In 2023, the capital, Port-au-Prince, and other areas of the country continued to be rocked by politically and economically rooted gang violence, which at times exploded into full-scale street battles, including battles in April and May that resulted in hundreds of deaths and injuries. Our teams admitted about 50 people with gunshot and knife wounds to our medical facilities on April 24, 2023 alone.

In early November 2024, Haiti’s transitional presidential council appointed Alix Didier Fils-Aimé as the third prime minister to serve this year, after successive incumbents either resigned or were fired by the council. Meanwhile, The foreign intervention requested by Prime Minister Ariel Henry did not materialize during the year but remains a looming presence as Haitian citizens, particularly in the capital, are confronted with the daily threat of being kidnapped, mugged, sexually assaulted, or even killed.

The results of an MSF survey indicate that between August 2022 and July 2023, more than 40 percent of all deaths in Cité Soleil, Haiti’s largest slum, were linked to violence. Forty percent of the women surveyed said they had foregone prenatal care due to the risk of being exposed to violence while traveling to a hospital or clinic.

However, our teams have not been not immune to the risks posed by the volatile security situation in the country. Critical incidents, which endanger our staff and have resulted in the deaths of two of our patients, have forced us to suspend some of our activities. We ended our support to Raoul Pierre Louis Hospital in Carrefour in January 2023 when a wounded patient was removed by gunmen and shot dead. We temporarily closed our Cité Soleil hospital in February and April 2023 due to fighting in neighboring streets, and suspended activities at our Tabarre facility for almost two months after armed men stormed in and forcibly removed a patient in July 2023.

In December, the Turgeau Emergency Center closed its doors for several months when a patient was taken from an ambulance and killed in the street.

A deterioration of security in February and March of 2024 disrupted supply lines and causes a nearly three-month pause in delivery of humanitarian and medical supplies. 

In November 2024, a series of threats by Haitian police forces against MSF staff forced the organization to suspend its activities until further notice in the metropolitan area of Port-au-Prince; police officers stopped MSF vehicles multiple times and directly threatened MSF staff members, including by threatening death and rape.

MSF is still working to care for already hospitalized patients in our medical facilities and mobile clinics in the Port-au-Prince metropolitan area, and our maternal health activities in the south of the country will also continue.

Sexual and gender-based violence

Sexual and gender-based violence is a widespread issue in Haiti. The deepening socioeconomic crisis and high levels of armed violence have had a considerable impact on the psyche of entire communities, who have become isolated and more exposed to the risk of sexual aggression.

Since 2015, we have run a specialized clinic in Port-au-Prince  to provide comprehensive medical care and psychological support to survivors of sexual violence and intimate partner violence. A free telephone helpline has also increased access to care, offering victims remote psychological support and referrals to health centers. Our mobile clinics working in hard-to-reach neighborhoods include care for survivors of sexual violence in their services.

Maternal and neonatal health

The provision and accessibility of maternal health care is extremely limited in Haiti, contributing to the highest maternal and neonatal death rates in the western hemisphere (5.3 percent and 2.4 percent respectively). Our activities in the south of the country aim to respond to these pressing needs. In 2023, we reopened a hospital for maternal and neonatal health care in the town of Port-à-Piment, a formerly government-run facility that was damaged beyond repair in the 2021 earthquake. Our teams rebuilt and upgraded the hospital, which now offers surgery for patients with obstetric complications as well as pre- and neonatal care. However, as many other medical facilities in Sud department were never properly repaired, access to health care remains limited for pregnant women and newborns.