The cholera outbreak that had begun in October 2022 persisted into 2023, with cases continuing to be reported across Port-au-Prince and in some provincial areas as the underlying conditions enabling transmission — disrupted water systems, inadequate sanitation, and limited healthcare access — remained largely unchanged. Health authorities and international medical organizations maintained their response operations but were unable to fully contain a disease that spread wherever clean water and functioning health services were absent.
The ongoing cholera situation illustrated the connection between the security crisis and public health outcomes with brutal clarity. Gang control of areas near water infrastructure disrupted treatment operations. Displacement of communities into overcrowded sites without adequate sanitation created ideal conditions for transmission. Healthcare workers unable to safely reach affected neighborhoods could not provide the early treatment that prevented mild cases from becoming fatal.
MSF and Partners in Health maintained cholera treatment operations under difficult conditions, providing oral rehydration therapy and more intensive treatment for severe cases at facilities they could keep operational. Their work saved lives that would otherwise have been lost to a disease that is almost entirely preventable and treatable with basic medical resources. But the scale of their operations remained insufficient for the breadth of the outbreak.
Public health experts warned that as long as the security crisis prevented the restoration of functioning water and sanitation infrastructure, cholera would continue to circulate in Haiti’s most vulnerable communities. The disease was a barometer of governance failure — its presence measuring the distance between the services a state should provide and those that Haiti’s crisis-ridden institutions were actually delivering.