On March 14^th, thousands of doctors and nurses across Haiti went on strike to protest inadequate security amidst a rise in gang-related kidnappings. The most recent incident involved two doctors who were abducted the week before the strike, prompting Port-au-Prince’s General Hospital to join the protest and shut down. Across the country, only emergency rooms remained open in many hospitals. As high rates of violence and a sluggish pandemic response continue to strain Haiti’s medical system, the health worker strikes threaten to exacerbate the country’s ongoing crisis.

Haiti has been in turmoil since the assassination of President Jovenel Moïse last July, followed by a 7.2-magnitude earthquake just days later that killed 2,200 people. Left with no president and no stable government, gangs seized the opportunity to take power. According to Crisis Group, these armed gangs are overwhelmingly made up of young men from the poorest urban areas who lack viable employment options. Kidnappings are one of the major ways these gangs finance themselves.

Gang members will often abduct victims for ransom from the grid-locked streets of Port-au-Prince whenever an opportunity presents itself, the Guardian reports. Such incidents have increased by 180% since last year, making Haiti the kidnapping capital of the world. When one gang abducted 16 American missionaries and 7 clergy members last year, the Archdiocese of Port-au-Prince warned that Haiti was entering a “descent into hell.”

“We are living in a catastrophic situation where no one is protected,” Dr. Louis Gerald Gilles told AP News after closing his private practice on the 15^th to join the health worker protests. Hospital union workers have criticized Prime Minister Ariel Henry for not releasing funds to the Ministry of Health for essential services. These obstructions to the healthcare system are especially dangerous given that Haiti remains vulnerable to future COVID-19 outbreaks. With only 1% of its population vaccinated, Haiti ranks second worst in the world on the International Rescue Committee’s 2022 Emergency Watchlist.

Haiti is already the western hemisphere’s poorest country, and an exacerbated health crisis will only destabilize its economy further. If Haiti does not put security provisions in place to end the strike soon, health outcomes there could deteriorate and deepen the country’s economic slump. What’s worse, some observers fear that a continued lack of employment opportunities might strengthen the gangs’ ranks.

Prime Minister Henry has vowed to crack down on the surge in gang violence, and the U.S. is among the countries that have pledged resources to bolster the under-resourced police force. (International attention only focused on the issue after Americans fell victim to the kidnappings, however.) The Congressional Black Caucus has made halting expulsions and providing accommodations to the waves of Haitian migrants arriving on American shores one of the top items on its agenda to the Biden administration. This is at best a temporary solution, though, and is limited by competing efforts to accommodate Afghan refugees fleeing the Taliban takeover and Ukrainian refugees fleeing the Russian invasion.

It is critical that foreign nations and multilateral aid organizations do not send in their own people to resolve the security crisis in Haiti’s hospitals. For one, the power vacuum since Moïse’s assassination means that foreign involvement of any kind will likely be met with hostility. Any foreign security provisions would incite political uproar. For another, sending in even non-political humanitarian workers to offset the strike’s effects is problematic because they will be high-reward targets for future kidnappings. Instead, international aid should be channelled through local civil society initiatives. This not only avoids politically charged foreign involvement, but also provides opportunities for Haitians on the ground to direct their own safeguarding efforts.

In the meantime, the U.S. should cease deportations to avoid putting further weight on Haiti’s already-overtaxed institutions.

More broadly, foreign actors can indirectly support healthcare in Haiti by funding N.G.O.s capable of delivering vaccine services where governments cannot. Chief among these is the International Rescue Committee, which has announced that it needs only $96 million – equivalent to 0.006% of the US health budget⁠ – to vaccinate nearly 16 million people in the world’s worst crisis zones.