BACK TO 'HAITI BRIEFING' COVERS Doing the election dance
The Health of Nations
The Lonely Planet: Dominican Republic and Haiti.
Haiti's debt - can't pay, won't pay?
Haiti Briefing Number 35 September 1999
In 1990, the majority of Haitians were enthusiastic voters, but then saw their choice of candidate overthrown by a military coup. When, three years later, President Aristide was returned to power by the United Nations, part of the deal was that he abandon his programme of reforms to benefit the poor.
The US, using the UN fig-leaf, pressed ahead with parliamentary elections in mid-1995, and 50% of the electorate turned out to give democracy another try. They voted in candidates who were expected to represent the needs and aspirations of the majority, but the new Parliament soon found its hands tied by the strings attached to international aid funding. In this peculiar form of democracy, all the important decisions, especially about the economy, were being made, not by elected representatives, but by the IMF and World Bank planners.
When it became clear that the elected officials were essentially powerless, not surprisingly, the electorate lost even more faith in the process. A spontaneous boycott of the partial Parliamentary elections in 1997 produced a turnout of just 5%. A few months later, the Prime Minister and a third of the Ministers resigned. Factionalism within the Parliament prevented the appointment of replacements, and, in a quite surreal fashion, government continued without them for a year and a half. No problem for the international planners - they agreed 'shadow programmes' and 'memoranda of understandings' with what was left of the government.
Another round of partial parliamentary elections, scheduled for the end of last year, just didn't happen, and in January, when the life of the remainder of the Parliament expired, President Préval closed it altogether. Since then, Haiti has been governed without reference to any elected representatives at all. For many it must be hard to notice the difference - with or without a Parliament, life goes on, decisions are taken, and aid money is spent, supposedly on their behalf.
For the 'international community', for whom democracy is synonymous with elections, it is more than a trifle embarrassing. Aid money has been put on hold until new elections take place, and the UN, the EU, and the US are all supporting efforts to hold a general election before the end of this year. They have, though, two looming problems, the resolution of which appears to be irreconcilable. On the one hand, the elections will only be credible if there is significant voter participation. On the other, it seems probable that the only party that can drum up any popular support is that of former President Aristide. The elections will only be credible if enough people vote, and if enough people vote, Aristide's party will surely win.
This quandary explains the current round of 'election engineering' in Haiti. Attempts by US agencies to build a viable electoral coalition to represent conservative interests have failed, mainly because the right wing parties are so unpopular - as Haitians say, "none of them can gather 10 people under a lamppost". Now, attention is focusing on the new voter identification cards which, for the first time, must bear the voter's photograph. The US is paying for the cards, a Canadian company will supply them, and the US-funded International Fund for Electoral Systems will oversee the process. There are four million people of voting age in Haiti, two-thirds of them living in the back of beyond, far, far away from such a thing as a photo booth.
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The Health of Nations
A New York Times article earlier this year questioning AIDS research in Haiti has once again drawn attention to the way the poor people of Haiti have been made to suffer in the name of profits and the free market.
One of the pioneers in the macabre trade involving Haitians in medical research was the leading Duvalierist, Luckner Cambronne. In the late 1970s, Cambronne's profitable sideline selling the blood of Haitians to US laboratories earned him the nickname, "Vampire of the Caribbean". (see box 1)
| Vampire of the Caribbean Through his company, Hemocaribian, (Cambronne) shipped five tons of plasma a month to American laboratories directed by Armour Pharmaceutical, Cutter Laboratories, Dow Chemical, and others. Haitian blood is extremely rich in anti-bodies, for survivors of the country's high disease and infant mortality rate develop much richer supplies of antibodies than necessary in less unhealthy societies. Haitian blood was therefore in great demand, and Cambronne did all he could to satisfy it. He organised clinics that paid donors, indiscriminately chosen, $5 a pint for their blood, then resold it at $35 a pint to the United States. Cambronne also dealt in cadavers, in almost as much demand. To save the living, medical students must dissect the dead, and obtaining corpses in sufficient quantity is the perennial problem of medical schools. Haitian cadavers, readily available once Cambronne entered the business, had the distinct advantage of being thin, so the student had not layers of fat to slice through before reaching the object of the lesson. Cambronne, using the refrigerated container service recently introduced to Haiti, supplied these corpses on demand. When the General Hospital failed to provide him with enough despite the $3 he paid for each body, he simply stole them from various funeral parlours. More than one mourning family opened a coffin for a final viewing to discover it was empty. Source: The Duvaliers and their Legacy by Elizabeth Abbott, 1988. |
Following the collapse of the Duvaliers' nationalist dictatorship in 1986, all aspects of the Haitian economy were opened up to foreign and private business interests. While the Duvaliers had exercised strict supervision of the economy - almost entirely for their own personal gain - the late 1980s saw the first effects of neo-liberalism in Haiti. Just as the ports were opened to allow the flowering of private import-export business to the detriment of Haitian agricultural production, other areas of Haitian society, such as the health sector, could now be easily exploited by foreign organisations and their Haitian cohorts.
