Haiti health system nears collapse as medicine dwindles, gangs attack hospitals and ports stay shut

PORT-AU-PRINCE, Haiti (AP) — On a recent morning at a hospital in the heart of gang territory in Haiti’s capital, a woman began convulsing before her body went limp as a doctor and two nurses raced to save her.

They stuck electrodes to her chest and flipped on an oxygen machine while keeping their eyes on a computer screen that reflected a dangerously low oxygen level of 84%.

No one knew what was wrong with her.

Even more worrisome, the Doctors Without Borders hospital in the Cite Soleil slum was running low on key medicine to treat convulsions.

“The medication she really needs, we barely have,” said Dr. Rachel Lavigne, a physician with the medical aid group.

It’s a familiar scene repeated daily at hospitals and clinics across Port-au-Prince, where life-saving medication and equipment is dwindling or altogether absent as brutal gangs tighten their grip on the capital and beyond. They have blocked roads, forced the closure of the main international airport in early March and paralyzed operations at the country’s largest seaport, where containers filled with key supplies remain stuck.

“Everything is crashing,” Lavigne said.

Haiti’s health system has long been fragile, but it’s now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical infrastructure in the capital and beyond.

The violence has forced several medical institutions and dialysis centers to close, including Haiti’s largest public hospital. Located in downtown Port-au-Prince, the Hospital of the State University of Haiti was supposed to reopen on April 1 after closing when the attack began, but gangs have infiltrated it.

One of the few institutions still operating is Peace University Hospital, located south of the shuttered airport. From Feb. 29 to April 15, the hospital treated some 200 patients with gunshot wounds, and its beds remain full.

“We urgently need fuel because we operate using generators. Otherwise we run the risk of closing our doors,” hospital director Dr. Paul Junior Fontilus said in a statement.

More than 2,500 people were killed or wounded across Haiti from January to March, a more than 50% increase compared with the same period last year, according to a recent U.N. report.

Even if a hospital is open, sometimes there is little or no medical staff because gang violence erupts daily in Port-au-Prince, forcing doctors and nurses to stay at home or turn around if they encounter blocked roads manned by heavily armed men.

The spiraling chaos has left a growing number of patients with cancer, AIDS and other serious illnesses with little to no recourse, with gangs also looting and setting fire to pharmacies in the capital’s downtown area.

Doctors Without Borders itself has run out of many medications used to treat diabetes and high blood pressure, and asthma inhalers that help prevent deadly attacks are nowhere to be found in the capital, Lavigne said.

At the Doctors Without Borders hospital, medical staff recently tried to save a boy with a severe asthma attack by giving him oxygen, she said. That didn’t work, and neither did another type of medication. Finally, they ended up injecting him with adrenaline, which is used in emergencies to treat anaphylactic shock.

“We improvise and we do our best for the people here,” Lavigne said.

People’s health is worsening because the daily medication they need for their chronic conditions is not available, warned Doctors Without Borders project coordinator Jacob Burns.

“It becomes acute and then they run out of options,” he said. “For certain people, there are very, very few options right now.”

Despite the pressing need for medical care, the Doctors Without Borders hospital in Cite Soleil has been forced to cut the number of outpatients it treats daily from 150 to 50, Burns said, though all emergencies are attended to.

Scores of people line up outside the hospital each day and risk being shot by gang members who control the area as they await medical care.

Everyone is allowed to enter the hospital compound, but medical staff set up a triage to determine which 50 people will be seen. Those with less urgent needs are asked to return another day, Burns said.

On Friday morning, 51-year-old Jean Marc Baptiste shuffled into the emergency room with a bloody bandage on his right hand. He said police in an armored vehicle shot him the previous day as he was collecting wood to sell as kindling in an area controlled by gangs.

Once inside, nurses removed the bandage to reveal a gaping wound in his thumb as he cried out in pain. Lavigne told him he needed a plastic surgeon, which the hospital does not have, and ordered X-rays to ensure there was no fracture.

On average, the Cite Soleil hospital sees three wounded people a day, but sometimes it’s up to 14 now, staff said.

Recently, five people wounded by bullets arrived at the hospital after spending all night inside a public bus that couldn’t move because of heavy gunfire, Burns said.

“Cite Soleil was long the epicenter of violence,” he said. “And now violence is so widespread that it’s become a problem for everyone.”

