Caracol's Industrial Park...Not so Risky (Posted by Roger Annis-CHAN)

SAE-E's "risky" play in Haiti (Caracol Industrial Park)

 

By CEPR, October 23, 2012

http://www.cepr.net/index.php/blogs/relief-and-reconstruction-watch/sae-as-risky-play-in-haiti

 

As both Clintons and a coterie of celebrities and foreign investors flew into northern Haiti yesterday, some took the opportunity to praise Sae-A, the giant Korean garment manufacturer that opened a factory in the new Caracol industrial park. Hillary Clinton, for one, told reporters: "And I too want to thank Sae-A, because Sae-A took a decision that was something of a risk, never having worked in Haiti before, after a tremendous natural disaster that was so devastating. But they brought their expertise and they brought their commitment. And Chairman Kim, we thank you for everything that you and the leadership of Sae-A is doing."

 

But Sae-A's decision to set up shop in Caracol could hardly be described as risky, as almost the entire cost of the project was borne by other actors. The New York Times, in an in-depth July investigation into the new park in July, 2012, reported that the land was provided free of charge by the Haitian government, the physical infrastructure was provided by the Inter-American Development Bank for around $100 million, and the United States government chipped in $124 million for infrastructure, energy and housing services. The industrial park tenants are also granted significant tax-exemptions, and will only have to pay docking fees, which are estimated to be just $17,500 a year, hardly a boon to Haiti's coffers. Sae-A, which reported over $1.1 billion in export business last year, committed to spending just $39.2 million on the factory.

 

Additionally, U.S. legislation provides duty-free access to the U.S. market, which was used by Clinton to "woo" the apparel industry. Deborah Sontag of the Times sums it up: "In exchange, thanks to a deal that Secretary of State Hillary Rodham Clinton helped broker, Sae-A looked forward to tax exemptions, duty-free access to the United States, abundant cheap labor, factory sheds, a power plant, a new port and an expatriate residence outfitted with special kimchi refrigerators. "

 

Of course, it is also the case that if labor costs go up, subsidies end, or business doesn't boom, Sae-A can simply walk away. Though non-binding, a memorandum of understanding between the Haitian Ministry of Economy and Finance, the World Bank's International Finance Corporation, the IADB, and the United States Department of State includes the following provision: "It shall be acknowledged by the Participants that the continuation of participation under this MOU for Sae-A is contingent upon the existence of adequate infrastructure, labor force, labor policies, favorable access to export markets, access to sufficient funding and any other circumstances that affect the feasibility of investment by Sae-A."

 

Sae-A and other global apparel companies often compete in a race to the bottom, leaving countries in search of lower labor costs after wages rise. Due to rising expenses in Guatemala, Sae-A has closed their factory there. A local paper carried the story with the headline, "A Maquila Closes and Goes to Haiti." A Sae-A spokesperson also told the New York Times that once trade preferences for Nicaragua end in 2014, "a lot of product orders now going to factories in Nicaragua can go through the Haiti operation.? But what's preventing this from happening in Haiti down the road?"

 

Mr. Aguerre, of the IADB sums it up: "Yes, it's low-paying, yes, it's unstable, yes, maybe tomorrow there will a better opportunity for firms elsewhere and they will just leave. But everyone thought this was a risk worth taking."

 

So, though there may not be much risk for Sae-A, there is a definite risk for the people of Haiti. There's also conceivably a risk for the U.S. government, which is touting this as the "centerpiece" of their reconstruction efforts, as well as for the IADB, Haitian government and other entities that are providing financial backing for the project.

 

Two Years of Cholera...Posted by Roger Annis (CHAN)

Two years after the outbreak of cholera in Haiti, access to clean water and sanitation is desperately needed

Oct. 22, 2012, Washington, D.C. – On the second anniversary of the outbreak of the cholera epidemic in Haiti, human rights groups, faith-based organizations, policy institutes, and humanitarian organizations renew their call for the United Nations andU.S. government to help Haiti install the clean water and sanitation infrastructure necessary to control the ongoing epidemic.

The cholera epidemic in Haiti has received less U.S. attention during the presidential campaign season, but it remains a critical problem for this Caribbeanneighbor that is not being adequately addressed and is undermining broader aid efforts.  Last month, 260 new cholera cases were reported daily, and 2-3 children died a day.  Since the epidemic broke out in October 2010, 7,564 Haitians have reportedly died from cholera and some 600,000 persons (6% of the Haitian population) have been infected. The number is undoubtedly much higher, as cases in more remote areas are often unreported. As the World Health Organization has stated, those without access to safe drinking water, proper sanitation, and hygiene constitute the majority of cholera cases.

Two years after the epidemic started, not enough action has been taken to assist the Government of Haiti in acquiring essential water and sanitation infrastructure.  A regional coalition that includes the U.S. Centers for Disease Control and Prevention, and the World Health Organization is developing a plan with the Government of Haiti to build water and sanitation systems that will cost $2.2 billion. Despite this encouraging progress, the plan still needs to be finalized and funded before implementation can begin.

The U.N. especially has a legal and moral responsibility to play a leadership role in helping end the epidemic. Independent scientific studies have established that cholera was brought to Haiti by troops from the UN Stabilization Mission in Haiti (MINUSTAH) and that the waste disposal practices at the UN base allowed the bacteria to contaminate Haiti’s largest river system.  The undersigned groups call on the U.N. to commit long-term resources to work with the Government of Haiti to build water and sanitation systems that are critical to halting the continued spread of the disease.

This July, 104 members of Congress sent a letter to Susan Rice, U.S. Ambassador to the UN, requesting that she urge the world body to act decisively to addressHaiti’s cholera crisis. Congressional members Chris Smith and Albio Sires made a similar plea to Secretary of State Hillary Clinton.  The undersigned groups urge Ambassador Rice and Secretary Clinton to fulfill these important appeals and to call on the UN to help Haiti acquire the necessary funding to develop the water and sanitation infrastructure needed to stop the epidemic.

