An anecdotal account of Haiti's medical situation created by structural violence and negligence. Go to Peoria's Medical Mafia and PMM Daily to see Peoria's role. Also see Live From Haiti and Haitian Hearts.
Saturday, October 29, 2011
Sobering Statistics
Photo by John Carroll
Haiti: A History of Poverty and Poor Health
Haiti has extremely poor health indices. The life expectancy at birth is 61 years (9), and the estimated IMR (Infant Mortality Rate) is 64 per 1,000 live births, the highest in the Western Hemisphere. An estimated 87 of every 1,000 children born die by the age of 5 years (9), and >25% of surviving children experience chronic undernutrition or stunted growth (10). Maternal mortality rate is 630 per 100,000 live births (10).
Haitians are at risk of spreading vaccine-preventable diseases, such as polio and measles, because childhood vaccination coverage is low (59%) for polio, measles-rubella, and diphtheria-tetanus-pertussis vaccines (9). Prevalence of adult HIV infection (1.9%) and tuberculosis (312 cases per 100,000 population) in the Western Hemisphere is also highest in Haiti (11,12), and Hispaniola, which Haiti shares with the Dominican Republic, is the only Caribbean island where malaria remains endemic (13).
Only half of the Haitian population has access to health care because of poverty and a shortage of health care professionals (1 physician and 1.8 nurses per 10,000 population), and only one fourth of seriously ill persons are taken to a health facility (14). Before the earthquake hit Haiti in January 2010, only 63% of Haiti’s population had access to an improved drinking water source (e.g., water from a well or pipe), and only 17% had access to a latrine (15).
Emerging Infectious Diseases
Friday, October 28, 2011
Monday, October 24, 2011
Malaria Vaccine
Photo by John Carroll
October 23, 2011
New York Times
Two Cheers for the Malaria Vaccine
A vaccine to protect children against malaria has been shown moderately effective in a large clinical trial — an achievement that could save millions of lives. The vaccine, known as RTS,S and made by GlaxoSmithKline, is the first ever to be shown effective against a human disease caused by parasites. When tested in 6,000 infants ages 5 to 17 months in seven sub-Saharan nations, it reduced the risk of infection with severe malaria by 47 percent during the year after the shots, far less than the 90 percent efficacy rate typically sought for other vaccines. And there are other big hurdles still to surmount. There are hints that the protection may wane over time and results from administering a booster shot won’t be known until 2014. Side effects could pose a problem; seizures and fevers were higher among children given the vaccine.
If final results of this ongoing study, which involves more than 15,000 children in all, show that the vaccine is safe and effective, the goal is to deploy it in 2015.
Glaxo has pledged to sell the vaccine at its manufacturing cost plus 5 percent that will be spent on research on malaria and neglected diseases. The company has not set a price, and, once it does, international donors and African health systems will have to find the resources to buy and administer it at a time of global recession.
The Bill & Melinda Gates Foundation deserves major credit. Glaxo spent $300 million over 25 years to develop the vaccine for military personnel and travelers but was unwilling to pay for pediatric trials for impoverished nations without a partner. The Gates Foundation donated $200 million to drive the research to completion, and Glaxo expects to add another $100 million of its own.
The fight against malaria has made gains thanks to effective drug treatments, insecticide-treated bed nets and programs to spray the interior walls of houses. With the vaccine, health experts are talking with renewed optimism about eradicating malaria entirely (some countries already have). But it will take vigilance and money to stay ahead of resistant mosquitoes and parasites.
Wednesday, October 19, 2011
Cholera Vaccinations to Start
Photo by John Carroll
Cholera Treatment Center
Haiti
Haiti turns to vaccinations a year after cholera struck
Jacqueline Charles
jcharles@MiamiHerald.com
In a dramatic policy shift, Haiti has agreed to support a massive vaccination program to slow a cholera outbreak that has claimed more than 6,000 lives and sickened almost a half-million people.
Beginning in January, Boston-based Partners in Health will provide two dosages of the oral vaccine Shanchol to 100,000 Haitians living in two vulnerable communities: a neighborhood in Port-au-Prince, where potable water and latrines are luxuries, and to an isolated rural village in the lower Artibonite Valley region. The disease outbreak was first detected in the region a year ago this moth.
