WASHINGTON — With Covid cases rising in Haiti, the World Health Organization has been urging the vaccination of medical professionals, but for Dr. Eugene Maklin, who built a hospital from scratch in Cap-Haitien, the only option is to find a way to get to the U.S. where vaccines are plentiful.
"Covid-19 is very scary and everyone is panicked," Maklin told NBC News from his New Hope Hospital in the northern Haitian city. "Every day we see 15 to 20 cases."
More than a year into the pandemic, the poorest country in the Western hemisphere, has not yet started vaccinating its health-care workers, much less its population — and as many as four-fifths of hospital workers might reject vaccines even if they were available.
The Biden administration announced that the U.S. will buy 500 million Pfizer vaccine doses for developing countries, including Haiti, but it's unclear when those donations will arrive. Eighty million doses from U.S. stocks are due to be shipped out soon to Brazil but so far none to Haiti.
Meanwhile, vaccines that have been promised have not yet arrived, while thousands of other doses just a short plane ride away in the U.S. expire unused because of lack of demand.
About 130,000 doses of the Astra Zeneca vaccine were supposed to arrive in Haiti on June 14 but because of production delays in India, they have been indefinitely delayed, according to the Pan American Health Organization (PAHO).
"That's the problem, we don't know when they will be made available, " said Maklin.
PAHO told NBC News earlier this week that production issues have slowed vaccine rollout.
In a statement, a White House official said, "As a vital part of our commitment to share at least 80 million safe and effective COVID-19 vaccines, the Biden administration is actively engaging with Haitian government officials on how to get vaccines to Haiti as soon as possible. While no plans have been finalized, we hope to share more news on our commitment to Haiti in the immediate future."
The U.S. embassy in Haiti, the Haitian embassy in the U.S. and the Haitian health ministry did not immediately respond to requests for comment.
The true level of infection in Haiti is unknown, but its population of 11 million is densely packed together, often in unsanitary conditions. It is the only country in the Americas that is a member of COVAX, the global vaccine consortium run by the World Health Organization, that has not yet started vaccination.
And Maklin said even though he has been encouraging vaccine acceptance, there is reluctance among fellow Haitians to take the Astra Zeneca vaccine because it was initially rejected by the Haitian government due to concerns about blood clots. Maklin says there is more trust in the Pfizer and Johnson & Johnson vaccines.
Five hours away in Port au Prince, Father Richard Frechette faces two intertwined crises at St. Luke's Hospital, which he founded: escalating gang violence and rising Covid cases. He has 115 Covid beds but says he can only use 90 because of a lack of oxygen for patients. To refill oxygen tanks, his staff has to weave through gang wars to the factory where they can be refilled.
"It is hair raising — but will be more so if we fail at this routine and see many suffocate at our center," he wrote in an email. "Certain days with the gang wars the workers at the factory cannot arrive, so there is no production. This is total panic."
Frechette said he got on the phone with a gang leader this week to try and convince him to allow safe passage for his medical staff since the gangs might need their life-saving care.
Just a two-hour flight away in Miami, while Florida is a top ten state in infection rates, it is close to the national average in terms of fully vaccinated adults and Covid cases are declining. Government-run mass vaccination sites have been shut down due to lack of demand, and 5.7 million vaccine doses intended for Florida residents have been returned to the federal government's supply because they would otherwise go to waste.
On June 11, more than 90,000 Covid vaccine doses at Florida providers expired, according to state health officials. At Miami's CVS pharmacy locations, hundreds of vaccination appointments remain unfilled this week.
Father Frechette says a handful of his staff with visas flew to the U.S. to get vaccinated and about 30 more got special permission to get the vaccine from the nearby U.S. embassy, but efforts to get expiring shots donated from the U.S. have fallen flat.
Barbara Campbell of the Cleveland, Ohio-based Dalton Foundation has been conducting informal surveys of Haitian health-care workers and hosting biweekly calls with medical teams on the ground. She estimates 80 percent of the medical staff in Haiti are vaccine resistant due in part to widespread misinformation.
She said her organization was contacted by some U.S. state health officials offering their expiring Johnson & Johnson vaccines, but the officials ultimately concluded they could not send them independently without approval from the U.S. government that has still not come.
Father Frechette said he did the rounds on his Covid ward this week and was heartened to see some beds had emptied out. He said just 5 percent of the patients had been “discharged to heaven.” He says he is certain, however, that the beds will fill up again very soon.
Among the Covid cases in his ward are elderly nuns who have been devoted to caring for Haiti’s poor. Father Rick said one of them, Sister Rose, recently had the oxygen saturation level in her blood fall from 94 to 80 percent.
“She had been doing great, now she is in danger,” he wrote. He added that she would have benefited from all the things he doesn’t have, like remdesivir — and vaccine.
“She would have been a great candidate for vaccination.”