Martissant, Haiti: “Most of the people we see in our emergency room are civilians”

Interview with Evelyne De Decker, doctor returning from MSF project in Martissant, Haiti (18 June 2008)

© Massimo Mastrorillo

How much does the violence affect the people we treat in our clinic?
The majority of the people we treat in our emergency room are affected directly or indirectly by the violence. We are talking about injuries caused by shooting and by other weapons such as knives or machetes. Several people also come with heavy burnings caused by accidents, because they do not have electricity at home and use fire for cooking.

What do you mean exactly by “indirectly” affected by the violence?
Everybody knows somebody or has somebody in their family who has been attacked or injured; people live with the constant threat of violence. People in the slum hear frequent shooting, they also hear stories of people being attacked or kidnapped and they know it could happen to any of them. This causes a lot of distress, although these people can handle much more than we could, because they are used to it, they grow up in such environment.

What does MSF do to help these people?
MSF provides medical care to people who come to us with traumas and by stabilizing those patients who need to be referred for surgery. Besides that, we also offer psychosocial care, but not all the patients respond to this offer. We have three psychologists and one social assistant in our clinic. Normally people come through the emergency room or our mobile clinics; our doctors can refer some of them to get psychological assistance. People do not come looking for it directly, because they are not used to getting such support and they do not even expect it. Normally we only see them once, they do not come back afterwards. We might see between 250 and 300 people per month who are referred by our doctors to the psychologists; we are talking about all types of traumas, women who have been raped, children who have been shot, etc.

© Massimo Mastrorillo

Is the violence a constant threat for the people of Martissant?
There is a constant threat of violence in the slum, but of course it is not permanently present with the same intensity: there are moments of acute violence and others that are calmer. These waves are linked to several factors, one of them being the immediate need of money. Back in April for example we saw an increase of violent acts that can be linked to the rise in food prices; in the past few months for example a basic good like rice has doubled in price and this is creating tension among a population that is already very poor.

How was it for you to work in such violent environment?
Surely so much indiscriminate violence made an impression on me. However, MSF is very well known and respected among the people of Martissant. Last April, riots against the food prices were making the security in Martissant extremely volatile and nobody could move around without getting stones thrown at them; only the MSF cars could pass untouched. It was very rewarding to work in a place where you can really make a difference for those people and I felt comforted by so much  respect. The most difficult thing for me over this time was to see so many innocent people being hurt. People get wounded just because they are passing in the street at the wrong time; it happens often, most of the people we see in our emergency room are civilians.