(2024-04) Sitiyasyon imanitè ak sektè sante an Ayiti, avril 2024

REPUBLIQUE D’HAITI MINISTERE DE LA SANTE PUBLIQUE ET DE LA POPULATION UEP/MSPP Avril 2024 MSPP SITUATION HUMANITAIRE ET SECTEUR DE LA SANTÉ EN HAITI (avril 2024) HUMANITARIAN SITUATION AND HEALTH SECTOR IN HAITI (April 2024) PAIX ET SANTE MSPP The WHO Constitution recognizes the link between health and peace, as it emphasizes that "the health of all peoples is a fundamental condition for world peace and security." Similarly, in 1981 the World Health Assembly adopted resolution WHA34.38, which emphasized the role of the health sector in promoting "peace as the main factor in achieving health for all". (WHO, Fundamental Documents, 49th edition) The concept of health as a catalyst for social cohesion and peace in conflict areas was first defined by the Pan American Health Organization in the 1980s, resulting in the creation of the WHO Health Bridge to Peace programme in 1997. While this programme sought to carry out health interventions in conflict zones, the Global Health for Peace Initiative goes further and aims to have a positive influence on the dynamics that govern conflict and peace, mainly at the local level, based on the premise that there can be no health without peace, nor can there be peace without health. Peace is a structural determinant of health. Conversely, conflict has catastrophic consequences for people's health and health systems. And we are crying out for the Haitian people. In Haiti, the health sector continues to bear a heavy brunt of armed gang violence, as insecurity continues to disrupt operations and impede access to some institutions and referrals of patients to health facilities. SITUATION HUMANITAIRE ET SECTEUR DE LA SANTE EN MSPP HAITI (avril 2024) Situation of hospitals and other health institutions Violence in some neighbourhoods has hampered the supply of medical inputs and the movement of staff to health facilities, while preventing people from accessing health care providers. Several health facilities or hospitals have been attacked or forced to suspend operations due to threats or violence by gangs Closure and reduction of staff at Fontaine-Cité Soleil Hospital – November 2023 Doctors Without Borders' activities suspended at Turgeau emergency centre after armed individuals pulled an injured patient out of an ambulance and shot him dead in the street – 14 Dec 2023 "With each passing day, our stocks are decreasing because we can't get supplies and with each passing day we will be forced to close the doors of the few functioning hospitals. A hospital that doesn't have inputs, oxygen, blood or medication can't do anything, and employees can't get to their workstations. They are fleeing gangs as well," (Dr. Ronald Laroche (advisor to the Association of Private Hospitals of Haiti- March 7, 2024). 18 health institutions closed in PAP 10 health institutions closed in Artibonite UNHCR in Beudet attacked and looted (April 2024) St Francis de Salles Hospital looted and vandalised (4-5 March 2024) Port-au-Prince Sanatorium (more than 100 tuberculosis patients): completely looted on March 16, 2024 Delmas 18 Hospital, St Martin Health Centre (26-27 March 2024), Bernard Mevs Hospital HUEH: closed since February 29, 2024, the reopening announced for April 1 but April 2. Armed gangs have taken control of the hospital, hoping that the premises will serve as a strategic base. SITUATION HUMANITAIRE ET SECTEUR DE LA SANTE EN MSPP HAITI (avril 2024) Food security "By 2024, an estimated 5.5 million Haitians will depend on humanitarian protection and assistance, including 3 million children (some suffering from acute