Saturday, September 10, 2011

Tuberculosis



(Photo by John Carroll, September 2011)


See this from Crofs Blog:


Fuelled by the HIV pandemic and the spread of drug-resistant strains, tuberculosis (TB) has re-emerged as a major threat to global health. TB is a curable disease that continues to affect millions of people globally each year, and is a leading cause of death in HIV positive people.

According to the 2009 WHO Report on Global TB Control, there were 9.4 million new TB cases in 2008, out of which 1.4 million (14%) were HIV positive (78% of them were in Africa and 13% in Southeast Asia). Mortality from TB was 1.7 million, and about 0.5 million of these deaths were in People Living with HIV (PLHIV), who are at a much increased risk of contracting TB.

In high burden HIV settings (like the sub Saharan region) more than 70% of TB patients are living with HIV. So, universal access to HIV care cannot be achieved without addressing TB.

To make matters worse, over the last decade, 5 million people developed drug-resistant TB, but less than 1% had access to appropriate treatment, and 1.5 million died. Only 7% of the estimated 440,000 MDR-TB cases in 2008 were reported to the World Health Organization (WHO), and only about 1% of the patients were enrolled under programs to provide internationally quality assured treatment. India is home to 2.5 million people living with HIV and bears one fourth of the estimated global burden of MDR-TB.

Infection with HIV further complicates management of MDR TB, and data from many settings suggest that mortality from MDR TB in HIV infected patients is very high. So MDR TB/HIV is the Perfect Storm and we cannot wait any more to let it pass.
In resource limited settings, which carry most of the burden of MDR TB and co infection with HIV, there is insufficient access to quality assured diagnostic capacity, which results in delays of diagnosis and probably in deaths, especially among the PLHIV.
HIV infected patients often have sputum negative and extra pulmonary TB which further complicates diagnosis. Limited quality assured drug access, drug-drug interactions, side effects, pill burden, and long treatment duration add to the problem of treatment adherence.

These issues were raised at the recently concluded 10th International Congress on AIDS in Asia and the Pacific (10th ICAAP). One of the meetings, organized by Medicins Sans Frontieres (MSF), focused on the challenges in scaling up Diagnosis and Treatment of Drug Resistant TB in PLHIV. Results of a case study from MSF HIV project in Mumbai, India, treating MDRTB/HIV co-infections were also shared.

This study is among the first cohorts of HIV/MDR-TB co-infected patients in India. It was a highly resistant cohort with previous exposure to second line TB drugs, mainly in the private health sector. To date, a cohort of 71 HIV infected patients have been diagnosed with MDR TB, 56 cases were confirmed and 15 were suspected. 59 patients were started on treatment. One of these with susceptible TB was excluded from analysis.

Out of the 12 who did not begin treatment, 7 died. Final outcomes (in the 2007 to 2011 cohorts, n=58) were as follows:--13 (22%) were successfully treated, 13 (22%) died, 7 (12%) defaulted, 2 (3%) failed treatment and 23 (40%) are alive in treatment. Thus, overall 20 of the 71 patients died, including the 7 who were not initiated on treatment. All the patients demonstrated significant immunological improvement (increased CD4 counts).

The Truth Hurts



(Photo by John Carroll, September 2011)

In 2007, residents of Cite Soleil told me that UN helicopters were shooting down on them in late December, 2006.

MINUSTAH denied this. Would the UN lie about this?

See this article from Ansel Herz.

Tuesday, September 06, 2011

Haiti's Needless Cholera Deaths



(Photo by John Carroll--September 6, 2011--"MINUSTAH and cholera are twins" on the billboard)


"Haiti’s Needless Cholera Deaths"
Published: September 6, 2011
The New York Times
Editorial


A cholera outbreak has killed more than 6,000 people in Haiti since October and is far from under control. More than 420,000 people have been sickened since the disease emerged in a rural area north of Port-au-Prince, apparently after sewage from an encampment of United Nations peacekeepers contaminated the Artibonite River.