Signed,

Alternative Chance; American Jewish World Service; Canada Haiti Action Network; Center for Economic and Policy Research (CEPR); Center for Gender & Refugee Studies; Environmental Justice Initiative for Haiti; Grassroots International; Hastings to Haiti Partnership; Institute for Justice & Democracy in Haiti; Just Foreign Policy; li, li, li! Read; Mennonite Central Committee, U.S. Washington Office; New Media Advocacy Project; Other Worlds; The Haiti Support Group (UK); TransAfrica Forum

Press contact:: Nicole Phillips, staff attorney, Institute for Justice & Democracy in Haiti (IJDH), Nicole@ijdh.org, 510.715.2855
Web source: http://ijdh.org/archives/29141

Recent BBC News report on cholera: http://www.bbc.co.uk/news/world-latin-america-20024400

Partners in Health e-Advertisement Regarding Cholera

The numbers are staggering, John.

Since the epidemic began in Haiti two years ago, cholera has sickened more than 600,000 people and killed more than 7,500. Last year, Haiti logged more cases than all the rest of the world combined, according to the World Health Organization. 

This year the epidemic is on track to be among the world's worst again, with nearly 77,000 cases and 550 deaths, according to the Haitian Ministry of Health. We're continuing to see cases rise and fall with seasonal rains. Hurricane Sandy, which passed by Haiti last night, brought downpours that have swelled rivers and already contributed to an increase in cases.

There's another number I can't shake.

Zero.

That's how many cholera deaths we should be willing to accept. Cholera is a preventable, treatable disease that has been eliminated in the wealthy world through access to clean water and decent sanitation.

Baseball in the Time of Cholera, Money, and Mud Pies in Haiti.....by Roger Annis

 

1. Two years of the cholera epidemic in Haiti

 

October 18, 2012

 

Dear Reader,

 

Two years ago today, in the center of Haiti's verdant agricultural region, an innocent man fell victim to cholera; he was dead within hours from an illness never before known in Haiti’s history.  Over 7,500 deaths later, the epidemic, brought to Haiti by UN troops, continues to ravage Haiti's poor, killing hundreds each month and most recently re-surging in the wake of Tropical Storm Isaac.

 

Thanks to you, our committed supporters, IJDH and BAI continue fighting to end the epidemic by calling upon the UN to provide clean water and sanitation.  We also lead the fight for Haitians whose fundamental human rights have been violated as a result of rape, forced eviction, wrongful imprisonment, and other violations of their basic human rights.  We have been moved by your powerful response to the recent death threats against BAI Managing Attorney Mario Joseph and by your generous participation in the Giving Commons Challenge fundraiser.

 

To commemorate those who have lost their lives in this needless tragedy and to strengthen our mutual commitment to ending the epidemic, we invite you to watch (or watch again) the 29-minute, award-winning documentary Baseball in the Time of Cholera: http://www.youtube.com/watch?feature=player_embedded&v=BK318mYuBWg. 

 

With your continued support, on the third anniversary of the epidemic, we hope to be celebrating the installation of water and sanitation systems and justice for the Haitian people.

 

In Solidarity,

 

Beatrice Lindstrom, Esq.

IJDH Staff Attorney

 

Institute for Justice & Democracy in Haiti
666 Dorchester Avenue Boston, MA 02127
(617) 652-0876 | http://ijdh.org | info@ijdh.org

 

 

2. Film Screening in Winnipeg: Haiti: Where Did The Money Go?

 

Panel discussion following the film, with activists enaged locally in Haiti solidarity

 

Date: Thursday, Nov 22, 2012, 7 pm to 9 pm
At: Winnipeg Cinematheque, 100 Albert St. #304

Presented by: Winnipeg Film Group and Winnipeg Haiti Solidarity Group. Part of the ongoing series We Rise Above, generously sponsored by the Canadian Museum for Human Rights.

 

In the United States alone, half of all households gave a total of $1.4 billion to charities, yet almost two years later more than half a million people in Haiti still live in squalid camps. Only a few have access to drinking water. Sanitation is woefully inadequate. Malnutrition and cholera are on the rise. What happened?

 

Haiti: Where Did The Money Go? asks the pivotal question: why did so much money buy so little relief? And why are so many still living in squalor? Cameras take viewers to crowded camps where thousands of families live under tattered tarps beside overflowing latrines, and then into the board rooms of relief organizations, where journalist Michele Mitchell asks the American Red Cross and others about why conditions in Haiti continue to deteriorate when people have donated billions of dollars for aid. By Director Michele Mitchell | 2012 | U.S. | 53 min.

 

“On Monday night I went to Goldcrest to finally view a screening of Haiti: Where Did the Money Go? What I saw filled me with anger, sympathy, and many, many questions.” - THE OBSERVER (UK) 

 

 

3. A State of Denial

 

By Dr. John Carroll, published on Dr. CArroll's blog on the Peoria Daily Star, Oct 16, 2012http://www.pjstar.com/haiti_ugc_blog/x1708948256/A-State-of-Denial

 

In 2007, I posted that people in Soleil were so hungry they were eating mud. As people found out about this atrocity, I think they were in disbelief. One commenter wrote that maybe the lady who makes the mudpies in Soleil should "turn into a Mrs. Fields and export her mudpies to the States". *

 

In 2012 people in Soleil are still eating mudpies. Her "factory" is in the same location in an especially dangerous part of Soleil. And as you can see as of an hour ago [go to web link for photo] , she is still hard at work. She insists her dirt is special dirt from Hinche and she says she mixes it with butter, salt, and water. I think you can see the rivulet of toxic filthy water running beside her.

 

As a cigarette hangs from her lips, she slops the concoction together and forms saucer-sized circular mudpies that harden quickly in the Soleil sun.

 

Denial is good for us when it comes to thinking about this. It could not be happening, we tell ourselves. This can't be happening 90 minutes from Miami.

 

We need to make light of this. We need to deny.

 

* Mrs. Fields is a U.S. franchise that sells baked sweets.

 

 

4. Video of recent panel discussion on post-earthquake Haiti

 

October 17, 2012

 

A panel discussion on Haiti took place at the Congressional Black Caucus Foundation's 42nd Annual Legislative Conference that took place Sept 19-22, 2012 in Washington DC. The panel featured remarks by Representatives John Conyers and Maxine Waters as well as speakers from the State Department, USAID, Haiti's International Lawyers' Office (Bureau des Avocats Internationaux), the Institute for Justice and Democracy in Haiti, TransAfrica, and Alexander Main of the Haiti Reconstruction Watch project of the CEPR.

