More than six million Haitians need urgent humanitarian aid: ‘The population is at breaking point’

Haiti is no longer just a failed state; it has become a territory where survival is a daily act of resistance against unrelenting violence. The figures emerging from the island reveal the depth of the collapse: more than six million people — more than half the national population — require urgent humanitarian assistance to avoid succumbing to hunger, disease and violence.

Marisela Silva Chau, head of the International Committee of the Red Cross (ICRC) delegation in Haiti, paints a stark picture. “We are witnessing a population at breaking point, facing a critical humanitarian situation, without access to essential services,” she warns.

Haiti’s collapse has been dizzying. In January 2024, there were around 300,000 internally displaced people. By April 2026, the figure had reached 1.4 million.

“We are seeing a population without access to essential services, such as basic healthcare and access to safe water,” says Silva Chau. “There is also a food crisis comparable to those occurring in regions affected by protracted armed violence. And there are a number of safety concerns, including restricted movement, exposure to the risk of being injured or killed in crossfire, and situations of sexual violence.”

The current crisis is not a random event, but rather the result of a spiral of armed violence that intensified in 2020. According to ICRC analysis, Haiti recently experienced two major periods of conflict. The first, between June 2020 and January 2024, was marked by high-intensity clashes between rival groups in strategic enclaves of the capital, such as Cité Soleil, Bel Air, and Martissant.

However, the decisive turning point occurred on February 29, 2024. On that date, former rivals united under the Viv Ansanm coalition to launch coordinated attacks against state institutions: the police, the armed forces, and international peacekeeping missions. This criminal alliance has managed to seize control of 85% of Port-au-Prince, the capital.

The violence, however, is no longer confined to the capital. The wave of terror has spread north to the Artibonit department and inland to Mirebalais. Just a few weeks ago, a massacre in rural areas left 70 people dead, confirming that the network of armed groups defying the government has turned the country’s interior into a battlefield.

The healthcare system has suffered a near-total collapse: only 30% of health facilities across the country remain operational. The remaining 70% ceased operations between 2020 and 2026 due to the complete lack of safety guarantees for staff and patients. Humanitarian organizations have seen their work turn into the kind of medical care normally associated with war.

The ICRC has had to implement a four-tiered strategy to try to contain the crisis, explains Silva Chau. First, by training community health workers in pre-hospital first aid, an intervention that is often the only difference between life and death for gunshot victims who cannot reach a hospital.

At a second level, supporting ambulance services — both the National Ambulance Center (CAN) and the Haitian Red Cross — is vital to move patients through areas of active conflict. At present, only 10 health facilities in the capital receive direct support in the form of specialized medical‑supply kits for treating firearm injuries. Among them, the standout is La Paix University Hospital, the only major public center still holding out against the crisis.

Even for medical staff, simply traveling from home to the clinic has become an act of heroism, Silva Chau notes. They cross invisible borders controlled by gangs or authorities, often encountering violence that reaches the very doors of the hospitals. The psychological toll is so severe that the ICRC has had to deploy emergency psychosocial‑support programs for health workers themselves, who see their tools rendered insufficient by the magnitude of the tragedy.

“We maintain dialogue with all armed actors in an effort to change behaviors,” Silva Chau explains. “This takes time, of course, but it is the ICRC’s first major objective: to insist that the population must be preserved, must be protected, and kept away from the impact of armed violence.”

This dialogue does not imply political endorsement but rather operational necessity. The police, the armed forces, and the armed groups are all transparently informed of the daily movements of humanitarian teams, the ICRC’s head of delegation explains. If the context does not allow it, or local actors consider it is not the right moment, the activity is rescheduled.

Thirst and hunger

If health care is precarious, access to safe water is a nonexistent luxury for millions. Since 2020, many areas of Port‑au‑Prince have lost access to basic services because clashes prevent people from reaching supply points. Going out to fetch water means risking being caught in the crossfire.

To mitigate this crisis, humanitarian organizations, in coordination with the National Directorate for Potable Water and Sanitation (DINEPA), have turned to water trucking: using tanker trucks to deliver drinking water to besieged areas and building water kiosks at strategic points. However, every trip by a tanker truck requires prior negotiation to ensure the water reaches its destination without the workers being attacked.

International fatigue

The international community views Haiti with a mixture of helplessness and weariness. There is frequent talk of “donor fatigue,” a notion that Silva Chau insists should be eradicated from the diplomatic lexicon. “There is no excuse for saying that nothing can be done. There is an obligation to provide the necessary resources,” she states firmly.

Haiti is preparing for the deployment of the Gang Suppression Force beginning in May 2026. Expectations are high, but so is a well‑founded fear: that the isolated use of force in densely populated areas could result in even more severe humanitarian consequences and trigger a new wave of internally displaced people who no longer have anywhere to go.

Despite the collapse of institutions, the rampant sexual violence, the forced recruitment of children, and living under a permanent state of siege, the Haitian population “has not lost hope,” says Silva Chau. “We must honor that hope because, on the ground, they still feel that the situation can improve at some point,” she says.

It is this resilience that challenges the world. “We must continue to stand with the people,” she adds.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition