The health crisis linked to the COVID 19 pandemic highlighted the problems that may arise in Martinique in times of national and international health crisis. Indeed, the COVID 19 pandemic severely restricts the possibilities for health transfer to the hexagon. Patients, especially those with cancer or chronic pathologies, could not be transported to France as part of their therapeutic protocol and very often had to deal with the severe worsening of their pathology. The geographical distance of Martinique from France Hexagonale therefore has a particularly negative impact in times of health crisis on the care of its patients. In view of the local assessment of the effects of the pandemic and of the lockdowns (past, present and future effects), the CHU Martinique, in a spirit of resilience, has chosen to focus its efforts on redefining its medical sectors of excellence, but also by the creation of new medical services in order to no longer be under the yoke of health transfers and to be able to cope with a future pandemic or epidemic by ensuring the population the most effective global and local health care.