 

The panelists focused on the challenges facing Haiti as it continues to recover from the effects of the 2010 earthquake and the ongoing cholera epidemic. Among the issues discussed were international aid accountability and transparency, cholera and the United Nations Stabilization Mission in Haiti (MINUSTAH), access to affordable and sustainable housing and efforts to bring Jean Claude Duvalier to justice.

 

Panelists included:
Brian Concannon, Director, Institute for Justice & Democracy in Haiti
Ron Daniels,President, the Institute of the Black World 21st Century
Joel Danies, Deputy Special Haiti Coordinator for Political Affairs, US State Department
Elizabeth Hogan, Director, USAID’s Haiti Task Team
Mario Joseph, Director, Bureau des Avocats Internationaux
Alexander Main, Senior Associate for International Policy, Center for Economic and Policy Research
Melinda Miles, Director, Let Haiti Live/TransAfrica

 

Watch the video here:

Part one (one hour): http://www.youtube.com/watch?v=C8UYR5JNRH0

Part two (one hour): http://www.youtube.com/watch?v=6MI07brVv74&feature=youtu.be

 

 

 

5. Fidel Castro and Hugo Chávez played role in Colombia's peace talks with FARC

 

Meetings in Havana paved the way for negotiations that open in Oslo on Wednesday (Oct 17) on ending long-running civil war

 

Peter Beaumont, Foreign Affairs Editor, The Observer (UK, Guardian on Sunday), Sunday, October 14, 2012

http://www.guardian.co.uk/world/2012/oct/13/fidel-castro-hugo-chavez-colombia-farc-talks?newsfeed=true

 

The ailing former Cuban leader Fidel Castro, together with Venezuela's recently re-elected leader Hugo Chávez, played a critical role in bringing the Colombian government and the deadly Farc guerrilla group together for peace talks that could end one of Latin America's longest-running civil wars, the Observer has learned.

 

According to sources closely involved in the peace process, which sees historic talks opening in Oslo on Wednesday, the key breakthrough after almost four years of back-channel talks between the two sides came during a visit earlier this year by Colombia's president, Juan Manuel Santos, to Cuba, where he met both Castro and Chávez, who was in Cuba being treated for cancer.

 

That meeting was the first of many in Havana between the two sides, facilitated primarily by Cuba and Norway with the backing of Venezuela, which saw agreement on the detailed agenda for the first round of talks this week. "Officially President Santos went to Cuba to discuss the Americas summit," said a source intimately involved in the peace negotiations. "But the purpose of that trip was to discuss the peace initiative."

 

The meetings earlier this year followed the decision last year by Santos to take the step of recognising that an "armed conflict" existed in his country, an initiative encouraged by Chávez since 2008. Those contacts also came in the same period that Farc announced it was ending kidnapping, one of five preconditions for talks that had been set down by Santos as a gesture of goodwill.

 

Farc and the government have been at war since 1964, with the group more recently accused of having taken a directing role in coca production in areas it controls, an issue that will be on the agenda for the talks. But in what is being billed as the best chance to bring about a negotiated end to the long-running conflict, the Colombian government delegation will sit down with Farc leaders whose Interpol arrest warrants have been suspended to allow them to travel to Oslo without fear of arrest.

 

The government delegation, for the first time ever, will include retired generals with the trust of the country's military and representatives of Colombia's business elite, whose presence, it is hoped, will help sell any peace deal that emerges to those hostile to the process.

 

After the failure of the last round of peace negotiations, which foundered 12 years ago, top of the agenda will be the issues of land reform – Farc's key demand – political participation, the disarmament of the guerrilla group and the issue of paramilitaries who have in the past sought to torpedo any deal.

 

The disclosure of the key role of Cuba in organising support for the peace process marked the culmination of a long period of back-channel talks first initiated by Santos's predecessor as president, Alvaro Uribe, under whom Santos served as minister of defence. During those four years contacts continued despite the death during an army operation of Farc's leader, Alfonso Cano, last year.

 

Others credited with having created the conditions for the talks in Norway are unnamed former participants in the Northern Ireland peace process.

 

The talks are due to begin amid warnings from both sides, as well as observers, that a serious threat exists from those on both sides of Colombia's political divide who might attempt to use violence to derail the process. The attempt to reach a negotiated peace settlement foundered over a decade ago as both sides accused the other of stalling and rebuilding their forces, a period, observers say, that saw a doubling of anti-Farc paramilitaries.

 

A senior Colombian government source, who briefed the Observer on condition of anonymity, described the chances for talks as the best ever, adding that the Santos government had already enacted a new law for land reform and victim restitution. "President Santos is a pragmatist. He has already presented to congress a framework for an agreement. Colombia was already moving into a post-conflict phase, in some respects, even as the conflict continues. It is the right moment. Farc have a historic opportunity – probably the last – to find a solution to this conflict with dignity. To go into history and say they fought for social justice. To say they fought for land reform.

 

"We want to see 'Timochenko' [Rodrigo Londoño Echeverri, who took over command of Farc after Cano's death in 2011] in Colombia's congress just as we have seen Gerry Adams in the Northern Ireland assembly."

 

The sense of a guarded new optimism is shared by outside observers, including Marc Chernick, a US academic who has followed the history of Colombian peace negotiations and written The Farc at the Negotiating Table. Speaking from Colombia on Friday, Chernick said: "I've observed all the previous negotiations and I have been optimistic before, but this time I believe there is a real seriousness on both sides that has not been shown before.

 

"In the past Farc has always asked for a demilitarised zone as a precondition and this time it has not pressed for that. Four years ago it started to release prisoners, first civilians then military, and then renounced kidnapping.

 

"Clearly they want to talk. And they stayed at the table for the pre-negotiations even though three senior leaders were killed, including Alfonso Cano.

 

"Santos is clear, too. He was former minister of defence under President Uribe. They pushed the war as hard as they could and killed leaders. Now he has recognised that it will go on indefinitely. So Santos has come to the conclusion that only a negotiated solution is possible."

 

Chernick – like the senior government source – warned of the risk of violence during the peace talks from those, particularly on the right, opposed to peace with Farc, not least, he says, from paramilitaries who, although officially "disbanded", are still active and supported by elite sectors of society. "What is different this time," added Chernick, "is that both sides have signed up to the idea that the intended end of the peace talks is the end of the conflict."

