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 February 29, 2024, the humanitarian situation in Haiti has rapidly escalated due to the rise in violence linked to gang activities in Port-au-Prince and nearby areas. The State of Emergency declared for the West Department, including Port-au-Prince has been once again extended until 7 April 2024.
The population of Haiti is grappling with an unprecedented lack of access to medical services, particularly in the capital where most major hospitals have closed due to the inability to guarantee the safety of staff and patients and shortage in necessary resources to maintain their operations. In the Port-au-Prince metropolitan area (PaP), less than half of the health facilities are operating at their normal capacity, placing immense pressure on local healthcare systems. Difficulties in accessing services are adversely affecting patients with chronic illnesses and pregnant women, leading to an increase in critical medical and obstetric emergencies.
Highlights
As of April 1st., 2024
Hospitals: The Hopital Universitaire d'Etat d'Haiti (HUEH), the biggest and most important hospital in Haiti, is still closed.
Hopital Universitaire la Paix (HUP) remains the only public health facility in the metropolitan area with the capacity to manage mass casualties.
Attacks on healthcare facilities by gangs continue in the Metropolitan area of Port-au Prince, further restricting access to healthcare.
Armed groups raided at least 10 pharmacies near Haiti's State University Hospital last week, worsening the population's ability to obtain necessary medications.
The National Ambulance Centre (CAN as per French acronym) was forced to close temporarily for three days due to gang violence in the area.
Internally Displaced Persons (IDPs): There are over 360,000 IDPs reported in the country, with a significant increase between January and March 2024. Some IDP sites are in critical challenges in access to water and latrines and growing morbidity conditions (fever, malnutrition, diarrhea, cough, sexual violence).
Over the past two weeks, 53,000 individuals have been compelled to depart the capital city of Port-au-Prince due to the worsening security conditions in the metropolitan area, among them 68% already living in IDP sites.
Ports of entry: The international airport remains closed and the national port of Port-au-Prince remains difficult to access as the surrounding areas are under gang control.
Fuel: Fuel supply disruptions resulting from gang violence have delayed tanker deliveries to the main terminal, leaving some service stations without fuel and hindering 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 31 January 2024 (latest official report), the MSPP reported 79,411 total suspected cases, 4,608 confirmed cases, 75,160 hospitalized cases, 887 institutional deaths and 285 community deaths.
Recent months have seen a steady reduction in the number of reported cholera cases. While the outbreak seems to be receding and under control, high levels of insecurity are negatively impacting cholera response and case reporting.
Risk factors for cholera spread remain present and are heightened by the crisis as water supply becomes scarce and sanitary conditions deteriorate, which could result in a resurgence of new cholera cases. Continued support to surveillance, early detection and rapid response are essential conditions for maintaining the control of the outbreak and breaking the transmission chain in a sustainable way.
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.
"PAHO/WHO's support to the MSPP has enabled nearly 20,000 medical consultations to be carried out and over 3 tonnes of medicines and medical equipment to be supplied for the care of internally displaced persons."
Donation of more than 4 tons 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 23 sites in the Port-au-Prince metropolitan area to 37,000 internally displaced persons.
Support local authorities to resume 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.
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 25 camps in the metropolitan area of Port-au-Prince hosting over 37,000 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) and the Central Emergency Response Fund (CERF).
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;
Providing technical, operational and logistics support to HUP and other operational health facilities (fuel, minor repairs, generators, mass casualty plan) to maintain operations;
Supporting the National Ambulance Center to increase the transfer of patients and victims (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.