malnutrition or wasting), the highest number ever recorded. The latest Integrated Food Security Phase Classification (IPC) from September 2023 shows that 44 percent of the population, or 4.35 million people, are food insecure. (IPC3+). In addition, 1.4 million people are in IPC 4 (on the brink of famine). The closure of the border with the Dominican Republic has exacerbated these challenges." (Human Rights Report, 2024) Situation of medicines and pharmacies Pharmacies can no longer replenish their stocks pharmaceutical inputs of essential medicines and One of Haiti's major laboratories has already closed its doors, two others are operating at a slower pace, and several other pharmaceutical agencies have been looted, ransacked or burned by armed bandits Almost all the pharmacies that were in the vicinity of the HUEH were set on fire by the bandits on March 28. SITUATION HUMANITAIRE ET SECTEUR DE LA SANTE EN HAITI (avril MSPP 2024) Access to safe drinking water and sanitation DINEPA personnel are unable to reach the sites where the wells and generators are located and difficulty in supplying the stations due to lack of fuel and chemicals (Director of DINEPA) Water scarcity: Several areas in the metropolitan area of Port-au-Prince are threatened by possible water scarcity. This is due to the control of some roads by armed gangs, which hinders access to drinking water. Unsanitary conditions: The metropolitan area of Port-au-Prince faces problems of unsanitary conditions and insecurity. Local residents are neglected and the authorities seem powerless in the face of the situation. Piles of waste are piling up and town halls are having difficulty collecting them either because of insecurity or lack of fuel. Costs of Health Services According to local actors, the situation has increased their costs of health services and medicines, forcing some to reduce or close their services. The closure of the border with the Dominican Republic has exacerbated the shortage of essential medical supplies. Access to Blood Access to blood collection stations is severely affected by insecurity. However, since 29 February, the United Nations Humanitarian Air Service (UNHAS) has transported 800 kg of blood bags to support the health response (Situation Report, OCHA) SITUATION HUMANITAIRE ET SECTEUR DE LA SANTE EN MSPP HAITI (avril 2024) Sexual violence According to the High Commission for Human Rights (OHCHR), "gangs continued to use sexual violence to spread fear, subjugate and punish the population. During gang attacks, several women and girls were raped, including gang rapes, in their homes, often after witnessing the murder of their husbands. Sexual violence remains very underreported due to community stigmatization, significant threat of reprisals from perpetrators, inadequate health care and psychosocial services for survivors, and lack of trust in the justice system. Even when such incidents are reported, impunity for sexual violence is widespread." Psychological impact and education Hundreds of children are orphaned. The organizations highlight the psychological scars and the bleak future that awaits young people. A total of 362,000 people, including nearly 200,000 children, have been displaced in Port-au-Prince and Artibonite. This figure has doubled in the space of a year. In the chaos of displacement, children are seeing their human rights violated. "Since January 2024, access to education has been severely disrupted for thousands of Haitian children. Some schools have ended up in war zones, others are occupied by displaced families or simply inaccessible because of street fighting. Several classrooms have also