Haiti

International Activity Report, 2009

 

Political stability in Haiti, however weak, was achieved with the election of a new government in 2006. However, 2009 was characterised by rising food prices, chronic unemployment, and a dysfunctional healthcare system. Slum dwellers in the capital Port-au-Prince continued to live in deplorable conditions. Haiti has the highest level of maternal mortality in the western hemisphere (67 deaths for every 10,000 live births). Poverty, in combination with a mostly privatised healthcare system, has compromised maternal healthcare for women living in slum areas in Port-au-Prince. MSF was one of the main public health care providers in the Haitian capital before the earthquake in January, 2010, providing obstetric care, emergency care and trauma care to the population.

 

Women’s health

 

In 2009, a surge in the number of births prompted MSF to move the maternity hospital in Port-au-Prince to a larger facility in the city. To avoid any duplication of public health services, MSF focussed on helping women who were experiencing complications, and transferred those with straightforward pregnancies to government-run centres in the city. MSF also managed antenatal care in three slum locations in the capital, carrying out 1,500 consultations a month. Since the emergency obstetric programme was opened in 2006, more than 40,000 babies have been delivered, clearly indicating the huge need that exists for maternity care in the slums.

 

Emergency trauma care and training

MSF has been providing comprehensive trauma care in Port au Prince since 2004, as a response to the increasing violence at the time. It first started at St Joseph Hospital and then moved to the 75 beds Trinité Trauma Center in Delmas 19,  to be able to offer a higher level of care. Trinité trauma center is the place where MSF introduced for the first time ever in its program, the internal fixation technique, allowing patient to walk again within a couple of weeks, instead of a couple of months.  Patients were then transferred to Pacot Rehabilitation Center for physiotherapy and follow up consultations. In 2009, 9,969 patients were treated in the emergency room of Trinité while 4,266 underwent surgery.  As witnessed after the collapse of a school in Petionville in December 2008, when most patients were brought to the MSF Trinité Trauma Center, appeared to be the main functioning emergency structure in Port au Prince.

 

Through Martissant Emergency Centre, MSF provides life-saving medical care in one of the most poverty stricken neighbourhoods, home to approximately 400,000 people. Opened in 2006, the project was created to respond to medical needs resulting from the high level of armed violence in the Martissant area. Today, although armed violence has decreased, the medical needs remain huge. In 2009, the MSF team performed more than 97,000 medical consultations for nearly 48,000 patients. Over 60 per cent of the new patients were victims of trauma, such as car accidents, and one in ten was wounded as the result of violence.

 

In Martissant, patients with severe medical needs are stabilised and those requiring surgery or longer hospitalisation are transferred to other medical structures, including MSF facilities in Port au Prince Maternite Solidarite and Trinité Trauma Center. Referrals to public medical structures, however, prove difficult. The lack of personnel, poor organisation and high cost of services mean that many patients are left without the medical care they urgently need. To increase the capacity of Martissant Emergency Centre and reduce the amount of referrals, the number of beds in the centre was increased from 13 to 35 in August and Martissant has since been able to offer short term hospitalisation.