On the heights of Port-au-Prince, patients continue to push the doors of health centers weakened by insecurity and years of underinvestment. With the support of the Humanitarian Fund for Haiti, healthcare workers maintain services and facilities are being rehabilitated to preserve access to care, which has become increasingly difficult. At the Jalousie Health Center in Pétion-Ville, Nayra, who is 22 days old, rests in her mother Michaelle Belizaire's arms while waiting for her consultation, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) in a report. When their turn comes, a healthcare worker measures the oxygen level in Nayra's blood. The examination takes less than a minute. It is a routine gesture, but access to routine care has become increasingly difficult throughout the metropolitan area. Health centers under pressure Across Port-au-Prince, armed violence has displaced families, disrupted essential services, and limited movement between neighborhoods. Jalousie, Kenscoff, and Fermathe are mountainous areas in the Port-au-Prince district. In Kenscoff, in the southeast of the capital, an armored police vehicle is parked in front of the health center. Inside, the years of underinvestment are visible. The paint is peeling off the damp walls, the equipment is aging, and several rooms no longer serve their original purpose. In Fermathe, the radiology service remains closed. Patients' records are kept in stacks of paper folders, while humidity has damaged the walls and infrastructure. Nevertheless, patients continue to come. In Kenscoff, a nurse prepares for a blood draw. In Jalousie, another nurse takes care of mothers waiting with their young children one after the other. Despite the increasing difficulties, healthcare workers continue to provide care. Supporting essential services Since April 2026, the AVSI association has supported four health facilities in the West Department: Jalousie, Kenscoff, Fermathe, and the Sainte-Catherine Labouré Hospital. This action is part of a multisectoral emergency response funded by the Humanitarian Fund for Haiti and implemented by a consortium led by ACTED, with Concern Worldwide and Solidarités International. This support aims to maintain services while improving the conditions in which patients receive care. At Jalousie, planned work includes improving the entrance and waiting room, rebuilding the access ramp, and creating additional spaces to better preserve the privacy of patients during consultations. In Kenscoff, two prefabricated structures will increase the center's capacity by accommodating a pediatric unit and consultation rooms. The rehabilitation will also include repairs. In Fermathe, renovations will focus on the entrance, maternity ward, and radiology service. Equipment and protective infrastructure are planned to allow the resumption of services safely. The facilities also receive medicines and equipment. Their delivery has become increasingly difficult, as insecurity disrupts access and supply routes. On August 27, AVSI delivered medicines and health products to Fermathe Hospital, contributing to maintaining services for communities affected by recent violence. The support also extends beyond fixed facilities. Mobile clinics reach people who face difficulties accessing care, including communities affected by displacement and insecurity. AVSI supports the care of children suffering from acute and moderate malnutrition, as well as prevention services for pregnant and breastfeeding women. Following the recent intensification of violence in Kenscoff, the program has expanded its support to newly affected households, providing temporary economic assistance to 3,750 of the most vulnerable families over a three-month period. Healthcare workers also receive additional training, while nutrition, protection, and food security activities continue alongside health services. What it means to stay open The improvements to infrastructure have strengthened the quality of care and will allow, in some cases, to expand the services offered. Women coming for prenatal consultations no longer wait under leaking roofs. Examinations have more space, diagnostic services are functioning, and medicines are available when needed. In Kenscoff, these improvements mean a dedicated space for children receiving care, and in Fermathe, the reopening of a radiology service that had been silent for years. For Michaelle, it means that she may one day be able to return with Nayra to a facility that is easier and safer to access. Healthcare workers will be able to return to better working conditions to continue serving their communities. For the people who arrive every morning, these improvements mean something simple but essential: the doors remain open and someone is there to welcome them, thanks to the generous support of donors to the Humanitarian Fund for Haiti. NOTE: The photos and testimonies from this report were collected in June 2026. Since then, the security situation in Kenscoff has deteriorated significantly, with repeated attacks by armed groups. The attack that occurred during the night of August 23 to 24 would have caused more than 47 deaths, 22 injured, 50 people kidnapped, and more than 4,200 displaced. Despite this deterioration, the four facilities supported by AVSI were still operational as of October 1, 2026.