Haiti’s public hospital system entered a state of near-collapse in 2019 as the combined pressures of staff salary arrears, pharmaceutical shortages, disrupted supply chains, reduced government funding, and the additional burden of treating protest-related injuries pushed facilities to and beyond their operational limits. The University Hospital of Haiti (HUEH) — the country’s largest public hospital and the primary referral center for the capital — became the most visible symbol of a system in crisis.
HUEH, which was supposed to serve a catchment population of millions and provide specialized care unavailable elsewhere in the public system, operated with chronic shortages of every essential input: doctors and nurses who had not been paid, electricity supplies dependent on generators that needed fuel, surgical supplies that were not being restocked, and diagnostic equipment that functioned intermittently when not broken entirely.
Medical staff who continued to show up despite salary arrears described conditions that violated every standard of decent healthcare. Operating rooms where procedures had to be delayed or canceled for lack of supplies. Emergency departments with patients on gurneys in hallways because the wards were full. A morgue overwhelmed beyond capacity. The gap between what the hospital was supposed to provide and what it could actually deliver was a daily source of professional anguish for the healthcare workers who witnessed it.
International medical organizations provided support and reinforced certain services, but the scale of the institutional crisis at HUEH and across the public hospital network went far beyond what any external assistance program could fully address.