Hospitals under attack: Gang violence threatens Haiti’s healthcare system

The Bernard Mevs hospital in Port-au-Prince, Haiti’s only neurological trauma center, was set on fire with Molotov cocktails last week by a coalition of gangs known as Viv Ansanm. With 87 beds, it served nearly 12 million people and had managed to continue its operations through such devastating events as the 2010 earthquake and the coronavirus pandemic. “We are disoriented. More than 30 years of work and dedication to the medical sector were lost in one night,” lamented a source close to the hospital, who asked to remain anonymous for fear of retaliation.

Then, a week later on Christmas Eve, an armed attack rocked the State University of Haiti Hospital. Viv Ansanm launched its assault on the facility in broad daylight, unleashing chaos among patients and staff. Paradoxically, the day should have been one of celebration, having been the date on which the major hospital was scheduled to reopen after being forced to close by another gang attack in February 2024. Instead, at least four people were killed, including two Haitian National Police officers. In addition, more than 15 people were shot and wounded, several of them journalists.

Following this latest attack, Minister of Health Duckenson Lorthé Blaima was removed from his post after serious doubts were raised regarding his management of the hospital’s reopening. The official’s decision to organize the event without consulting the National Police is being called into question, and is believed to have led to an absence in security that facilitated the gang’s attack. Blaima’s team has dismissed such accusations, maintaining that he took all necessary measures to ensure safety.

These episodes are further evidence of the authorities’ inability to curb growing violence, and have had a profound impact on a city that had limited medical services to begin with. Most hospitals in Port-au-Prince are under gang control, and the few that remain operational are difficult to access due to security concerns. Business leader Harold Marzouka Jr., who supported the hospital financially for a decade, said that Bernard Mevs provided essential services for the country’s critical cases. “Other hospitals could only receive patients after they had been stabilized here,” he said.

Medical services on the brink

“It was the only place in Haiti capable of keeping a patient intubated for weeks or even a month, something other hospitals cannot guarantee,” said Pierre Louis Antoine, a physician associated with Bernard Mevs. The facility also stood out for its ability to provide emergency care for gunshot wounds, car accidents and severe trauma and long-term follow-up care to patients. In the field of neurosurgery, Bernard Mevs was distinguished for being able to carry out advanced procedures like endoscopic ventriculostomy for the treatment of hydrocephalus in children, as well as treating cranial tumors and spinal injuries.

In the armed attack, gang members destroyed important facilities at the privately funded hospital, which offered accessible services to the general public. The operation took place after the hospital suffered several assaults during the previous Sunday and Monday. Among the losses were four operating rooms, a laboratory, two scanners and administrative offices.

The hospital was known for having some of the country’s most advanced medical imaging technology. It was also key in the training of medical students, as it housed the only residency program in neurosurgery. “We’re down to zero. Even for simple cases like appendicitis, there is nowhere to operate anymore,” Marzouka said. The businessman sharply criticized the international community’s inaction in the face of Haiti’s plight. “It’s like watching a ship sink with people on board while you have life jackets and do nothing,” he said.

Despite the efforts of private clinics and hospitals run by non-profits to fill the gap left by the destruction of Bernard Mevs, resources are insufficient to meet growing demand. The healthcare situation in Haiti has worsened considerably in recent months. According to the Ministry of Public Health and Population (MSPP), “insecurity has worsened the situation, forcing the closure of more than 31 hospitals throughout the department,” said a representative from the West Health Directorate in a statement to EL PAÍS, a panorama that has left the population without adequate access to medical services. According to the United Nations, since May 2024, only six out of every 10 hospitals in Haiti still have some operational capacity due to gang violence in the capital, Port-au-Prince.

The situation is further complicated by the exodus of medical professionals, which has left hospitals without trained staff. One study found that 40% of doctors who were trained in Haiti have left the country due to insecurity, and of those, 13% have emigrated to the United States. According to numbers from the MSPP, Haiti has only 5.9 doctors for every 10,000 residents.

Meanwhile, La Paz University Hospital, the sole functioning public hospital in the Port-au-Prince metropolitan area, remains overwhelmed. In November 2024, the facility registered 49 patients who had been injured by firearms in just one week. Violence remains the main challenge for the health system, and the hospital is stretched to capacity in trying to handle the growing numbers of victims of gang confrontations. Despite some attempts to restore security in the area, such as the arrival of Kenyan-led multinational forces in June 2024, results have been limited.

The prolonged closure of the General Hospital has also affected the training of new physicians. Residents in various specialties, such as anesthesiology and urology, were unable to complete their academic year due to lack of space and unsafe conditions. “We are in a critical situation, it is a lost year for all residents,” commented Rodolphe Malebranche, director of residencies at the university hospital. Interim measures, such as the relocation of residents to other health centers, have not solved the underlying program. According to Malebranche, if the General Hospital reopens, “residents will have no place to stay and perform night shifts,” which could worsen the situation.

As more physicians leave the country and residents drop out, Haiti’s capacity to deal with health emergencies has become seriously compromised. “Those of us who remain as physicians and residents are facing an untenable situation,” said Dr. Yveline Michel, a resident in anesthesiology. And with no solution in sight to the security crisis, healthcare in Haiti remains in a critical state that has left millions of people without adequate access to medical care.

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