One of the most notorious episodes was the experiment with the Norplant contraceptive implant involving women in the Port-au-Prince slum of Cité Soleil. In 1986, a series of private organisations were contracted by the US Agency for International Development and Family Health International to begin administering Norplant - a form of birth control. (see box 2) One of them was a Cité Soleil clinic run by Réginald Boulos, a Haitian doctor who was soon re-emerge as a close associate of Marc Bazin, the Prime Minister who represented the military dictatorship in 1993-4. At this time, Boulos' clinic was also accused of employing members of the FRAPH death squad.
| (box 2) Norplant, commonly referred to as "the five year injection", is an implant which prevents a woman from conceiving for five years. Haiti was one of 22 countries where the same research was conducted on poor women at the behest of the New York-based Population Council, which pioneered laboratory research on Norplant. Researchers chose three private clinics in Haiti to conduct their experiments. One of them was the Development and Health Centre (CDS) in Cité Soleil. In 1991, five years after the trials began, a document published in New York outlined the devastating impact of the experiment on the women's lives. For one thing, a crucial ingredient was in too high a dosage. There were testimonies from women in Cité Soleil haemorrhaging for an entire month. Some suffered severe migraines, dizziness, and nausea, tremendous weight gains and loss; others had lumps develop in their breasts and stomachs. Some had their hair fall off, while others experienced increased high blood pressure and difficult blood circulation. An article that appeared in Population Reports at the time, brought to light additional problems the women experienced: 36% of those who used the product had experienced unfettered haemorrhage for at least 31 days; 12% bled constantly for nine to twelve months. It was also revealed that 24% had not menstruated for nine to twelve months. Overall, this project was not conducted with the aim of empowering women to exercise birth control. Rather, they were used as experimental subjects. While the research was probably very profitable for its sponsors, it created nothing but havoc for the poor women on whom it was done. To add insult to injury, when some of the women wanted to remove Norplant, they received no collaboration from the doctors. (According to Libète editor, Jean-Yves Urfié, women who wanted the implant removed had to pay 100 gourdes, US$6, - a fortune in Cité Soleil.) Source: Health, Population, and Family Planning by Rose-Anne Auguste, Roots Vol.1, No.3, Summer 1995. |
The Boulos family was involved in yet another scandal in 1996 when at least 60 children died after taking a cold cure medicine supplied by the Boulos' Pharval Laboratory. The toxic syrup base of the medicine - containing diethylene glycol, commonly used in anti-freeze - was traced to a German manufacturer and a Dutch distributor. The incident drew attention to the absence of State control of potentially lethal imports, and the lack of State intervention in the health sector in general. The reduction of State intervention is, of course, something that the IMF and World Bank are demanding in Haiti, as elsewhere, in return for aid money. Chandel, a popular organisation Port-au-Prince, declared that the deaths were a result of "privatisation, because the State has dumped peoples' health into the hands of the private sector."