“We need to bring every resource available to stop the epidemic,’’ said Dr. Paul Farmer, a Harvard University professor who co-founded Partners In Health and serves as deputy U.N. Special Envoy for Haiti.
On the eve of last year’s presidential election, former President René Préval declined to launch a similar vaccination program, fearing social unrest. Government health officials said the program was not adopted because there weren’t sufficent vaccines for everyone.
President Michel Martelly, who was elected in March, and Prime Minister Garry Conille have voiced support for the new vaccination campaign.
“President Martelly is definitely behind the vaccine and so encouraged his ministry of health,’’ said Dr. Louise Ivers, senior policy adviser for Partners In Health. She believes continued deaths and advocacy from health groups helped shape the new policy.
The group is launching the program with Haiti’s health ministry and the GHESKIO Center, a well-respected Haitian aid group known for its groundbreaking work with HIV/AIDS patients in Haiti.
Partners In Health, which spends about $500,000 a month to treat cholera patients, says Haiti’s epidemic is the world’s largest. The decision to vaccinate Haitians comes as the country struggles to bring cholera under control, access to portable water and latrines in the country’s post-earthquake camps sharply decline and as international aid dollars wither.
“There is a steady erosion of support of people coming and leaving,’’ said Farmer, who calls it the “Attention Deficit Disorder” of humanitarian work. “Wavering attention, short cycle of interest.”
Still, getting the international community to pay for the vaccine, which costs $185 per dose, remains a challenge. The United Nations has struggled to raise $300 million for cholera outreach in recent months. At the same time, those opposed to vaccinations, are concerned that it will detract from public campaigns for better sanitary measures in Haiti, and from the need to promote potable water and improved sanitary conditions in a country were many people lack both.
A recent a survey of 626 camps with 502,000 homeless quake victims by water and sanitation experts, showed that access to potable water had gone from 48 percent in March to 7 percent in August. Meanwhile, the percentage of camps with available hand washing stations went from, 20 percent to 12 percent during the same period.
Conille, a medical doctor, said tackling cholera is among his top priorities. He wants to launch an army of young Haitians — one for every 200 households — to educate communities about prevention and treatment of waterborne disease.
“I see this, despite the fact that it has had a devastating effect, as an opportunity for us to quickly strengthen our system and address other big public health issues,’’ he said.
Meanwhile, those supporting the use of vaccines dismiss arguments that it will take away from public education campaigns promoting better hygiene among Haitians.
“I have access to potable water. That is not the case of the majority of the people who don’t have enough water to dink much less to wash their hands,’’ said Bill Pape, director of the GHESKIO Center.
Across from the clinic are two well known slum communities, the City of God and Eternal, constructed below sea level.
“If you start to dig for latrines you hit water,” Pape said.
Pape said the best solution to solving cholera in Haiti is improving water and sanitation in the country, which has some of the worst conditions in the world. But that cannot be done overnight, he said. The benefits of the chosen vaccine, which provides 70 percent effectiveness, last for about two years and the impact on the community is “enormous,” Pape said.
By vaccinating about 50 percent of a population, the immunity could spread to the entire community, experts say.
“I don’t see why you don’t provide it. It’s like going to war, using the artillery and not the aviation,’’ Pape said. “We need to give everything that is available. The disease is going to be here for a long time.’’
Still, introducing the disease has been controversial. Last year, as some pushed for vaccination, Haitian government health officials rejected the idea. They were concerned about social unrest because there were only 200,000 doses available.
Some officials also feared usage could divert attention from public prevention campaigns pushing potable water and sanitary measures. The Pan-American Health Organization was also reluctant to introduce a limited supply of vaccines early in the outbreak. The group “strongly recommended” after a meeting last December with cholera, immunization and disease control experts that a stockpile of vaccines should exists before vaccinations begin.
Jon Andrus, deputy director of PAHO, said the multiple doses that must be ingested could pose a problem.
“The more doses of vaccines makes it more difficult, particularly in Haiti,’’ Andrus said. “If there was to be developed a single-dose vaccine, particularly for children, that would be marvelous. Trying to get a second dose in a person in a refugee emergency, new settlements (and) migrating earthquake population is going to be tough.”
