A multi-layer crisis
For several years, Haiti has been engulfed in a socioeconomic, political and humanitarian crisis that has reached critical levels since mid-September 2022 due to escalating armed violence and gang control of territory. Widespread insecurity and political instability have drastically affected the country's access to essential goods and services, such as food, water and sanitation, and health care, and forced hundreds of thousands of people to flee their homes.
Meanwhile, a cholera epidemic resurged in October 2022, after 3 years without cases, and spread rapidly across the country. While the cholera outbreak seems under control, conditions remain in place for a heightened risk of further spread of the disease, as well as other diseases such as dengue, TB, measles, and polio, notably in Internally Displaced Populations (IDP) sites.
Current Situation & Health Impact
Since 11 November, armed violence in the metropolitan area of Port-au-Prince metropolitan (MAPAP) is once again impeding people’s access to basic health services and complicating the delivery of essential supplies by PAHO/WHO.
About Health impact, obtaining accurate and timely data on operational capacity at facilities remains a challenge. Since March 2024, access to healthcare has been extremely limited and has worsened since November. In the MAPAP, only 41% of health facilities remain fully operational, while 40% have been forced to close due to prolonged insecurity, and 19% are operating at reduced capacity.
On 17 December, the Bernard Mevs hospital was vandalized and partially set on fire, leading to its closure.
Hopital Universitaire d’Etat d’Haiti which was looted and rendered inoperative last March, was attacked by armed man on 24 December during a ceremony to mark its partial reopening. The attack has left 4 people dead and a further 10 wounded, 4 of whom are in a critical condition.
This means that 2 out of the 3 major hospitals in Port-au-Prince are now out of commission with HUP, the last remaining public hospital in the MAPAP capable of handling mass casualties, operating under immense pressure as it struggles to manage a growing number of patients amidst a volatile environment.
In 2024, a total of 21 attacks on the healthcare system were recorded (including on infrastructure, referral systems (ambulance, etc.), healthcare professionals, patients, etc ...). These attacks led to 9 death and 6 wounded among patients and healthcare professionals.
Highlights
As of November 21, 2024
The security situation remains volatile and unpredictable in Port-au-Prince, continuing to hinder access to essential services like healthcare.
While there has been a decline in suspected cases of cholera nationwide, localized outbreaks are still being recorded. Therefore, the Ministry of Public Health and Population (MSPP, as per its French acronym), in collaboration with PAHO/WHO, continues to maintain proactive and responsive surveillance to prevent any potential spread of the disease, especially in Internally Displaced Persons sites (IDPs).
Overcrowded living conditions in IDPs sites poses risks of disease spreading. Due to this new wave of violence the number of displaced people in Haiti has jumped from
700 000 to 1 000 000 people according to the International Organization for Migration (IOM), bringing the number of IDP sites from 117 to 142. PAHO/WHO is supporting the MSPP in the provision of basic health services, WASH supplies and epidemiological surveillance.
Internally displaced people: About 1,000,000 people, more than half of them children, are currently displaced within the country. Some IDP sites face critical problems of access to water and latrines, and increasing morbidity (fever, malnutrition, diarrhea, coughing, sexual violence).
As of November 11, 2024, some 80,000 displaced people were still being housed in the 40 sites supported by the West Department Health Directorate (DSO) in collaboration with PAHO/WHO. This number represents close to 50% of the total number of displaced people spread over 108 sites in the Port-au-Prince metropolitan area.
Ports of entry: Albeit its reopening, the security situation around the international airport prevents both commercial and cargo planes to operate, Leading PAHO/WHO and other UN agencies to rely increasingly on the UNHAS to provide humanitarian assistance. The partial resumption of activities at the seaport is allowing PAHO/WHO to replenish its stock.
Fuel: disruptions to fuel supplies due to gang violence have delayed tanker deliveries to the main terminal, leaving some service stations without fuel and hampering operations.
Cholera Situation
After more than 3 years with no cases, on 1 October 2022 Haiti national authorities reported two confirmed cases of cholera in the greater Port-au-Prince area. As of 07 december 2024 (latest official report), the MSPP reported 88,087 total suspected cases, 4,870 confirmed cases, 85,509 hospitalized cases, 1,010 institutional deaths and 314 community deaths.
While recent months have seen a steady reduction in the number of reported cholera cases nationwide, localized outbreaks are still being monitored in some communes of the Artibonite department as well as in Maissade (Centre) and Anse-a-Pitre (Sud-Est). PAHO is working with the MSPP to strengthen the local cholera response team and provide essential drugs and supplies for treatment despite the security situation, which is severely hampering the response.