Cholera is preventable and easily treated, but containment has been stymied by the chronic deficiency — or utter absence — of clean water and sanitation systems in Haiti, particularly in the countryside, where cholera hit first and hardest. The cholera mortality rate in Haiti’s vulnerable Southeast region was 5.3 percent in July. Access to proper treatment could keep that rate below 1 percent.

The United Nations’s Pan-American Health Organization, the United States and the rest of the international community should be working with the Haitian Health Ministry to wage a more aggressive and effective effort, which should include not only clean water and sanitation systems but more antibiotics and cholera vaccinations. A cheap, effective cholera vaccine is available, but there are currently fewer than 400,000 doses worldwide. Ramping up manufacturing to make more vaccine could be readily done and would have global benefits.

Cholera victims are among the many casualties of the unfinished rebuilding of Haiti, still choked by rubble and political paralysis. Haiti’s new president, Michel Martelly, a political novice, has been unable to form a government. Donations have lagged, construction plans are stuck on drawing boards and hundreds of thousands are in displaced-persons camps, hot spots of disease and suffering.

A United Nations report in August warned that money and manpower are running short. Staff members assigned to cholera treatment centers was decreasing, it said, as “humanitarian partners are gradually reducing their operations.” In many areas, nongovernmental health organizations are handing treatment facilities over to the Health Ministry, which lacks capacity to support them.

The ministry, like practically every government agency, was flattened in the quake and has barely benefited from the flow of aid. Controlling this epidemic requires building up the public sector — which is the only hope for Haitians after charitable aid dries up.

Monday, September 05, 2011

Jenny Still Survives

 

(Photo by John Carroll--September 5, 2011)

Jenny had heart surgery at OSF-SFMC in Peoria in 1999. At nineteen years of age she looked like a victim from Auschwitz before her heart surgery.

I have been treating her in Haiti for over a decade since her surgery in Peoria. Haitian Hearts has provided her with medication, echocardiograms, and money in Haiti.

Jenny needs more heart surgery, but OSF-SFMC won't take her back. I gave OSF-Children's Hospital of Illinois a check for $23,000 dollars before her surgery in 1999. (All the physicians did pro-bono work.)

Other medical centers believe she is OSF's medical and ethical responsibility. And she is.

Jenny has survived tropical storms, hurricanes, kidnappings, heart failure, a biblical earthquake (she was living in a car), and poverty.

However, I don't think she will survive the greed and power of our Catholic hospital in Peoria.


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Labor Day is Every Day in Haiti's Tent Cities

 

(Photo by John Carroll--September 5, 2011)
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Wednesday, August 31, 2011

Cholera is Embarrassing for Haitians

(Eighty-four year old man admitted today with cholera. Photo by John Carroll, August 31, 2011)

To have cholera is embarrassing for Haitians. And it shouldn't be.

I think Haitian nurses and doctors don't even like to talk about it or admit it is in their area.

It is not the poor Haitian's fault of course. But they are still blamed for not washing their hands and contaminating themselves.

If Haitians could protect themselves from Vibrio cholera, I am sure they would.

Tuesday, August 30, 2011

What Have We Come Too?



(Photo by John Carroll, August 30, 2011)


This lady was begging for powdered milk for her baby this afternoon.

She has chronic deforming leprosy.

How can she cuddle her baby?

Born in a Tent



(Photo by John Carroll)

Many babies have been born in deplorable tent cities in P-a-P since the earthquake.

See this article.

The USNS Comfort

 

(Photo by John Carroll)

Please go to the Peoria Journal Star website here to read about our experiences working with the USNS Comfort in Port-au-Prnce.
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Friday, August 26, 2011

Thursday, August 25, 2011

Advice: Don't be a Sick Baby in Haiti



Photo by John Carroll
August 24, 2011

Pediatric Genocide in Haiti (UPDATE)



Photo by John Carroll
August 24, 2011


What should be more important than a baby?

Should my laptop be more important? Should my car? Should my easy life be more important?

