As Security Collapses, Health Care Providers in Haiti Face a Myriad of Threats

By Noah Smith

In Haiti, hospitals and health centers across the Caribbean nation are facing considerable new challenges, including funding shortfalls. Armed gangs have mostly taken hold of Port-Au-Prince, as well as outlying areas such as Mirebalais, leading to increased violence and massive disruptions to supply lines for food, medicine, and fuel.

At Hospital Albert Schweitzer, or HAS, located in the Artibonite Valley, staff were preparing to break ground on two long-planned infrastructure projects in January 2025. Both the water system expansion and large solar power upgrade were funded through a third-party organization under a U.S. government aid program. However, the projects are currently paused due to a suspension of the expected funding. 

 ”We were literally days away from issuing the first contractor payments,” said Jessica Laguerre, chief operating officer at HAS, to Direct Relief on April 8. “We’re apolitical, so we’re just waiting for the final decision. We don’t have anyone to ask,” she said. 

Haiti Health Network, or HHN, a coalition that coordinates among more than 250 health facilities across the country, found itself on the other end of the spectrum, with a major regional project nearing completion when funding was halted. 

 ”There are a lot of ambiguities, and no precedent,” Barbara Campbell, executive director of HHN told Direct Relief on April 2.

The interruption in previously reliable funding sources coincides with a worsening security and political crisis. But for healthcare providers trying to operate in an increasingly chaotic environment, the funding uncertainty has complicated their operations even further. 

 The situation on the ground, aid workers say, has rapidly deteriorated since late 2024. Gang control has spread to nearly every district, with the few remaining communities under self-organized security brigades. Sexual violence against women and girls remains widespread. Food insecurity is staggeringly high. Public infrastructure has buckled under pressure. All of which has led to hundreds of thousands of people being displaced from their homes. 

  “Every time we think it can’t get worse, something else happens… I’ve stopped reacting with shock to the sound of automatic gunfire,” Laguerre said. “It’s become part of daily life. And I say that as someone privileged to be indoors, in a house, with electricity. There are families living in tents, exposed to all of it.” 

 Despite these circumstances, Hospital Albert Schweitzer remains open, though every day feels uncertain for staff. The facility, which has long benefited from external aid, including for healthcare workforce training, community health initiatives,  surgical supplies, and specialized medical equipment, now shoulders the costs and services that had been externally supported. 

 Programs significantly affected include  HIV treatment and family planning. With funding suspended, partner organizations handling existing grants immediately ceased operations. 

 ”The work we’ve done to provide these services, family planning and HIV treatment, discreetly, respectfully, with cultural sensitivity, has taken years to build,” Laguerre said. “We have activated this ’emergency mode’ to fill in these gaps. We are not willing to lose these programs,” she said. 

 Fuel availability is also a daily concern. Without the planned solar expansion, the hospital relies heavily on costly diesel generators to power clinical equipment, refrigeration, and communications. The solar and water projects would have saved the hospital roughly $50,000 a month in fuel expenses, which represents a significant cost in a place where transportation of goods has become increasingly expensive. 

 ”We’ve built in as much self-sufficiency as possible,” Laguerre said. “We have warehouse containers converted into refrigerated storage, staff housing on campus, backup power, and stockpiled supplies. But at some point, without consistent support, even that starts to run thin.” 

 HHN’s Barbara Campbell said the sudden nature of the funding halt has added uncertainty to an already complex operational environment. 

One of HHN’s interrupted projects focused on standardizing medical equipment across 12 hospitals was in its final stages. The program included training for local technicians, a parts depot, and a shared inventory system designed to make donated equipment more usable long term, thereby improving the quality of care that can be delivered. 

 ”No one’s certain what’s been canceled and what’s on hold. But the need hasn’t changed. We’ll finish it another way, it’ll just take longer,” Campbell said. 

Other healthcare providers report similar disruptions. Midwives for Haiti reported in an email this week that Mirebalais has fallen completely under gang control, which has resulted in 22,000 people being displaced. The local hospital, which serves 185,000 people, is closed.

Midwives for Haiti reports they have set up mobile maternity units to care for pregnant women who have fled the violence and are responding to more than two dozen camps for internally displaced people with fortified food supplements.

The organization noted they were able to receive 228 Direct Relief Midwife Kits with enough consumables to support 11,400 safe births.

Despite mounting challenges healthcare workers in Haiti say the motivation to continue is personal as much as professional.

“We’re not here because it’s easy,” Laguerre said. “Most of us are Haitian. We know what’s at stake. If we don’t find a way to keep moving, who will?”

In March 2025, Direct Relief allocated $150,000 among five Haitian healthcare organizations, including Hospital Albert Schweitzer, Haiti Health Network, and Midwives for Haiti, to help sustain essential healthcare services during this difficult period. The organization continues working to mobilize support for Haiti in accordance with all applicable laws and regulations. 

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