It is in this context that the New York Times article raised concerns about the rights of Haitians participating in AIDS research at a clinic in Port-au-Prince, run by the US Cornell Medical College. As part of its work with sexually-transmitted diseases, the clinic is conducting an eight-year study of couples where one partner is HIV + and the other is not, and they are having unprotected sex. Researchers, seeking clues to developing as vaccine, study the blood of both partners, particularly the uninfected ones who continue to be exposed to the virus. They are trying to find out whether some people have natural protections against infection with the AIDS virus that could be replicated in a vaccine.
The author focuses on the seeming double standards of such research in the US compared with Haiti. US regulations are strongly influenced by outrage over the Tuskegee syphilis study earlier this century when US public health officials withheld effective treatment from poor black men for years. Accordingly, "subjects are not to be pressurised to participate in research…are to be fully informed about the research's purposes and risks…(and) must receive the best available therapy for their illness."
However, although Cornell has received US federal funding (US$7 million over fifteen years) it appears that the Haitian subjects are not told they are part of a study, nor are they offered the anti-retroviral drugs that are now available in the US. Finally , as Haiti Info points out, "there is a question about whether or not patients are adequately counselled against unprotected sex since there is an obvious conflict of interest, especially once a couple has been in the study for a while."
The quandary is that Haiti so badly needs the discovery of an AIDS vaccine. It is estimated that around 300, 000 Haitians are HIV+, that is, around 10% of sexually-active city dwellers, and around 4-5% of sexually-active people in rural areas. (see box 3) It is then perhaps understandable that Haitian doctors involved in AIDS research believe it is their duty, as one put it, "to choose between the survival of ten people and the survival of a nation." However, is it ethical for Haitians to always be the guinea-pigs for medical research when inevitably it will be the inhabitants of rich countries who will benefit first?
To discuss these and other issues concerning the struggle for effective health care in Haiti, the Haiti Support Group has invited Dr. Paul Farmer to the UK. Farmer has battled AIDS in rural Haiti and deadly strains of drug-resistant tuberculosis in the slums of Peru. A physician-anthropologist with more than fifteen years in the field, Farmer is the author of AIDS and Accusation (1992), The Uses of Haiti (1994), and editor of Women, Poverty and AIDS (1996). His new book, Infections and Inequalities, is described by The Guardian as "a powerful and rigorously argued critique of economic and health care inequality". For more information, contact the Haiti Support Group, E-mail us at: haitisupport@gn.apc.org
| (box 3) In the early 1980s, Haiti was identified by the US Centre for Disease Control as a possible source of the HIV/AIDS virus. As a result, Haitians, along with heroin users, haemophiliacs and homosexuals, were stigmatised with the label of HIV carriers. Later investigation showed that this early association between Haiti and AIDS was without basis. In fact, according to Paul Farmer in his book, The Uses of Haiti, there are significant indications that the virus was introduced to Haiti by sex tourists from the US. A 1984 study found that a large number of the early cases of HIV+ among Haitians involved those who had sexual contact with US tourists. Farmer writes, "These studies are entirely unsurprising to those who knew something about Haitian tourism, which mushroomed in the 1970s , as it did elsewhere in the Caribbean. Tourism brought in more than just foreign exchange; it reinforced institutionalised prostitution. Although many commentaries on prostitution in Haiti are retrospective assessments made in light of the AIDS crisis, most agree that economic desperation gave the possessors of even modest sums of money access to a sexual-services marketplace unconscionably tilted in their favour. "Fantasies came true" raved one promotion, on payment of what was, for the fortunate outsider, "a nominal charge." What options - let alone fantasies - were left to the Haitian poor? Not many. There were few avenues of escape for those caught in the web of urban migration, severe unemployment and extreme poverty. This combination, added to the marked dependency of the Haitian economy on the United States, set the stage for a devastating epidemic." Source: The Uses of Haiti by Paul Farmer, 1994. |
The Lonely Planet: Dominican Republic and Haiti.
by Scott Doggett and Leah Gordon
£10.99/$15.95
A Lonely Planet travel guide with a large section on Haiti! Does this mean tourism has returned after fifteen years? The answer is not yet, and the most obvious reason for this book is the ever-increasing popularity of the Dominican Republic. Around two million tourists visit the D.R. each year, and obviously this book is primarily aimed at visitors who are looking for something more than the all-inclusive beach resorts.
