Searching for healing: Inside one of the last hospitals in Haiti's capital

Al Jazeera

2 days ago

A reporter's experience inside one of the last hospitals in Haiti's capital Orthopedic surgeon Kokou Madou stands in a corridor of the Doctors Without Borders facility in the Tabarre neighbourhood of Port-au-Prince, Haiti [Odelyn Joseph/AP Photo] Orthopedic surgeon Kokou Madou stands in a corridor of the Doctors Without Borders facility in the Tabarre neighbourhood of Port-au-Prince, Haiti [Odelyn Joseph/AP Photo]
Port-au-Prince, Haiti – Tabarre Hospital in Port-au-Prince does not look as you expect. It is a collection of shipping containers and single-storey modular units, connected by gravel pathways along which two pet peacocks strut, surrounded by barbed-wire fencing.
The facility has an air of impermanence to it. That is deliberate. Doctors Without Borders, the nonprofit that runs the place, had always hoped that, at some point, it would not be needed in Haiti.
But that day looks a long way off. The country's health system has almost completely collapsed. Tabarre is one of the few trauma hospitals left open in Haiti's capital.
Port-au-Prince has turned into a combat zone. Armed groups have seized power in much of the country, and more than 5,600 people were killed last year, according to the United Nations.
The mechanical cough of automatic gunfire is now a regular sound in the streets of the capital.
Those armed groups are currently fighting government forces. They are winning. They control up to 90 percent of Haiti's capital, and they have joined together to form an alliance called Viv Ansanm, which translates to "Live Together".
Police and community-led self-defence groups have been pushed into small pockets of territory. Haiti's interim government, meanwhile, is mired in accusations of infighting and corruption. The country has not held a federal election since 2016.
Trapped in the middle of the uncertainty and violence is a desperate, traumatised civilian population. The armed groups are accused of using rape as a weapon of war, maiming civilians and forcing residents from their homes en masse.
More than 1 million people in Haiti are currently displaced. And about half the population is going hungry.
Amid the crisis, hospital after hospital has been forced to close its doors. The reasons are multiple. It is difficult to get medical supplies and equipment into the capital, for starters: Armed groups control all of the routes in and out of Port-au-Prince.
It is also hard for medical staff to get to work. Travelling through the many areas controlled by armed groups is dangerous. Some health professionals have left the country altogether.
And hospitals themselves have come under attack. A nurse examines an injured patient at a clinic run by Doctors Without Borders in Port-au-Prince, Haiti [Odelyn Joseph/AP Photo] A nurse examines an injured patient at a clinic run by Doctors Without Borders in Port-au-Prince, Haiti [Odelyn Joseph/AP Photo]
Gunmen fired on the capital's largest public healthcare centre, the State University Hospital of Haiti, during a news conference to announce its partial reopening last December. Two journalists and a police officer were killed. In February, one of its buildings was burned.
The facility ultimately never reopened.
While my Al Jazeera colleagues and I were in the country to shoot a documentary in April, another hospital shut down after armed groups took control of the surrounding area.
Doctors Without Borders itself had to suspend its services in Port-au-Prince for three weeks late last year. Its ambulance service was down when we visited, after a convoy faced gunfire in March.
But the staff at the Tabarre Hospital carry on.
"We consider ourselves the last line of defence in the trauma field, in a way," said Xavier Kernizan, a surgeon. "If Doctors Without Borders were to close, the impact will be really, really heavy for the population."
My documentary team spent a week at the hospital. The flow of gunshot wounds to its emergency room rarely slowed during that time.
We would sometimes leave the emergency room for a quick break, heading out on the gravel paths to grab some of the powerful black coffee kept in an urn by the guard's hut. Inevitably, when we returned, the emergency room was full with a new raft of patients, many with life-threatening injuries.
The only time that the ER was largely empty was at night. At first, we were puzzled. Wasn't that when most of the city's gun battles were taking place?