 

A losing battle

The Revolutionary Armed Forces of Colombia (Farc) has been fighting a guerrilla conflict since 1964. Formed by Marxist-Leninist intellectuals, it claimed to represent the poor against the ruling elite and the stranglehold of the US.

 

By the 1990s it had become one of the richest guerrilla armies in the world, financed through kidnapping, drugs and illegal gold mines. In 2008 several Farc leaders, including Alfonso Cano were killed, weakening the group, which is now led by Rodrigo Londoño, better known as Timochenko. The Colombian military says the rebels' strength is down from 16,000 fighters in 2001, when they controlled nearly a third of the country, to about 8,000 in rural areas.

***
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Attorney Mario Joseph in Haiti....from Roger Annis

Public support grows for threatened human rights attorney Mario Joseph in Haiti

Published on CEPR's Haiti Relief and Reconstruction Watch blog, Wed. October 17, 2012

http://www.cepr.net/index.php/blogs/relief-and-reconstruction-watch/public-support-grows-for-threatened-human-rights-attorney-mario-joseph

[Please refer to the original article for complete links to sources and related documents.]

Haiti’s leading human rights attorney Mario Joseph has been the subject of death threats and police surveillance and harassment in the past several months, along with other lawyers. As the Institute for Justice and Democracy in Haiti (IJDH) reports, Joseph, IJDH Managing Attorney and the director of its Haitian affiliate Bureau des Avocats Internationaux (BAI), has received as many as 3-4 death threats a day, while police in vehicles with tinted windows have monitored the BAI office in Port-au-Prince and harassed and searched people leaving.

Threats against BAI and Mario have also been spray painted on walls nearby. While IJDH notes that Joseph has been the targets of threats in the past, it says “the current intimidation appears more organized, more persistent and more closely linked to the Haitian government than previous incidents.”

U.S. Congressman John Conyers (D – MI), the Ranking Member on the House Judiciary Committee, condemned the threats this week, saying: "As a long-time supporter of Haiti in the United States Congress, I am concerned by recent reports that suggest that Haitian attorneys and human rights advocates, including prominent attorney Mario Joesph of the Bureau des Avocats Internationaux (BAI), are being targeted with political intimidation and threats of physical harm as a result of their legal representation of politically vulnerable individuals and groups."

"The ability of an attorney to provide legal assistance free of harassment to any client is a critically important component of a well-functioning justice system. All necessary steps should be taken to protect these attorneys and advocates, who help ensure that all Haitians have equitable access to justice and due process. My office has contacted the State Department to express my concern about these recent reports."

As the Miami Herald reported earlier this month, "Joseph and other lawyers may be the targets of political persecution by the Martelly government. Chief Prosecutor of Port-au-Prince Jean Renel Sénatus claims Haiti's Justice Minister Jean Renel Sanon fired him after he refused to issue an arrest warrant for Joseph and 35 other 'political opponents.' "

The Herald also reported, "Senatus also said that Josue Pierre-Louis, a presidential legal advisor and head of the six-member electoral council, asked him to serve warrants against two attorneys — Newton St. Juste and Andre Michel — who have brought corruption complaints against the presidential family and members of Haiti’s government."

Sanon, Sénatus claims, said the arrest warrants “would make the President very happy.” The reported arrest warrants followed Joseph’s summoning by Investigating Judge Jean Wilner Morin of the Port-au-Prince Trial Court in September to appear for questioning in what appears to have been another effort at harassment and intimidation.

Amnesty International issued an October 4 alert about the attorneys, "Urging authorities to immediately and independently investigate the accusation of threats and intimidation towards the lawyers – ensuring that those responsible are brought to justice – and providing effective protection to the lawyers according to their wishes; asking the Haitian authorities to clarify why the arrest of the 36 political opponents is being sought and insist that any accusation must be carried out under internationally recognizable criminal offences; asking authorities to ensure that anyone charged is given a fair trial in compliance with international standards. "

The National Lawyers Guild and a number of other organizations have also condemned the threats and intimidation against Joseph and the other attorneys.

Joseph and BAI have taken on a number of politically sensitive cases, including efforts to prosecute former dictator Jean-Claude Duvalier – whom the Martelly administration has been reluctant to pursue, the defense of government critics, and of course the claim against the United Nations on behalf of thousands of cholera victims. Joseph has also helped impede the forced evictions of internally displaced persons from camps, and has pursued rape and gender based violence (GBV) cases on behalf of women and children living in the camps, among other cases.

Joseph said in an interview this week with the Pacifica Evening News that the threats and intimidation began after a judge dismissed political violence charges against Duvalier in January 2012, and intensified soon after Joseph filed a request for an investigation by the Inter-American Commission on Human Rights (IACHR) into what he termed “the deterioration and contempt for human rights in Haiti” under the Martelly government. IJDH also recently released a report on the Martelly administration’s intimidation and “stonewalling” of the media, one of the concerns Joseph highlighted in his appeal to the IACHR.

It would be difficult to overstate Joseph’s importance in confronting the powerful and the work that he, BAI and IJDH have done to bring rule of law and justice to Haiti. Joseph and IJDH Director Brian Concannon were responsible for the convictions of 53 soldiers and death squad members in Haiti’s landmark Raboteau Massacre trial. Martelly provoked outrage early in his term when he nominated Bernard Gousse to be Prime Minister, since Gousse had shown sympathy for Louis Jodel Chamblain, Jean Tatoune, and others convicted for their crimes in the massacre and had previously served as Justice Minister during the unelected interim regime following the 2004 coup d’etat, in which Haiti experienced some of the worst political violence in the hemisphere.

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Haitian Medical Team to Work in Peoria

It was recently announced that a Haitian medical team will be working in Peoria in mid-January 2013. The team will include 17 people including nurses, doctors, cooks, a big crowd-control-man, a podiatrist, and a “leaf doctor” who is described as an "absolute riot".

Dr. Jean-Maxmillian Beauvoir St. Volel ("Dr. Max") is the leader of the team. He sat down with me in Port-au-Prince today which marks the anniversary of the death of the leader of Haiti's revolution for independence, Jean-Jacques Dessalines.

Dr. John: Dr. Max it is nice to see you. Please tell us about yourself.
Dr. Max: Bonjour, Dr. John. I am pleased to tell you that I am a physician here in Haiti having trained at the Papa Doc School of Medicine here in downtown Port-au-Prince. My speciality is Internal Medicine and Tropical Diseases.

