back for an assessment. "But with the doctors gone, hardly anyone comes to St Nicolas any more."
Since the middle of February, shortly after violence flared in Haiti, MSF has sent more staff and 16 tonnes of medical equipment to the country to assist in the emergency action. The Saint Nicholas Hospital has been receiving constant assistance and is one of a small number of health facilities that is offering free medical care to people injured in the violence.
The facility is almost empty however. In part because the key medical staff have left the area because of their specific insecurity.
The three doctors who normally do the consultations and oversee treatment have all fled to the capital, Port-au-Prince, a two-hour drive to the south. When Saint-Marc changed hands twice in early February, first taken by the opponents of the current government and then re-taken by the police, the doctors found themselves on the wrong side of the political fence. Before the current clashes started, that was not a big problem. Now, everything has polarized and Saint-Marc is heavily policed. Some supporters of President Aristide have been hunting down known opponents. The doctors simply did not feel safe any more.
From February 2 to 11, Saint Nicolas received 23 wounded, all injured by bullets. Today, only one of these injured remains in the hospital. David Elcius, a 29-year-old farmer from nearby Lagarene, was in †town to sell his produce when fighting erupted around him. A bullet caused a complicated fracture in his right lower leg.
Elcius does not care much about politics. "I am a farmer from a small village. I care about feeding my family," he said. He was just in the wrong place at the wrong time. Now he faces the prospect of a slow recovery during which he will not be able to provide for his wife Velina Sera and for their two little children who are now staying with their grandmothers.
MSF staff now take charge of the continuity of treatment. Congolese doctor Albert Tshiula is training health staff and has set up a system for rotating duty. Access to treatment is guaranteed but, without the regular medical staff, capacity is severely limited. Should there be another fight for control over Saint Marc - and everybody fears that another round of warfare will be coming - then the only public hospital in the town will quickly be overstretched.
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