Hospitals in Haiti’s capital of Port-au-Prince face the threat of shutting down if fuel supplies for diesel power generators and vital medical supplies aren’t made available soon, Médecins Sans Frontières (MSF) warned Friday. 

“We will not be able to operate our medical facilities for more than a few weeks if we do not have access to fuel,” said Mumuza Muhindo, MSF’s head of activities in Haiti. “In addition, medical equipment, which we also need to continue to treat cholera cases and provide care to the population, is currently blocked at the port.”

Shortages have been exacerbated by the ongoing gang blockade of a key fuel terminal in the country, which has led its neighbour, the Domican Republic, to approve a request to export 20,500 gallons of diesel to Haiti for use principally in hospitals, according to documents seen by Reuters.

As chronic outages continue to hit Haiti’s power grid, fuel is the only way hospitals can ensure consistent electricity. And the Haitian capital’s health services are already on the brink of collapse.

For the last several days, Port-au-Prince hospitals have been forced to reduce their services due to the fuel shortage as the country teeters between prospects of foreign intervention and revolution. 

MSF reports over 100 people a day with cholera like symptoms

Cholera in Haiti UPDATE:

For the past week, teams in Port-au-Prince have received approximately 100 patients every day at its cholera treatment centers throughout the capital.

Haiti is facing a major health disaster. https://t.co/PSVY7Kd0JG

— Doctors w/o Borders (@MSF_USA) October 21, 2022

Amid the chaos, the re-emergence of cholera, officially confirmed on October 2, poses a growing threat. As of 8 October there were 224 cases officially confirmed, according to WHO.  

Accounting for the breakdown of the government’s ability to operate, experts warn official figures drastically underestimate the scale of the outbreak. Over the last seven days, MSF reported receiving over a hundred patients with cholera-like symptoms in each of its four treatment centers.

Unsafe water is one of the main causes for the spread of cholera, and with no functioning government, escalating violence, and no clear path to a resolution of its political crisis, the resurgence of the disease in Haiti could be disastrous, warned Auguste Ngantsélé, MSF’s Haiti Medical coordinator.

“Without drinkable water, treatment, and good waste management, the risk of a spike in the number of cases is very high and needs to be addressed urgently,” he said.

Additional reports emerged last week of an outbreak in an overcrowded prison where dozens of people were infected, triggering fears that transmission may grow out of control.  

Patients can’t get to hospitals 

Even if hospitals in the island’s capital manage to remain open, the roads to treatment are dangerous. Violence on the streets has made every trip through Port-au-Prince perilous, and even seeking access to facilities capable of providing adequate treatment present a life-threatening challenge for patients. 

“In 20 years of working in Haiti, we have never seen something like this,” Fiammetta Cappellini, country representative for the Avsi Foundation told the Guardian. “Violence is everywhere and touches everybody. The most vulnerable people are literally struggling to survive as humanitarian aid is failing to reach people.”

Accounts from doctors on the ground provide grim evidence for Cappellini’s view. 

“Last week, a pregnant woman came to our hospital in Cité Soleil needing an emergency cesarean section. We tried to transfer her to a medical facility where she might find that kind of treatment, but she died”, said MSF doctor Dr. Luxamilda Jean-Louis. “Whether it’s due to insecurity on the roads, or to health structures no longer functioning, events like this happen every day in Port-au-Prince.”

The gangs – who took the opportunity to expand their control over the country after the assassination of its prime minister last year – have gone to extremes to enforce their rule over the capital. 

Last week, the UN Human Rights Office published a report detailing that children as young as 10 have been subjected to sexual violence – including collective rapes for hours in front of their parents or children by more than half a dozen armed elements. 

“Gangs use sexual violence to instil fear, and alarmingly the number of cases increases by the day as the humanitarian and human rights crisis in Haiti deepens,” said acting UN Human Rights Chief Nada Al-Nashif. “The gruesome testimonies shared by victims underscore the imperative for urgent action to stop this depraved behaviour, ensure that those responsible are held to account, and the victims are provided support.”

On Friday, the UN Security Council unanimously approved a sanctions regime for Haiti, targeting gang leaders and those who finance them, in hopes of easing the violence and lawlessness. The resolution specifically sanctions notorious gang leader Jimmy Cherizier, an ex-police officer who is reportedly the most powerful gang boss in the country, known by his alias “Barbeque”.

“We are sending a clear message to the bad actors that are holding Haiti hostage,” said US UN Ambassador and co-pen holder on Haiti, Linda Thomas-Greenfield. “The international community will not stand idly by while you wreak havoc on the Haitian people.”

Thomas-Greenfield added that the US and Mexico are working on a resolution to authorize a “non-UN international security assistance mission” to address security issues and facilitate humanitarian aid. Given Haiti’s past experiences with foreign intrusions, the plan is controversial, and has sparked large protests in the capital.

Haiti’s acting, but unelected prime minister, Ariel Henry, asked for the international community to deploy a “specialized armed force” in the country on October 7. Despite United States acknowledgement of the depths of the Hatian crisis on the international stage, many refugees arriving at its borders fleeing the violence continue to be sent back.

Crises collide: ‘catastrophic’ hunger recorded in Haiti for first time

#Haiti: As crises collide, WFP is committed to continuing to support vulnerable Haitians amidst multiple security challenges.

Working with Haitians to boost their resilience to future shocks remains WFP’s top priority in the country. pic.twitter.com/LyR0vp2ef3

— World Food Programme (@WFP) October 14, 2022

On the same day of the release of the sexual violence report, the UN’s World Food Programme published its own finding: hunger in Haiti has reached catastrophic levels. 

According to the media release, a record 4.7 million people are facing acute hunger, including 1.8 million facing what the UN describes as “emergency phase” hunger. And, for the first time ever in Haiti, 19,000 people are facing “catastrophic” hunger, and are barely surviving. 

Today, 65% of the residents in Cité Soleil, an extremely impoverished and densely populated neighborhood of Port-au-Prince, are facing high levels of food insecurity.

With armed groups vying for control of this now lawless area of the capital, people have lost access to their jobs, markets, health and nutrition services. Many have been forced to flee or simply hide indoors, the UN said. 

Beyond the chaos of Port-au-Prince, rural communities are not faring much better. Food security has continued to deteriorate in these areas as harvest losses due to light rainfall compounded by the 2021 earthquake that struck the island in August last year hit food supplies. 

“For years, natural hazards and political turmoil have taken a toll on Hatians already in need in both rural and urban areas,” the UN stated. “The onset of the global food crisis, with rising food and fuel prices, has led to growing civil unrest that has plunged Haiti into chaos.”

As the parallel crises of hunger, violence, and cholera collide, whether Haiti’s hospitals survive the fuel shortage will determine the lives of thousands of Haitians.