Frontline World

HAITI - The Struggle for Water, October 2004
a FRONTLINE/World Fellows project

Haiti: The Struggle for Water
The CommunityThe FamilyThe Water TrucksThe Street SellersThe HospitalThe Vodou Ceremony
IntroductionMore Info On The EnvironmentMore Info On The Water SystemReact
The hospital exterior; Woman with sick baby in background; Woman wasing baby

THE HOSPITAL -- "Water Is Life"

A shriek like breaking glass shattered the quiet hum of the pediatrics ward as a mother wailed at the death of her newborn. A crowd gathered at the door while the woman collapsed on the floor. Yet the staff continued their work -- the nurses perusing their charts, the doctors continuing a meeting -- as the baby's body lay wrapped in a white blanket. Haiti has one of the highest infant mortality rates in the world. About 79 of every 1,000 babies born die before the age of 1. Babies die here all the time.

The pediatrics ward at Justinian Hospital in the northern city of Cap-Haïtien operates far below international standards. They are short on equipment, medical supplies, medication and, most important, water. Pediatrics has no running water: no water for cleaning the hospital, bathing the patients or drinking. The nurses complain that they don't even have water to wash their hands between patients.

"We don't have enough support for the water," Ingrid Manijat, a nurse at the hospital for 18 years, told me. "The children, they are very fragile, and they need water to drink, water to be cleaned."

Yet water is so scarce that parents and relatives of the patients have to supply their own. "We've been here for 13 days," Alexis Perilio, a young mother whose child has a heart condition, told me. "We brought food and water with us, but we are out, so my sister is out looking for food and water."

Justinian Hospital is a 300-bed facility that serves roughly 600,000 people from Cap-Ha´tien and surrounding areas. During the dry season, only one of the two wells on the hospital grounds functions. According to the International Plumbing Code, 30,000 to 40,000 gallons per day is suggested for a 300-bed hospital. Currently the hospital operates using 6,000 gallons per day.

Although the Haitian Ministry of Health runs the hospital, it is the Service National d'Eau Potable (SNEP), Haiti's national water service, that is supposed to be in charge of providing the hospital with water. Yet SNEP does not have the resources to help. At the time of my visit, only the maternity ward and the emergency and operating rooms had running water, and even then the water pressure was insufficient. The water pressure (measured in pounds per square inch, or psi) at the hospital is from 2 psi to 10 psi. Most municipal systems in the United States operate at 40 psi to 80 psi.

At the back of the hospital, women straddled crude benches in front of washbasins and scrubbed all of the hospital's laundry by hand. The grass beside them looked like a patchwork quilt, littered with doctors' scrubs and bed sheets drying in the sun.

"You've got people with all kinds of diseases; they are washing the scrubs by hand," Hugh Tozer, an American public engineer, told me. "They can't get the temperature of water hot enough to sterilize, so they are exposing themselves to some pretty nasty diseases just by doing the laundry." Tozer volunteers with the Maine-based nonprofit Konbit Sante (konbit is a method that Haitians use to help till one another's crops, and sante is the Creole word for "health"). The organization ( has partnered with Justinian Hospital in order to help improve overall conditions there. Tozer, in charge of improving the water situation, has made several trips to Haiti to assess the needs of the hospital and explore solutions.

The hospital needs new wells dug and an overhaul of the plumbing system to protect the water from contamination. Tozer says that short-term solutions -- a new well and a disinfection system -- would cost about $25,000. And any long-term projects -- a rain capture system or an overhaul of the municipal water system -- will be in the range of $2 million.

The United States Agency for International Development has recently committed some funding to help the hospital's water situation. But Konbit Sante will have to secure more funding to meet all of the hospital's needs, and Dr. Antoni Constance, the organization's director, has a wish list a mile long. He wants an ambulance, a blood bank and a new conference room -- but most important, Constance wants water.

"The water is the main problem because water is life," he says.

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