This baby in the picture was my first patient in pediatric clinic yesterday in Soleil.

His name is Aristide.

Aristide is eight months old and had been sick for 6 days with fever, diarrhea, and a cough. His mother stated that he is not eating or drinking much.

The baby was hot to touch and he did not respond normally to stimuli. He was breathing over 80 times per minute. I did a quick exam and quickly wrote a referral note to a nearby hospital and asked them to admit Aristide for sepsis.

Aristide's situation is obviously critical but since he is a baby he is trying to hold on.

And Soleil is full of babies like this.

His mother is young, but a "good mom" in my opinion. She just doesn't have many health care options for baby Aristide. She doesn't have Caterpillar insurance. She doesn't really have anything except her darling Aristide.

Mom did hurry to the hospital and he was admitted and started on IV ampicillin and gentamycin.

I will check on him to day and let you know if he survived.

President Martelly and the Haitian government need to get their act together and put babies, and clean water, and basics first. What can be more basic than good care of babies?

Bottom line: Aristide shouldn't have got this sick in the first place. But when babies are disposable objects here in Haiti, this is what happens.
-------

Update August 25, 2011: I checked on Aristide in the hospital this afternoon. He looks better.





Barefoot Haitian Women



(Photo by John Carroll--August 24, 2011)


I was at a Haitian hospital yesterday and watched a lady walk by me.

She was walking slowly.

I noticed that blood was oozing from the back of her right hand where an IV had just been removed. Cotton balls had been placed on the area with no tape to hold them or tamponade the IV site. And the cotton was soaked with blood.

The back of the woman's night gown was stained with bright red blood.

And she was barefoot.

The woman had just delivered a stillborn.

This poor young woman headed out the gate of the hospital onto the filthy rotten asphalt street in front of the hospital. She was headed "home" with little support of any kind after her loss.

No smiley faces, balloons, or courteous hospital attendants pushing her stuff on a cart.

She had no stuff, no newborn.

Not even shoes.

Read this article from CHAN.

Tuesday, August 23, 2011

Lost an Arm, Saved Two Lives

 

(Photo by John Carroll--August 23, 2011, Cite Soleil)

The lady in this photo brought her todder to the clinic today. Her 20 month boy had diarrhea and was moderately dehydrated.

I asked the mother if she lost her arm in the earthquake and she nodded yes. And when I looked at the boy's dossier, I saw that he was born on January 12, 2010.

Mother told me that she was in a hospital in Port-au-Prince and gave birth to her son seconds before the earthquake occurred. After delivering she was told to run as the hospital started to shake and then collapse.

She lost her left arm but got the baby out intact.

Mom is expecting.


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Women Leaving Haiti to Give Birth

See this article in the Washington Post.

Monday, August 22, 2011

Tent Cities Struggling



(Photo by John Carroll-- August 22, 2011)

My 22 year old nephew and I walked through a small tent city a couple of days ago near the Haitian Coast Guard in Carrefour.

Several hundred people have been there since the earthquake.

No one was complaining. They just kept working.

These makeshift homes were tiny....maybe 15 feet by 15 feet? And small charcoal fires sit right outide the front door serving as a hazard for toddlers playing close by.

It was terrible.

Here is an article from The Guardian.

Sunday, August 21, 2011

USNS Comfort in Haiti



USNS Comfort
Bay of Port-au-Prince
August 19, 2011
Photo by John Carroll

Haitian Hearts had the opportunity to work with the USNS Comfort in Haiti. So here we are...

However, Tropical Storm Irene had other ideas.

Please see Crof's post.

Also, please see Maria's posts at www.livefromhaiti.blogspot.com.


