Haiti faces a sexual violence and abuse crisis as gang violence spreads, health charity warns

Sexual Violence Crisis Deepens in Haiti as Gang Control Expands

Sexual violence in Haiti has reached alarming levels, with cases tripling over the past four years as gang control tightens its grip on the Caribbean nation’s capital, according to a new report from Doctors Without Borders (MSF).

The organization’s Pran Men’m clinic in Port-au-Prince has treated nearly 17,000 survivors of sexual violence since opening a decade ago, including 2,300 in just the first nine months of 2023. Medical staff report being shocked not only by the rising numbers but also by the increasing severity of attacks.

“The extent to which numbers have increased has shocked us,” said Diana Manilla Arroyo, MSF’s head of mission in Haiti. “It is not only the numbers, but the severity.”

More than half of patients seeking treatment were attacked by multiple members of armed groups, with some survivors reporting assaults by ten or more perpetrators simultaneously. The average case involves three perpetrators, reflecting the systematic nature of sexual violence as a weapon of terror.

Gangs now control approximately 90% of Port-au-Prince, employing sexual violence as a deliberate strategy to instill fear and assert dominance. These attacks frequently occur during kidnappings, territorial takeovers, and as a means to control humanitarian aid distribution.

“Armed groups are using sexual violence to terrorize, control and subjugate communities,” Manilla explained.

The demographic profile of victims has also shifted significantly. Before 2022, half of all patients treated at the clinic were under 18 years old, compared to just 24% today. Particularly concerning is the sevenfold increase in victims aged 50-80, suggesting a broadening of targets beyond traditional patterns of sexual violence.

The humanitarian crisis has created additional vulnerabilities, with the United Nations reporting a record 1.4 million people displaced across Haiti due to gang violence. Nearly 70% of sexual abuse survivors seeking help between January and September 2023 were displaced persons, many living in makeshift shelters with minimal security.

A 34-year-old woman quoted in the report highlighted the dangers in these settings: “Mothers are forced to stay close because when a child begins to grow, they can become a target for rape at any moment.”

Access to timely medical care has deteriorated markedly. Since 2022, the proportion of survivors who sought help at the Pran Men’m clinic within three days of their attack has dropped by half, from almost two-thirds to one-third. This delay means nearly 70% of patients arrive too late to receive post-exposure prophylaxis for HIV prevention.

Similarly, the percentage of patients seeking care within five days has fallen from 72% to 41%, leaving almost 60% of survivors without access to emergency contraception to prevent unwanted pregnancies.

Fear of reprisals, ongoing stigma, and lack of faith in Haiti’s police and justice system contribute to underreporting and delayed treatment. Civilians from neighborhoods controlled by gangs risk being attacked by vigilante groups if they seek medical care, as they may be automatically associated with the armed groups that control their areas.

The MSF clinic also faces challenges finding safe shelters willing to accept patients after treatment. Women with children, those who are pregnant, or those requiring ongoing medical care are frequently rejected by shelters.

“The lack of available services leaves survivors exposed to the same risks that led to their initial trauma,” the MSF report states. “Without safe shelter or relocation options, MSF discharges its patients straight back into the nightmare they came from, just to see them return another day after being violated again.”

Local initiatives are attempting to address the psychological trauma and stigma. Nègès Mawon, an independent Haitian feminist group, uses arts, theater, and music to create safe spaces for survivors to process their experiences.

“They find a way to understand their own reality, their own experiences,” explained Pascale Solages, the group’s coordinator, acknowledging the difficulty of this healing process.

MSF has called on Haiti’s government to allocate more funding toward free healthcare and support services for sexual violence survivors. The organization recommends establishing a 24/7 government-operated hotline to provide confidential guidance and connect survivors with critical resources as an immediate practical measure to address the crisis.

As gang violence continues to escalate throughout the country, the need for coordinated international response and sustainable security solutions becomes increasingly urgent for Haiti’s most vulnerable populations.