ICM’s member association in Haïti, L’Association des sage-femmes d’Haïti (ASFH), is fighting to support women’s safety and rights through a violent humanitarian crisis that is threatening Haitians’ human rights.
UN High Commissioner for Human Rights Volker Türk warned in November 2022 that unremitting armed violence has “precipitated Haiti’s descent into the worst human rights and humanitarian situation in decades.”
According to UNFPA, gang violence has been surging across Haiti since July 2022 as a result of turf wars between rival gangs in Croix-des-Bouquets, one of the main communes of the metropolitan area of Port-au-Prince. Hundreds of people have been killed, raped and kidnapped and more than 25,000 have been driven from their homes in the capital in search of shelter – most of them women and children.
Now amid an almost complete lack of basic services, including functioning health centres, access to safe drinking water, sanitation facilities and refuse collection, a cholera outbreak is threatening the health and lives of millions of already vulnerable and impoverished people. The water-borne disease causes acute diarrhoea that can be deadly if left untreated within the first few hours: So far 18 people have died and there are over 250 suspected cases.
Registered midwife and Communications Officer for ASFH, Jeffthanie Mathurin, says these conditions have devastated Haitian lives across the country and exacerbated an existing lack of resources for women and children.
“The problem is felt especially on women,” said Jeffthanie. “It has been noticed that with these cases of constant displacement, the rate of gender-based violence has increased considerably.”
Jeffthanie says the wars between armed gangs prevent midwives from even getting to work every day and inhibit women from arriving safely to clinics or hospitals to give birth. For fear of being killed on their way to the hospital while in labour, many women opt to give birth alone at home or end up giving birth unsupervised outdoors.
The working conditions are also dire for those midwives who are able to work; without access to fuel, and consequently medicines, personal protective equipment, and tools, midwives work through the night in the dark, with only a small lamp to light their life-saving care.
ASFH is doing the best they can with few resources to support women’s right to healthcare. In 2020, they launched a new, free telephone line called ‘Hello Midwives,’ where women in pregnancy, childbearing age, or post-partum may seek consultation with qualified midwives from the comfort of their own home. This platform is open 7 days a week and 10 hours a day and seeks to fill the gap in care that the unrest has cause in maternal, sexual and reproductive healthcare.
“It’s so hard. Our midwives are obliged to guide women to go through the childbirth continuum alone,” said Jeffthanie. “Can you imagine? We midwives who have been working so hard to increase the institutional delivery rate in Haiti in order to reduce the maternal mortality rate are now advising women to stay home, because they risk being murdered otherwise.”
Despite the tragic circumstances, ASFH still aims to continue growing and help midwives provide better care to Haitian women. Last month, the association developed training modules in respectful maternity care and has already provided 2 sessions of training for healthcare providers.
With more financial autonomy, ASFH would like to one day launch their own midwifery clinic, where midwives could manage their own, regulated scope of practice.
“With more financial autonomy, we could be more independent in what we want and what we do,” said Jeffthanie. “It would be not only an opportunity to provide care to women in our communities, but also an opportunity to develop ourselves as a midwives’ association.”