been destroyed or looted by armed groups." (Testimony of Mr. Bruno Maes, UNICEF Representative in Haiti) SITUATION HUMANITAIRE ET SECTEUR DE LA SANTE EN MSPP HAITI (avril 2024) Medical staff Since the beginning of the crisis, several medical personnel (mainly doctors) have been killed, injured or kidnapped. In many parts of the capital, staff are unable to go to work because of insecurity. This has an impact on the delivery of services in the few institutions that remain in operation. Moreover, according to the same Human Rights report (March 2024), around 40 per cent of medical staff have left the country recently due to insecurity. According to OHCHR, hospitals have been burned, medical staff killed, injured and abducted, and there is a shortage of basic medical supplies. The violence displaced nearly 17,000 people in Port-au-Prince between 8 and 14 March and hampered the delivery of humanitarian aid. In conclusion, it is important to highlight the remarkable work of the Ministry of Public Health and Population and its entire team at the levels of Senior Management, Central, Departmental, Communal, Institutional, the National Blood Transfusion Center and the National Ambulance Center which continue to provide care to the entire population in areas that are still accessible. Coordination of partners, distribution of inputs and supervision continue as the situation is present. Health workers, particularly those at La Paix University Hospital, remain committed to providing their services to the distraught population. MSPP Monthly Service Report 9 New Institutional Attendance Période Janvier à Mars 2022 Janvier à Mars 2023 MSPP Janvier à Mars 2024 Visites des Total Visites des Visites des Total Visites des Visites des Visites des Visites des Visites des Visites des Visites Visites des Visites des Personnes a visites Visites des Personnes a Personnes a visites Visites des Personnes a Personnes a Jeunes Personnes a Jeunes jeunes des Jeunes jeunes jeunes adultes mobilite institution Femmes mobilite mobilite institution Femmes mobilite mobilite adultes 15 mobilite reduite adultes 15 - adultes 20 adultes 15 adultes 20 20 - 24 ans reduite nelles Enceintes reduite reduite nelles Enceintes reduite reduite 19 ans (sensoriel) 19 ans - 24 ans - 19 ans 24 ans (moteur) nouvelles (moteur) (sensoriel) nouvelles (moteur) (sensoriel) Département / Données Total visites institutionnell es nouvelles Visites des Femmes Enceintes Artibonite 118 427 24 534 9 717 13 365 7 775 33 85 656 23 726 8 450 10 833 935 34 68 565 15 718 8 521 11 087 44 45 Centre 76 555 16 506 8 990 14 179 165 148 73 654 16 081 8 587 13 270 139 74 52 261 11 203 4 640 6 511 137 64 Grand-Anse 35 076 7 042 2 273 2 875 90 135 32 983 7 949 2 312 3 276 47 93 Nippes 23 521 3 510 1 434 2 043 258 106 21 555 3 064 1 389 1 866 532 10 16 892 1 892 1 032 1 407 256 8 Nord 94 705 15 068 6 312 9 041 977 106 78 975 13 925 4 938 6 319 603 40 75 360 12 286 4 754 6 621 963 130 Nord-Est 27 785 9 615 1 560 2 211 28 538 8 361 1 470 2 076 1 20 487 7 155 1 204 1 765 4 5 Nord-Ouest 40 355 9 256 3 156 4 214 295 106 47 685 9 002 2 798 3 343 82 70 28 702 4 829 2 401 2 729 65 51 Ouest 205 978 72 906 19 852 29 971 2 016 144 164 194 53 222 18 140 24 412 1 712 93 104 917 30 526 10 035 13 869 1 177 331 Sud 82 973 10 466 5 801 7 441 1 302 35 70 548 12 214 4 625 7 096 798 47 51 889 7 315 2 909 3 896 246 13 Sud-Est 31 965 6 687 1 414 2 301 236 38 35 339 7 467 2 164 2 588 379 12 30 575 5 047 1 625 2 286 133 11 Total 737 340 175 590 60 509 87 641 13 114 851 639 127 155 011 54 873 75 079 5 228 473 449 648 95 971 37 121 50 171 3 025 658 MSPP Emergency room Période Janvier à Mars 2022 Violences