Dr. Arthur Fournier, co-founder of University of Miami’s Project Medishare, which operates three cholera treatment centers in Haiti’s central plateau, said the cholera epidemic has not received the attention it deserves.
“I am OK with doing a cholera vaccination program as long as we do all we can in terms of community education,’’ he said.
Read more: http://www.miamiherald.com/2011/10/19/v-print/2462505/haiti-turns-to-vaccinations-a.html#ixzz1bHjYQUs3
Haiti's First Cholera Anniversary
Photo by John Carroll
Cholera Treatment Unit
Port-au-Prince
In October 2010 cholera started started infecting and killing Haitians.
It has been one year now and conservative numbers say that cholera has infected 500,000 Haitians and killed 6,500 of them. This is more than any place in the world. Including India, Africa, Anywhere....
And these numbers are the "documented" cases. The sick little old man who couldn't make it across the swollen creek yesterday in Haiti's mountains is left out of these statistics.
Dirty water is to blame. And Haiti's water was deplorable long before the earthquake in 2010. It was deemed worst in the world in 2002....
That is one of the reasons I named this blog Dying in Haiti six years ago. Dirty water....
Below is an article by Trenton Daniel that summarizes the cholera situation in Haiti very well.
AP Interview: Expert says Haiti has worst cholera
Associated Press
PUBLISHED TUESDAY, OCT. 18, 2011
PORT-AU-PRINCE, Haiti -- Haiti has the highest rate of cholera in the world a mere year after the disease first arrived in the Caribbean nation, a leading health expert said Tuesday.
Dr. Paul Farmer, one of the founders of the medical group Partners in Health and U.N. deputy special envoy to Haiti, said cholera has sickened more than 450,000 people in a nation of 10 million, or nearly 5 percent of the population, and killed more than 6,000.
Farmer told The Associated Press on the anniversary of cholera's arrival in Haiti that it's also on the verge of becoming the leading cause of death by infectious disease in the Caribbean nation.
"It's freakin' incredible," Farmer said by telephone. "In 365 days, you go from no cases to the largest number in the world."
That's significantly more than the 100,000 to 300,000 cases documented annually in Bangladesh, Farmer said. The Democratic Republic of Congo sees 13,000 to 30,000 cases a year.
He also said that cholera is likely to become endemic in Haiti, meaning it will become "native" to the country.
"It's going to be with us for a long time," he said.
Farmer attributes the spread of the disease to what he describes as Haiti's status as the "most water insecure" country in the world, which means many people have insufficient access to clean water.
Cholera is caused by a bacteria found in contaminated water or food. It spreads quickly in unhygienic environments and can quickly kill people through complete dehydration, but is easily treatable if caught in time.
Haiti has long suffered from improper sanitation because of its poverty but sanitation conditions in the capital and other urban areas became much worse after last year's earthquake forced thousands of people to set up makeshift shelters in public plazas, soccer fields and other open areas.
Evidence suggests that the disease inadvertently arrived in Haiti by U.N. peacekeeping troops from Nepal. Cholera then spread through Haiti's biggest river because a Haitian contractor failed to ensure proper sanitation at the U.N. base.
There were no documented cholera cases in Haiti prior to the start of the outbreak a year ago this month.
The epidemic threatens to worsen before it abates as the year's second rainy season causes the disease to spread.
The foreign aid group Doctors Without Borders said in a statement Tuesday that it continues to see "dangerous and unpredictable fluctuations" in the number of cholera cases.
For example, the group said it treated 281 patients for cholera in the Haitian capital in the last week of August. That number jumped to 840 per week a month later.
Aggravating the situation will be the withdrawal of humanitarian workers who leave because of a lack of funding, the United Nations' Office for the Coordination of Humanitarian Affairs said Tuesday.
That means fewer drainage services and less maintenance on the latrines aid workers set up in the settlement camps.
Out of 12,000 latrines needed, only about a third were reported to be working in August, down from more than 5,800 the month before, OCHA said. Meanwhile, the number of nonfunctional latrines more than doubled, from about 1,300 in July to about 2,600 in August.
Also, more than 1,000 latrines have been abandoned, leading to outdoor defecation, which heightens the risk of contamination for people living in the camps.
The United Nations Office for Project Services and the government's water and sanitation agency halted the cleaning of latrines at the end of August because of lack of funding, OCHA said.
