WASHINGTON, DC, United States (AFP) — While fighting between criminal groups in Haiti decreased during 2024, attacks on civilians have risen, including an expanded use of “horrific sexual abuse”, according to a new report by Human Rights Watch (HRW).

“Criminal groups have often used sexual violence to instil fear in rival territories,” the New York-based group says.

“The rule of law in Haiti is so broken that members of criminal groups rape girls or women without fearing any consequences,” according to HRW researcher Nathalye Cotrino.

HRW said it conducted scores of in-person and remote interviews with survivors of sexual abuse in the impoverished Caribbean nation, as well as with officials and rights and humanitarian workers.

It said that from January to October of this year, “nearly 4,000 girls and women reported sexual violence, including gang rape”.

And it cited United Nations research showing cases involving children were up 1,000 per cent from the 2023 period.

“The bandits don’t care about their age,” one aid worker said. “They rape because they have the power. Sometimes they do it for days or weeks,” leaving some survivors pregnant — in a country that bans abortion — or injured without access to care.

One 25-year-old mother said she was gang-raped by four men while looking for water for her children.

“They didn’t used to do this, but now they do whatever they want,” she said.

Rape has become so “normalised that most women who come to us say, ‘They raped me, but at least they didn’t kill me’,” one humanitarian worker is quoted as saying.

The escalating violence has left the health system on the brink of collapse.

Doctors Without Borders, known by its French acronym MSF and which long provided free emergency care across Haiti’s capital city Port-au-Prince, suspended service there following attacks on its personnel as well as “death and rape threats against MSF staff from members of the Haitian National Police”.

The latter attacks followed allegations that MSF provided medical support to criminal groups. The organisation says it “provides care to everyone based solely on medical needs”.

HRW called on the international community to urgently increase funding to support a response that improves security while respecting human rights.

Among other steps, it urges the Government to decriminalise abortion; provide adequate support for abuse victims; and discipline police officers who have threatened the MSF.