In heart of Haiti’s gang war, one hospital stands its ground

Black Immigrant Daily News

The content originally appeared on: Caribbean News Service

When machine gun fire erupts outside the barbed-wire fences surrounding Fontaine Hospital Center, the noise washes over a cafeteria full of tired, scrub-clad medical staff.

And no one bats an eye.

Gunfire is part of daily life here in Cit? Soleil – the most densely populated part of the Haitian capital and the heart of Port-au-Prince’s gang wars.

As gangs tighten their grip on Haiti, many medical facilities in the Caribbean nation’s most violent areas have closed, leaving Fontaine as one of the last hospitals and social institutions in one of the world’s most lawless places.

“We’ve been left all alone,” said Loubents Jean Baptiste, the hospital’s medical director.

Fontaine can mean the difference between life and death for hundreds of thousands of people just trying to survive, and it offers a small oasis of calm in a city that has descended into chaos.

The danger in the streets complicates everything: When gangsters with bullet wounds show up at the gates, doctors ask them to check their automatic weapons at the door as if they were coats. Doctors cannot return safely to homes in areas controlled by rival gangs and must live in hospital dormitories. Patients who are too scared to seek basic care due to the violence arrive in increasingly dire condition.

Access to health care has never been easy in Haiti, the poorest nation in the Western Hemisphere. But late last year it suffered a one-two punch.

One of Haiti’s most powerful gang federations, G9, blockaded Port-au-Prince’s most important fuel terminal, essentially paralyzing the country for two months.

At the same time, a cholera outbreak made worse by gang-imposed mobility restrictions brought the Haitian health care system to its knees.

The U.N. high commissioner for human rights, Volker T?rk, said this month that violence between G9 and a rival gang has turned Cit? Soleil into “a living nightmare.”

Reminders of the desperation are never far away. An armored truck driven by hospital leaders passes by hundreds of mud pies baking in the harsh sun to fill the stomachs of people who can’t afford food. Black spray-painted “G9” tags dot nearby buildings, a warning of who’s in charge.

In a February report, the U.N. documented 263 murders between July and December in just the small area surrounding the hospital, noting that violence has “severely hampered” access to health services.

That was the case for 34-year-old Millen Siltant, a street vendor who sits in a hospital hallway waiting for a checkup, her hands nervously clutching medical paperwork over her pregnant belly.

Nearby, hospital staff play with nearly 20 babies and toddlers — orphans whose parents were killed in the gang wars.

Normally, Siltant would travel an hour across the city by colorful buses known as tap-taps for her prenatal checkups at Fontaine. There she would join other pregnant women waiting for exams and mothers cradling malnourished children in line for weigh-ins.

All the clinics in the area where she lives have closed, she said. For two months last year she couldn’t leave the house because gangs holding the city hostage made travel through the dusty, winding streets nearly impossible.

“Some days, there’s no transportation because there’s no fuel,” she said. “Sometimes there’s a shooting on the street and you spend hours unable to go outside … Now I’m worried because the doctor says I need to get a C-section.”

Health care providers told the Associated Press that the crisis has caused more bullet and burn wounds. It has also fueled an uptick in less predictable conditions such as hypertension, diabetes and sexually transmitted infections, largely because of slashed access to primary care.

Pregnant women are disproportionately affected. Gynecologist Phalande Joseph sees the repercussions every day when she leaves her hospital dormitory and pulls on her light blue scrubs.

The young Haitian doctor snaps on a pair of white surgical gloves and makes an incision into a pregnant patient’s belly with a steady hand that only comes with practice.

She works swiftly, conversing with medical staff in her native Creole, when a burst of wailing erupts from a baby girl nurses swaddle in pink blankets.

Operations like these have grown more common, Joseph explains in between C-sections, because the very conditions that have intensified amid the turmoil can turn a pregnancy from high risk to deadly.

This year, 10,000 pregnant women in Haiti could face fatal obstetric complications due to the crisis, according to U.N. data.

Those risks are only compounded by the fact that many of Joseph’s patients are sexual violence survivors or widows whose husbands were killed by gangs. Permeating the struggle is an air of fear.