After a couple of days, we realised what was happening: It was too dangerous to transport people through Port-au-Prince's streets in the dark. Victims were forced to lie where they had been shot, waiting for daylight to come. Only then would it be safe enough to take a motorbike or taxi to the hospital. Medical staff operate on a woman at the Doctors Without Border facility in Port-au-Prince, Haiti, on May 8 [Odelyn Joseph/AP Photo] Medical staff operate on a woman at the Doctors Without Border facility in Port-au-Prince, Haiti, on May 8 [Odelyn Joseph/AP Photo]
That was the case for Chrismene Desilhomme and Jean Claude Saget, two cousins who live together and feature in our Fault Lines documentary, The Last Lifeline.
She works as a maid, and Jean Claude as a security guard.
The cousins arrived at the hospital at 8am after a night spent in agony at their house. Jean Claude had been shot when attackers broke in, and he had a broken leg after jumping off the roof to avoid them.
Chrismene too had been fired upon at close range, and her foot was so badly damaged that it had to be amputated the same day.
"I don't understand why they shoot at everybody," she said. She was in shock, traumatised and weary.
It was unclear why their house was targeted: They had little of value to steal.
Another patient at the hospital, who had been shot in the hand, offered a possible explanation. He told us that the armed groups shot civilians to force them out of their homes, so that they could use the buildings to expand their territory.
When the man returned to his neighbourhood, he said he discovered that the armed fighters had knocked through the walls of his house and every other one on the row, to create passageways that allowed them to move through the area without being exposed.
As the week went on, I began to get used to the hospital. Despite the daily gunfighting outside its walls, it was an island of relative peace for those within.
Guards would listen to the soulful reggae of Lucky Dube as they smoked outside their hut, and women occasionally burst into song in the wards. In quiet moments inside the emergency room, there were jokes, laughter and camaraderie, even joy. Medical staff transport a patient on a stretcher through the Tabarre facility on May 8 [Odelyn Joseph/AP Photo] Medical staff transport a patient on a stretcher through the Tabarre facility on May 8 [Odelyn Joseph/AP Photo]
The most peaceful area in the entire hospital was a small patio at its centre, where patients rested on benches beneath a wooden pagoda. Nearby, a small, colourful obstacle course helped survivors regain their mobility after surgery and other intensive treatments.
That's where we met four-year-old Alexandro and his mother, Youseline Philisma.
Alexandro was just one month old when an armed group set fire to the displaced persons camp where they were living. He was plucked from the flames, alive but severely burned.
Since then, Youseline had been taking him to Tabarre's burn unit — the only one left in the country.
"When I come to the hospital, it's another world. Everybody understands my little one. Everyone gives us a lot of love," she told us.
Alexandro will need the burn unit's care for the rest of his life. Surgeon Donald Jacques Severe is among the doctors treating him.
Severe could leave the country. His wife and children have already done so, departing four years ago for the United States. Armed fighters had overrun their home. Severe himself has a visa to live in Canada. But so far, he has not left.
His fellow surgeon, Xavier Kernizan, tried to explain the sense of duty he and Severe share.
"We know that if we're not here, someone will struggle," Kernizan said.
"Personally, we are close to burnout. Sometimes we are close to depression. But there is also this satisfying feeling of having helped to improve someone's daily life, of offering a little hope to someone in their darkest moments."
But if the security situation continues to deteriorate, it is impossible to know whether Tabarre Hospital will survive.
On April 11, my documentary team and I drove out of the hospital gates for the first time in a week. We were heading to Petion-Ville, one of the few places in Port-au-Prince still under government control.
There, we walked across a football pitch near the Karibe Hotel, where a helicopter from the World Food Programme picks up passengers. It's the only way out of the capital right now.
We clambered into the helicopter, its rotors began their churn, and the Haitian capital began to grow smaller as we rose into the air, sailing above the bubble of violence below. I remember feeling relief.
The staff at the hospital stayed behind. They have no intention of leaving.