Sexuelles | Decedes Janvier à Mars 2023 Janvier à Mars 2024 Nombre Nombre Nombre Nombre Nombre Nombre Nombre Nombre de Violences Nombre de Violences Nombre de Violences Accidents de Nombre de Violences Violences Accidents de Accidents de Accidents de la Accidents de de Accidents de violences Physiques | Violences Sexuelles | violences Physiques la voie Violences Sexuelles | Physiques | la voie la voie voie publique | la voie violences la voie publique | Sexuelles Decedes publique | Physiques Decedes Sexuelles Decedes Physiques | Decedes Decedes publique Decedes publique Physiques publique Decedes Decedes Département / Données Nombre de Violences Sexuelles Artibonite 61 777 3 500 7 75 513 Centre 79 377 2 258 17 69 220 Grand-Anse 50 448 907 3 42 315 Nippes 15 365 653 2 6 192 Nord 86 758 2 472 5 64 582 Nord-Est 15 191 504 3 5 172 Nord-Ouest 42 369 696 14 248 Ouest 77 909 Sud 69 Sud-Est Total 1 1 4 4 075 10 41 372 454 1 574 14 34 376 12 140 412 15 152 506 4 788 365 3 142 6 17 051 61 2 4 391 6 44 925 1 234 6 46 293 1 210 465 2 15 148 280 2 2 1 581 6 48 583 1 159 4 1 413 1 23 117 343 2 24 60 214 1 2 108 595 456 1 1 1 680 5 37 741 1 1 201 12 1 021 8 40 496 2 883 7 1 456 2 10 148 8 12 292 36 287 3 511 331 4 7 729 27 11 MSPP Consultations prenatal Période Département / Données Janvier à Mars 2022 Janvier à Mars 2023 Janvier à Mars 2024 Nombre de femmes Pourcentage de Nombre de femmes Pourcentage de premieres Nombre de femmes enceintes ayant premieres consultations enceintes ayant consultations prenatales enceintes ayant beneficie beneficie de quatre prenatales effectuées au beneficie de quatre effectuées au premier de quatre consultations consultations premier trimestre de la consultations prenatales trimestre de la grossesse prenatales prenatales grossesse Pourcentage de premieres consultations prenatales effectuées au premier trimestre de la grossesse Artibonite 2 490 39.3 1 982 35.1 1 509 39.9 Centre 1 506 29.7 1 509 33.9 1 122 34 Grand-Anse 836 35.6 958 34.9 Nippes 344 45.5 174 32.7 121 29.2 Nord 1 716 40.5 1 754 41.2 1 235 42.4 Nord-Est 1 278 35.8 1 059 37.2 989 39.4 Nord-Ouest 941 32 1 086 35.8 754 37.5 Ouest 6 484 38.8 5 106 38.2 4 451 44.2 Sud 1 018 28.2 1 065 28.5 790 34 Sud-Est 607 32 601 35.8 481 39.8 Total 17 220 36.4 15 294 35.9 11 452 39.6 12 MSPP Deliveries Période Janvier à Mars 2022 Janvier à Mars 2023 Janvier à Mars 2024 Département / Données Accouchements Institutionnels Accouchements Non Institutionnels Accouchements Institutionnels Accouchements Non Institutionnels Accouchements Institutionnels Accouchements Non Institutionnels Artibonite 4 088 1 698 3 413 1 586 2 303 1 737 Centre 4 348 594 4 081 516 1 894 730 Grand-Anse 806 981 698 1 053 Nippes 648 105 527 185 369 91 Nord 3 129 1 377 2 573 1 165 2 127 1 068 Nord-Est 1 594 891 1 576 787 1 194 766 Nord-Ouest 1 734 606 1 835 691 1 037 453 Ouest 5 491 4 838 4 232 4 030 3 177 3 472 Sud 2 718 282 2 870 297 2 360 276 Sud-Est 767 379 922 278 513 261 Total 25 323 11 751 22 727 10 588 14 974 8 854 13 Children fully vaccinated MSPP Période Janvier à Mars 2022 Janvier à Mars 2023 Janvier à Mars 2024 Département / Données Nombre d’enfants completement vaccinés Nombre d’enfants completement vaccinés Nombre d’enfants completement vaccinés Artibonite 4 948 3 396 4 313 Centre 2 101 2 200 2 773 Grand-Anse 1 763 1 920 1 719 Nippes 1 893 1 701 1 014 Nord 5 106 5 227 4 877 Nord-Est 3 171 2 273 2 863 Nord-Ouest 2 852 2 703 1 791 Ouest 8 639 9 453 9 864 Sud 1 964 1 884 1 906 Sud-Est 933 1 369 1 160 Total 33 370 32 126 32 280 14 MSPP Nutrition Période Janvier à Mars 2022 Janvier à Mars 2023 Janvier à Mars 2024 Nombre de Femmes Nombre de Femmes enceintes