Haiti's Public Health System Failing Patients

As Haiti's prime minister, the UN Secretary General, representatives from more than 30 donor countries, and multilateral agencies convene tomorrow in Washington, D.C., to fund strategies for Haiti's future economic and social development, they must not neglect the country's immediate public health crisis, said the international medical humanitarian organization Doctors Without Borders/Medecins Sans Frontieres (MSF). MSF calls on the Haitian government and international donors to immediately implement concrete measures to improve access to health care for the Haitian population.

"It's unacceptable today that Haiti's poorest have no access to affordable and quality emergency trauma and obstetrical care services," says Brian Phillip Moller, head of mission for MSF's Trinite trauma and rehabilitation center. "While the Haitian government and donors focus on the economic development of the country they can no longer ignore the desperate needs of impoverished Haitians for quality and accessible public medical care."

Despite improved stability in the last two years, Port-au-Prince's poorest residents are still highly dependent on MSF's free emergency health-care services. Fees charged by public and private health structures make care unaffordable for most people. Public hospital and clinics are often plagued by management problems, strikes, and shortages of staff, drug, and medical supplies.

"Our medical structures are overwhelmed by patients and sometimes we have no other choice but to send patients to other public hospitals, even though they will face many obstacles to get treated," says Massimiliano Cosci, head of mission for MSF projects in Martissant. "Many patients tell us stories that there were no drugs in the structures or no staff to receive them or that they were sent back home because the structures were full. In many cases, they had to abandon treatment for lack of money to cover the costs. For patients in need of lifesaving care, this can be fatal. The situation is very alarming.""

Often, patients choose to stay home because they don't have affordable options. This was evident in early February, when MSF's emergency obstetric hospital closed for two weeks to move to a new location. "After assessing the situation during the closure of our hospital we discovered that many women had nowhere to turn for obstetric care," says Hans Van Dillen, head of mission for MSF's Jude Ann emergency obstetrical hospital. "At its peak, MSF's Jude Ann hospital was delivering 1,600 babies per month with nearly half of these cases involving life-threatening conditions for mother and child."

MSF started providing emergency care when violence in Port-au-Prince limited access to health care for its population. Today, although the security situation has improved, the health needs of the vulnerable population of Port-au-Prince remain largely unaddressed.

MSF invests more than 13 million euros (US $17.5 million) per year in its emergency medical programs in Haiti. MSF's obstetric hospital currently manages 40 percent of all obstetric emergencies for vulnerable women in Port-au-Prince, while MSF's Trinite hospital treated close to 17,950 trauma cases in 2008, and has the only adequate burns unit in Haiti. Likewise, 16,950 medical emergency cases were treated at MSF's hospital in the slum Martissant in 2008, where no other public health services exist.