“If they start having contractions at 3 a.m., they are terribly scared of coming here because it is too early, and they are scared something might happen to them because of the gangs,” Joseph said. “Many times when they arrive, the baby is already suffering, and it is too late so we need to do C-section.”

That became most evident to Joseph last October when four men came rushing to a hospital carrying a woman giving birth stretched out on top of a door. Because of gang lockdowns, the woman couldn’t find any transportation to the hospital after her water broke.

“These four men were not even her family. They found her delivering on the street … When I heard she lost the baby, it shook me,” she said. “The situation in my country is so bad, and there is not much we can do about it.”

Started as a one-room clinic to provide basic medical services to a community with no other resources, Fontaine Hospital Center was opened in 1991 by Jose Ulysse.

Ulysse and his family have worked to expand the hospital year after year. They fight to keep their doors open, Ulysse said.

Even when firefights arrive at the doors of Fontaine, the hospital reopens few hours later. If it were to close for longer, administrators worry that it could lose momentum and would be hard to reopen.

Today, it’s the only facility to perform C-sections and other high-level surgeries in Cit? Soleil.

Because most of the people in the area live in extreme poverty, the hospital charges little to nothing to patients even as it struggles to purchase advanced medical equipment with funds from UNICEF and other international aid providers. Between 2021 and 2022, the facility saw a 70% jump in the number of patients.

The hospital possesses a certain level of protection because it accepts all patients.

“We don’t pick sides. If the two groups face off, and they arrive at the hospital like any other person, we treat them,” Jean Baptiste said.

Even the gangs understand the importance of medical care, he added. Yet the walls still feel like they’re closing in.

Rising carjackings of medical vehicles have made it impossible for Fontaine to invest in an ambulance. When ambulance operators are called from areas like Cit? Soleil, they offer a simple response: “Sorry, we can’t go there.”

Fontaine’s mobile clinic can now travel little more than a few blocks outside the facility’s walls.

Doctors worry, but they keep working, just as they’ve always done.

“You say, well, I have to work. So let God protect me,” Jean Baptiste said. “As this situation gets worse, we go out and decide to face the risks. … We have to keep pushing forward.”

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UN chief slams ‘climate-wrecking’ firms at human rights body

Black Immigrant Daily News

The content originally appeared on: Caribbean News Service

U.N. Secretary-General Antonio Guterres on Monday stressed the importance of legal challenges against “climate-wrecking corporations” like fossil-fuel producers, ratcheting up his call for the fight against climate change — this time before the U.N.’s top human rights body.

Guterres opened the latest session of the Human Rights Council, part of an address that decried summary executions, torture and sexual violence in places like Ukraine; antisemitism, anti-Muslim bigotry and the persecution of Christians; inequality and threats to free expression, among other issues.

Guterres also sought to undergird the concept of human rights — which have faced “public disregard and private disdain — and tie them together with environmental concerns.

“Human rights are not a luxury that can be left until we find a solution to the world’s other problems. They are THE solution to many of the world’s other problems,” he said. “From the climate emergency to the misuse of technology, the answers to today’s crises are found in human rights.”

Guterres has previously said that fossil-fuel producers need to be held to account, but pressing the issue before the U.N.’s top human rights body — made up of 47 member countries, plus scores of observer states — raises the stakes.

Nearly half the world’s population — 3.5 billion people — live in “climate hot spots” that are “fast becoming human rights disaster zones where floods, droughts and storms mean people are 15 times more likely to die of climate impacts,” he said.

Then, he emphasized the role of the International Court of Justice, the U.N.’s main judicial body, to improve accountability for the most serious crimes — and said he welcomed moves toward accountability for human rights abuses “including those committed by the private sector.”

“Legal challenges against climate-wrecking corporations are an important step forward,” Guterres said.

“Fossil fuel producers and their financial backers need to understand a crucial truth: pursuing mega-profits when so many people are losing their lives and rights, today and tomorrow, is completely unacceptable,” he added.

