Two months into the widely-followed doctors' strike in Haiti, five public hospitals stand near-deserted, unable to provide emergency services. The doctors are no longer willing to tolerate a chronic lack of basic supplies and unsafe work conditions which they say endanger their patients' lives.
When the pregnant woman died outside one of Haiti's major public hospitals in Port-au-Prince last week, her family and neighbors lashed out in despair and anger. Striking medical resident Joseph Herold shared in mourning her death, but he blames the government for starving the health system of essential funding and support. Surgeons in Port-au-Prince, he says, have put up for too long with extraordinarily challenging work conditions.
‘Doctors in Haiti are no longer willing to tolerate a chronic lack of basic supplies and unsafe work conditions which they say endanger their patients' lives.’
"Just imagine - you are in the middle of surgery and suddenly the power cuts out. Doctors have to finish operating by the light of their cell phones. Meanwhile, the anesthetic machine is losing pressure - your patient is waking up, in agony because the drugs aren't working any more, and you have to fight to pin him down on the operating table."
Huddled in a little office in the University Hospital of Port-au-Prince, also known as the General Hospital, Herold and his fellow strikers - both interns and residents - reel off a long list of grievances. They barely raise an eyebrow as a mouse scurries past underfoot.
"That's nothing," says Herold. "There are rats in our living quarters, and flies in the operating room. How can we think about providing emergency care when we don't even have a pair of gloves," asks Herold. "It's up to families to buy everything, and unfortunately, many don't have the means to pay for prescriptions. People often blame us and we are harassed all day long."
The lack of hygiene is well known among health authorities in the poorest country in the Americas. But they say they are powerless to help. "The problem comes from the area surrounding the hospitals: neighbors dump garbage daily near health centers and those responsible don't pick up," says Gabriel Thimote, general director of the Haitian health ministry.
In addition to improving sanitary conditions and access to medical materials, the strikers are also demanding pay raises. Despite high inflation, salaries have not gone up since 1990. "People here think medical staff are privileged, but we earn less than textile factory workers," Herold complains.
After six years of higher education, interns make less than half the minimum wage, which is set by law at 240 gourdes ($3.80) for an eight-hour workday. Residents physician in hospitals receive the equivalent of $123 per month, and doctors make a monthly wage of $390.
Thimote admits the wages of medical staff are not commensurate to their skills and training. But he says his ministry is hamstrung after more than a decade of budget cuts - a downward curve that started well before the 2010 earthquake dealt a crippling blow to Haiti's infrastructure.
Health expenditure currently accounts for 4.7% of the national budget - well below the 15% recommended by the World Health Organization. The $38.7 million allocated to the national public health sector in the 2015-2016 budget is not enough to cover current operating costs in Haiti's hospitals.
With Haiti in the grips of a drawn-out electoral crisis, the government has no more than a temporary mandate - and is refusing to take on the country's beleaguered health system. "We just can't," said presidential spokesperson Serge Simon. "The job of the provisional government is to organize elections to install an elected government - which can then take responsibility for the situation."
The University Hospital in Port-au-Prince - which is still under reconstruction six years after the quake leveled a third of its buildings - is currently off limits to photographers wishing to document the health crisis.
Some strikers accuse the Haitian elites of hypocrisy towards the struggling public system. "We've seen politicians come here for emergency care," says Herold. "But once they are in stable condition, they get themselves transferred to a private clinic so their friends and relatives don't have to witness the appalling state of affairs."
But for the 60% of Haitians living below the poverty line - including interns and residents themselves who are not entitled to civil servant health insurance - a private room in a clinic, or even a flight abroad for a medical procedure, are luxuries beyond their wildest dreams.