Why are we there?
- Social violence
- Healthcare exclusion
- Endemic/epidemic disease
- Natural disasters
- Letter from the field: “Call for backup – all hands on deck!”
- Haiti: Deplorable conditions for cholera patients
- Haiti three years on: Much work remains to improve access to healthcare
This is an extract from our latest Activity Report, looking back on our work in the previous year.
Reconstruction has been slow since the 2010 earthquake, and many Haitians continue to rely on humanitarian aid for emergency medical care.
Delays in disbursements and in the realisation of planned projects mean the reconstruction of the health system is far from complete. Access to healthcare was a problem for vast numbers of people even before the disaster: fees were unaffordable and there were few adequately equipped public hospitals.
Médecins Sans Frontières/Doctors Without Borders (MSF) continues to fill gaps in emergency care with more than 500 beds in four hospitals. Teams also provide treatment for cholera, a potentially deadly water-borne disease, which according to Haitian authorities had affected 638,000 people and killed almost 8,000 by the end of 2012.
Pregnant women in Haiti often find themselves in a precarious situation in emergencies. MSF runs a 130-bed obstetric and neonatal emergency hospital in the Delmas 33 neighbourhood of Port-au-Prince, offering free, round-the-clock emergency care for women experiencing complications, including common hypertensive disorders such as pre-eclampsia. In 2012, 7,980 patients were admitted to the hospital and teams assisted 6,360 births.
In addition, the hospital provides a full package of reproductive healthcare services including family planning, prevention of mother-to-child transmission of HIV, neonatal and postnatal care and mental health counselling. A 10-bed cholera centre has also been set up inside the hospital for pregnant women who have contracted the disease.
Emergency surgery in the capital
In February, MSF opened the Nap Kenbe – Creole for ‘staying well’ – surgical centre in Tabarre, eastern Port-au-Prince. Teams provide emergency trauma, orthopaedic and abdominal surgery for victims of gun crime and domestic violence as well as people injured in road accidents. Of almost 1,200 patients in 2012, 18 per cent had suffered violent trauma and 72 per cent were victims of accidents.
MSF continued to work out of the 130-bed Drouillard trauma hospital close to the Cité Soleil slum in the north of the city. This facility is equipped with an emergency department, operating theatres and intensive care and burns unit, and provides physiotherapy and mental health services.
In 2012, hospital staff cared for 19,700 emergency patients and carried out 8,000 surgical procedures, treated 480 people with burns and provided medical and psychological support to 150 victims of sexual violence.
Martissant emergency and stabilisation centre
The only MSF facility that remained intact after the earthquake was the 35-bed Martissant clinic for paediatric care, maternity services and internal medicine.
A 100-bed cholera treatment centre remained open until June. MSF closed its mental health programme at Martissant at the end of the year. In total, more than 61,200 patients received treatment at the facility in 2012.
Chatuley hospital, Léogâne
The 160-bed container hospital run by MSF in the city of Léogâne, close to the earthquake’s epicentre, is the only facility in the region offering free 24-hour care for medical and surgical emergencies.
Some people travel from Port-au-Prince for medical attention there. Facilities include a laboratory, radiology, physiotherapy and mental health services and a special outpatient department for pregnant women and children under five.
In 2012, staff assisted 6,600 births and carried out 3,600 surgical procedures – most of these were for women requiring caesarean sections and victims of road accidents. The cholera treatment unit is the only facility treating patients suffering from cholera-associated medical complications.
Cholera can cause rapid dehydration and death if untreated and is commonly found in areas with unsafe water and poor sanitation control. Unhygienic living conditions and a lack of healthcare have exacerbated the cholera crisis that began in the country in 2010. Public cholera treatment centres remain inadequate throughout Haiti and the overall response to the crisis is limited because of reduced international funding.
In 2012, MSF treated close to 25,000 people with cholera in Port-au-Prince and Léogâne. Patient numbers increased after hurricanes Isaac and Sandy, when rains caused open sewers to overflow and led to the spread of contaminated water, but the peak period was in April and May, during the rainy season.
Teams continued preventive measures, including distribution of hygiene kits, water chlorination and education and awareness activities. MSF was still treating more than 500 people for the disease per week at the end of the year.
Completion of anaesthesia training
In September, MSF completed the training of nurses in anaesthesia. In the absence of other educational institutions providing such training, this course equips nurses with the critical skills they need in the management of obstetric and surgical emergencies.
At the end of 2012, MSF had 2,582. MSF has worked in the country since 1991.
Moïse, 33 years old
“I’m from Bogbanique. The illness began when I was in my garden. I was working. It began all of a sudden. I didn’t know what was happening to me. I lost consciousness. Some people took me to the clinic. They put me on a drip.
"I remember that, because that was when I came to. But the medical centre there didn’t have the right treatment for me, so they put me on a motorbike and we came to Thomassique. I fainted again. I don’t remember arriving here. But now I am conscious again, and I feel better.
“I’ve seen others with cholera. I don’t think I’m any worse off than them, but I’m no luckier either. When this disease gets you, it’s life or death.”