Saturday, August 20, 2011

Haitian Cholera Epidemic Shouldn't Be This Bad



Photo by John Carroll
August 18, 2011


Thousands of Lives Could Be Saved, and Haiti’s Cholera Epidemic Managed, With Greater Treatment and Prevention Efforts, CEPR Paper Finds

Recent Cholera Spike Was “Entirely Predictable,” Yet Treatment Efforts Fell Off

For Immediate Release: August 18, 2011

Washington, D.C.- A new paper from the Center for Economic and Policy Research argues that cholera treatment and prevention efforts in Haiti have fallen woefully behind, leading to thousands of preventable deaths, even though the dramatic rise in new cases this spring and summer was entirely predictable. The paper, “ Not Doing Enough: Unnecessary Sickness and Death from Cholera in Haiti”, by researchers Jake Johnston and Keane Bhatt, argues that it is not too late to bring the 10-month old cholera epidemic under control and save thousands of lives by ramping up treatment and prevention efforts.

“Haiti’s cholera epidemic has been much worse than it could have been, and thousands more people have died, due to an inadequate response from the international community, going back to when the outbreak began,” CEPR Co-Director Mark Weisbrot said. “It’s time to reverse course and get serious about controlling and eventually eliminating cholera from Haiti.”

“In July 2011, one person was infected with cholera almost every minute, and at least 375 died over the course of the month due to an easily preventable and curable illness,” the paper notes. A March 2011 article in the medical journal The Lancet predicted that cholera infections would spike with the onset of the rainy season following a drop-off during the drier months of late 2010 and early 2011. Yet overall cholera efforts were scaled back just as infections were increasing: only 48 nongovernmental organizations (NGOs) were addressing cholera in July, down from 128 in January.

As predicted, new cholera infections increased with the onset of the rainy season this year, reaching an average of 1800 new infections per day in June – almost twice as many as in May and three times as many as in March and April, the paper notes.

The paper also notes that NGO’s and international agencies have targeted urban centers over rural areas, despite the anticipated spread of the disease to all corners of Haiti, and significantly higher case fatality rates in some rural areas. The department of Sud Est, for example, currently has the highest fatality rate, at 5.4%, but no Cholera Treatment Centers.

The authors recommend several ways in which the cholera epidemic could be brought under control -- and thousands of lives saved -- including expanding the reach of inpatient facilities in the hardest-hit areas, scaling up antibiotic and supplement treatment efforts, prevention and care through education campaigns, and a vaccination strategy. International donors also have fallen far behind on their pledges for cholera assistance.

The paper outlines a number of other factors that contributed to the severity of the epidemic, one of the most important being the relative scarcity of potable water in Haiti. The authors describe various ways in which public water systems have been under-funded and implementation delayed by the international community, while some donors have pushed instead for “cost recovery” water systems in camps for internally displaced persons (IDP’s) and elsewhere. These would require residents to pay for potable water, and likely lead to an increase in cholera infections as potable water would be put out of reach of IDP's and other low-income Haitians.

“Safe, clean drinking water for all Haitians should be a top priority for international donors,” Weisbrot said. “And if it had not been so neglected years ago, when loans for this purpose were blocked by the United States, the severity of this outbreak might have been drastically reduced.”

The paper’s lead author, Jake Johnston, added: “The money is there: the U.S. Congress appropriated $1.14 billion for Haiti a year ago, and most of that money has not been spent; and a lot of the $1.4 billion that Americans gave to private charities after the earthquake – including the biggest organizations such as the American Red Cross -- also remains unspent. And there are also hundreds of millions of dollars of international aid that were pledged by governments but not yet delivered. These funds can be used to expand treatment and prevention of cholera in Haiti, and to build the necessary water infrastructure.”

Monday, August 15, 2011

WikiLeaks and Haiti



(Photo by John Carroll)


If you don't read anything else on this subject, please read this written by Kevin Edmonds posted on CHAN.


