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Five years after Haiti’s massive earthquake, the health system is only partially reconstructed and specialist services remain out of reach for many people.

Médecins Sans Frontières has continued to fill gaps in the Haitian healthcare system, gaps it has been filling since before the catastrophic earthquake in 2010, and has been helping build local capacity by training national staff. Haitians need better access to lifesaving, emergency services, including obstetrics, neonatology, surgery and trauma care. Cholera is an ongoing health threat but there is a lack of available finances to tackle it and no effective response plan in place. Médecins Sans Frontières is regularly stepping in to treat patients and prevent major cholera outbreaks and loss of life.

Drouillard burns unit
Domestic accidents and poor living conditions are the main cause of burns in Haiti, and victims are predominantly women and children. Médecins Sans Frontières continued to run the only facility treating burns patients in the country, in Drouillard hospital, close to the Cité Soleil slum in Port-au-Prince. To focus on the treatment of burns patients, Médecins Sans Frontières closed the trauma unit it was running inside the hospital. There were 481 patients hospitalised for burns in 2014.

Emergency services in Port-au-Prince
Responding to more than 45,000 emergencies in 2014, the Martissant emergency and stabilisation centre is a free, around-the-clock resource for people experiencing any kind of medical emergency, caused by violence, accidents, burns or obstetric complications. Staff treated more than 25,000 patients with accidental trauma, 13,250 with violent trauma and more than 3,700 people with cholera.

Teams responded to more than 9,880 emergencies and performed more than 4,200 surgical procedures in 2014.

Specialist care for obstetric emergencies
Located in the central Delmas 33 neighbourhood of Port-au-Prince, MSF’s 140-bed Centre de Référence en Urgence Obstétricale (CRUO) continued to provide 24-hour, free obstetric care to pregnant women experiencing serious and life-threatening complications such as pre-eclampsia, eclampsia, obstetric haemorrhage, prolonged and obstructed labour and uterine rupture. CRUO offers a range of reproductive healthcare services, including ante- and postnatal care, family planning and prevention of mother-to-child transmission of HIV, as well as neonatal care and mental health support. There is also a 10-bed ‘Cholernity’ ward for pregnant women with cholera. There was an average of 17 births a day in the CRUO in 2014. Some 10,400 patients were admitted to the facility.

Chatuley hospital
Following the January 2010 earthquake, Médecins Sans Frontières constructed a temporary container hospital to conduct surgery in Léôgane, an area that was 80 per cent destroyed by the disaster. The programme has evolved to handle emergencies, focusing mainly on complications in pregnancy and road accident victims. Basic medical care is also provided to pregnant women as well as children under five.

In February 2014, a cholera treatment unit that had been running since 2010 was closed. As of November, only emergency services for pregnant women, newborn babies and children under five were being provided.

In 2014, Médecins Sans Frontières admitted 6,782 patients to Chatuley hospital, carried out 2,617 consultations for children under five, provided 6,162 antenatal consultations and assisted 3,298 births.

Cholera response
Four years after cholera’s first appearance in the country, the Haitian health system is still facing a shortage of funds, human resources and drugs. Many Haitians continue to lack access to clean water and adequate latrines, resulting in regular outbreaks of cholera, a potentially deadly communicable disease. There are insufficient public cholera treatment centres (CTCs) in Haiti and reduced international funding has limited the delivery of medical care and the provision of clean water and sanitation services. Teams focused on preventive measures, including distribution of disinfection kits (chlorine, bucket, etc), and awareness and education activities. More than 224,600 people were reached via these activities and 1,640 disinfection kits were distributed. Overall, more than 5,600 people received Médecins Sans Frontières -supported cholera treatment.

Médecins Sans Frontières  first worked in the country in:

No. staff:
This text is an excerpt from the 2014 International Activity Report, published annually looking at our work in the previous year. The full report is available here.

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