At the end of 2011, almost two years after the earthquake, nearly half a million Haitians were still homeless and living in unhealthy conditions. The health system requires a huge amount of investment in reconstruction.

Médecins Sans Frontières (MSF) continued to respond to the cholera epidemic and provide specialist medical care in Port-au-Prince and nearby Léogâne.

Cholera epidemic

The cholera epidemic, which broke out in October 2010, had infected 520,000 people by the end of 2011, killing more than 7,000. MSF treated around 170,000 patients for cholera symptoms during this time, working in 50 facilities across the country.

In Nord department, MSF opened 19 treatment centres and 90 oral rehydration points. Staff treated more than 31,700 patients in Nord department alone. In the first months of the year, when the number of new patients started to stabilize, MSF began to hand over activities. Staff provided six months of training and logistical support to Ministry of Health workers in Nord department before withdrawing in October.

MSF continued to provide treatment for cholera elsewhere in Haiti, particularly for people suffering complications due to pregnancy or existing chronic diseases. In May, the rainy season began and the rate of infection rose again. Staff reopened emergency treatment centres in Port-au-Prince, bringing capacity up to 1,000 beds in eight sites.

At the end of the year, cholera was still not under control, and unexpected rises in infection continued to occur. As long as people are obliged to live in conditions that exacerbate the spread of infectious diseases – half the population of Haiti does not have access to safe drinking water – the resurgence of cholera will be a risk. MSF spoke out about the need to strengthen the national surveillance and response systems.

Maternal healthcare

Before the earthquake, MSF’s work in Haiti concentrated on maternal healthcare. A large proportion of maternal deaths are due to pregnancy-related hypertension disorders, such as pre-eclampsia, which are treatable, but many women do not have access to emergency obstetric care.

The earthquake destroyed MSF’s emergency obstetric hospital in Port-au-Prince. In March 2011, a new referral centre for obstetric emergencies (CRUO) was opened in the neighbourhood of Delmas 33. This 80-bed hospital offers free 24-hour care to women experiencing serious complications in their pregnancies. Staff at the centre also provide postnatal and neonatal care, family planning, mental healthcare and a program to prevent mother-to-child transmission of HIV. In 2011, MSF assisted over 4,000 births at the centre, most of which were emergency deliveries.

Hospital care in the capital

At hospitals across the capital, MSF has switched its focus from emergency response to more routine specialist medical services. Bicentenaire hospital, which had been set up in a former dental clinic just after the quake, was closed in July. It offered emergency care and surgery, pediatric care and mental health services, as well as ambulance referral. In the hospital and two mobile clinics, Bicentenaire staff saw around 4,000 patients a month in 2011.

In the impoverished neighbourhood of Cité Soleil, MSF staff at the Ministry of Health’s Choscal hospital worked in the two operating theatres, the emergency department and the pediatric and maternity wards. They also provided medical and psychosocial care to victims of sexual violence.

MSF’s 40-bed emergency and stabilization centre in Martissant withstood the earthquake. In addition to emergency assistance, the hospital continues to offer maternity care, internal medicine and mental health services. In Sarthe, MSF runs a centre offering wound care and orthopaedic and reconstructive surgery. Handicap International physiotherapists work with MSF to rehabilitate patients and help them adapt to mobility aids.

In May, MSF’s inflatable hospital, set up on school playing fields in the days after the earthquake, was replaced by a new 200-bed hospital in Drouillard district. Drouillard hospital offers a wide range of services and has a specialized burns unit. Surgeons performed around 20 operations a day, and 29,000 patients were admitted for emergency treatment over the course of the year.

Access to care outside the capital

Léogâne, a city just west of Port-au-Prince, was almost completely destroyed by the earthquake. In October 2010, MSF replaced the tent hospital it had set up in the city immediately after the earthquake with a semi-permanent container hospital. Chatuley hospital has 160 beds and mainly focuses on trauma and obstetric emergencies. The outpatient department offers basic healthcare to women and children under the age of five.

In Jacmel, in the southeast of the country, MSF began supporting Ministry of Health staff at the Saint Michel hospital directly after the earthquake. Staff provided emergency care, surgery, pediatric and maternal care, as well as mental health services. In February 2011, as emergency needs had abated, MSF withdrew.

At the end of 2011, MSF had 3,872 staff in Haiti. MSF has been working in the country since 1991.

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