Residents in northeastern Haiti struggle to find care amid inadequacies in healthcare system

FORT-LIBERTE— Sandy Pierre, a young woman suffering from a complicated pregnancy, sits on a crowded concrete bench for more than five hours waiting for help inside Hôpital Saint Joseph, the largest government-run medical facility in Fort-Liberté—the capital city of the Northeast Department. Pierre, who has been carrying the baby for over 28 weeks, made a 10-mile journey walking across the valley from her home in  Ferrier  to the hospital, seeking prenatal care.

“It’s been almost a full day since I left my house,” she said, her voice tinged with exhaustion. “I came here for a consultation to avoid paying high fees in private clinics, only to find myself trapped in this hospital for hours. No specialist is available, and no one even asks me how I am doing.”

The shortage is glaring. Even Saint Joseph hospital, the largest in the department, does not have, among other departments of medical service, orthopedics, pediatrics, ophthalmology, dermatology and odontology.

The situation Pierre described has become the norm in the northeast. Patients continue to express frustration and despair due to the absence of healthcare professionals at public medical facilities. Numerous patients told The Haitian Times that they would instead go to private medical facilities if they could afford the cost of services.

“I no longer want to go to public hospitals; they are always short of staff and material resources,” said Claudine Joseph. “I prefer to go to private facilities even though those places charge a lot of money.”

Still, several others said the quality of healthcare services at private health centers in the region is not much better either, despite these facilities charging hefty fees. “You would pay so much for so little in return,” Pierre told The Haitian Times. “That’s why people who can afford it often cross the border east to find better quality care in the Dominican Republic,” she added.

But the influx of Haitians at the Ouanaminthe–Dajabon border in search of better quality healthcare is pushing Dominican authorities to take drastic measures to prevent Haitians from being treated in public hospitals.

For Magdala Saint-Claire, even though patients may face similar or worse conditions at public hospitals or clinics, at least they don’t have to pay more for less.

“Most private clinics in my hometown charge no less than 2500 gourdes or $19 (USD) for a consultation,” said Magdala Saint-Claire, who traveled about 24 miles from her hometown Vallières to the public hospital in Fort-Liberté, where she paid 10 times less. “It’s 250 gourdes or about $1.90 (USD), which some patients still find difficult to come up with in a country where most people live on less than two dollars a day.”

“A cesarean section at a private health center in Ouanaminthe costs more than 75,000 gourdes or $568 (USD) compared to about 20,000 gourdes or $151 (USD) at a public facility,” Alvaro Jean emphasized. “Having a baby in a hospital in Ouanaminthe can put a family under tremendous 

financial stress.”

“Health service providers would come daily to private facilities so that they could make money off patients,” he said. “Most of them have no equipment, medicines, or basic accessories to provide essential services. For instance, you would go to those places, they charge you for consultations, and then they would tell you to go to a public hospital in Fort-Liberté or Ouanaminthe because they lack imaging devices, critical for accurate diagnosis and treatment.”

impacted by shortage of personnel and material deficiencies

According to medical professionals in the region, the conditions inside most medical facilities, including Hôpital Saint Joseph, highlight the inadequacies across the healthcare system.

Facilities have been coping with a lack of qualified personnel coupled with poor infrastructure and a lack of material resources.

With a population of about 400,000 inhabitants (2015 estimate), the Northeast has 42 health centers spread across different parts of the department. These centers are facing a multidimensional crisis that affects Haiti as a whole.

According to an Ouanaminthe Medical Community Center (OCMC) report, 150,000 people do not have access to quality healthcare in the Northeast Department.

For instance, at Hôpital Saint Joseph, the largest and main regional medical center, only four out of 13 departments providing essential services to patients are functioning. Besides surgical, laboratory, radiology, pharmacy, infectious disease, and community services, none of the other departmental services are operational due to a shortage of personnel and material resources.

Since gang-fueled insecurity has exacerbated Haiti’s crisis, many doctors, nurses, medical assistants, and certified technicians have left the region either to join their families abroad—notably in the United States under the  humanitarian parole program, also known as the Biden Program—and Canada, or to work in the neighboring Dominican Republic for better pay and conditions.

Some medical professionals also left the healthcare system altogether to join international organizations for better pay and benefits.

“Many specialists who worked in the northeast health system have left because the salaries received could not meet their needs,” said Dr. Jean Denis Pierre, the departmental director of the Ministry of Public Health and Population (MSPP).

“On top of the insecurity climate, the deteriorating economic situation in the country, rising inflation, and the salary policy at the MSPP do not encourage personnel to stay in the system,” Dr. Pierre added.

He outlined that the monthly gross salary of a doctor in the northeast health department varies between 34,000 gourdes or $257 (USD) and 49,000 gourdes or $370 (USD). Despite the meager salary, the government often struggles to pay them on time.

“Healthcare workers at the Northeast Health Directorate often wait for months before receiving part of their salaries,” said Horderline Louis, a nurse working in the public health system.

The exodus of healthcare professionals has hit medical centers across the department hard, leaving patients deeply concerned about their future health prospects.

“In my community in Carice, most basic healthcare services are not available,” said the mayor of the town, Amide Gabriel. “At the municipality’s medical center, only a vaccination service with the support of non-governmental programs for children is provided. There is no medical director at the center, which is largely understaffed.”

Patients call for improvement

At the Centre Medico-Social de Ouanaminthe, another public hospital in the region, the situation is not different.

Patients like these two women dropped off there by a motorcycle taxi—among them an elderly woman suffering from severe stomach pain—have to spend hours in waiting areas for basic emergency treatments, labor and delivery services, prenatal and postnatal care.

While many wait in the hallway, most of the time on their feet, other people continue to come in. Usually, a trainee nurse, fitted with a white dress and green and white bodice, would register them, hoping for an absentee doctor to show up.

“It is important that the authorities at the MSPP’s departmental directorate take measures to improve service quality and address the inadequacy of care in the region,” said Judeline Joazard. “We are suffering badly. We come here [hospital] for care, but there is no doctor. Only a nurse assistant is present to register our names,” the Centre Medico-Social de Ouanaminthe’s patient added.

According to the department of health director general, Pierre, the government is working on necessary measures to address the issues at much as possible. 

“We are discussing with local officials, community members, and grassroots organizations’ leaders in search of a sustainable solution,” Dr. Pierre said. “The problem underscores an exacerbated multidimensional crisis affecting all aspects of living conditions in Haiti, including healthcare and humanitarian services, not just in the northeast.”

The post Residents in northeastern Haiti struggle to find care amid inadequacies in healthcare system appeared first on The Haitian Times.

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Residents in northeastern Haiti struggle to find care amid inadequacies in healthcare system was first posted on July 23, 2024 at 9:14 am.