Fieldset
Haiti: “She has been rushed here, barely alive”

Armed violence plagues areas of Haiti’s capital city. When a little girl is shot, her family and the MSF team must race to save her life. Surgeon Federica Iezzi shares the story…  

Mirlande* arrives from Cité Soleil, one of the most troubled neighbourhoods in the Haitian capital Port-au-Prince. She looks at us with black eyes, which show all the fear of a seven-year-old, waking up in hospital after being wounded in a shoot-out between armed groups.  

We are at the Tabarre emergency trauma and major burns centre that Médecins Sans Frontières / Doctors Without Borders (MSF) runs in the capital. Mirlande has been rushed here, barely alive, in the back of a truck.

You don't play in the streets of Cité Soleil. You don't visit friends, you don't go for walks

Her family explains that she had been on her way home from school with her father when a barrage of bullets hit both her legs.  

And that was the moment the world collapsed for both Mirlande and her loved ones.

The risks

You don't play in the streets of Cité Soleil. You don't visit friends, you don't go for walks.  

You only go out for essential reasons, to go to work, to school or to the hospital. You take big risks when you do, and you have to decide what risks your children will take. Even the curfew won’t save you.

There are many risks. Alongside the danger of stray bullets, there is also, for example, that of fire: a dangerous game used by members of armed groups to intimidate and indiscriminately punish men, women and children.

Our hospital offers specialist burns care, but despite this, the damage is often irreparable, and many people die from their injuries. For people who survive severe burns, reintegrating into the community is extremely difficult.  

The impact of violence

Haiti is a nation with a rich political and cultural history. It was the first independent black republic in the modern era. But Haitians have faced decades of political instability, violence and persistent poverty, and today many people know Haiti as a country in crisis.  

Haiti is one of the most densely populated and poorest countries in the Western Hemisphere. Private healthcare is out of reach for the majority, who may find it hard to pay even for transport to a medical facility. People in the poorest areas struggle to meet basic needs like food, clean water and shelter.

This violence would have claimed Mirlande’s life today had she not been rushed to the operating theatre under the worried, loving gaze of her father... 

For residents of embattled neighbourhoods like Martissant, Cité Soleil, Carrefour, and Croix-des-Bouquets, violence has become a public health problem, severely impacting their access to medical care.

Entire neighbourhoods are sealed off by firefights and barricades that prevent the movement of vehicles and ambulances.

As the violence spreads to larger and larger areas of the capital people are forced to make long detours to reach certain neighbourhoods of Port-au-Prince.  

Displacement

Recurrent clashes between armed gangs have driven thousands of people to flee their homes.

Sometimes this is temporary: people take refuge with host families and wait for the violence to ease.

All the operating theatres are occupied. Next to Mirlande several other patients are fighting for their lives...

However, for others, it’s more permanent. If they have the financial means they will find alternative accommodation elsewhere, otherwise they end up in camps for displaced people where living conditions are extremely poor.  

My colleagues tell me that many Haitians dream of leaving the country.

Vital surgery

This violence would have claimed Mirlande’s life today had she not been rushed to the operating theatre under the worried, loving gaze of her father.  

Large-calibre firearms are often merciless. Easy to use, accurate, effective, the bullets explode in the body. Extracting each fragment can be an exhausting task for the surgical team.  

All the operating theatres are occupied. Next to Mirlande several other patients are fighting for their lives. Battling exhaustion, resignation and horror, the medical teams work on.

Mirlande is lucky: she will survive.  

First steps

Eventually she is moved out of the intensive care unit and into the ward, but the fear of not being able to walk again, or perhaps the worry of returning to a home she no longer feels is safe, continues to torment her throughout her stay in hospital. It is only when, after days of tears, she puts her feet back on the ground and tentatively takes her first steps that she gives us her first smile. 

She looks up, confused and a little surprised, and seeks her father's warm gaze as she walks slowly along the corridor.  

As I watch her, I can’t help but wonder what would have happened if our hospital had not been here? Where would Mirlande have been taken? Tabarre is the only facility in the area which can offer the level of care that Mirlande needed. And in a place as ravaged by violence as Port-au-Prince, a hospital can mean the difference between life and death.

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