19259: (Hermantin)Sun-Sentinel- Rebellion pushes Haitis hospitals to brink of collapse (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>

Rebellion pushes Haiti’s hospitals to brink of collapse

By Tim Collie
Staff Writer
Posted February 26 2004

PORT-AU-PRINCE · Widler Christophe lay bleeding in the emergency room of
this city's main hospital, shot in the head at a roadside barricade, as
nurses tried to determine if the facility's only X-ray machine worked on
Wednesday morning.

After determining that the rusting machine was broken, his family wheeled
him out of the hospital, down a dusty street and up a flight of stairs to a
private X-ray clinic nearby. Once they had the X-rays in hand, they wheeled
him back down the street to a musty room at the State University of Haiti
Hospital, where a nurse assured the patient's family that surgery would be
performed -- once a doctor could be located.

"No, no, no!" screamed the man's aunt, Mica Christophe. "You can't be
serious. Look at him!" Blood and fluid flowed from his wound and onto the
floor. Nearby, another wounded man begged passers-by for money to buy
antibiotics for an infection.

"Once you get shot here, there's really nothing they can do for you," said
Joseph Pierre, a friend who found Christophe lying in the middle of the road
and took him to the hospital. "Here was a guy who wasn't doing anything, and
they just shot him for no reason. But then after that, he cannot get any
decent medical care."

In Haiti, few can these days, as a 3-week-old anti-government rebellion has
thrown the nation into crisis. Rebels, seeking to overthrow the government
of President Jean-Bertrand Aristide, have overtaken more than a dozen cities
and towns, leaving more than 70 people dead in skirmishes with
pro-government police since the uprising began Feb. 5.

If rebel leaders make good on their promises to take Port-au-Prince, one of
the last remaining Aristide strongholds, the fighting on city streets could
pale compared to the suffering that awaits the wounded in this poor nation's
primitive hospitals. There are three major hospitals in the capital, and
none could be described as functioning this week.

Overwhelmed by the growing number of Haitians injured in street fighting
between pro- and anti-Aristide groups, hospital workers are struggling to
keep up with the daily press of casualties. Fresh medical supplies, in
demand during even the best of times, are hard to come by because barricades
have been erected along major routes leading to the city to repel rebel
forces, who now control about half of Haiti. And, out of fear, fewer
health-care workers are reporting to work each day.

As Pierre and other wounded men arrived at State University Hospital on
Wednesday morning, they were greeted by a handful of nurses with little more
than a few bandages and some bottled water to treat them.

Most of the hospital's doctors had not arrived for work -- many were in
hiding or have fled the nation -- and most of the facility's diagnostic and
surgical equipment was not functioning. Most days, there is no running
water, and electricity is sporadic. Dried blood covers many sections of the
emergency room's floor, and dust stirred up from the nearby street blows in
through the windows over the bandaged and open wounds of dozens of injured
men and women.

It's not unusual for armed men to show up at this and other hospitals around
the city, pull patients out of their beds and demand care for their own
wounded comrades.

Most patients only get what they pay for: medicine that has to be purchased
at the little drugstores just outside the hospital's gates. While there is
no shortage of sophisticated weapons on the streets -- dozens of youths
carry shiny handguns and elite assault rifles -- even the most basic medical
technology is in short supply at the city's hospitals.

International health experts said on Wednesday that only one hospital is
fully functioning in Port-au-Prince, a city of about 2.6 million people -- a
private hospital primarily patronized by the city's wealthiest residents,
who can afford to pay for care.

"We're just an empty box. There's no medicine here, none of the doctors have
showed up, and all we really have to offer someone with a severe wound is a
bit of gauze," said a State University Hospital nurse, asking not to be
named.

"It's been this way for months, but nobody dares to complain or you get
labeled as `opposition' by the government," said the nurse, as she stood
over a man who had been shot in the abdomen at a roadblock. "If there's a
bloodbath here, there's really nothing we'll have to treat the wounded.
Nothing at all."

The International Committee of the Red Cross said plans are under way to
take over the ward of at least one hospital in Port-au-Prince and staff it
with emergency room physicians as well as Cuban doctors who make up a large
portion of the country's health care system. There are about 300 Cuban
doctors in Haiti, and they are an essential part of the country's
deteriorating health-care system.

The ICRC's plans come in response to reports that raids on hospitals had
increased in recent weeks and that wounded patients had been kidnapped by
gunmen. One of the key tasks, said Yves Giovannoni, head of Red Cross
operations in Latin America and the Caribbean, will be to brace for an
influx of wounded, if major fighting breaks out in Haiti's besieged capital.

"Handling war wounded -- meaning people with bullets in their body or with
cuts by knives, machetes -- requires a particular surgical technique,
particular policies, in terms of using antibiotics," said Giovannoni.

The violence that has wracked Haiti has hit hospitals hard -- cutting off
the flow of drugs and supplies and also putting health-care workers at risk.
As attacks on the opponents of Aristide have increased, along with the
crowds of demonstrators demanding his resignation, militant supporters of
the embattled president have surrounded hospitals where protesters have
fled, occasionally chasing them inside and pulling out wounded patients.

"This is a regular routine of ours: After every demonstration, we go to the
hospital and care for our wounded, because there's always going to be
wounded after a demonstration here," said Charlie Baker, a businessman and
leader in the Group of 184, one of the moderate groups leading the
opposition. "And you never know what to expect because the hospital can be
just as dangerous as the street."

Alain Grimard, an official with the United Nations Development Program in
Haiti, said the deteriorating conditions have pushed Haiti's health-care
system to the brink of collapse.

"Even in the best of times the health-care situation in this country has
been abysmal," he said. "There isn't enough medicine -- the poor have to buy
their own -- and that's only for those who have a chance at affording it.
The vast majority of people in this country have no real access to health
care."

Chereste Auguste, 46, was brought to the State University Hospital on
Wednesday after being shot when militant pro-Aristide gunmen known as
chimère commandeered his taxi scooter.

"These people were base," Auguste said, as he waited to be treated for his
wounds in the hospital's emergency room with about two dozen other patients
nearby. "They just shot me and stole the taxi. Now I'm in really deep pain.
I cannot feel my legs and I need more drugs. But I don't have the money for
more drugs."

After a moment, he turned to a reporter and asked, "Can you give me
anything, anything, please?"

Tim Collie can be reached at tcollie@sun-sentinel.com or 954-356-4573.
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