FILE - Marc Baptiste rests on a bench after being treated at a Doctors Without Borders emergency room in the Cite Soleil neighborhood of Port-au-Prince, Haiti, Friday, April 19, 2024. Baptiste said police in an armored vehicle shot him the previous day as he was collecting wood to sell as kindling in an area controlled by gangs. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa, File)

Police stop at a car to inspect in Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

FILE - A malnourished child waits to be treated at a Doctors Without Borders emergency room in the Cite Soleil neighborhood of Port-au-Prince, Haiti, Friday, April 19, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa, File)

A person takes a bath at a public school that serves as a shelter for people displaced from their homes due to clashes between armed gangs in Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa )

A domino player wears clips on his arm, placed every time he loses, at a public school that serves as a shelter for people displaced from their homes due to clashes between armed gangs in Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond.(AP Photo/Ramon Espinosa)

FILE - Denize Flerino wipes sweat from the brow of her son who is suffering from high fevers at a Doctors Without Borders emergency room in the Cite Soleil neighborhood of Port-au-Prince, Haiti, Friday, April 19, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa, File)

A body lies in the middle of the street as commuters make their way through the Petion-Ville neighborhood of Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

FILE - A man lifts a chain being used as a barricade for neighbors to pass into the neighborhood as they work to prepare a metal gate to protect themselves from gangs, in the Petion-Ville neighborhood of Port-au-Prince, Haiti, Saturday, April 20, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

FILE - Neighbors raise a metal gate as they work to install it as a barricade against gangs, in the Petion-Ville neighborhood of Port-au-Prince, Haiti, Saturday, April 20, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

FILE - A woman accompanied by her daughter, waits to be treated at a Doctors Without Borders emergency room in the Cite Soleil neighborhood of Port-au-Prince, Haiti, Friday, April 19, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa, File)

People walk past tires and a burned-out vehicle used to create roadblocks in the Canapé Vert area of Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

A youth washes clothes at a public school that serves as a shelter for people displaced from their homes due to clashes between armed gangs in Port-au-Prince, Haiti, Monday, April 22, 2024. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa)

FILE - Marc Baptiste is treated for a bullet wound at a Doctors Without Borders emergency room in the Cite Soleil neighborhood of Port-au-Prince, Haiti, Friday, April 19, 2024. Baptiste said police in an armored vehicle shot him the previous day as he was collecting wood to sell as kindling in an area controlled by gangs. Haiti's health system has long been fragile, but it's now nearing total collapse after gangs launched coordinated attacks on Feb. 29, targeting critical state infrastructure in the capital and beyond. (AP Photo/Ramon Espinosa, File)

WEST PALM BEACH, Fla. (AP) — Israeli Prime Minister Benjamin Netanyahu worked to mend ties with Republican presidential candidate Donald Trump on Friday and offered measured optimism about progress toward a cease-fire deal for Gaza as he neared the end of a contentious U.S. visit that put on display the growing American divisions over support for the Israeli-Hamas war.

At Trump's Florida Mar-a-Lago estate, where the two men met face-to-face for the first time in nearly four years, Netanyahu told journalists he wanted to see U.S.-mediated talks succeed for a cease-fire and release of hostages.

“I hope so,” Netanyahu said, when reporters asked if his U.S. trip had made progress. While Netanyahu at home is increasingly accused of resisting a deal to end the 9-month-old war to stave off the potential collapse of his far-right government when it ends, he said Friday he was "certainly eager to have one. And we’re working on it.”

As president, Trump went well beyond his predecessors in fulfilling Netanyahu’s top wishes from the United States. Yet relations soured after Netanyahu became one of the first world leaders to congratulate Joe Biden for his 2020 presidential victory, which Trump continues to deny.

The two men now have a strong interest in restoring their relationship, both for the political support their alliance brings and for the luster it gives each with their conservative supporters.

A beaming Trump was waiting for Netanyahu on the stone steps outside his private club and residence in Palm Beach, Florida. He warmly clasped the hands of the Israeli leader.

“We’ve always had a great relationship,” Trump insisted before journalists. Asked as the two sat down in a muraled room for talks if Netanyahu’s trip to Mar-a-Lago was repairing their bond, Trump responded, “It was never bad.”

For both men, Friday’s meeting was aimed at highlighting for their home audiences their depiction of themselves as strong leaders who have gotten big things done on the world stage, and can again.

Netanyahu’s Florida trip followed a fiery address to a joint meeting of Congress on Wednesday that defended his government’s conduct of the war and condemned American protesters galvanized by the killing of more than 39,000 Palestinians in the conflict.

On Thursday, Netanyahu had met in Washington with Biden and Vice President Kamala Harris, who appears on track to becoming the new Democratic presidential nominee after Biden decided to step out of the race. Both pressed the Israeli leader to work quickly to wrap up a deal to bring a cease-fire and release hostages held by Hamas.

Trump’s campaign said he pledged in Friday's meeting to “make every effort to bring peace to the Middle East” and combat antisemitism on college campuses if American voters elect him to the presidency in November.

Netanyahu handed Trump a framed photo that the Israeli leader said showed a child who has been held hostage by Hamas-led militants since the first hours of the war. “We’ll get it taken care of,” Trump assured him.