Despite the spread of cholera, Farmer said it was possible to wipe out the disease by improving Haiti's water system and sanitation. The use of education and oral vaccines is also important, he added.
"To eradicate cholera we're going to have to vaccinate huge numbers of people," Farmer said. "It's going to require a massive campaign like polio."
Monday, October 17, 2011
Sunday, October 16, 2011
Haiti Does Not Need An Army
The Washington Post
A new army is not what Haiti needs
By Editorial, Sunday, October 16, 6:29 PM
HAITI’S CATALOGUE of critical needs seems endless, all the more so since the crippling earthquake in January last year. But one item nowhere near the top of Haiti’s list of priorities, nor even remotely advisable, is reconstituting a national army. Unfortunately, President Michel Martelly wants to do just that.
Haiti’s army was disbanded in 1995 by President Jean-Bertrand Aristide, and with good reason. Four years earlier, Mr. Aristide was just the latest of many Haitian leaders whose tenures were violently cut short by army officers or enlisted men; he abolished the army after being restored to power by the United States.
Whatever Mr. Aristide’s other merits or flaws, getting rid of the army counts as a signal achievement. For years, the army, in the absence of real external threats, had been primarily an instrument of repression and blood-curdling human rights abuses.
Mr. Martelly, a political novice who took office this year, has argued that a new Haitian army would bear no resemblance to the bad old one. He says a reconstituted force would be used mainly to respond to natural disasters and emergencies or to interdict contraband and drug transshipments.
It would be nice to believe that; it would also be naive. Mr. Martelly has extensive ties with right-wing groups, including allies of former dictator Jean-Claude Duvalier, whose regime carried out atrocious abuses. With little support in parliament or from any organized political party, he finds himself perched perilously atop a political system that he has been unable to bend to his will. The temptation must be strong to follow the example of so many former Haitian leaders who found it convenient to fashion a band of loyalists into an armed force beholden to the president and hostile to his rivals — a far cry from what Haiti needs.
The start-up costs of establishing an army are estimated at $95 million — a huge sum in a country whose annual budget barely exceeds $1 billion. It’s not clear where the funds would come from; under no circumstances should the United States or other donor countries contribute.
That money could be put to much better use: fighting a cholera epidemic that has killed or sickened hundreds of thousands; removing rubble that still clogs entire neighborhoods; resettling thousands who remain without permanent homes; and rebuilding government ministries in the capital, Port-au-Prince.
Haiti does have a crime problem; its 8,400-man police force is inadequate in a country of 9 million. It makes more sense for Mr. Martelly to beef up and professionalize the police than to revive an institution so closely identified with the violence, terror and repression that have plagued Haiti for years.
A new army is not what Haiti needs
By Editorial, Sunday, October 16, 6:29 PM
HAITI’S CATALOGUE of critical needs seems endless, all the more so since the crippling earthquake in January last year. But one item nowhere near the top of Haiti’s list of priorities, nor even remotely advisable, is reconstituting a national army. Unfortunately, President Michel Martelly wants to do just that.
Haiti’s army was disbanded in 1995 by President Jean-Bertrand Aristide, and with good reason. Four years earlier, Mr. Aristide was just the latest of many Haitian leaders whose tenures were violently cut short by army officers or enlisted men; he abolished the army after being restored to power by the United States.
Whatever Mr. Aristide’s other merits or flaws, getting rid of the army counts as a signal achievement. For years, the army, in the absence of real external threats, had been primarily an instrument of repression and blood-curdling human rights abuses.
Mr. Martelly, a political novice who took office this year, has argued that a new Haitian army would bear no resemblance to the bad old one. He says a reconstituted force would be used mainly to respond to natural disasters and emergencies or to interdict contraband and drug transshipments.
It would be nice to believe that; it would also be naive. Mr. Martelly has extensive ties with right-wing groups, including allies of former dictator Jean-Claude Duvalier, whose regime carried out atrocious abuses. With little support in parliament or from any organized political party, he finds himself perched perilously atop a political system that he has been unable to bend to his will. The temptation must be strong to follow the example of so many former Haitian leaders who found it convenient to fashion a band of loyalists into an armed force beholden to the president and hostile to his rivals — a far cry from what Haiti needs.