WikiLeaks Cables Show Haiti as Pawn in U.S. Foreign Policy

July 27, 2011

http://www.coha.org/wikileaks-cables-show-haiti-as-pawn-in-u-s-foreign-policy/

This analysis was prepared by COHA Research Associate Katie Solts

The U.S. tried to undermine Haiti’s oil deal with Venezuela in order to protect the vested interests of U.S. oil corporations.
Under the Obama administration, the U.S. embassy worked with major textile companies to cap the minimum wage in Haiti at 31 cents per hour.
Election monitors from the U.S. and the international community knowingly supported elections that did not remotely follow accepted democratic standards of procedure.
When WikiLeaks announced its plan to release tens of thousands of classified U.S. diplomatic cables to the public, the U.S. government feared a massive international backlash and threat to national security. Although WikiLeaks’ impact on Latin America does not severely jeopardize U.S. security, the diplomatic cables could nevertheless cause irreparable harm to U.S. relations with several Latin American nations. Information released by WikiLeaks points to a continuation of U.S. dominance and the application of “neo-imperialist” diplomacy in Latin America, and the cables regarding Haiti, the poorest country in the Western hemisphere, exemplify the persistence of U.S. interference.


Haiti’s history is one of brutal colonial exploitation followed by systematic neocolonial intervention, and today the country faces extreme poverty and political turmoil. According to the UN Development Program, 78 percent of Haitians live on less than USD 2 per day and 54 percent of the population, or around four and a half million people, currently live on less than USD 1 per day.[1] In light of the problems facing this troubled nation, the new information revealed by WikiLeaks concerning U.S. involvement in Haiti is particularly disconcerting. Janet Sanderson, the previous U.S. Ambassador to Haiti, once dubbed the U.S. “Haiti’s most important and reliable bi-lateral partner,” but the cables released by WikiLeaks show a much more one-sided relationship.[2] Instead of helping Haiti develop economically and politically, Washington’s foreign policy seems completely dominated by influential and well-connected U.S. economic interests.

Petrocaribe: Haiti and Venezuela

René Préval became president of Haiti in 2006 and immediately attempted to improve U.S.-Haiti relations. U.S. Ambassador Sanderson reported in a cable that Préval “wants to bury once and for all the suspicion in Haiti that the United States is wary of him. He is seeking to enhance his status domestically and internationally with a successful visit to the United States.”[3] Yet despite his desire to improve relations, newly elected President Préval unintentionally began alienating the United States on the very day of his inauguration. On this day, Préval signed a deal with Venezuela to join the Caribbean oil alliance, Petrocaribe, which allowed Haiti to buy subsidized oil from Venezuela. The government of Haiti would pay only 60 percent up front and then pay the rest at 1 percent interest over the next 25 years.[4] This payment schedule would save the Haitian government USD 100 million per year, with which the government planned to supply basic needs and services to 10 million Haitians and increase investment in social projects like hospitals and schools.[5] Additionally, the Petrocaribe deal would help lower and stabilize the cost of oil in Haiti after several years of high prices.

However, the new Haiti-Venezuela alliance unnerved Washington, and Ambassador Sanderson abetted U.S. interests in Haiti. Apparently determined to hold a tough stance against the oil deal, she wrote in a cable on April 19, 2006, that “Post [the Embassy] will continue to pressure Préval against joining Petrocaribe.”[6] For two years, the U.S. government worked with ExxonMobil and Chevron, the two U.S. oil companies operating in Haiti, to undermine the new deal between Petrocaribe and Venezuela. The U.S. oil companies feared that they would have to buy their oil directly from the government of Haiti and would lose their profit margins as a result. As Thomas C. Tighe, a U.S. official in Haiti, wrote in a cable, “Chevron country manager Patryck Peru Dumesnil confirmed his company’s anti-Petrocaribe position and said that ExxonMobil, the only other U.S. oil company operating in Haiti, has told the Government of Haiti that it will not import Petrocaribe products.”[7] Because Chevron and ExxonMobil controlled shipping and distribution channels, these two companies were able to prevent the Petrocaribe deal for two years simply by refusing to transport Petrocaribe oil and blocking their shipments. Throughout this time, Tighe said the Haitian government was “enraged that ‘an oil company which controls only 30% of Haiti’s petroleum products’ would have the audacity to try and elude an agreement that would benefit the Haitian population.”[8] Chevron eventually signed the agreement in 2008, but the two-year fight against the deal exemplifies Washington’s willingness to disregard Haiti’s interests for its own economic and political agenda.

