Doctors Without Borders (Médecins Sans Frontières, MSF) has announced the suspension of its operations across Port-au-Prince and its surrounding metropolitan area due to alarming levels of violence and direct threats to its staff from the Haitian police. This decision, effective immediately as of November 20, 2024, marks a significant setback for healthcare provision amid the country's deepening humanitarian crisis.
The charity made this announcement following several intimidating incidents involving the police, including threats of rape and death against its team members. The situation escalated dramatically after the MSF experienced a deadly incident where two patients were shot and killed when one of their ambulances was attacked. Following this event, police vehicles frequently stopped MSF cars, making it increasingly untenable for the organization to operate safely.
Christophe Garnier, MSF's mission chief for Haiti, emphasized the dire circumstances, stating, "We are used to working in conditions of extreme insecurity... but when even law enforcement becomes a direct threat, we have no choice but to suspend our projects." This poignant remark highlights the unusual predicament faced by the organization, which has operated under difficult conditions for many years.
MSF’s withdrawal from Port-au-Prince leaves the region with very few healthcare options. The United Nations recently reported concerning figures indicating only about 24% of health facilities within the metropolitan area are operational. With street violence on the rise and many hospitals incapacitated, MSF has been one of the primary providers of free and life-saving healthcare services. Its facilities, including those dedicated to trauma and burn victims, have been lifelines for Haitians affected by the increasing gang violence.
This decision is particularly heartbreaking as it means the closure of two major medical centers run by MSF, effectively shutting down over 120 inpatient beds at the worst possible time. Reports estimate MSF treated approximately 1,100 outpatients each week and had been actively addressing over 80 cases of sexual and gender-based violence weekly.
Just the day before the announcement, police forces reportedly took violent action against suspected gang members, illustrating the precarious balance of power within the capital. During these clashes, police and civilian vigilante groups engaged gang members, resulting in at least 28 of the latter killed. Such events signify the rampant instability and highlight the dangers confronting not only local citizens but also the humanitarian organizations trying to assist them.
Speaking on the current healthcare scenario, Garnier stated, "Every day we cannot resume activities is a tragedy. We are one of the few providers of medical services during this extremely difficult year." The implications of MSF's suspension will likely exacerbate healthcare shortages, especially for trauma patients who rely on its specialized services.
This suspension of operations is not merely procedural but is also reflective of the deteriorated trust between the public, law enforcement, and humanitarian organizations. It raises serious questions about the safety of healthcare workers and the general public within the volatile regions of Port-au-Prince. The Haitian police have expressed their inability to comment on the alleged threats, indicating the murky dynamics at play.
The organization has emphasized it will continue to care for patients who are currently hospitalized and maintain mobile clinics and maternal health services outside of the affected area. They’ve committed to providing care where it is safe to do so, highlighting their core dedication to the Haitian population.
Historically, MSF has been instrumental during crises, providing urgent medical assistance after earthquakes, natural disasters, and cholera outbreaks. Its immediate response capabilities have placed it at the forefront of emergency healthcare. The current suspension, due to rising gang control and police aggression, poses serious long-term threats not only to MSF but also to public health infrastructure across Haiti.
Haiti has seen renewed violence and instability over the past years, again reaching crisis levels. With police unable to guarantee safety for healthcare providers and civilians alike, the future of humanitarian aid—and healthcare overall—stands on shaky ground.
Solutions to restore order and safety in the capital seem distant, requiring not only reform of law enforcement but also significant investment and international support to reclaim public trust and safety for those risking their lives to deliver care.