Dr. John: How nice. Why did you organize this trip to Peoria? This seems to be unprededented. Dr. Max: (Shifting in his chair) We quite frankly just love the people of the United States. You have helped my country so much during the last two hundred years. You even wrote our Constitution for some unknown reason after your army occupied us in the early 1900’s. And your State Department is extremely efficient at getting rid of our Presidents as necessary and replacing them with people from Boca Raton or somewhere.  

Dr. John: I sense you feel sorry for us or something?
Dr. Max: We don’t exactly feel sorry for you, Dr. John. We just worry about you. There is a difference. Let me explain. We know that you have a high pain threshold, but your health indices as a developed country just aren’t that good. 45 million Americans have no health insurance and one American dies every 12 minutes because of that. Did you know that, Dr. John?

Dr. John: Please don’t confuse me with facts. So where do you plan on working in Peoria?
Dr. Max: We will set up in a parking lot somewhere near Taft Homes.

Dr. John: You know that is kinda dangerous there, right?
Dr. Max: (Eyes become slits and moisten with tears, starts to laugh, and his stomach adiposity shakes every which way) Yes, we know, but we are use to these conditions. We will have our machetes with us and I will ask your mayor to tell all Peorians visiting us to leave their guns at home...just like Haiti. I can’t imagine any real problems.

Dr. John: What kind of facility will you work out of in the parking lot?
Dr. Max: We will bring one huge tent, we will have our own cooks, a portable outhouse, and a goat or two.

Dr. John: Well what about the language barrier? You guys speak French and Creole and we barely speak English.
Dr. Max: No pwoblem. We are bringing some interpreters with us who have a very good medical vocabulary. Like you should hear them say: “When was the last time you had dengue fever?” or "When was your last attack of malnutrition?" Stuff like that.

Dr. John: I would expect massive crowds to visit you each morning. How will you manage the crowd waiting to be seen and examined by the Haitian doctors and nurses? Our crowds can get unruly.
Dr. Max: Good question, Dr. John. But we are ready. We have already cut some wicked branches off of Haiti’s ten remaining trees and will use them on the backs of Peorians as necessary to keep control. This technique in Haiti works extremely well. Actually, you all taught us how well this works. Should not be a big deal...

Dr. John: You know, Dr. Max, it is going to be cold in Peoria in January. At least I think it is. Are you ready for that?
Dr. Max: How cold? We brought sweaters.

Dr. John: What kind of medicine are you bringing the needy people of Taft Homes?
Dr. Max: We have 13 large green army bags of medicine that we are packing right now. They are full of very helpful things like cough and cold medications for babies, tons of tylenol, two types of worm medication, chloroquine for malaria, gallons of antacids, and if anyone has hypertension, I think we have some blood pressure medication. Should be good to go.

Dr. John: Dr. Max, what will you do if you examine someone and they obviously have problems that need inpatient care in a hospital?
Dr. Max: We have that covered too. We have a grant to purchase three large green wheelbarrows from Nena True Value in Peoria.

Dr. John: Why the wheelbarrows?
Dr. Max: Good question. If the patient is too sick to walk to one of your three fine medical centers, we will plop the patient in one of the wheelbarrows and convince some of your young strong men to push them to the hospital. This seems to work in Haiti just fine.

Dr. John: This is kind of a personal question. But none of your team would think about defecting would they?
Dr. Max: Let me be very clear here: I just don’t know.

Dr. John: Dr. Max, we can hardly wait for your arrival in Peoria.
Dr. Max: It is our pleasure. (Laughing) As you would say, “It is the least we can do”.

John A. Carroll, MD
www.haitianhearts.org

Sarah from Soleil Returns (Dedicated to Augusta Dwyer)

Sarah from Soleil
St. Catherine's Hospital
October 16, 2012
(Photo by John Carroll)

A few months ago I wrote this post about an infant girl named Sarah from Soleil.

Please read this post while I wait. Go ahead and take your time. I am in no hurry.
------

Good. You are back.

Well, during the last few months I had concluded that Sarah most likely died. No one had any definite news on her. I did not think her mom had breast fed her adequately. She lived in Wharf Soleil, just a few blocks from this pediatric clinic, which is the worst place on the face of the earth.

In July I worked at We Advance at Wharf Jeremy which is another pathetic slum near Soleil. The staff  at We Advance told me that said they had not seen Sarah or her mother to offer her free powdered milk.

Today, out of the blue, Sarah was carried into our clinic in Soleil by her mother. She is alive and looks much better but she is quite ill with fever, vomiting, and diarrhea. (Surprise.)

But Sarah is alive and is seven months old. She weighs 5.7 kg which is 12. 5 pounds! And the only reason she survived is her mother breast fed her.

Success for Sarah. Success for Soleil. Success for all of us.

We admitted Sarah to St. Catherine's Hospital this morning, started and IV, and she is on ampicillin and gentamycin. I watched through the slats in the window as her mother breast fed Sarah.

This is much better than I ever dreamed.


John A. Carroll, MD
www.haitianhearts.org

Another Stupid Disease

Neonatal Tetanus
Cite Soleil
October 16, 2012
(Photo by John Carroll)

Why does this 12 day old infant boy have tetanus? Because his mother was not fully immunized against tetanus while she was pregnant with him. That would not have cost much money. Five billion dollars was pledged to Haiti post earthquake. However, none of these funds helped this little dude.

Thus, this guy has a very stupid disease that could and should have been prevented. His back is arched and he has seizures. He stands about a 20% chance of surviving. This boy needs a good pediatric intensive care unit. Soleil doesn't have one. Soleil doesn't have much of anything except good people and misery everywhere you look.

There are about one million cases of tetanus in the world each year. Most cases occur in the developing world. And about 40% of these people die. Neonates have the highest mortality rate.

Stupidity in systems breeds catastrophes like this one.


John A. Carroll, MD
www.haitianhearts.org

A State of Denial

Mudpie Factory--Cite Soleil
October 16, 2012
Photo by John Carroll

In 2007 I posted that people in Soleil were so hungry they were eating mudpies.

As people found out about this atrocity I think they were in disbelief. One commenter wrote that maybe the lady who makes the mudpies in Soleil should turn into a Mrs. Fields and export her mudpies to the States.

In 2012 people in Soleil are still eating mudpies.

