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MSF Emergency Centre in Turgeau
An MSF staff member accompanies a patient at the emergency centre in Turgeau, Port-au-Prince, where victims of violence are treated and stabilised. Haiti, June 2022.
© MSF
People in Haiti continue to bear the brunt of political instability and escalating violence, which have pushed the healthcare system to the brink of collapse.

In Haiti, we provide care to victims of trauma, survivors of sexual and gender-based violence, as well as sexual and reproductive care. With natural disasters regularly occurring in the country, emergency response also remains a central aspect of our work in the country.

Since the assassination of the Haitian President in 2021, the people of the capital Port-au-Prince have been struggling to survive as armed gangs, police, and civilian self-defence brigades fight in the streets of the city. The already volatile situation has been deteriorating even further after an announcement on 28 February 2024 that elections would be postponed until as late as August 2025. More than 15,000 people were displaced in Port-au-Prince within just one week in early March.

We are scaling up our medical activities to care for the mounting number of people injured in the escalating violence and political unrest that has engulfed the city.

Our teams currently run two trauma hospitals  in Tabarre and Carrefour, two emergency centres in Drouillard and Turgeau, and one centre for survivors of sexual violence in the Port-au-Prince metropolitan area. Mobile clinics have been temporarily suspended due to  the volatile situation.

The situation in Haiti is the climax of an escalation of violence that has been ongoing for years. An MSF survey showed that between 2022 and 2023, the mortality rate in Cité Soleil was exceptionally high. One in eight people were exposed to episodes of extreme violence such as murder, rape or lynching in the street.

The deteriorating humanitarian situation in Haiti has not been met with an adequate humanitarian response, especially for health, water and sanitation. The healthcare system is on the verge of collapse, with public hospitals no longer able to provide free care. Displaced people are living in unsafe and unsanitary conditions and require humanitarian support.

Port-au-Prince is being devastated by a wave of violence and insecurity that is causing a great number of injuries and large-scale displacement, while making it nearly impossible for patients to access medical care and for medical facilities to continue functioning.

Tabarre hospital increased its capacity by 50 per cent and another hospital has opened in Carrefour, while our Emergency Centre in Turgeau re-opened earlier than planned due to the recent escalation of violence.

Our response relies on our ability to ensure sufficient supplies for our hospitals; this ability is currently threatened by the blockage of our incoming medical supplies at the city port, due to the length of the custom clearance procedures and the disruption caused by the fighting. We are now urging the authorities to expedite said clearance and are trying to make sure these supplies are shipped to our medical facilities with the utmost urgency. It is essential that our teams are able to bring in supplies to continue responding to the growing health and humanitarian needs in Haiti.  

The airport also remains closed, making it impossible for supplies or staff to arrive by air. We are exploring all options to move additional medical supplies and specialised staff into Haiti, to maintain and even further increase our activities.

 

What we do in Haiti

Our activities in 2023 in Haiti

Data and information from the International Activity Report 2023.

MSF in Haiti in 2023 Amid increasing instability and violence in Haiti in 2023, Médecins Sans Frontières (MSF) worked to maintain vital services, including treatment for trauma, burns and sexual violence, and maternal and neonatal healthcare.
Haiti IAR map 2023
Country map for the IAR 2023.
© MSF

Years of political turmoil and gang warfare have taken their toll on the physical and mental health of the people of Haiti, and on the provision of basic services, such as healthcare. Since the assassination of President Jovenel Moïse in 2021, however, the situation has taken a marked turn for the worse and pushed the western hemisphere’s poorest country to the brink of collapse.

In 2023, the capital, Port-au-Prince, and other areas of the country, continued to be rocked by politically and economically rooted gang violence, which sometimes exploded into full-scale street battles, such as the ones in April and May, which resulted in hundreds of deaths and injuries. On 24 April 2023 alone, our teams admitted around 50 people with gunshot and knife wounds to our medical facilities.

The foreign intervention requested by Prime Minister Ariel Henry did not materialise during the year, but remains a looming presence as Haitian citizens, in particular in the capital, are confronted by the daily threat of being kidnapped, mugged, sexually assaulted or even killed.

The results of an MSF survey indicate that between August 2022 and July 2023, more than 40 per cent of all deaths in Cité Soleil, Haiti’s largest slum, were linked to violence. Forty per cent of the women surveyed said they had foregone antenatal care due to the risk of being exposed to violence while travelling to a hospital or clinic.

Our teams continued to deliver a range of medical services in Port-au-Prince and several other areas in the country, including general healthcare and treatment for burns, trauma, and sexual and gender-based violence. Our facilities include hospitals in Tabarre and Cité Soleil, a sexual violence and reproductive healthcare clinic in Delmas, and an emergency and stabilisation centre in Turgeau. In addition, we support health centres and operate mobile clinics in the most affected neighbourhoods of Port-au-Prince, such as Brooklyn, Bel Air and Delmas 4, as well as sites where people have gathered after fleeing violence. We are able to work in these hard-to-reach areas because MSF’s work is perceived positively and respected by the communities.

However, our teams were not immune to the risks posed by the volatile security situation in the country. Serious security incidents, which endangered our staff and resulted in the deaths of two of our patients, forced us to suspend some of our activities. We ended our support to Raoul Pierre Louis hospital in Carrefour in January when a wounded patient was removed by gunmen and shot dead. We temporarily closed our Cité Soleil hospital in February and April due to fighting in neighbouring streets, and suspended activities at our Tabarre facility for almost two months after armed men stormed in and forcibly removed a patient in July.

In December, the Turgeau emergency centre closed its doors indefinitely when a patient was taken from an ambulance and killed in the street.

Sexual and gender-based violence

Sexual and gender-based violence (SGBV) is a widespread issue in Haiti. The deepening socio-economic crisis and high levels of armed violence have had a considerable impact on the psyche of entire communities, who have become isolated and more exposed to the risk of sexual aggression.

We ran two clinics, one in Port-au-Prince and one further north in Gonaïves, to provide victims and survivors of SGBV with specialist medical, psychological and social care. A free telephone helpline has also increased access to care, offering victims remote psychological support and referrals to health centres. Our mobile clinics working in hard-to-reach neighbourhoods include SGBV care in their services.

Maternal and neonatal health

The provision and accessibility of maternal healthcare is extremely limited in Haiti, contributing to the highest maternal and neonatal death rates in the western hemisphere (5.3 per cent and 2.4 per cent respectively). Our activities in the south of the country aim to respond to these pressing needs.

In February, we reopened a hospital for maternal and neonatal healthcare in the town of Port-à-Piment, a former government-run facility that was damaged beyond repair in the 2021 earthquake.

Our teams rebuilt and upgraded the hospital, which now offers surgery for patients with obstetric complications, as well as ante- and neonatal care. However, as many other medical facilities in Sud department were never properly repaired, access to healthcare remains limited for pregnant women and newborns.

 

in 2023

Image use and consent policy

Visual storytelling lies at the heart of Médecins Sans Frontières’ (MSF’s) social mission. Our images are crucial in allowing us to bear witness to crises, inform the public, inspire action, and raise the funds that allow us to continue our lifesaving activities.  

The power of an image lies in its ability to tell a story, but this cannot come at the expense of the dignity, privacy, or agency of the people depicted. In telling the stories of our staff and the people we assist, we need to do so with great responsibility – both to those being photographed and filmed, and to our audience.  

Every image must reflect the core values of MSF: humanity, respect, and integrity. By holding ourselves accountable to these standards, the stories we tell will then amplify voices, rather than silence them, and build understanding, rather than perpetuate stereotypes.    

Bearing witness

Together with our medical action, we speak out about the underlying causes of people’s suffering and advocate change. This speaking out is often referred to in MSF as témoignage, which in French means ‘to bear witness.’ For us, this means a willingness to speak out about what we see, to share what our staff and the people we assist tell us.  

Visual content plays a crucial role in our mission of bearing witness. It provides a powerful medium that draws attention to humanitarian crises, such as conflicts, disease outbreaks, natural and human-made disasters, and exclusion from health care.

We share the stories of people we work with and assist through written testimonies, photography, videography, audio, and other documenting mediums.

Portraying medical action with dignity

Gathering images in health facilities is sensitive, as it directly touches on the dignity, privacy, and vulnerability of patients. In these environments, people are often in distress, undergoing treatment, or facing serious health challenges.  

Patients in hospitals are entitled to an environment where they feel safe, respected, and protected from overexposure. In medical settings, we approach photography and videography with extreme care and ensure that it is only done with the patient’s full understanding and voluntary consent.  

MSF’s commitment to dignity and respect is a shared core principle in our Visual Storytelling Guidelines and in the Patient Charter. This means patients are not only respected during their treatment, but also in how they are represented in public communications. They must be portrayed in a way that respects their agency, honours their humanity, avoids perpetuating stereotypes, and does not exploit their suffering.

In practice, in our visual storytelling, we focus on the process of alleviating suffering and providing medical care, not solely on suffering.

How do we manage consent and image use?

