PORT-AU-PRINCE, Haiti, April 15 – I couldn’t believe what I was hearing — “They were asked to leave.” This is what a group of volunteer medical personnel from the Spanish organization Huarralde were apparently told when they arrived to work at a Port-au-Prince hospital one recent morning. The group, which has been providing emergency medical care to Haitian earthquake survivors since the early days after the disaster, also helps the Haitian medical system deal with the day-to-day medical needs of the general population. Now, the volunteers were being told they were no longer needed.

One issue that has created the current Haitian medical crisis is the desire of the government to resume charging patients for care. The Haitian government does not benefit from foreign organizations providing free medical care to its citizens, and now they want their piece of the pie. The government would rather have the NGO’s (Non-Governmental Organizations) leave the millions of dollars of donated medical supplies and medications in their hospital storage rooms, go home, and allow Haitians to be charged for access to that material. NGO’s have already largely abandoned some facilities like HCH (Haitian Community Hospital) because they are no longer welcome.

The post-surgical wing of HCH Hospital in the Delmas neighborhood of Haiti is pictured on April 8, 2010. The hospital halls were previously over-flowing with earthquake patients and volunteer medical staff from around the world. The facility now is virtually deserted. © Keith Dunlop

When I recently visited HCH for the second time earlier this month, I found only a small handful of foreign medical workers servicing the overcrowded hospital. Two nurses from Haurralde and one American were running the entire urgent care area with no assistance from Haitian hospital employees. Rotating teams of medical personnel from America had been running the hospital since the earthquake, but they had packed up and left due to alleged friction with administrators.

The UN has recently warned hospitals that they will cut-off shipments of free medical supplies if it is discovered that Haitians are being charged for care. Over 1 million dollars of medication have been provided by the UN to public Haitian hospitals to date. This figure doesn’t include private and NGO contributions. Private hospitals run by non-profit’s and NGO’s would be exempt from sanctions if they are able to adequately show that patients are not being charged.

A Haitian mother with her infant baby girl who suffers from diarrhea and dehydration waits to receive medical treatment at HCH Hospital in Delmas Haiti. © Keith Dunlop

Public Haitian hospitals don’t need to charge its patients, according to the UN, because health care workers are being paid by the Haitian Health Ministry with donated funds. However, these funds don’t reach privately run medical facilities, which has caused the second major part of the current crisis. CDTI (Center for Diagnosis, Treatment, and Imaging) recently closed its doors because it cannot pay its employees or provide for the infrastructure costs needed to continue running the facility. Other private facilities face similar financial problems and some will likely close. CDTI played a crucial role in caring for victims of the January 12, 2010 earthquake, and possesses diagnostic equipment not available anywhere else in the country. The reasons for CDTI’s failure are several, most involve money. More important are the dire consequences to the Haitian population from the loss of a critical health care facility in a country that can least afford it.

Since the rains arrived several weeks ago, malaria is reportedly on the rise in the Haitian refugee camps. There are also fears that the wet season, in combination with poor sanitation, will lead to epidemics of dengue fever, measles and cholera.  The country must also deal with everyday traumatic events such as traffic accidents and common injuries. The UN’s latest published situation report issued April 12, acknowledges that there are “gaps” in health care delivery, and concludes that a strategy to retain national health professionals needs to be developed and implemented immediately. Unfortunately, this revelation may be too late to save the lives of those being lost in the current system.

The following images were captured during a recent visit to the government-run HCH Hospital in the Delmas neighborhood outside Port-au-Prince Haiti. None of these images would be possible without the support of the Dominican Republic based NGO MOSCTHA (see links section), who is working tirelessly to bring aid to the people of Haiti, including but not limited to, the medical workers from Huarralde featured in this article.