enceintes MAM/MAS PB<210mm prises en charge (MAM/MAS) Nombre de Femmes Nombre de Femmes enceintes enceintes PB<210mm MAM/MAS prises en charge (MAM/MAS) Département / Données Nombre de Femmes enceintes PB<210mm (MAM/MAS) Nombre de Femmes enceintes MAM/MAS prises en charge Artibonite 143 499 160 331 174 399 Centre 53 31 52 35 32 25 Grand-Anse 187 123 63 14 Nippes 3 3 10 5 14 7 Nord 27 21 64 46 59 28 Nord-Est 59 43 54 28 42 11 Nord-Ouest 164 425 236 540 102 314 Ouest 92 165 73 254 49 65 Sud 74 177 742 62 67 64 Sud-Est 7 21 4 11 1 1 Total 809 1 508 1 458 1 326 540 914 15 MSPP Chronic Diseases Période Janvier à Mars 2022 Janvier à Mars 2023 Janvier à Mars 2024 Nombre Nombre Nouv Nomb Ancien Nouve Nouve Nomb Ancien Nouveau Ancie Nouve Nombr Ancie Nombr Ancien Nouv Nombr de décès de décès eaux re de Anciens Nouveau Nombre de s cas aux cas Ancie Nouveau Nombre Anciens aux re de s cas x cas ns aux e de ns cas Département / Anciens Nouveaux e de s Cas eaux e de | | cas décès | Cas x Cas décès | insuffi insuffis ns Cas x Cas de décès Cas Cas décès | insuffis insuffisa Cas Cas décès | insuffi Insuffisa Insuffisa insuffi Insuffi Données Cas HTA Cas HTA décès | Diabèt Cas décès | Diabèt Diabèt ance nce Diabè Diabèt Diabèt sance Diabète Diabète Diabète sance ance HTA HTA | HTA HTA HTA e HTA HTA nce nce sance sance rénale rénale e e rénale rénale te e e rénale rénale rénale rénale rénale Artibonite 4 697 4 318 2 017 1 654 Centre 4 893 2 706 Grand-Anse 1 819 Nippes 4 1 5 1 804 348 125 10 652 5 321 139 2 2 1 306 1 169 10 492 231 4 2 Nord 6 023 5 435 6 1 624 1 113 2 Nord-Est 915 1 238 547 203 Nord-Ouest 1 108 1 361 2 234 165 3 Ouest 7 944 6 482 40 3 158 1 931 15 78 Sud 2 153 6 504 808 1 189 8 21 Sud-Est 1 661 1 425 2 339 164 Total 32 519 31 290 66 10 344 7 137 1 3 852 4 137 4 156 2 913 1 861 568 3 1 627 1 288 3 14 4 931 4 966 6 1 413 1 014 21 42 979 1 091 2 469 144 28 53 16 1 137 1 533 1 226 142 2 12 8 196 6 335 37 3 182 1 681 11 104 2 149 6 182 4 1 141 1 689 1 4 1 848 1 666 2 356 30 736 30 679 67 9 846 6 454 1 46 2 29 38 253 165 4 2 13 1 321 873 788 413 319 85 631 185 3 1 4 1 3 220 3 876 1 139 1 053 1 53 14 2 803 2 603 1 573 342 2 6 9 6 732 901 1 384 143 4 1 1 5 779 5 139 16 1 485 1 158 4 4 3 228 27 2 577 1 027 227 193 2 1 730 986 95 116 5 39 4 4 175 4 266 32 1 206 974 13 13 4 1 699 3 976 5 835 1 096 3 1 307 1 486 5 170 24 26 0 60 6 114 5 265 5 22 197 168 12 21 022 190 33 12 11 2 24 19 1 40 62 8 7 9 1 4 13 69 150 16 12 MSPP SIGL 17 Essential medicines available at the beginning of the month (1) MSPP Données / Département Artibonite SIGL | PME - Acide Folique 5 mg Cp SIGL | PME - Albendazole 400 mg Cp SIGL | PME - Amoxicilline 250mg/5ml, Susp Buv, 100 ml SIGL | PME - Amoxicilline 500 mg gel. SIGL | PME - Ampicilline 1 g PPI Inj SIGL | PME - Ampicilline 500 mg PPI Inj SIGL | PME - Benzathine Benzyl penicilline 2.4 M UI PP Inj SIGL | PME - Carbamazepine 100mg/5ml Sp, 100 ml SIGL | PME - Carbamazepine 200 mg Cp SIGL | PME - Ceftriaxone 1g PPI Inj SIGL | PME - Chlorure de Potassium 10% Inj, 10ml SIGL | PME - Chlorure de sodium 0.9% solute pour Perfusion, 500ml SIGL | PME - Chlorure de sodium 0.9% solute pour Perfusion, 1000ml SIGL | PME - Ciprofloxacine 500 mg Cp SIGL | PME - Co-trimoxazole 240mg/5ml Susp Buv, 120ml SIGL | PME - Co-trimoxazole 480 mg Cp SIGL | PME - Compresse 40 cm x 40 cm sterile SIGL | PME - Coton hydrophile 500 g SIGL | PME - Dexamethasone 4mg/1 ml Inj SIGL | PME - Dextrose 5% Solute pour Perfusion, 1000 ml SIGL | PME - Dextrose 5% Solute pour Perfusion, 500 ml SIGL | PME - Diazepam 10mg/2ml Inj SIGL | PME - Diclofenac 75mg/3ml Inj SIGL | PME - Eau Pour Preparation Inj, 5ml SIGL | PME - Epinephrine ( Adrenaline) 1mg/1 ml Inj SIGL | PME - Erythromycine 250 mg Cp SIGL | PME - Fer + Acide folique 200mg/0.25mg Cp SIGL | PME - Fluconazole 150 mg gel. SIGL | PME - Furosemide 20mg/2ml Inj SIGL | PME - Furosemide 40 mg Cp Centre 30 000 1 024 Mars 2024 Grand-Anse Nippes 22 1 009 Nord 58 879 24 706 Nord-Est Nord-Ouest 280 250 Ouest Sud Sud-Est 266 Total 89 159 26 268 7 2 948 1 852 80 166 956 4 307 8 900 400 240 866 4 961 109 801 9 919 7 6 000 459 185 100 9 193 4 494 316 100 520 115 107 15 293 5 476 616 7 432 439 2 335 85 2 799 65 000 254 10 3 379 10 200 58 83 248 2 224 95 730 41 2 1 230 60 1 333 4 000 220 28 250 65 532 1 054 365 2 773 1 500 696 45 110 71 252 1 750 438 3 133 66 1 025 545 1 636 23 20 43 254 5 110 2 159 488 5 313 113 154 4 275 2 831 21 100 3 270 1 035 30 10 200 25 700 170 190 2 700 170 267 5 846 3 747 499 15 513 243 854 4 543 3 241 25 670 10 459 504 11 105 000 65 220 1 700 7 19 33 18 Essential medicines available at the beginning of the month (2) MSPP Mars 2024 Données / Département Artibonite Centre Grand-Anse Nippes Nord Nord-Est Nord-Ouest Ouest Sud Sud-Est Total SIGL | PME - Gant chirurgical latex sterile, paire 650 3 574 2 365 26 6 615 SIGL | PME - Gant d'examen latex (gant propre), paire 11 200 111 342 4 400 56 126 998 139 10 2 218 71 725 38 850 84 1 290 3 317 2 129 2 8 229 2 646 9 11 474 45 97 1 689 SIGL | PME - Gluconate de Ca++ 10% (100 mg/ml) Inj, 10ml SIGL | PME - Griseofulvine 250 mg Cp SIGL | PME - Hydrochlorothiazide 25 mg Cp secable SIGL | PME - Ibuprofene 400mg Cp 13 300 22 000 SIGL | PME - Insuline intermediaire NPH 100 UI/ml Inj, 10 ml 52 SIGL | PME - Intranule avec ailettes (Intracath) 18 G - 24 G 559 SIGL | PME - Ketamine 500mg/10ml Inj SIGL | PME - Metoclopramide HCl 10mg/2ml Inj 120 77 1 373 20 151 SIGL | PME - Metronidazole 125mg/5ml Susp Buv, 100 ml 220 961 29 SIGL | PME - Metronidazole 250mg Cp SIGL | PME - Miconazole 2% Cr, 30gr SIGL | PME - Nifedipine 10 mg Cp SIGL | PME - Nystatin 100 000 UI Cp Vaginal 10 000 449 1 200 23 990 288 29 557 2 760 7 045 49 100 100 150 31 94 SIGL | PME - Oxygene, gaz pour inhalation, Bouteille, 50 l 149 1 645 2 183 1 210 400 94 SIGL | PME - Oxytocine 10 UI/ 1 ml Inj 170 SIGL | PME - Paracetamol 160mg/5ml Sp, 60 ou 100 ml 738 SIGL | PME - Paracetamol 500 mg Cp SIGL | PME - Perfuseur sterile, une voie +aiguille 22 G + prise d'air 63 000 SIGL | PME - Phytomenadione ( Vitamine K1) 10mg/ 1ml Inj 2 302 88 110 64 167 41 035 1 186 30 951 2 860 94 1 918 5 3 762 106 80 110 079 10 497 183 656 96 4 768 548 5 412 30 1 200 98 1 328 SIGL | PME - Polyvidone iodee 10% sol U. Ext, 200 ml 115 4 211 171 4 497 SIGL | PME - Ringer lactate Solute pour Perfusion Inj, 1000 ml 604 2 822 838 SIGL | PME - Ringer lactate Solute pour Perfusion Inj, 500 ml 2 093 18 12 96 SIGL | PME - Sels de rehydratation orale (SRO) F/OMS sachet 3 800 SIGL | PME - Seringue 3 pieces 21 G, 10 ml avec aiguille 84 1 627 4 276 96 7 938 12 088 74 23 984 1 127 6 829 5 690 34 13 680 SIGL | PME - Seringue 3 pieces 21 G, 5 ml avec aiguille 1 020 12 617 4 750 37 18 424 SIGL | PME - Serum antitetanique 1500UI/1 ml Inj, Unidose 2 66 10 78 SIGL | PME - Sulfate de Magnesium 500mg/ml, 10ml 32 360 200 592 SIGL | PME - Tetracycline 1% pommade ophtalmique, 5 g 14 218 52 284 19 nd The 32 Meeting of Chief Medical Officers: • Note the presentation by Haiti entitled “Humanitarian Situation And Health Sector In Haiti (April 2024)” which highlights the issue of violence as a public health issue • Express solidarity with Haiti during the ongoing humanitarian crisis • Strongly recommend that CARICOM advocate for Haiti to bring this presentation to the agendas of WHA, COHSOD, and PAHO Directing Council