  • Respect and dignity: MSF is driven by the principles of medical ethics and prioritises patients’ well-being, dignity, and privacy at every step.  
  • Having a clear purpose: communication is only pursued when there is something meaningful to convey, whether it’s to present a specific point of view or share an important message.
  • Context and accuracy:  storytelling should be accurate and specific, reflecting the context in which we are working and avoiding oversimplified representations
  • Safeguarding and do no harm: we prioritise people’s right to be protected from risk, harm, and stigmatisation above all else.  
  • Informed consent: people have agency and control over how they are represented; they are listened to and make free and informed decisions. 
  • Quality, not quantity: we take the time to build trust with people and communities while carefully gathering visual content 
  • Accountability: We are accountable to people and communities and to each other. We take responsibility when misrepresentation or misuse occurs.  
  • Challenge stereotypes and power dynamics: we strive not to replicate representations of saviourism, sensationalism, victimhood, and colonialism.  

We believe taking photos of someone is not an extractive process, but a collaborative one. 

Before taking an image, the photographer or a communications professional will take time to explain to people why we wish to photograph them, why it is important as part of MSF’s work, and how the images could be used. As a critical part of that conversation, it is also explained that their decision does not in any way affect the care and medical support they may receive from us.

If they accept, they will either sign a consent form or be filmed or recorded giving their consent. The quality of the conversations is what makes the difference in obtaining informed consent; a written consent form and a signature alone do not indicate a meaningful consent process.

The safeguarding of people being photographed always comes first, before any considerations for communications or fundraising. MSF has a responsibility to protect people from any harm in the context of participating in content gathering. What does ‘do no harm’ mean?  

  •    Gathering content should not pose a physical nor psychological risk to the contributor.  
  •    Content gathering should not pose a risk of stigmatisation, discrimination, nor stereotyping. 

Sometimes, concealing the identity of individuals may be necessary to mitigate the risks of negative consequences, such as social reprisals, violence, or stigmatisation.  

For groups at heightened risk, such as unaccompanied minors and victims/survivors of sexual or gender-based violence who are minors, we preserve their full anonymity. 

A person has the right to withdraw their consent for use of their image.

When consent is given in writing, individuals are provided with a slip of paper reminding them of their option to withdraw consent, along with contact details for the local MSF office and the person to reach if they wish to do so.

Anyone wishing to remove their consent can send their request to [email protected], or use the process described on the copy of the consent form. The material will be removed from MSF’s media database and all attempts to track and erase previous uses will be made.  

All MSF photos, including archival images dating back to the inception of MSF, are stored in our own media database. This allows all MSF staff to search through content to find what they need. This tool also allows us to regulate who can see and download images, but also how the content is being used.

We consider that content older than five years has expired consent. It is then subsequently restricted for internal use only and not readily accessible for most staff; it must be requested if needed.

The media database is available to all MSF staff, but also, with restrictions, to other people from relevant professional backgrounds or needs. This can include external contractors, staff from other nongovernmental organisations, media, and academics. These non-MSF users only have access to recent and pre-approved content.

All MSF pictures and videos on our internal media database are tagged with specific usage rights ranging from MSF use only to external media.  

MSF does not sell, make money or profit from any picture taken either by MSF staff, hired photographers, or agency photographers documenting our projects. This includes prints or digital files online. MSF does not sell images as art prints or as a stock photo agency.

At MSF, collaborating with external media, photographers, and filmmakers has always played a vital role in helping us tell important stories, include diverse perspectives, and maximise visibility on critical issues.

Who are third parties? 

In this context, third parties refer to individuals or organisations that are not directly employed by MSF but are either commissioned by MSF, or are granted access to our hospitals or activities, to document our work. This can include media outlets, agency photographers, and independent filmmakers.  

Establishing a relationship of trust with these collaborators is key. When we facilitate their visit, we ensure they are fully briefed on our ethical standards and policies before they begin their work.  

Examples of third-party collaborations:

Contracted commissions 
When MSF directly commissions an external producer (e.g., a photographer or filmmaker), they sign a contract with MSF and are required to follow our Visual Storytelling Guidelines and Code of Conduct. Depending on the copyright agreement, we often retain more control over the content they create and can review their work to ensure it aligns with our ethical guidelines before it is published or distributed. 

Access to MSF-run or supported hospitals and activities 
Sometimes, third parties are granted access to document our work in hospitals or activities run or supported by MSF. In these cases, we have less control over how the content is used and shared. Additionally, access to facilities supported by MSF may sometimes be granted by local authorities, such as the Ministry of Health, rather than by MSF itself.  

Media visits 
For media visits, we follow a specific process outlined in our Media Visit Charter, which sets out our key ethical guidelines. Journalists are briefed on this before they visit our projects. However, once the visit is complete, we do not have direct control over the content they choose to publish or how they use the material they gathered during the visit.

Ultimately, by working closely with trusted collaborators and maintaining strong ethical standards, the stories we share uphold the dignity of those we serve and bring important humanitarian issues to the forefront of global conversations. 

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