The start-up costs of establishing an army are estimated at $95 million — a huge sum in a country whose annual budget barely exceeds $1 billion. It’s not clear where the funds would come from; under no circumstances should the United States or other donor countries contribute.
That money could be put to much better use: fighting a cholera epidemic that has killed or sickened hundreds of thousands; removing rubble that still clogs entire neighborhoods; resettling thousands who remain without permanent homes; and rebuilding government ministries in the capital, Port-au-Prince.
Haiti does have a crime problem; its 8,400-man police force is inadequate in a country of 9 million. It makes more sense for Mr. Martelly to beef up and professionalize the police than to revive an institution so closely identified with the violence, terror and repression that have plagued Haiti for years.
Monday, October 10, 2011
Haiti's Stalled Recovery
(Photo by John Carroll)
Editorial, Toronto Star, October 7, 2011
http://www.thestar.com/opinion/editorials/article/1066878
“As school goes, so goes the nation.”
That’s how Josué Mérilien, a Haitian teacher and union leader, sees it. And the schools aren’t going well. Teachers make as little as $100 a month, fees are high, and there’s a “terrible problem” of kids showing up faint with hunger.
“What we have is an absurd imitation of a school that isn’t conducive to thinking,” he recently told Le Nouvelliste newspaper.
It’s a depressing sign of the times nearly two years after the earthquake that shattered Haiti, leaving 220,000 of its 10 million people dead and cities in ruins. Today, 600,000 still live in sketchy, cholera-threatened camps, their lives on hold. Like Haiti’s promised rebirth.
After presiding over a half-year of political wrangling, Haitian President Michel Martelly finally obtained parliament’s approval this past week for a prime minister. Garry Conille will preside over a cabinet with the daunting task of rebuilding the country. “My greatest fear is that if we don’t buy time, this country will explode in a few weeks, a few months,” Conille told the Miami Herald. Sadly, others don’t seem to share that sense of urgency.
Although Canada is a key donor, pledging $1 billion in help, Foreign Affairs Minister John Baird did not mention Haiti’s needs in his Sept. 26 speech to the United Nations General Assembly. That’s how little attention Haiti is getting these days. The world is distracted by the Arab Spring, famine in Africa and Europe’s economic woes.
Of the $5 billion promised for reconstruction, Haiti has seen just $2 billion so far. Of that, less than $300 million has gone through the Haitian government, sapping its credibility. And incredibly, United Nations relief chief Valerie Amos says Haiti has yet to see $160 million of the $380 million in urgent humanitarian relief that was promised. The camps are short on food, drinking water and toilets.
As Martelly pointed out in his own UN address, the world’s grand promises are fast becoming “dead letters.” That neglect, coupled with the regime’s precariousness, could prove explosive.
Martelly won power in a deeply flawed presidential election earlier this year. Chillingly, his supporters welcomed the return of past dictator Jean-Claude (Baby Doc) Duvalier with open arms. And Martelly has been criticized for wanting to build up the army (as the Duvalier family had) rather than the police.
None of this is reassuring. But Haitians have made their choices, and the world must honour its promises to help them rebuild. That means delivering the remaining $3 billion in help promised for this year, channelling more of it through Haiti’s government to strengthen its credibility and capacity, and keeping a sufficiently robust UN peacekeeping force in place until the growing police service can take over.
It also means making sure kids don’t faint from hunger in school.
Thursday, October 06, 2011
Wednesday, October 05, 2011
Monday, October 03, 2011
An Old Story on Baby Doc
Photo by John Carroll
Monday, Feb. 10, 1986
Haiti Bad Times for Baby Doc
By John Moody.;Dean Brelis/Port-au-Prince and Bernard Diederich/Miami
Like a hurricane born in the Caribbean and gathering momentum as it pushes northward, word spread last week that Jean-Claude Duvalier, 34, Haiti's President-for-Life, had fled his country. The reports said that Duvalier, who is known as "Baby Doc," and members of his family had gone into exile rather than face vengeance at the hands of a burgeoning populist movement against him. On Friday, in response to growing unrest throughout Haiti, Duvalier imposed a state of siege. Hours later White House Spokesman Larry Speakes made the dramatic announcement to reporters traveling with President Reagan aboard Air Force One that the Haitian government had fallen and Duvalier had left Haiti.
Yet within hours, to the vast embarrassment of the Reagan Administration, the pudgy dictator appeared in the capital, Port-au-Prince, like a spirit conjured up by practitioners of voodoo, Haiti's folk religion. Baby Doc cruised through the streets in a BMW, surrounded by a bevy of armed outriders. In a radio broadcast to the country, he used an old Creole saying to brag, "I am here, strong and firm as a monkey's tail."
Haiti's crisis last week centered on a family that has used terror and corruption for 28 years to grow wealthy by imposing its will on the poorest country in the Western Hemisphere. For the first time in Baby Doc's reign, spontaneous demonstrations throughout the country brought misery-ridden Haiti close to open revolt. Rioters controlled many parts of the countryside, and the government was firmly in control of only the capital.
The demonstrations against Jean-Claude Duvalier stood in stark contrast to the events of Jan. 22, 1971, when then President-for-Life Francois ("Papa Doc") Duvalier decreed that his 19-year-old son, quickly nicknamed Baby Doc, would succeed him. The elder Duvalier died three months later, leaving a legacy of brutality and fear on which he had built a dictatorship after his election in 1957.
At first it appeared that Jean-Claude might be a more enlightened despot. He promised an end to repression and an economic revolution. But he actually made few real improvements. True, political opponents were no longer executed as often as they had been under Papa Doc, but the son imitated the father in using the army and the secret police, the dreaded Tonton Macoute (a term for bogeyman in Haiti's Creole dialect) to brutalize the population.
The second-generation Duvalier flaunted an opulent life-style in the midst of incredible poverty. The President, who is fond of yachts and sports cars, did not forgo either pleasure when a critical shortage of foreign currency last year left the country almost without fuel. His most costly indulgence may have been his 1980 marriage to Michele Bennett, 34, a Haitian divorcee who once worked in New York City as a secretary. Their wedding was Haiti's social event of the decade. The price tag: $3 million. Fireworks alone cost $100,000.
Michele Duvalier at first endeared herself to the population by distributing clothes and food to the needy and opening several medical clinics, but her avarice quickly outpaced her husband's. Today she is one of the world's richest women. On shopping sprees to the U.S. and Europe, she has acquired an array of furs hardly appropriate to Haiti's steamy climate. Late last year, in the middle of an economic crisis, she flew to Paris to buy designer clothes, jewelry and works of art.
Government officials fear the First Lady because her power rivals, or perhaps exceeds, her husband's. While Jean-Claude sometimes dozes through Cabinet meetings, his wife scolds ministers. The birth of her son, Francois Nicolas, in 1983 provided an heir apparent to the Duvalier fiefdom.
At the same time that the Duvaliers have been salting away millions of dollars in foreign banks and squandering millions more, the vast majority of Haitians live in deep poverty. Eight out of ten people are illiterate. Most earn less than $150 a year, although the official per capita figure is about $280. The tropical farmland produces coffee and mangoes for export, but the country is plagued by widespread hunger. Its once thriving hardwood forests have been chopped down for fuel.
Given that yawning gap between haves and have-nots, political ferment was inevitable. The U.S., which provided $54 million in aid to Haiti in 1985, warned Duvalier that future payments would be jeopardized unless he improved the country's human rights record.
The regime's reply was a nationwide referendum last July 22. Truckloads of illiterate Haitians were driven from one polling place to another to vote oui a dozen times or more. The official results: 99.98% reaffirmed Baby Doc as President-for-Life.
Young opponents of the regime, outraged by the sham referendum, started organizing nonviolent protests that tapped a wellspring of discontent. When three students were killed on Nov. 28 during an antigovernment protest in Gonaives, demonstrations followed in a dozen cities and towns. Last month an army captain and two members of the Tonton Macoute were charged with the murders.
The government in recent months has tried to intimidate the Roman Catholic Church, which has become a center of dissent. Some 80% of Haitians are nominally Catholic, and the clergy has spoken out more since the 1983 visit of Pope John Paul II, who criticized the Duvalier regime and assured the downtrodden population "I am with you." One day after the July referendum, a 78-year-old Belgian-born priest was beaten to death by thugs. Three other priests, including the director of the Catholic-run radio station Radio Soleil, were expelled from the country in July.