What is interesting for Haiti and its people is the prospect of the more adventurous travellers venturing across the border clutching their Lonely Planet guide. With Thomson now offering flights from London to Santo Domingo from as little as £129 return, and a luxury coach service running daily to Port-au-Prince, it is now possible to get to Haiti without breaking the bank.
The Haiti section, written by our own Leah Gordon, is by far the most comprehensive and informative guide to the country yet. There is great attention to detail, including illuminating sections on subjects as diverse as annual Vodou festivals, and bird-watching.
As the author writes in her introduction, "Haiti can be a very rewarding place to visit, but its lack of infrastructure makes life difficult, and the level of poverty can leave even the most hardened traveller feeling uneasy", and for these reasons this book is highly recommended to anyone planning to make a trip. Port-au-Prince is especially difficult to get to know, and valuable tips for getting around and making some sense of it all are included. Concentrating on the cities of Port-au-Prince, Jacmel, and Cap-Haitien, the Haiti section is particularly good at pointing out the cheaper places to eat and drink, and explaining from where tap-tap buses for other towns leave.
The Lonely Planet guide is an essential companion if you want to visit the nation "populated by resilient and determined people, such as the street barbers who set up impromptu parlours powered by a line running from overhead electric cables, and students who study their books under gas station lights during blackouts."
Haiti's debt - can't pay, won't pay?
At Mare Rouge,in north west Haiti, schoolleavers were being asked to sign a Jubilee 2000 petition.
"I don’t owe any money. I don’t have any debt."
"The government borrowed the money, not us. We never got any money, so why are you asking us to sign a petition?"
Elicoeur Beaubrun smiled patiently. When he heard about the Jubilee 2000 campaign at his local church he knew he had to do something. But collecting signatures for the petition wasn’t easy. He thought the school pupils would be easiest to talk to. But they weren’t.
"I explained to the students that when you were born you owed money. We are still responsible for the debt because we live in this country. I explained very patiently and with humour. I never got cross". Other groups had been afraid to sign because they didn’t understand it or they couldn’t read. But Elicoeur’s patience had borne fruit, and he had managed to collect ten sheets of signatures. These had been sent to Cologne (G8 summit).
But Cologne had not been good news for Haiti. Their desperate case for debt remission had not even been heard.
And Haiti’s case is desperate. "Haiti’s debt is unjust and immoral", Eddy Lacoste told us as we sat round a table in his bustling Haiti Jubilee 2000 office in Port-au-Prince. Everyone knew the Duvalier regime had been corrupt, Eddy explained, but the world financial institutions continued to lend him money. Structural adjustment policies were imposed which led to deepening poverty and even higher unemployment. "The policy of the US was to squeeze the poor" said Eddy "but no action was taken against Duvalier".
"Haiti is a country that still needs to be built, so how can we be structurally re-adjusted?" Eddy asked. "Structural adjustment policies have been applied for years and yet all the indicators - health, education - get worse. So why do these policies carry on being applied?"
Haiti’s debt currently stands at $60m per annum. US support for the return of Aristide was on condition that he paid Haiti’s debt arrears. "The conditions for Aristide’s return", Eddy said, "were so severe that if they were implemented in full, there would be civil war".
But Eddy and his colleagues in Haiti Jubilee 2000, with Christian Aid’s support, are committed to a peaceful debt cancellation campaign. Already they have collected 100,000 signatures.
"We want debt remission and transparency. Debt cancellation is linked to a new state we want to create". Eddy showed us the poster which had been designed by the Episcopal Justice and Peace Commission. The image of the cross symbolised debt. The arm of the cross - the burden of debt crushing the backs of the poor.
"Haiti’s case is a special case," said Eddy. "Morally speaking you are supposed to have special cases."
Barbara Calvert - a member of a Christian Aid group that visited Haiti in July.
Unless otherwise indicated all articles are copyright of the Haiti Support Group.
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