Her "factory" is in the same location in an especially dangerous part of Soleil. And as you can see, as of an hour ago, she is still hard at work. She insists her dirt is special dirt from Hinche and she adds butter, salt, and water. I think you can see the rivulet of toxic filthy water running besides her.

She slops the concoction together and forms saucer-sized circular mudpies that harden quickly in the Soleil sun.

Denial is good for us when it comes to thinking about this. It could not be happening we tell ourselves. This can't be happening 90 minutes from Miami.

We need to make light of this.

We need to deny.

(Photo by John Carroll)

John A. Carroll, MD
www.haitianhearts.org

Reality Check in Cite Soleil

St. Catherine's Hospital
Cite Soleil
October 15, 2012
(Photo by John Carroll)

Asleep

Photo by John Carroll

Sorry, my dear, but we just didn’t care. You probably realize that by now.

You appeared with a tense, distended, and painful abdomen. For the previous four days you hadn’t been able to relieve yourself nor even sleep due to horrible visceral pain that distended lumens cause.

You winced as we poked and prodded your silent belly. And we used those big words as we concluded that you had a bowel obstruction.

Your eyes searched our eyes. You looked but we couldn’t. 

But what did we do with the gift of our knowledge about your condition? Our minds and hands could not be pushed into action for you.

My dear, you know why you got into this mess in the first place? It was us. We are corrupt. And we steal lives.

And people like you don’t count ESPECIALLY when you are sick. Your lives mean nothing to us. You knew that, right?

But you were generous and gave us one last chance at redemption.  Why did you think we would care now when you neared the end when we didn't care in the beginning?

Something for pain for you? Pain control for the poor? I don’t think so. No morphine, no dilaudid, no fentanyl patches for you. There aren't any here. You need to groan and roll slowly from side-to-side... waiting for sleep.

Well, your bed was empty this morning. Thank God. He took you. Your celestial discharge has happened and you got your wish for sleep. 

But make no mistakes...we don’t really care one way or the other.

You paid the big price for our corruption.

And we will too. 

(Photo by John Carroll)

John A. Carroll, MD
www.haitianhearts.org

Two Years of Cholera....by Crof

Please read this excellent summary of the two year anniversary of cholera in Haiti by Crof.

Tempered Happiness

St. Catherine's Hospital--Cite Soleil
Rehydration Room
October 12, 2012
(Photo by John Carroll)

The Haitian Public Health nurses (MSPP) working in this cramped tiny room tucked away on the second floor of St. Catherine's Hospital in Soleil save many little lives EACH day. With salt and sugar mixed in a bag of sterile water. And knowing where tiny collapsed veins course under the skin without being able to see or feel them they start tiny IVs.

This one year old was lying fairly lifeless with her eyes sunk and half closed two hours before this photo. She was one of a jillion babies and toddlers in Cite Soleil today with terrible vomiting and diarrhea. They finally get so weak they refuse the breast and they all seem to hate oral rehydration solution.

So with some history from the mother, the look of the child and the mother, the status of the child's lips and eyes, and your OWN gut reaction, you throw out all the clinical rules you once thought were important, and you start an IV on the patient.

And after just a little while they all wake up and look around.  And the blan doctors are all so happy, but the Haitian MSPP nurses take it all for granted. Because being this ill is taken for granted in Soleil.

And the prolonged assault by the army of sick babies never ends during the daylight. However, night time kills these babies in the arms of their mom in their shacks. The babes don't even whimper....they just slip away into the Light.

But you and I know they shouldn't have got sick in the first place. And so many more should have been treated today that didn't make it to the Rehydration Room.

In good Irish form our happy thoughts are tempered.


John A. Carroll, MD
www.haitianhearts.org

CITE SOLEIL

CITE SOLEIL
OCTOBER 10, 2012
(PHOTO BY JOHN CARROLL)

"My Dad is in Prison"

Zima
October 9, 2012
(Photo by John Carroll)

Dear Everyone/Anyone,

My name is Zima and I am two years old. As you can see, I don't feel well.

Full disclosure:  I did not really write this entire letter to you. An adult helped me. But believe me, if I were a few years older, I would agree with most of it.

So here goes.

I live in Beleko which is a neighborhood in Cite Soleil. It is infamous for the number of gang related violence during the last six years.

My family is very poor as is everyone in Beleko. I live with my mother and three siblings.

My dad has been in prison for the last two years in the penitentiary down town in Port-au-Prince. I don't know why he is there and each time my mom tries to visit him, she is turned away at the prison door. She says it is a bad place.

I have heard my mom say that there are thousands of men like my dad there being held without charges. She has no money to get him a lawyer. The inmate's cells are so crowded the men sleep standing up. I worry about my dad. I hope he is still alive.

Please watch this video when you have time. It is short.

My mom took me to the pediatric clinic today in Soleil. I am just not doing well.

First of all I weigh twenty pounds and am two years old. I don't even want to eat at this point. And my mom doesn't have much to give me in the first place. My legs have swollen in the last several months because I don't have enough protein in my diet. Therefore, fluid seeps out of the blood vessels into the tissues of my legs. They hurt. The university people call me an "apathetic kwash". I don't know what that means and I don't really care.

I also have diarrhea all the time. I am passing mucous, blood, and my mom says I have white worms too. We don't have clean water to drink and many toddlers in Beleko are just like me. We are chronically sick and many of us die before we even go to school.

For some reason I have a fever and a cough and the doctor just told my mom I may have pneumonia.

I am going to be admitted to St. Catherine's Hospital in a few minutes.  I knew I shouldn't have come here in the first place. Someone will need to watch my brothers and sisters at home because my mom has to be with me 24/7 at the hospital because the MSPP nurses can't do everything. At least they don't charge pediatric patients like me.

Well, gotta go.

Thanks for reading this. Please pray for me and my family and especially my dad.

Love,

Zima

-------------

John A. Carroll, MD
www.haitianhearts.org

Respect for Life in the Slum--Updated October 8, 2012

Respect for Life Baby in Soleil
October 8, 2012
(Photo by John Carroll)

You may remember the little baby in trouble on Friday afternoon.

Well here she is today (Monday) with no oxygen requirements. She is breathing easy on her own. This is good because there are no ventilators at St. Catherine's Hospital in Soleil.

