Haiti: making impossible choices in a health-care system on the verge of collapse

As armed clashes between the Viv Ansanm coalition of armed groups and government forces increase in the capital, the glaring lack of resources and staff is forcing Port-au-Prince's health-care workers to make impossible choices. Many health-care facilities have been looted or set on fire, and the few remaining ones are seeing an influx of twice as many patients as before. Overloaded emergency services are operating at breaking point. Wounded people, victims of sexual violence and displaced people suffering from malnutrition are among the most common patients.

"The entire health-care chain is disintegrating," laments Amélie Chbat, head of ICRC operations in Haiti.

This dramatic situation is illustrated at Hôpital Universitaire La Paix (HUP), the only major public hospital still operating in Port-au-Prince. Shortages of medicines, beds and staff, combined with the massive influx of wounded and injured people, are forcing doctors to decide who can be treated immediately and who will have to wait — at the risk of losing lives.

"Every day, the operating theatres are at full capacity. We have to prioritize certain critical cases and postpone others, sometimes at the cost of human lives," explains Dr Jean-Philippe Lerbourg, Medical Director at HUP. "More than 400 patients are waiting for an operation, on a list that can be several months long. These are not the kinds of choices that should have to be made in a hospital," he stresses.

Since 2024, HUP has seen admissions double across all departments. Emergency departments, which used to see between 800 and 1,200 patients a month, are now seeing up to 2,000. "They come from all over the metropolitan area and include gunshot victims, victims of sexual violence and displaced people. Our team is at the end of its tether," adds Dr Lerbourg.