Early in the morning of January 24, heavy fighting erupted between UN Stabilization Mission in Haiti troops (MINUSTAH) and local armed groups in the Port au Prince slum of Cité Soleil. In the following 48 hours, the St. Catherine hospital, which is supported by Médecins Sans Frontières (MSF), received 17 people with gunshots wounds. Among them were six women and a five-year-old child. A woman was wounded by a tear gas container.

"A woman who had a gunshot wound arrived at the hospital in a desperate condition. She was immediately transferred to the operation theatre, but unfortunately she did not survive," said Fabio Pompetti, Head of Mission for the MSF program in Cité Soleil. "Once again the situation has deteriorated in this area of Port-au-Prince and the population finds itself trapped in a wave of violence and insecurity."

Cité Soleil is a deprived slum in the capital city, Port-au-Prince, where an estimated 200,000 people live amidst poverty and violence. In August 2005, MSF rehabilitated the only two health structures in the slum: the St. Catherine Hospital and the primary health centre of Chapi, both located in the heart of the slum. When MSF started its involvement, both structures had literally been abandoned because of insecurity.

"We reopened the St. Catherine Hospital in August 2005 and, thanks to our committed Haitian staff, we've never interrupted our around the clock activities," said Pompetti. "When heavy fighting erupts here the population of Cité Soleil face a war-like situation. The medical team immediately activates the emergency plan. At the entrance of the hospital patients go through a first medical screening and those in need are sent directly to the two operations theatres functioning inside the hospital."

Since last December, the situation in Cité Soleil has become more and more volatile with clashes erupting regularly between armed groups and UN troops. Civilians are often caught in the cross-fire and they are not even safe in their homes.

"A few weeks ago I was at home with my son when a stray bullet entered the house and hit me in the abdomen," said a 22-year-old patient hospitalized in St. Catherine. "I was immediately taken to the hospital here. That day there were many wounded with me. The doctors transferred me to the operation theatre. I was six months pregnant. I survived but my baby died."

Elsewhere a 14-year-old boy is assisted by his mother. His neck is completely patched and he can hardly breathe.

"He was sitting at home with me and we were eating", explained his mother. "Then a bullet hit him in the neck. He has already been operated on twice he has been in hospital for more than a month now."

In the last three days no more fighting has been reported inside Cité Soleil. However the situation remains extremely tense.

In St. Catherine hospital, in addition to emergency care to victims of violence, MSF also runs the paediatric, medicine and maternity ward with an average of 450 patients hospitalized, 1,500 consultations and 200 deliveries every month.

In Port-au-Prince, outside Cité Soleil, MSF runs other health facilities. In La Trinité hospital, in addition to trauma care and post-surgical rehabilitation, MSF offers specific care of psychological violence-related trauma. At the Jude Anne Hospital, MSF assists an average of 1,300 deliveries per months. Since June 2006, the Jude Anne hospital also has a program to prevent mother to child transmission of HIV.