“Currently, the major problem is finding patients, because many have moved because of insecurity,” worries Carmen Jean, UNHCR coordinator at Bon-Repos.
Living in Canaan for ten years, the 41-year-old HIV-positive patient with a rejuvenated complexion, deserted in haste, under threat from the gang led by Jeff (Kanaran) Larose, in September 2023.
“I was only able to take with me my identity documents, some clothes and a backpack,” relates the tiling professional and beauty products seller, between words punctuated by silence.
Housed at the premises of the “Gipa Network Haiti” association in Delmas, this mother of 5 children, 4 of whom are also HIV positive, illustrates the impact of gang violence on these patients in ongoing treatment.
Having contracted the virus through her mother, the lady has been raising her offspring alone since the death of her husband in a road accident in 2018.
Despite the difficulties in finding food and housing, the small family nevertheless continues to follow their treatments. However, the woman claims to know other HIV-positive people who sleep on the street and have great difficulty continuing to obtain medication.
I was only able to take with me my ID, a few clothes and a backpack.
Expressing her dismay, she declares, with a shifty look: “I feel sad and guilty, because I have nowhere to go, and I carry the weight of having children who did not choose to live in this situation. »
The gang attacks of February 2023 in Port-au-Prince put eleven of the 32 sites of the UGP-MSPP/PEPFAR network providing vital HIV-AIDS care, AyiboPost learns from a medical source.
The precarious context of these “crisis sites” raises great fears about an increase in new cases of infection in the days to come, jeopardizing “significant progress” in the fight against HIV in Haiti — where the news infections and disease-related deaths were reduced, respectively, by 21% then 75% between 2010 and 2022.
According to a press release from 1is December 2023, from the United Nations Integrated Office in Haiti (BINUH), HIV prevalence was estimated at 1.7% among adults aged 15 to 49.
Since the end of February 2024, gangs have attacked, looted, burned and maintained pressure on various institutions in the metropolitan center of Port-au-Prince, including hospitals.
The precarious context of these “crisis sites” raises great fears about an increase in new cases of infection in the days to come.
At a standstill since last March, patients and staff of the University Hospital of the State of Haiti (HUEH) have deserted the space around rue Monseigneur Guilloux, controlled by bandits.
Thus, the dysfunction of the HIV monitoring site there forces certain HIV-positive patients to continue their treatment at the La Paix University Hospital in Delmas 33 or in a new location in Turgeau.
Read also: Haiti: hospitals overwhelmed by events
La Paix University Hospital, hosting an HIV service delivery site for hundreds of HIV-positive patients, including 93 children, lost sight of these people during the surge in gang violence.
“In our site, the number of patients lost to follow-up amounts to around 120 people, including two children,” explains Keisha Elisma, coordinating doctor responsible for infectious diseases at La Paix Hospital.
During the unrest, three hospital patients under medical supervision were murdered. Two others died as a result of a break in treatment due to their travel outside of Port-au-Prince, according to officials.
Most patients generally coming from areas like Carrefour, Gressier Tabarre, Bon-Repos, Sarthe, Cabaret, Arcahaie, Saint-Marc, Cap-Haïtien, Jacmel, can no longer attend the hospital to stock up on medicines.
In our site, the number of patients lost to follow-up amounts to approximately 120 people, including two children.
In Croix-des-Bouquets, several patients’ houses were abandoned when health workers went to the scene to try to provide them with medicine.
Forced to leave their homes, some patients went to provincial towns, to the Dominican Republic or to the United States of America.
Due to the closure of a site at the Gheskio center and the University Hospital of the State of Haiti (HUEH), La Paix Hospital receives around ten of these patients on average per week, to direct them towards nearby medication providers.
On March 4, acts of vandalism followed by looting were carried out on the grounds of the Saint-François de Sales hospital, on rue Chareron.
The hospital Carrefour-Feuilles Sanatoriumfor its part, has been closed since the bloody offensive of the Grand Ravin gang on the population of Carrefour-Feuille, in August 2023.
Read also: Carrefour-Feuilles: Sanatorium hospital seeks refuge for scattered tuberculosis patients
Insecurity also affects other hospital centers in the metropolitan area such as the Bon Repos community referral hospital (HCR – Croix des Bouquets), the Dr Ary Bordes hospital in Beudet and the Croix health center. -missions.