In a speech later Friday before a group of young Christian conservatives, Trump said he also asked Netanyahu during their meeting how “a Jewish person, or a person that loves Israel” can vote for Democrats.

He also laced into Harris for missing Netanyahu's speech and claimed she “doesn’t like Jewish people” and “doesn’t like Israel." Harris has been married to a Jewish man for a decade.

For Trump, the meeting was a chance to be cast as an ally and statesman, as well as to sharpen efforts by Republicans to portray themselves as the party most loyal to Israel.

Divisions among Americans over U.S. support for Israel’s war against Hamas in Gaza have opened cracks in years of strong bipartisan backing for Israel, the biggest recipient of U.S. aid.

For Netanyahu, repairing relations with Trump is imperative given the prospect that Trump may once again become president of the United States, which is Israel’s vital arms supplier and protector.

One gamble for Netanyahu is whether he could get more of the terms he wants in any deal on a Gaza cease-fire and hostage release, and in his much hoped-for closing of a normalization deal with Saudi Arabia, if he waits out the Biden administration in hopes that Trump wins.

“Benjamin Netanyahu has spent much of his career in the last two decades in tethering himself to the Republican Party,” said Aaron David Miller, a former U.S. diplomat for Arab-Israeli negotiations, now a senior fellow at the Carnegie Endowment for International Peace.

For the next six months, that means “mending ties with an irascible, angry president," Miller said, meaning Trump.

Netanyahu and Trump last met at a September 2020 White House signing ceremony for the signature diplomatic achievement of both men’s political careers. It was an accord brokered by the Trump administration in which the United Arab Emirates and Bahrain agreed to establish normal diplomatic relations with Israel.

For Israel, it amounted to the two countries formally recognizing it for the first time. It was a major step in what Israel hoped would be an easing of tensions and a broadening of economic ties with its Arab neighbors.

In public postings and statements after his break with Netanyahu, Trump portrayed himself as having stuck his neck out for Israel as president, and Netanyahu paying him back with disloyalty.

He also has criticized Netanyahu on other points, faulting him as “not prepared” for the Oct. 7 Hamas attacks that started the war in Gaza, for example.

In his high-profile speech to Congress on Wednesday and again Friday at Mar-a-Lago, Netanyahu poured praise on Trump, calling the regional accords Trump helped broker historic and thanking him “for all the things he did for Israel.”

Netanyahu listed actions by the Trump administration long-sought by Israeli governments — the U.S. officially saying Israel had sovereignty over the Golan Heights, captured from Syria during a 1967 war; a tougher U.S. policy toward Iran; and Trump declaring Jerusalem the capital of Israel, breaking with longstanding U.S. policy that Jerusalem's status should be decided in Israeli-Palestinian negotiations.

“I appreciated that,” Trump told “Fox & Friends” on Thursday, referring to Netanyahu's praise.

Trump has repeatedly urged that Israel with U.S. support “finish the job” in Gaza and destroy Hamas, but he hasn’t elaborated on how.

Natalie Melzer in Tel Aviv, Israel, Adriana Gomez Licon in West Palm Beach, Florida, and Jill Colvin in New York contributed. Knickmeyer reported from Washington. Price reported from New York.

Follow the AP's coverage of the 2024 election at https://apnews.com/hub/election-2024.

Republican presidential candidate former President Donald Trump speaks at the Turning Point Believers' Summit, Friday, July 26, 2024, in West Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump listens as he meets with Israeli Prime Minister Benjamin Netanyahu at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump meets with Israeli Prime Minister Benjamin Netanyahu at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump speaks while meeting with Israeli Prime Minister Benjamin Netanyahu at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Israeli Prime Minister Benjamin Netanyahu speaks while meeting with Republican presidential candidate former President Donald Trump at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump meets with Israeli Prime Minister Benjamin Netanyahu, right, at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump meets with Israeli Prime Minister Benjamin Netanyahu at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

Republican presidential candidate former President Donald Trump meets with Israeli Prime Minister Benjamin Netanyahu at his Mar-a-Lago estate, Friday, July 26, 2024, in Palm Beach, Fla. (AP Photo/Alex Brandon)

FILE - President Donald Trump, right, meets with Israeli Prime Minister Benjamin Netanyahu in the Oval Office, Sept. 15, 2020, at the White House in Washington. Trump is due to talk face-to-face with Netanyahu for the first time in nearly four years. The meeting Friday, July 26, 2024, at Mar-a-Lago will mend a break that has lasted since 2021. Trump at the time blasted Netanyahu for being one of the first leaders to congratulate President Joe Biden for his election victory. (AP Photo/Alex Brandon, File)