By Sandrine Exil
Port-au-Prince, Mar 30 (EFE).- Haiti’s ongoing violence and severe medication shortages have pushed thousands to the brink of mental collapse. In the midst of the chaos, untreated psychiatric patients have become the invisible victims of an overwhelmed healthcare system.
Every day, Port-au-Prince wakes up to the echo of gunfire and the roar of motorcycles. The scent of street food mingles with stagnant water, while Haiti’s colorful ‘tap-tap’ buses weave through burning barricades.
Since 2023, armed violence has turned the capital into a deadly trap. Around 3.5 million Haitians live in gang-controlled areas, where gender-based violence and sexual abuse are used as weapons of terror.
According to the United Nations, at least 5,600 people have been killed due to violence in 2024, with 2,212 others injured and 1,494 kidnapped.
In the chaotic neighborhood of Carrefour Feuille, 32-year-old nursing student Marie Desir struggles to survive.
“I’m traumatized. I don’t even go outside anymore,” she confesses.
Forced from her home by gangs, Marie sought refuge in Delmas, another part of the city where violence remains relentless. “I have trouble sleeping; I’m always on high alert,” she says.
Haitian psychologist Ronald Florestal sums it up with a chilling statement: “More people in Haiti have died from depression than from bullets.” Despair is a silent disease that spreads rapidly.
Jean-Robert Augustin, a psychiatrist specializing in trauma, warns that Haiti is suffering from a state of “collective post-traumatic stress.”
“The wounds of this crisis are not only physical; entire generations are growing up in a constant state of fear,” he explains.
Augustin no longer lives in Haiti and, like many of his colleagues, had to leave to protect his family. Although no official data exists on the country’s “brain drain,” the lack of medical personnel is straining the healthcare system.
A Jul. 2024 report from Haiti’s National Network for the Defense of Human Rights (RNDDH) found that the number of healthcare workers has declined by 70%.
Mothers struggle in the abyss of displacement Camps
At the former Rex Theater, once home to grand film premieres in downtown Port-au-Prince, hundreds of makeshift tents now stand. Clothes hang across the stage, and mattresses cover the floor. Among the refugees, Joceline Pierre, a mother of eight, searches for the strength to keep going.
Since her husband disappeared, she has raised her children alone in brutal conditions. A lack of food, clean water, and security has pushed her to the brink.
“Some days, I don’t even have the strength to get up,” she its.
A study published by the Journal of Affective Disorders found that 67% of displaced women in Haiti show symptoms of severe depression. But in a country where psychological care is a luxury, many women like Joceline have no choice but to endure in silence.
Jean-Robert Augustin warns that the emotional collapse of these women could have devastating consequences. “Many mothers are on the verge of making extreme decisions,” he says.
Joveline Pierre lived with her husband in Port-au-Prince until one night, armed men invaded their home. They tied her up, raped her in front of her husband, and then murdered him before her eyes. She fled with the little money she had and found refuge at the Rex Theater.
“Nights are the worst,” she says, her voice trembling. “I close my eyes, and I relive everything.”
She has received neither psychological nor justice. Her story is just one of many in a country where 75% of female survivors of sexual violence do not receive adequate psychological care, according to Human Rights Watch.
The medication crisis hits psychiatric patients hard
Haiti’s medical exodus and lack of psychological care are compounded by a pharmaceutical crisis, leaving the most vulnerable without essential treatments.
Max-Weber Victor, a psychiatrist with 15 years of experience at Mars and Kline, Haiti’s only public psychiatric hospital, warns that mentally ill individuals are frequent victims of street violence in Port-au-Prince.
“Unfortunately, these cases go unreported,” he adds.
Jean-René Pierre, a 34-year-old man from downtown Port-au-Prince suffering from schizophrenia, began wandering the streets after running out of medication.
His mother, Marie-Rose Joseph, explains that without his treatment, Jean-René lost control and spent days wandering aimlessly in February. A week later, the family received the devastating news: he had been killed.
Samuel Louis, 29, from Musseau, was rescued from an armed group in January thanks to a neighbor who recognized him. He suffers from depression and anxiety.
His sister, Nathalie Louis, recalls the horror of finding Samuel with a deep machete wound on his head. “If he hadn’t been recognized, they would have killed him,” she says.
Haiti’s healthcare system is facing an unprecedented collapse due to violence and the blockade of streets, roads, ports, and airports. The country’s heavy reliance on imported medication has worsened the crisis.
In Mar. 2024, gangs set fire to more than 20 pharmacies in the capital. Saint-Damien Hospital, one of Haiti’s main medical centers, received only 43% of its supply orders in November, according to its head pharmacist, Rommel Cajuste.
“When ports and airports shut down, suppliers can’t fulfill orders,” he explains.
Additionally, national laboratories have been forced to cut production due to shortages of raw materials, forcing hospitals to prioritize only the most critical cases and further straining healthcare quality.
The crisis deepened when Mars and Kline closed in Mar. 2024 due to supply shortages and ongoing violence in the area. Many families have been forced to care for their mentally ill relatives without the necessary resources.
“The lack of antibiotics, painkillers, and cancer medications could increase mortality in the country,” warns Pierre Hugues Saint-Jean, president of Haiti’s Association of Pharmacists.
The impact on psychiatric patients has been particularly devastating. With no access to proper treatment, doctors have resorted to older medications with severe side effects, drugs that are also beginning to run out.
With few alternatives, some traders have turned to imports from the Dominican Republic, but costs have skyrocketed due to extortion by armed groups along the roads.
Medication prices have soared. According to Nathalie Louis, a box of 30 paroxetine pills, her brother’s antidepressant, now costs 77 dollars in Pétion-Ville, which is unaffordable for many families in a country where the monthly minimum wage is around 116 dollars, an income most Haitians do not reach.
Meanwhile, the country remains in turmoil, and the psychological suffering of its people remains invisible, an echo trapped in the empty streets of Port-au-Prince. EFE
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