Having suffered acts of vandalism in February 2023, the UNHCR site in Bon-Repos, an area suffocated by the Canaan gang led by the man named Jeff, cooperated with the Croix-des-Missions center to continue its activities, at times .
But in January 2024, the institution was forced to merge with the Croix-des-Missions Health Center, given the situation in Bon-Repos.
Forced to leave their homes, some patients went to provincial towns, to the Dominican Republic or to the United States of America.
Today, the Croix-des-Missions site remains impenetrable due to the erection of barricades and insecurity.
This once again forces those responsible to open a satellite site in Caradeux to continue providing assistance to HIV-positive patients, despite the pitfalls.
“Currently, the major problem is finding patients, because many have moved because of insecurity,” says Carmen Jean, coordinator of the UNHCR in Bon-Repos merged with the Croix des Missions center.
The two centers, which have respectively 624 and 334 patients affected by HIV, receive “around fifty per month for follow-up visits, during this period of crisis,” the doctor responsible for the site continues to AyiboPost. This differs from normal periods when the establishment accommodated this quantity during a day.
Read also: Haiti in danger: insecurity pushes specialized doctors to leave the country
The insecurity reigning in Croix-des-Bouquets for around five years has devastated the hospital institutions in the area. Residents are deserting the place controlled by the “400 Mawozo” gang, led by kingpin Wilson Joseph, alias Death Without Days.
Most of the area’s health center patients fled after the space was vandalized in 2022.
“This leads to a slowdown in our care activities for HIV-positive patients, because we cannot reach them in certain areas,” says a manager of the HIV program at the Croix-des-Bouquets health center. He requests anonymity because he is not authorized to speak on behalf of the institution.
For this site of more than a hundred patients whose “operation depends on the security climate of the area”, the reduction in attendance is alarming.
“We have recorded a drop of more than 50% in site visits,” continues the doctor, who also emphasizes that these patients who have stopped treatment can become a vector of transmission.
Currently, the major problem is finding patients, as many have moved away due to insecurity.
The most important site in the network of the Haitian Group for the Study of Kaposi Syndrome and Opportunistic Infections (GHESKIO), located at the Bicentenary, has been closed since the kidnapping for ransom of Doctor Douglas Pape, son of the doctor co-founder of the center, William Pape .
The Gheskio center, one of the largest HIV monitoring networks, with more than 20,000 patients, also faces the problem of treatment abandonment at its various sites.
“Patients lost to follow-up or moved to the provinces are estimated at 3,000,” informs Doctor Bernard Liautaud, one of the founding members of the center.
Despite the situation, Gheskio activities continue through other spaces located at Carrefour, the Military Hospital, Ruelle Berne, etc.
Given the growing insecurity, the staff of the Gheskio site at Bicentenaire were relocated to a new site, the Institute of Infectious Diseases and Reproductive Health (IMIS), located on the road from Tabarre to Chateaublond.
Patients lost to follow-up or moved to the provinces are estimated at 3,000.
The situation in the country is putting pressure on medical staff.
“To evolve in such a context, it requires will, because the employees also live in risk areas,” says the doctor at La Paix Hospital, Keisha Elisma.
Follow-ups with these patients continue through call operators, social workers and ambulant agents doing fixed points.
The Bon-Repos center, for its part, mobilizes its team even beyond working hours and days.
“We are doing everything possible,” relates Carmen Jean, head of the UNHCR at Bon-Repos, who also explains that the centers in the area and at Croix-des-Missions are trying to establish a connection with those in the provinces, there where patients go.
At the Caradeux center, a decrease in the stock of medicines is observed, but the staff does not hesitate to provide patients with supplies for several months in case they decide to leave the area.
According to figures from the platform, “Monitoring Evaluation and Integrated Surveillance” (Mesi), from January to March 2024, the HIV population of the 13 sites of the Ugp-Mspp-Pepfar network in the West is 12,915 infected patients.
This monitoring platform, designed in 2004 under the leadership of the Ministry of Public Health and Population (MSPP) and the National AIDS Control Program (PNLS), reported 8,388 people with a high viral load. , which can transmit the virus.
The PNLS was contacted before the publication of this article. This will be updated if the institution responds.
Cover image: A patient being tested for HIV/AIDS. | © freepik
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