Haiti’s hospitals plan to close amid fuel shortages
BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2379 (Published 03 October 2022) Cite this as: BMJ 2022;379:o2379Most of Haiti’s hospitals are cutting the number of patients they can admit or are readying to close as their supplies of fuel have reached critical levels.
Many hospitals depend on fuel generators to power their facilities, because the electricity grid is prone to outages, but gangs have blockaded the main fuel terminal in protest against rising gas prices, starving the country of fuel. Three quarters of the nation’s major hospitals are affected by the lack of fuel, Unicef said on 26 September.1
The shortages mean healthcare workers can’t get to work and hospitals are struggling to procure drugs and medical supplies. It is also becoming increasingly difficult to provide sterile conditions for medical procedures, and disruption to cold chain facilities means that vaccines could go to waste, Unicef said.
Many hospitals also lack oxygen, and only three ambulances are in operation in the capital, Port-au-Prince, which is home to more than a million people.
Haiti’s only major trauma centre, the Bernard Mevs Hospital, has enacted an emergency plan and drastically reduced the number of services it offers while relying on the little diesel it can get to power its wards.
“Faced with this harsh and sad reality, we will not be able to say until when the hospital will be able to resume normal operation if this shortage continues,” the hospital said in a statement on 27 September. “We hope that we can avoid a complete shutdown.”
Bernard Mevs is one of Haiti’s best equipped medical facilities. It treats the country’s most critically sick and injured patients and has the capital’s only neurosurgeons. It is also one the few hospitals with ventilators, but it can currently only operate one of its nine units, said Stacy House, a respiratory therapist working at the facility.
Surging fuel prices mean that hospitals cannot power medical equipment. The government set fuel price is $5.60 (£5; €5.74) for a gallon of diesel, but it is selling for multiples of that on the black market. The income for more than half the population is less than $3.20 a day.
Staff are taking on the personal expense of buying fuel to travel to work and risk their lives passing gang run barricades.
House said, “I really don’t know what to say. I’ve been here for five years, and I’ve never seen anything like this. I will stay here because this is my team and we are doing the best we can for this country, but until we can get fuel and get up and running there is not that much that we can do.”
The fuel shortage is the latest challenge for the country’s already chronically underfunded hospitals.
Many medical facilities closed in May when doctors protested against the lack of safety guarantees for medical staff, who were increasingly being kidnapped by the gangs for ransom.2
The medical crisis also overlaps with many others in Haiti. The number of hospital casualties has spiked because of street skirmishes, there are limited essential supplies, and an estimated one million people in the capital are going hungry as food prices soar, the UN said.3
Unicef estimated that 22 100 children under the age of 5 years and more than 28 000 newborns are at risk of not receiving essential healthcare services for the next four weeks.
Ulrika Richardson, the UN resident and humanitarian coordinator in Haiti, said, “Lives are being lost in Haiti because hospitals are unable to access fuel. If this situation continues, lifesaving services risk coming to a standstill, including for pregnant women, newborns, and children, as well as for persons suffering trauma and other life threatening conditions.”1