The baby is getting intravenous antibiotics ampicillin and gentamicin. She is not out of the woods but  she stands a chance.
------------

St. Catherine's is being repainted. It looks better than a few weeks ago.

This hospital is run by the Haitian government. But you know what? It needs to be torn down. The people deserve much more than this.

Just think if it were demolished and rebuilt in the middle of this horrible fetid slum. Just imagine a nice big hospital in this place that could provide basics for hundreds of thousands of people.

It could be a great teaching hospital because the pathology of hundreds of thousands of people nearby would keep it busy and full all of the time. The amount of heart disease, infectious disease, and trauma is incredible here. And most importantly the people of the slum would benefit.

Haitian medical staff have to be paid fairly. They work very hard and CARE for each other. The Haitian government needs to do the same.

Hold UN Accountable in Haiti

Hold the UN accountable for Haiti’s cholera epidemic 

By Myrtha Désulmé, Stabroek News (Guyana), Oct 1, 2012
http://www.stabroeknews.com/2012/features/in-the-diaspora/10/01/hold-the-un-accountable-for-haitis-cholera-epidemic/ 

Myrtha Désulmé is President of the Haiti-Jamaica Society and the Caribbean Representative of the Haitian Diaspora Federation 

On 24 August, Tropical Storm Isaac pummelled Haiti, resulting in floods, mudslides, and storm surges; downed trees and power lines. The storm threatened the lives of millions, particularly the more than 400,000 homeless Haitians, still living in flimsy tents, exposed to the elements like sitting ducks, two-and-half years after the January 2010 earthquake. Painful images of tent-dwellers bracing against fierce winds, with a background of flying tents containing all of their worldly possessions, were streamed on CNN between news of another US shooting incident, and the joys of Australian river rafting. 

Adding to the crisis was the fear of an ensuing surge of the cholera epidemic introduced into Haiti by the UN forces. The initial death toll from TS Isaac is reportedly at twenty-four, but this number could spike due to the potential increase in cholera cases. 

On 21 October, 2010, ten months after the greatest natural disaster of the modern age, cholera exploded in the Artibonite region along Haiti’s central river system, quickly spreading to other areas. Haiti went from never having had a cholera outbreak in recorded history, to now having, based on the Pan-American Health Organization (PAHO), “one of the largest cholera epidemics in modern history”, which has killed more than 7,585 Haitians, and infected over 594,198 to date. 

According to Duke University Professor Deborah Jenson, who has written extensively on Haiti, research of 19th century newspapers, and sea merchants’ journals, reveals that while cholera raged in the United States and much of the Caribbean, it always failed to take root in Haiti. When it first arrived in the Americas in 1832, Haitian President Boyer immediately announced public health measures to prevent the invasion of cholera. 

In 1892 President Hippolyte again published protocols to prevent the introduction of a Euro-American infection.  It is in fact this Euro-American epidemic which led to the development of sanitary sewer systems in Europe and America. 

Numerous independent DNA tests and epidemiological studies, including those of the UN itself, have established that Nepalese troops to the UN peacekeeping mission in Haiti (MINUSTAH) brought the vibrio cholerae bacteria to Haiti.  Geneticists have precisely matched the epidemic strain in Haiti to a particularly virulent, deadly cholera strain found in Nepal in the summer of 2010, just before the troops were deployed. 

Although Nepal has endemic cholera, the UN did not test or treat the Nepalese peacekeepers for cholera prior to their deployment.  In Haiti, they lived on a base with a haphazard and inadequate sewage system, and recklessly dumped all waste into an unfenced pit.  It was easily foreseeable that human faeces containing cholera bacteria could contaminate a tributary, which runs just meters from the base into the Artibonite River, travelling downstream to infect the Haitian families who drink, bathe, play, and wash laundry in the river. 

Three of the brave souls who have taken on the UN Leviathan are Attorneys Marguerite Laurent of the Haitian Lawyers Leadership Network (HLLN), Mario Joseph of the Bureau des Avocats Internationaux (BAI), and Brian Concannon of the Institute for Justice & Democracy in Haiti (IJDH). 

On 3 November, 2011, BAI and IJDH filed a lawsuit on behalf of 5,000 cholera victims. The case demands that the UN provide the only long-term solution, which is the comprehensive clean water and sanitation infrastructure necessary to control the epidemic. Cholera is generally easily treatable with oral rehydration solutions.  But for those who lack access to clean water and medical care, it can kill in a matter of hours. Medical treatment, vaccinations, and chlorine tablets are saving some lives for now, but cholera immunity lasts only a few years, while the cholera bacteria will remain in Haiti indefinitely.  The water and sanitation infrastructure will not only eradicate cholera, it will reduce all water-borne diseases in Haiti, which kill thousands every year. 

Incredibly, the UN initially denied responsibility on the premise that a “confluence of factors”, including Haiti’s weak sanitation and health infrastructure, were the real reasons for the outbreak. This preposterous, and legally invalid defence, is akin to starting a fire in a dry field, and blaming the wind for the spread of the fire. Before the outbreak, Haiti was widely known to be one of the most water insecure countries in the world, and after the devastating earthquake of January 2010, experts warned that outbreaks of water-borne diseases, especially cholera, would have disastrous effects. Haiti’s fragile conditions created a heightened responsibility for the UN to exercise care in its operations. Yet the UN failed to take simple measures that would have prevented the outbreak, like testing of its soldiers known to come from a cholera-endemic region, proper management and disposal of waste, and immediate corrective action.  By any legal code, the UN is legally responsible, because their carelessness directly caused foreseeable harm to victims. 

The victims of cholera filed complaints directly with the UN’s internal claims unit. MINUSTAH’s operations in Haiti are governed by a Status of Forces Agreement (SOFA), which affords the UN and MINUSTAH broad immunities from civil or criminal prosecution in Haitian courts. To balance this immunity, the SOFA requires the establishment of an independent Standing Claims Commission, to hear claims and compensate victims, who have been injured in the course of UN operations. Despite this requirement, no commission has been established during the eight years MINUSTAH has operated in Haiti.  In fact, there has never been a Standing Claims Commission established in over 60 years of UN peacekeeping, even though these commissions are a standard feature of most SOFAs. 

Momentum has been building, to pressure the UN to respond justly to the epidemic. In January, ABC News published an article entitled: UN Soldiers Brought Deadly Superbug to Americas. 

