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  • Louise Lindenmeyr

Haiti’s Death Spiral: How much worse does it have to get?



For over a year, the Haiti Health Network (HHN) has been sounding the alarm that healthcare is on the verge of collapse in Haiti, and that we were witnessing a humanitarian crisis unfolding. What is the breaking point before something is done? Should we accept daily kidnapping and murder as a normal fact of life? Should we accept Haitians dying every day of starvation and Cholera?


Haiti’s crisis has unfolded, and the deaths are spiraling out of control. Hospitals are unable to access medicines, medical supplies, fuel which are key to their functioning. Most HHN members are operating at a drastic reduction in services that are offered, including nutrition programs, emergency child and maternal services, and HIV, malaria and cholera prevention and treatment. There isn’t a member of HHN, staff, or patients that hasn’t been impacted by the horrific situation in Haiti.


It is imperative that these healthcare organizations remain open and operate as close to normal as possible, as quickly as possible. This post addresses the situation from three points:


(1) the current situation in Haiti,

(2) the regional impact of the situation, and

(3) the way forward.


The current situation in Haiti has gotten much worse than even four months ago, and the evidence is overwhelming. Haiti's capital taken hostage by brutal gangs. The social and health conditions are rapidly deteriorating throughout Port au Prince, and many other areas of the country, where gangs are committing horrific acts of violence, causing thousands to flee their homes, including the revictimization of many.


Furthermore, according to the U.N. humanitarian chief in the Caribbean nation, it is estimated that the gangs are controlling about 60% of Port au Prince, including access to major roads thus crippling transportation/distribution services for the entire country. A video created last November by an HHN member gave a detailed report of the location of gangs and their respective areas of control. Also in the fall of 2022, gangs seized the main fuel import terminal, blocking the delivery of diesel across the country, thus placing the delivery of healthcare, food, medicine, and emergency supplies at greater risk. Key fuel depot in Haiti reopens. Nothing has changed to prevent such an event from reoccurrence.



A further complication is the cholera outbreak, which was left unaddressed for several weeks due to the fuel blockade, with no access to clean water or proper sanitation. In October 2022, during his visit to Haiti, Brian Nichols stated that, “this outbreak puts 1.2 million Haitians at direct risk of infection and death.”



Critical to this is that healthcare facilities lack IV fluids, catheters, tubing, and PPE to battle this epidemic safely and effectively. Even after the fuel was released, the health facilities have not been able to regain access to supplies needed to control this outbreak.


Of enormous concern is the current food security situation “with armed gangs in charge of key transport routes in Haiti, the country could see famine conditions, unless a robust humanitarian aid plan is put in place,” as Jean-Martin Bauer, from WFP, has warned. For the first time in the western hemisphere, parts of Haiti are considered at Level 5 (“catastrophic”) for hunger and death from starvation and 48% of the country is at Level 3 or above for food insecurity.


For staff in most areas of the country, daily work means navigating roadblocks, with threats of violence (including possible death) and kidnapping. While HHN members are ready to assist with the many health challenges facing Haiti at this moment, including the cholera outbreak, a humanitarian corridor enabling safe passage is essential. Such a corridor does not exist, and all healthcare services remain in daily danger of disappearing due to increasing gang control.


The regional impact of the situation as described above will be felt throughout all neighboring countries. As the current trend continues, a ground intervention will become inevitable to salvage the deteriorating infrastructure and remaining resources of the Haitian nation. Violence and instability continue spreading to the neighboring Dominican Republic where the military has mobilized at the border due to gang activity, including robbery, hijacking, kidnapping, arson, and murder.


The Bahamas and Florida are already receiving large quantities of irregular migration. Turks and Caicos is under strain after 300 Haitian migrants were recently detained. Without intervention things will continue to worsen, and we will continue to witness Haitians dying inside of Haiti as well as out to sea, as they desperately seek safety anywhere outside of their native home.


In October 2022, Ariel Henry, Haiti’s interim prime minister, called for an international military force to come to Haiti and deal with the armed gangs terrorizing the country. Thus far, it does not appear that any member of the international community has stepped up to lead such an effort but rather discussions persist about the historical nature of interventions in Haiti–all while Haitians continue to die daily. In the meantime, the current Haiti administration has been unable to provide the security and stability of a functioning society.


It is true that Haiti has struggled for many years, and there are endless books and articles around this topic, what most (outside of Haiti) remain unaware of is the multi-layered fallout possible from a “failed state”, under the control of well-armed gangs, less than 100 miles from the coast of Florida. The way forward needs to address a terrible situation that continues to deteriorate which may cause more and more healthcare organizations and others to withdraw from working in Haiti.


The UN’s Deputy Secretary-General urged every country “with capacity” to urgently consider the Haitian government’s request for an international armed force to help restore security and alleviate a humanitarian crisis, which is in “a deepening crisis of unprecedented scale and complexity that is cause for serious alarm.” This request has caused numerous articles and forums highlighting the historical failures by the international community, and yet all these observations and opinions have had no impact on the actual security situation in Haiti.


What we see is continued gang mobilization–with increasing acquisition of political, financial, territorial, and military control of large areas of the country–perpetuating a life of violence, illness, malnutrition, and where many people are dying every day. We agree that a military intervention ought to be approached carefully, but the current situation cannot wait for long-term solutions to emerge from within Haiti. A Haitian-led solution ought to involve a national dialogue that addresses the freedoms Haitians should be enjoying in their country: political, economic, social, and personal security.


It is possible that there are ideas circulating about ways to restore security that are different from those tried previously. We need to listen to all ideas and insist on immediate solutions to the lack of security we are all experiencing in Haiti, as current conditions are unacceptable and inhumane. What many HHN members witness first-hand is the impact that inaction is having on the personal security of Haitians, thus preventing all other freedoms from materializing.


We all want the same thing – A peaceful Haiti, led by Haitians – yet this is not possible given the current realities. Among us, there are many leaders that are in the position to address these challenges and alleviate the immense suffering and incredible danger people are facing in Haiti.


We are asking for your help in sharing this communication with as many people as possible in your network – family, friends, neighbors, volunteers, donors, religious leaders, political leaders, and your local media.

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