The comments came as the council opened its “high-level segment” at the start of its longest-ever session — more than five weeks. The presidents of Congo, Montenegro and Colombia were also speaking Monday, followed by envoys including the foreign ministersof France, Germany and Iran.

The session comes as the world grapples with rights concerns including Russia’s war in Ukraine, repression of dissent in Russia and Belarus, new violence between Palestinians and Israelis, and efforts to solidify a peace deal in Ethiopia that ended two years of conflict between the national government and rebels in the Tigray region.

Proponents say the Geneva-based rights body has grown in importance as a diplomatic venue because the U.N. Security Council in New York has been increasingly divided in recent years because of a major rift between affiliations among its five permanent members: China and Russia on one side, and the U.K., France and the U.S. onthe other.

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Over 1 billion in 43 nations at risk amid cholera outbreaks, WHO says

Black Immigrant Daily News

The content originally appeared on: Caribbean News Service
A young child is vaccinated against cholera in Haiti. PAHO-WHO

Three countries, this week alone, have reported outbreaks, WHO cholera team leader Philippe Barboza told reporters at a press conference on Friday.

For the first time, WHO is asking donors for help to fight the outbreaks, he said.

Right now, 22 countries across the world are fighting outbreaks of the acute diarrhoeal infection caused by eating or drinking contaminated food or water. Cholera cases climbed in 2022, following years of falling numbers of cases, and the trend is expected to continue into this year, he said.

He said cases have been reported in five of the six regions where WHO operates. The latest WHO global overview published in early February showed the situation has further deteriorated since 2022.

Poverty, disasters, conflict and climate change consequences continue to be driving factors alongside a lack of access to safe water and sanitation, Dr. Barboza said.

Limited vaccine supplies

“An unprecedented situation requires an unprecedented response,” he said, drawing attention to the limited availability of vaccines, medicines, and testing kits.

Only 37 million doses are available in 2023, he said. More doses are expected to be available by next year.

As a result of the current global surge, WHO is, for the first time ever, appealing to donors to support a $25 million fund to help to address cholera outbreaks and save lives, he said.

Prevention is key, he said, noting that nearly half of the world lacks access to safely managed sanitation.

“Access to safe drinking water and sanitation are internationally recognized human rights,” he said. “Making these rights a reality will also end cholera.”

Outbreak in Africa

An exponential rise in the number of cholera cases in Africa includes an outbreak in Mozambique, which is also grappling with severe storms brought on by cyclone Freddy. The first case of cholera in the current outbreak was reported to the Ministry of Health and WHO from Lago district in Niassa province in September.

As of 19 February, Mozambique reported a cumulative total of 5,237 suspected cases and 37 deaths. All six cholera-affected provinces are flood-prone areas, and WHO anticipates that more will be affected as the rainy season continues.

Considering the frequency of cross-border movement and the history of cross-border spread of cholera during this outbreak, WHO considers the risk of further disease spread as very high at national and regional levels.

An estimated 26,000 cases and 660 deaths have been reported as of 29 January 2023 in 10 African countries facing outbreaks since the beginning of the year, WHO said. In 2022, nearly 80,000 cases and 1,863 deaths were recorded from 15 affected countries.

Multiple countries affected

Neighbouring Malawi is facing the deadliest cholera outbreak in two decades, and cases are being reported in other countries, including Ethiopia, Kenya and Somalia, WHO reported.

The UN health agency said challenges include climate change, which has led to drought or flooding in parts of Africa, resulting in increased population displacement and reduced access to clean water.

Worldwide, people in Haiti, India, Pakistan, the Philippines and Syria, among others, are also affected by outbreaks.

Global threat

Cholera remains a global threat to public health, WHO said. In 2017, affected countries, donors, and partners of the Global Task Force on Cholera Control launched a renewed global cholera control strategy, Ending Cholera: A Global Roadmap to 2030. It aims at reducing cholera deaths by 90 per cent over the next decade.

While the number of cases had been declining, WHO remains concerned about the current surge. Researchers estimate that every year, there are between 1.3 and 4 million cases and 21,000 to 143,000 deaths worldwide due to the infection.

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