In March, President Bill Clinton, UN Special Envoy for Haiti, publicly affirmed that UN peacekeepers were the “proximate cause” of the cholera epidemic.  Hundreds of Haitians marched from the UN’s base to the Haitian parliament, demanding justice for cholera victims. The New York Times ran a front-page story confirming the UN’s responsibility in bringing cholera to Haiti, and exposing its failure to respond accordingly.  After a visit to Haiti by the UN Security Council, the missions of the U.S., France, and Pakistan, declared to the Security Council that the UN must do “whatever is necessary to make this situation right”. 

In April, The Economist published a scathing piece calling on the U.N. to accept responsibility for its wrongdoings in Haiti.  In May, Nigel Fischer, UN Humanitarian Coordinator in Haiti, acknowledged that the UN’s current efforts were “patchwork, Band-aid work,” and that “the long-term solution was investment in improved drinking water sources and waste management.” 

The U.S. Centers for Disease Control and Prevention (CDC), and prominent French epidemiologists have published studies confirming the source of the disease; while Washington Post editorials, TransAfrica Forum, Human Rights groups, and faith-based organizations, like the Church World Service, have called for the UN and the international community to take responsibility swiftly in ending the epidemic. 

On 17 July, US Representative John Conyers, Jr. (D-Mich.), and 103 other Members of Congress sent a letter to Susan Rice, U.S. Ambassador to the United Nations, applauding her call for UN accountability, and asking her to urge the organisation to take a leading role in addressing the cholera crisis in Haiti, which according to the Haitian Government, infects 600 new victims every day. 

The Congressmen wrote: “As cholera was brought to Haiti due to the actions of the UN, we believe that it is imperative for the UN to now act decisively to eliminate this deadly disease from Haiti…. A failure to act will not only lead to countless more deaths: it will undermine the crucial effort to reconstruct Haiti.” 

The IJDH/BAI lawsuit aims to compel the UN to spend $750 million – 1.2 billion on comprehensive water and sanitation infrastructure, which would improve Haiti for decades.  By comparison, MINUSTAH’s operating budget in Haiti for one year is around $800 million, and only half of the $5.33 billion pledged for earthquake recovery has been disbursed. With nearly half-a-million homeless earthquake victims in sprawling tent camps, exposed to disease, eviction, arson, and violence, the Red Cross, whose core mission is humanitarian assistance during emergencies, is planning to build a hotel on a property it purchased for $10.5 million of funds collected in the name of suffering Haitians, while the Clinton-Bush Haiti Fund made a $2 million equity investment in the 5-star Royal Oasis hotel. 

If the lawsuit is successful, the clean water and sanitation infrastructure will save between 50,000  – 70,000 lives over the next ten years, by eradicating cholera, and all other water-borne diseases. 

On 4 June, 7 months after the filing of the lawsuit, a “Regional Coalition on Water and Sanitation for the Elimination of Cholera in the Island of Hispaniola”, was launched by UN agencies, World Health Organization (WHO), and UNICEF, in collaboration with the Pan-American Health Organization (PAHO), the Centers for Disease Control and Prevention (CDC), the Spanish Agency for International Development Cooperation (AECID), and the Inter-American Association of Sanitary and Environmental Engineering (AIDIS). The Coalition pledged to support efforts by the governments of Haiti and the Dominican Republic “to harmonize and streamline international assistance and investments in water and sanitation infrastructure aimed at eliminating cholera from the island”.  On 18 September, CARICOM joined the Coalition. 

But four months after its launch, the Coalition has done nothing to save lives or eliminate cholera, and does not even have any funding in place. It is merely “urging governments and international organizations to support their efforts”. While the UN, which has the funds and the legal obligation to right its wrongs, is not responding. Some believe that the Coalition is just a smokescreen, to take the pressure off the UN, which is simulating a response, without setting the precedent of accepting liability. 

In the words of Betsey Chace, a finance volunteer with IJDH, “… fair treatment of Haiti by the international community [is] the only thing that will enable Haiti to break the cycle of extreme vulnerability to disasters.  There is little natural about a death toll in the [hundreds] of thousands from an earthquake of 7.0 magnitude, or massive loss of life from heavy rainfall. These unnatural disasters result from political, environmental, and economic conditions, that will improve only when Haitians are supported rather than thwarted in building a system of laws, rights, and accountability, that are the foundation of a just and safe society.” 

On 28 July 2010, the UN General Assembly adopted a Resolution recognising access to clean water and sanitation as a human right essential to human dignity, and to the realisation of all other human rights.  We urge the entire Caribbean family to remain vigilant, to ensure that the basic human rights of the Haitian people are upheld, and that the UN returns to its core mission, of fighting infectious diseases, not spreading them.

 (This article was posted on the Roger Annis website CHAN.)

Everyone Counts in the Slum

Everyone Counts, October 5, 2012
(Photo by John Carroll)

Do four pound babies in one of the worst slums in the world really count?

It seems they do.

This precious little girl was born on Friday morning but was having trouble breathing by mid-afternoon.

So the nurses in the OB Ward wrapped up this baby, handed her to her sore sixteen year old mom, and told her to go to Pediatrics.

Mom carried the baby alone as she ambled over to Peds which was in a different building about twenty yards away.

A Peds nurse unwrapped the baby and pronounced the baby dead. She was cyanotic and not breathing or moving.

Another "health care provider" grabbed the baby and administered "bouche-a-bouche" (mouth-to-mouth) resuscitation.

The young mom watched showing no emotion whatsoever.

The little baby with no name started to breathe and move and she turned pink. And parents in the Pediatric Ward stretched their necks and watched from their own baby's miserable cribs.

A tiny nasal prongs was taped into the newborn's nostrils and attached to a huge five foot paint-peeling oxygen tank near by. Three liters of oxygen streamed into her airway.

A tiny bore nasogastric tube was passed and the baby's abdomen was decompressed to help her diaphragm work easier.  A 24 gauge IV was placed on one attempt into the back of her right hand. Sugar water dripped in.

The baby opened her left eye and looked around.

Her respirations were fast but her color was good and pink.

Throughout this effort, the Haitian nurses and doctor talked like usual, even joked, but no one screamed or yelled or went crazy. There was definite respect for this little life on the edge.

Life is important in the slum.


John A. Carroll, MD
www.haitianhearts.org