Medical facilities across Port-au-Prince came under direct attack or were forced to suspend operations due to surrounding gang violence at alarming rates in 2024, with MSF and other medical organizations reporting that their ability to maintain healthcare services was being directly compromised by the security environment. Hospitals that had managed to function through years of crisis found themselves in the crossfire of the February-March gang offensive and its aftermath, with some facilities looted, others damaged by gunfire, and others forced to close as staff could not safely reach them.
The pattern of healthcare facility attacks was documented by the UN and WHO as a potential violation of international humanitarian law, which prohibits the targeting of medical facilities and personnel in conflict situations. While the specific legal classification of Haiti’s situation remained contested, the documented attacks on medical infrastructure represented a form of violence with particularly severe humanitarian consequences — depriving communities of healthcare at precisely the moment when violence was generating acute medical needs.
Some of the most severe impacts on healthcare occurred in communities under gang siege, where residents injured in attacks could not access medical care and where the combination of malnutrition, violence, and untreated illness created conditions of extreme medical vulnerability. Deaths from treatable conditions in areas inaccessible to health workers were a form of casualty that never appeared in the violence statistics but represented a real and significant dimension of the crisis’s human toll.
Medical organizations called for specific protections for healthcare facilities and workers, including negotiated safe access guarantees and the designation of medical facilities as protected spaces respected by all armed parties. In an environment where no armed party demonstrated consistent respect for humanitarian principles, these calls had limited practical effect but maintained the normative standards that any eventual accountability would need to reference.