Haiti has been plagued by worsening gang violence since the 2021 assassination of its then-President Jovenel Moïse with gangs controlling around 90% of the capital.
The number of sexual abuse cases being treated at a clinic in Haiti's capital has tripled in the past four years as gang violence surges across the troubled Caribbean country, a health charity warned on Wednesday.
Doctors Without Borders (MSF) said it was "alarmed and outraged" by the overwhelming level of sexual and gender-based violence.
"The extent to which numbers have increased, it has shocked us," Diana Manilla Arroyo, the group’s head of mission in Haiti, said in a phone interview.
"It is not only the numbers, but the severity."
More than half of the patients being treated at the Pran Men’m clinic, which opened a decade ago in Port-au-Prince, were attacked by multiple members of armed groups, the charity said in a new report.
"Over 100 individuals were attacked by 10 or more perpetrators at a time," it said, noting an average of three perpetrators per case.
The clinic has treated nearly 17,000 patients in the past decade, including 2,300 in the first nine months of last year. More than 350 of those patients are boys and men, MSF said.
The demographics of those being attacked has also changed. Prior to 2022, half of all cases at the clinic involved patients younger than 18, compared with 24% today.
The number of cases in the 50-80 age range has increased sevenfold, according to MSF.
Control and power
Armed gangs control an estimated 90% of Port-au-Prince, with many resorting to sexual abuse to instil fear, experts say.
The abuse occurs during kidnappings, territorial takeovers and to control humanitarian aid, according to MSF.
"Armed groups are using sexual violence to terrorise, control and subjugate communities," Manilla said.
The report citied one 53-year-old unidentified woman who said she was raped by three men young enough to have been her children.
"They beat me and broke my teeth," she was quoted as saying. "After raping me, they also raped my daughter."
At particular risk are those living in makeshift shelters, with gang violence displacing a record 1.4 million people across Haiti in recent years, according to the United Nations.
A 34-year-old woman quoted in the report noted that young women and boys are mixed together at shelters.
"Mothers are forced to stay close because when a child begins to grow, they can become a target for rape at any moment," she said.
Nearly 70% of people who sought help between January and September 2025 after being sexually abused were displaced, according to the UN.
Fear over reporting sexual abuse cases persist because of ongoing stigma and a lack of faith in Haiti’s police and justice system.
Worsening conditions
The number of people uprooted by gang violence in Haiti has more than tripled in the last year to hit a record high of at least 1 million, the UN migration agency said last year.
The International Organization for Migration (IOM) said the situation is particularly severe in Port-au-Prince where "relentless gang violence" has fuelled a near-doubling of internal displacement and the collapse of healthcare and other services.
The forced return of around 200,000 people, mostly from neighbouring Dominican Republic, to Haiti has worsened the crisis, according to the UN agency. Both countries share the Caribbean island of Hispaniola.
Haiti has been plagued by worsening gang violence since the 2021 assassination of its then-President Jovenel Moïse.
Armed gangs now control most of Port-au-Prince and the arrival of a UN-backed multinational security force has had little impact so far.
More than 5,600 people were reported killed in Haiti in 2024, up 20% on 2023, according to data released by the UN Human Rights Office.