The crisis is impacting cholera response and case reporting, particularly in the Ouest Department (and part of the Artibonite Department).
While investigation and response activities are possible outside of the Ouest Department, samples are difficult to transfer to the National Laboratory in Port-au-Prince for testing due to the lack of air and ground access to the capital.
Similarly, the situation complicates the dispatch of medical and WaSH supplies from PAHO/WHO’s PROMESS warehouse in Port-au-Prince to other departments.
Despite this situation, PAHO/WHO was able to support a cholera vaccination campaign in the Artibonite Department between 16 and 22 December 2024. A total of 122,604 people were vaccinated in the communes St.Michel, Marmelade, Dessalines and Petite Riviere.
PAHO/WHO's Response
In response to the escalating insecurity and humanitarian crisis in Haiti, the Pan American Health Organization has been supporting the Ministry of Health (MSPP) and active health partners to mitigate the ongoing strain on the health sector caused by the prolonged gang violence and protecting the operational capacity of critical health facilities to continue providing emergency health services to the local populations.
This operation was made possible through a collaboration with WFP, the United Nations Humanitarian Depot (UNHRD) and with the financial support of the European Commission Humanitarian Aid (ECHO). These supplies were strategically pre-positioned into health facilities in the Centre, Nord-Est, Nord, Artibonite, and Nord-Ouest departments as contingency stock.
PAHO/WHO is distributing medicines and medical supplies to key health facilities through the PROMESS warehouse and ensuring the maintenance of the cold chain essential for vaccine preservation. As part of these efforts, PAHO/WHO recently donated medical equipment to Hôpital Universitaire de la Paix, enabling it to treat up to 3,000 seriously injured individuals and continue providing care to vulnerable populations, including pregnant women and internally displaced persons (IDPs) in the Port-au-Prince metropolitan area.
“PAHO/WHO's support to the MSPP has enabled nearly 20,000 medical consultations to be carried out and more than 38 tonnes of medical supplies to be provided from its stockpile in Panama to treat internally displaced people.”
Donation of medicines, medical supplies and equipment to health facilities that remain operational in the capital.
Delivery of blood supplies and consumables to the National Blood Transfusion Center to resume blood testing activities.
Distribution of hygiene and sanitation products in 40 sites in the Port-au-Prince metropolitan area to 80,000 internally displaced persons.
Support local authorities in providing surveillance activities and health service delivery (mobile clinics) at IDP sites.
Supply of fuel to the National Ambulance Center to ensure the continuity of ambulance operations within the PaP area.
Enhanced support to epidemiological and laboratory surveillance at national and department levels for cholera and other epidemic-prone diseases.
Psychosocial support to persons living in shelters facing stigma and fear of epidemics such as cholera.
Protecting the Health of Displaced Haitians
PAHO/WHO has been supporting response efforts of Haitian health authorities and other health partners to detect and attend the acute health needs of displaced populations in 40 sites in the metropolitan area of Port-au-Prince hosting over 80,000 persons.
Activities included support to care delivery through the distribution of medicines and medical supplies and mobilization of health workers, epidemiological surveillance, vaccination and psychological support, among others. These actions were carried out with the generous financial support of USAID's Bureau for Humanitarian Assistance (BHA), Global Affairs Canada (GAC), European Union Humanitarian Aid (ECHO), German Humanitarian Assistance and the Central Emergency Response Fund (CERF).
PAHO/WHO’s financial requirements to attend urgent public health needs of the Haitian population amount $24.5M for 2024. As of 1 November 2024, the organization has mobilized just over $8.5M in donor contributions to support targeted health interventions and health emergency response efforts throughout the country. The critical funding gap of over $15M significantly hampers the capacity of health partners to provide lifesaving and crucial health services to the most vulnerable Haitians.
PAHO/WHO is working closely with national health authorities, other UN agencies and local and international health partners to address the Haitian population's most pressing health needs during this crisis and protect the lives of the most vulnerable.
Critical health needs include:
Procuring blood transfusion supplies, oxygen, and essential medicines and medical equipment required by hospitals and health partners to support emergency care delivery;
Ensuring access to food, transportation, and financial gratification for overworked healthcare professionals reporting for duty;
Provide technical, operational and logistical support to HUP and other operational health facilities (fuel, minor repairs, generators, casualty contingency plan), to maintain operations;
Support the National Ambulance Center to increase patient and casualty transfers (fuel, spare parts, medical supplies).
Prepositioning and scaling up logistics and supply chain operations in the Dominican Republic for rapid mobilization of supplies wards Haiti until the humanitarian corridor opens.
Access Haiti's Health Emergency Appeal to learn more and donate.
