Haiti: Hospitals face critical oxygen shortages and warn of lack of fluids to treat cholera

A shortage of oxygen is the latest health crisis to hit Haiti where the scarcity is preventing hospitals from providing critical medical treatment.

The lack of supplies is largely affecting public hospitals outside the capital, where the inability to carry out procedures like caesarean sections is causing unnecessary deaths.

“Normally we support hospitals across the country with medical oxygen and our partners ensure all the equipment is functioning,” said Magda Cheron, who directs FHI 360’s project to supply oxygen to public hospitals across Haiti. “But currently the technical team can’t travel to repair the equipment. With the security as it is on the roads, we can’t even safely send filled oxygen cylinders.” FHI 360 is a human development organisation based in North Carolina.

Port-Au-Prince has been acutely hit by a series of severe and overlapping crises in recent months as the government has lost control of the capital to warring gangs.

Some of the major rival factions took control of key ports and seized the principal fuel terminal in September, forcing hospitals to close. Much of Haiti’s infrastructure relies on fuel as the country’s electricity grid is dysfunctional.

Malnutrition has reached historic levels, with 20 000 people facing famine. Cholera has also returned to the capital’s sprawling slums.

Security forces regained control of the terminal in the past month, allowing gas to return to the capital. This means that hospitals can expand their treatment capacity, despite supplies being intermittent and expensive.

However, for many regions outside Port-Au-Prince, especially in the north, gas remains scarce, Cheron said.

FHI 360 uses USAID funding to maintain 14 oxygen plants which were installed at public hospitals to support the treatment of covid-19. The plants are one to two years old and need maintenance or repairs to function but FHI 360 is unable to send support teams because of the threat of kidnap at gang checkpoints and the lack of fuel for transport. Eleven of the 14 plants are now out of action.

Hospitals would usually use emergency supplies when their generators fail but FHI 360 has been unable to get liquid oxygen from overseas. Supplies have either been stuck in ports because of gang blockades or the agency has been unable to transport them, particularly to more remote hospitals.

“One hospital told us they lost three babies because of lack of oxygen,” Cheron said. “People are dying and there is nothing that can be done.”

Oxygen is needed to treat many elderly patients as well as women giving birth and people in critical accidents.

Private hospitals, with their own oxygen plants and more funds, have been better able to maintain oxygen supplies, but they too have been affected by severe fuel shortages.

The Sacre Coeur Hospital, a private facility in the north of the country, has had to send the friends and family of patients to Haiti’s border with the Dominican Republic with a prescription to source oxygen canisters.

Harold Previl, the hospital’s executive director, said, “It was tough on the hospital and on the patients. When you have a patient who can barely breathe, and then they have the anxiety of that person not finding oxygen, this is really tough.”

The increase in fuel availability has made oxygen supplies sufficient once more at Sacre Coeur and the same will hopefully happen in public hospitals soon, Previl said.

Doctors Without Borders also told The BMJ that it has seen an improvement in fuel and oxygen supplies in the capital in recent weeks. The number of cholera cases seems to have stabilised in Port-Au-Prince following the successful treatment of those infected and the chlorination of water points.

There is a new concern, however, that intravenous fluids, which are imperative to treat cholera sufferers, are running low.

Hospitals also remain at the mercy of the gangs, which could cut off fuel supplies at any moment.

“We move from carrying one burden to the next and with a lack of resources to do so. It’s a constant struggle,” said Previl.