The real problem for the United States in this arrangement appears to be not just the challenge to U.S. economic interests but also the development of a lasting Haiti-Venezuela relationship. The U.S. is inevitably skeptical of Haiti’s ties with Venezuela, a nation whose leader fiercely opposes the United States. Préval continued to develop Haiti’s relationship with Venezuela, first with the proposed Petrocaribe deal in 2006 and, subsequently, with Préval’s attendance of the ALBA (Bolivarian Alternative for the Americas) summit in Venezuela in 2007. At the summit, Préval received a deal for an energy aid package from Cuba and Venezuela. Yet despite the proposed benefits for the Haitian people with both the Petrocaribe agreement and the later energy package, U.S. officials fought against the deals because they did not trust Haiti’s possible close relationship with these two demonstrably anti-American governments.

However, the United States’ determination to undercut these agreements seems unwarranted. Although Venezuela and Cuba are outspoken in their opposition to the United States, Haiti does not participate in their leftist, anti-American rhetoric. In fact, Washington was cognizant of the fact that Haiti’s participation in these agreements did not reflect an alliance against the United States. Sanderson reported in one cable that “at no time has Préval given any indication that he is interested in associating Haiti with Chávez’s broader ‘revolutionary agenda.’”[9] Instead, Préval’s relations with these other governments stemmed from his desire for socioeconomic improvement. The U.S. government acknowledged this, as seen by Sanderson’s report that Préval “will manage relations with Cuba and Venezuela solely for the benefit of the Haitian people, and not based on any ideological affinity toward those governments.”[10] Despite this recognition, the U.S. government fought strongly against these agreements, evidencing the true priorities of U.S. policies towards Haiti. The U.S. earlier stated that it is “Haiti’s most important and reliable bi-lateral partner,” but these cables show the limits of Washington’s commitment to aid Haiti. Rather than supporting Haitian attempts at development, the U.S. was willing to undermine beneficial agreements in order to continue its anti-Chávez policies and to protect the interests of big oil companies.

Textiles: U.S. Interference in Wage Laws

In another instance of U.S. interference documented by WikiLeaks, the Obama administration tried to prevent minimum wages in Haiti from rising above 31 cents an hour. In 2009, Port-au-Prince passed a law that raised the minimum wage from an astonishingly low 24 cents to 61 cents an hour.[11] This law would have increased the minimum wage by 150 percent to about USD 5 a day, but, even with this large increase, the new measure would still have fallen short of the estimated USD 12.50 a day needed to provide for a family of four in Haiti.[12]

The proposed wage increase was of course enormously popular with Haitians, who argued that the increase was necessary because of the rising cost of living. However, U.S. textile companies with factories in Haiti, including Fruit of the Loom, Hanes, and Levi Strauss, fought the measure, while the U.S. State Department also exerted pressure on the government of Haiti. David E. Lindwall, a deputy chief of mission, said the minimum wage increase “did not take economic reality into account” and was a populist measure for “the unemployed and underpaid masses.”[13] U.S. plant owners argued that, should the cost of labor rise substantially, these U.S. companies would have to close their factories in Haiti and relocate. Based on the insistence of these U.S. textile companies and the U.S. embassy, the Haitian government agreed to limit the increase to only 7 cents, at 31 cents an hour.[14]

The recent fight over the proposed wage increase is merely the most recent instance where U.S. foreign companies have tried to keep wages low by threatening to close production facilities in the country. The Haitian Platform to Advocate Alternative Development (PAPDA) argues that every time the government of Haiti has proposed a minimum wage increase, lead industries “cried wolf” and threatened to halt production in all major factories in the nation, further jeopardizing economic stability in the country. However, according to PAPDA, “in every case, it was a lie.”[15]