Last week's unrest began in church. Sunday's evening Mass at the old Cathedral of Cap Haitien had just concluded when a lone voice in the congregation bellowed out, "Abas (Down with) Duvalier!" With startling vigor, the cry was taken up by other worshipers, and the chanting demand for Duvalier's ouster quickly became the catalyst for a short-lived demonstration on the steps of the church.
Within minutes, army troops from a nearby barracks descended on the crowd. The soldiers fired rifles into the air, rained down blows with hardwood clubs, and barged into the cathedral in search of the instigators. As word of the brutal military response spread, thousands of demonstrators roamed through the historic town. The following day the Tonton Macoute showed it had learned nothing from the November killing of the Gonaives students. At a demonstration by several thousand people outside the Cap Haitien Cathedral, militiamen fired wildly into the crowd, killing three people and wounding 30.
On Wednesday the Cap Haitien warehouse of CARE, the U.S.-based relief organization, was stormed and looted by slum dwellers. They trampled three people to death, then fought over canisters of cooking oil and 100-lb. sacks of grain.
Almost hour by hour, the swells of revolt kept growing. Nearly half the 60,000 inhabitants of Cap Haitien marched peacefully through the streets Wednesday afternoon, calling on the army to stage a coup d'etat and take power. There were also appeals for a general strike to begin Feb. 12. Such a sustained work stoppage would probably cripple the moribund Haitian economy, which gets much of its foreign currency from tourism.
By Thursday the chant "Down with Duvalier!" was echoing across the country. Said one resident of Cap Haitien: "No one is afraid anymore. Duvalier must go." In Gonaives, thousands of protesters blocked the streets with barricades and burning tires. When the local army headquarters was overrun by anti-Duvalier marchers, agents of the Tonton Macoute tried to open fire, but they were disarmed by an army tactical battalion. Terrified, the agents ripped off their trademark blue denim uniforms and tried to escape the mob's wrath. More crowds demanded that the military overthrow the dictatorship, and rumors started that Baby Doc, his wife and an entourage of 100 had already fled to France.
Even after Duvalier had declared a 30-day state of siege and the armed forces put on a heavy display of power, the riots continued. At an early Mass at the St. Jean Bosco church in a poor district of the capital, a soldier shot and wounded the priest for no apparent reason. An enraged congregation spilled into the street and set off more protests. In other parts of town, militiamen fired into the crowds, while rioters smashed car and store windows, looted shops, and constructed roadblocks from tires and burning garbage. By week's end an estimated 26 people had been killed. Although none of the 14,000 U.S. citizens in Haiti were reported injured, the State Department advised Americans not to travel there.
On Saturday, the capital was tense but calm. There were reports of demonstrations in Cap Haitien, the second largest city, and the Dominican Republic, which lies east of Haiti on the island of Hispaniola, was nervously monitoring the volatile situation. While Duvalier was still in Haiti, there were serious questions about whether the President-for-Life would be President for long.
The protests that lured thousands of Haitians into the streets last week to denounce the government probably represent a point of no return for the country. Even if Duvalier's reign has not yet ended and he somehow manages to cling to power for a while, his viselike grip on Haiti has been irrevocably shattered.
Sunday, October 02, 2011
Roger Annis
Photo by John Carroll
Letter to the editor, Ottawa Citizen:
Foreign powers are the principal beneficiaries of impunity for human rights crimes in Haiti
Vancouver BC
October 2, 2011
To: Mr. Gerry Nott, Publisher and Editor in Chief, Ottawa Citizen
Mr. Peter Robb, Deputy Editor, News, Ottawa Citizen
Dear Mr. Nott, Mr. Robb,
The call by Amnesty International Canada's Alex Neve and co-author Andrew Thompson for prosecution of former Haitian tyrant Jean-Claude Duvalier in your edition of September 26 (reproduced below) is timely and welcome. We would like to add here a few critical thoughts and observations on the Canadian government’s role and responsibilities in Haiti that will help to set a fuller context.
Mr. Neve and Mr. Thompson write that Canada should press the current president Michel Martelly to "get down to the business of justice" by ending the standoff between himself and the country’s other elected institutions and proceeding with a prosecution of Mr. Duvalier. A little explanation is in order.
