Elizabeth Campa, senior health and policy advisor for Zanmi Lasante, as Partners In Health is known in Haiti, writes below how the organization is “entering a new normal for operations in Haiti,” where a 12-day lockdown paralyzed the country, closing banks, schools, and businesses and halting all public transportation. Violence and unrest across the country resulted in 26 deaths and dozens of injuries, according to reports by UNICEF.
During that time, PIH staff and clinicians maintained all 12 of its facilities open and operational, serving patients and working round-the-clock shifts to meet need.
The most recent national crisis that began close to three weeks ago on February 7th, but dates back to the summer of 2018, is far from over. While the national protests that choked Haiti into 12 days of consecutive lockdown have declined to more localized events, the unknown of ‘what is next’ is on the minds of all Haitians.
Zanmi Lasante maintained all its 12 facilities, opened, powered up, and receiving patients, while the challenges on the ground continued to make everyday activities more difficult. At University Hospital of Mirebalais, a 300-bed facility and one of the largest public hospitals in the country, a marked decline in women seeking services in labor and delivery is heavy on the minds of the team there. The last two weeks has documented a 30 percent decline in the area of maternal health. Women are too afraid to reach our sites. Regularly 40 percent of women come to University Hospital from outside the direct service area. Now, PIH is seeing considerably fewer women from the capital of Port-au-Prince or other areas. Where are these women going for labor? We do not know.
Our staff continue to face harassment and armed gangs that now control countless areas around the country. Yet, they still come to work; they still are there for our patients to ensure that if they do come in, we will be there for them no matter the obstacles. Staff morale has suffered, as they struggle to make every moment count when they get to communities to extend assistance to the Haitians patients too sick to travel for an appointment or to make it to our health facilities.
Haitians have seen a 30 percent increase in inflation in the past weeks. A cup of rice that previously cost 40 cents is now almost doubled at 75 cents. While this may not seem like a lot for many, for a population where 85 percent of individuals live on less than $2 dollars a day, this is devastating.
Fuel, while more readily available, is still being sold at close to five times the prices of January. Fuel is the lifeline for PIH’s facilities, as all depend heavily on generators to produce electricity that keeps facilities running. This price increase has had a major impact on a budget that had already been stretched to its limits. Tens of thousands of Haitians depend on PIH and its services in health care, water, and sanitation, and nutritional programming each day to ease their suffering. Knowing this, we need to make sure we have the vehicles and ambulances to get out to the communities and bring our services to them if they cannot come to us.
We need to continue to provide food, water, and shelter to our patients and staff. We need to continue to provide hope to those who are sick by ensuring our facilities stay stocked and powered. PIH in Haiti may be entering a new normal when it comes to a country under siege, but we will continue with our mission no matter the obstacles placed in front of us.
A PIH staff member in Haiti, who preferred to remain anonymous, wrote this account describing the recent lockdown and its impact on co-workers, patients, and loved ones:
It saddens me to see my country in this deteriorating state. Every day is a guessing game of whether or not another violent protest will take place. The 12-day lockdown was a reality check of the ongoing socio-political and economic challenges Haiti has been enduring for the past 200 years.
During the crisis, basic commodities such as drinking water, gas, and cooking fuel were hard to come by, resulting in people scrambling to obtain whatever they could in the markets. Panic and fear permeated the country when people understood the gravity of the situation. It also made me question how it must be for the approximately 60 percent of Haitians living in poverty who are unable to pay for basic staples, such as rice and beans, with the rapid devaluation of the Haitian gourde.
I thought about all the patients Zanmi Lasanate serves across its 12 sites, and about the staff who were unable to arrive to sites due to roadblocks. I commend my co-workers who worked eight days or more straight to provide services to the patients who were courageous enough to cross barricades and burning tires.
Although I understand where the protestors’ frustration derives from, violence is not the answer. In order for the country to move forward, we need our kids going to school. We need hospitals to remain open. And we need people to work. For the time being, things seem a bit calmer compared to earlier this month. However, people are still on guard, and tensions remain present. From experiences past, anything could happen in Haiti. So, as we say in Creole, “Nap swiv,” or, “We will just wait and see.”