PAPDA implies that closing factories is an empty threat made by U.S. businesses to extort low wages. Based on the actual cost of the minimum wage increase relative to overall profits, this is likely the case. According to a U.S. embassy cable, it would cost Hanes USD 1.6 million a year to pay its workers an extra USD 2 a day. This cost is very low compared to the company’s registered profits of USD 211 million with sales of USD 4.3 billion.[16] Furthermore, Haiti already has some of the lowest paid workers in the world, so finding cheaper labor would be unlikely. Yet whether or not U.S. factories would actually pull out of Haiti, the cables are significant in pointing to the weight of U.S. influence in Haiti. The degree of power U.S. businesses exert over the government of Haiti is particularly alarming as it prioritizes U.S. financial gains over fundamental economic improvements for 25,000 poverty-stricken textile workers.

Elections: International Support for Non-Democratic Process

Leaked cables also provide further information about the international community’s support for Haiti’s 2009 elections. International election donors, including ambassadors, members of NGOs, and leaders from the UN, were charged with monitoring the election procedures and reporting instances of electoral fraud. Yet these donors ignored their responsibility to uphold democratic standards, as they supported these elections despite unfair electoral procedures.

Haiti’s Provisional Electoral Council (CEP), which was appointed by then-President Préval, decided to exclude the political party Fanmi Lavalas (FL) under the guise of not having proper documentation. FL, the party of exiled former President Jean-Bertrand Aristide, is a leftist political party that is also very popular among the poor. However, its influence has waned since Aristide was overthrown in 2004 and exiled in a U.S.-supported coup. Since Aristide’s removal from office, Préval’s party has worked to curtail the FL’s influence and popularity, and the party has been excluded in several elections.

The FL’s exclusion caused concern among international donors charged with overseeing the electoral process. Canadian Ambassador Gilles Rivard questioned the impact that this exclusion would have on the elections: “If this is the kind of partnership we have with the CEP going into the elections, what kind of transparency can we expect from them as the process unfolds?”[17] Furthermore, leaked U.S. cables said the decision of the electoral council was “almost certainly in conjunction with President Préval,” as an attempt to rig the outcome of the election.[18] International donors recognized the dangers of supporting the elections: they would not only be undermining democratic procedures but also would be seen as supporting Préval.

Despite these initial concerns, the international community decided to support the elections. A cable sent by U.S. Ambassador Kenneth Merten recorded the views of a European Union representative, who said, “the international community has too much invested in Haiti’s democracy to walk away from the upcoming elections, despite its imperfections.”[19] Furthermore, Merten argued that the elections should proceed because “without donor support, the electoral timetable risks slipping dangerously, threatening a timely presidential succession.”[20] In total, international donors gave an estimated USD 12.5 million to finance the election—about 72 percent of the total cost—even though they knew that the election was not free or fair.[21]

The Organization of American States adjudicated the disputed first round results and decided that the run-off candidates would be Michel Martelly and Mirlande Manigat. Martelly proceeded to win the election, but, notably, only 23 percent of Haitians participated. This marks the lowest participation rate in the entire hemisphere since 1945. The lack of voter participation has been attributed to disappointment about the exclusion of the FL and dislike of the two candidates.[22]

The circumstances of the election reflect a difficult situation for the international community’s involvement in Haiti. Its disregard for standard democratic procedures, with open and fair elections, undermines a commitment to democratic ideals. On the other hand, if they had refused to support the elections, Haiti could once again fall into political turmoil. Such chaos would plague other international investments in the nation, while potentially further stalling the realization of stability and development in Haiti.

Conclusion

The repercussions of the WikiLeaks Haiti cables are a far cry from the massive national security breaches that the U.S. government originally feared. The cables detailing U.S. relations with Haiti do not contain the same devastating potential as other cables might have, and the information leaked here will not jeopardize national security. Whether or not WikiLeaks was justified in releasing this classified information, these cables shed valuable light on the hypocritical nature of U.S. foreign policy in one of the world’s most troubled nations. Based on these cables, we see a disturbing image where U.S. foreign policy is shaped by the interests of the rich and is geared toward underhanded interference in the affairs of other nations.