Martelly's constitutional role is to facilitate the formation of a government by nominating a prime minister. The nominee must be acceptable to Haiti's elected House of Representatives (Chambre des députés) and Senate, so a degree of tact and compromise on the part of the president is required. It is the successful nominee for prime minister who then forms a government.
The current standoff results from Martelly’s wish to have a fellow, right-wing ideologue accepted as prime minister. Thankfully, the House and Senate have refused to rubber stamp his first two nominations—businessman Daniel Gerard Rouzier and disgraced former chief cop of Haiti under the illegal coup d’etat regime of 2004-06, Bernard Gousse.[1]
Neve and Thompson write that Canada should pressure Martelly to get on with the nomination process. They are correct in so urging. But words of caution are called for.
Canada, the U.S. and Europe are part of the problem here because they bankrolled the exclusionary election process that brought Martelly to power six months ago. It is not surprising that Martelly would show no interest in the Duvalier prosecution because he is an associate of those with close ties to the former tyrant’s regime. He has surrounded himself with advisers who were ministers or other functionaries in and around the regime. Martelly was a vigorous supporter of the overthrow of elected government in 2004.[2]
What’s more, Canada has already refused an explicit call to assist the Haitian judicial system to prosecute Duvalier. It came in the form of a presentation to the Standing Committee on Foreign Affairs and International Development of the Canadian Parliament in early March 2011 by René Magloire, special advisor on legal issues to then-President René Préval.[3]
It now appears that the U.S., at least, is smarting under the international condemnation of the dysfunction of the Martelly presidency that is has so vigorously supported. Earlier this month, it stepped in to impose the nomination for prime minister of a Haitian-born but foreign-residing assistant to Bill Clinton named Garry Conille.[4] The House has accepted the new nominee in a unanimous vote; a vote in the Senate is still pending.
In arguing that Canada should step in and push Martelly in a certain political direction, Neve and Thompson pen an unfortunate and prejudicial choice of words. They write, “For too long, including during the terrifying Duvalier years, Haiti has suffered from a culture of impunity.”
Of which “Haiti” are they writing? Yes, the “Haiti” of the country’s economic elite has long enjoyed impunity in imposing extreme poverty and gross violations of human rights on their countrymen and countrywomen. Its ruthless rule has long enjoyed the backing or the acquiescence of the so-called democracies of the hemisphere and Europe.
The “Haiti” of the country’s poor majority, on the other hand, has always been deeply committed to democracy, the rule of law and accountability of political leaders. This Haiti rose up in 1986 in its millions to oust the Duvalier tyranny. Ever since, it has fought against great odds to move the country forward along a path of democracy, social justice and respect for human dignity.
Alas, that valiant struggle has been frustrated and betrayed every step of the way by the big countries that hypocritically claim to stand for human rights. In 2004, Canada, the U.S. and Europe joined in the overthrow of Haiti’s then elected and socially progressive government.
The overriding problem with human rights impunity in Haiti resides not within Haiti’s borders but within those countries that sponsor and organize coups, aid embargos and all kinds of other destructive intervention in Haiti’s internal affairs.
In Canada, members of Parliament and the Senate, all the major media outlets and an important part of the country’s international development community turn a blind eye to so much of what has gone wrong in Haiti. So who are the real perpetrators and beneficiaries of impunity in Haiti?
It is good that Amnesty International Canada is speaking out for democracy and human rights in Haiti. We hope to see more in the coming months. We urge it to direct more of its concerns towards ending the foreign intervention that is the fundamental reason for Haiti’s poverty and social underdevelopment. We urge it to join with us in seeing vocal and active advocates for social justice for Haiti among members of the Canadian Parliament and Senate.
Haiti is being run into the ground by an international intervention regime enjoying virtual impunity, for example in the case of the catastrophic introduction of cholera into the country by the Nepalese contingent of MINUSTAH. It now faces a new, grave threat in the form of a plan by Michel Martelly, apparently with the backing of the United States (and Canada?),[5] to revive a Haitian armed forces that was dissolved in 1995 by then-President Jean-Bertrand Aristide to the immense satisfaction of most Haitian people. The country needs all the genuine international assistance it can get.
Sincerely,
Roger Annis
Canada Haiti Action Network
778 858 5179