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Relief and Reconstruction Watch
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Questions? E-mail haiti(at)cepr.net.
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The cholera epidemic, brought to Haiti by UN troops over two years ago, continues to spread throughout the country claiming lives and sickening thousands. Since the passage of Hurricane Sandy in late October, over 175 Haitians have died and nearly 20,000 have fallen ill. In November, an average of 4 Haitians died each day due to the disease. Since the introduction of cholera, nearly 7,800 have died and over 625,000 have been sickened.
Today, in observance of Human Rights Day, Haitian grassroots groups Fan Rezo BAI (Women’s Network of BAI), MOLEGHAF (Movement for Liberty and Equality by Haitians for Fraternity) and KONAMAVID (National Coordination of Direct Victims) are protesting outside the UN Logistics Base in Port-au-Prince. The groups are calling on the UN to take responsibility for the epidemic and to provide reparations to the hundreds of thousands of victims across the country. (For updates, pictures and video from the protest, see @BuddhistLawyer, @melindayiti, @gaetantguevara, and @BriKouriAyiti on Twitter.)
Francois Moise of KONAMAVID comments:
“You always have human rights, they die with you. No one gives them to you, we demand justice to victims of cholera. We see people in the streets that we can’t help. We ask the UN to take responsibility for cholera that its troops sent to Haiti.”
For his part, David Oxygene of MOLEGHAF, who recently spent over two months in prison after being arrested during a previous protest, accused the UN of “violating Haitian’s human right to health and water,” adding, “the laws are violated here, the right to housing, health, education, to work, which are protected in the Universal Declaration of Human Rights. We don’t have any of the rights we are supposed to.”
The calls from Haitians grassroots groups build on an international campaign to hold the UN accountable. The award-winning filmmaker and director Oliver Stone created an online petition on Avaaz last week calling on the UN “to help Haitians stamp out killer cholera for good.” The petition has so far received nearly 6,000 signatures from all over the world.
In part because of the pressure from both within Haiti and internationally, the UN, together with the Haitian government and other international agencies are expected to announce tomorrow a $2.2 billion, ten-year plan to eradicate cholera from both Haiti and the Dominican Republic. The plan, while a step in the right direction, comes over two years since the UN introduced cholera and numerous questions remain as to the plan’s implementation, not least of which is where the $2.2 billion will come from. The AP reported in November that the only confirmed funding was $15 million from the World Bank.
For photos from today's protest, click read more.
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A new report [PDF] on gender-based violence (GBV) in Haiti “suggests that adolescent girls are disproportionately suffering social and violent aftershocks of the earthquake,” including “unwanted and early pregnancies, illegal abortions, and child abandonment” which have increased, while “reports link cases to sexual violence and increased ‘survival sex’ in teenage girls.”
The report, “BEYOND SHOCK - Charting the landscape of sexual violence in post-quake Haiti: Progress, Challenges & Emerging Trends 2010-2012,” was released by the organizations Poto Fanm-Fi (Women and Girls Pillar) and Poto Fi, and is based on information from over 60 agencies, field providers and additional groups and "perspectives from international groups with Haiti initiatives." It includes findings from a field research survey of some 2000 pregnant adolescents and family members.
Whereas much media attention has focused on particular forms of GBV – most notably rape, and often rape committed by strangers (the vulnerability of women and girls in IDP camps has been frequently stressed as well) -- the report presents a broader picture of GBV, noting, for example, that “Overall, domestic violence cases make up 90% of all GBV reported cases since 2010, dwarfing rape‐only cases by a broad ratio of 3:1. This was similar to the ratio before 2010, and calls for greater national action to prevent domestic violence.”
The report stresses the vulnerability of minors:
Adolescents and younger girls make up over 60% of reported rape cases since 2010 – the majority. As one Haitian advocates put it, “The adults get beaten; the younger ones get raped.” Both victims and perpetrators have gotten younger, say advocates. Reports of incest have increased; a possible sign families are more confident reporting crimes against children.
Regarding rapes, the report finds that “Contrary to early media reports, data suggest the majority of rapes since 2010 were committed by persons known to the victims ‐‐neighbors and acquaintances‐‐ not escaped criminals.”
The report also confirms a “boom” in pregnancies resulting from rapes and “survival sex” following the quake: “64% of 981 adolescents reported they got pregnant from rape.” Perhaps not surprisingly, the report finds that many adolescents and girls do not receive treatment or services following attacks, or once they are pregnant, but the numbers are staggering:
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In the coming weeks, Haiti, together with international partners, will call on donors to fund a $2.2 billion 10-year plan to upgrade the water, sanitation and health infrastructure in Haiti and the Dominican Republic. As Jonathan Watts of The Guardian reports, the plan “will be unveiled with the backing of foreign aid groups and the UN, which is accused of one of the greatest failures in the history of international intervention.” That failure, of course, is the introduction of cholera to Haiti, which a number of scientific studies have linked to the sanitation facilities at a MINUSTAH base located on a tributary of the country’s main water supply. The epidemic has thus far killed over 7,730 people in Haiti and sickened some 620,000 more, 6 percent of the entire population. While fatality levels are down from their peaks, over 125 people have died in just the last month.
As the AP’s Martha Mendoza and Trenton Daniel report, the plan – which is set to be released under the auspices of the Haitian and Dominican governments, the Pan American Health Organization, the Centers for Disease Control and Prevention, and UNICEF -- includes “building water supply systems, sewer systems and wastewater treatment plants, as well as improving access to latrines, especially in schools.” It also aims to provide significant capacity building support to the Haitian government, to ensure proper oversight and maintenance of the new facilities. The plan aims to provide 85 percent of Haitians with improved drinking water and 90 percent with improved sanitation facilities by 2022. In 2008, just 17 percent of Haitians had access to adequate sanitation facilities and 63 percent to adequate drinking water. The goal, as Dr. Jordan Tappero of the CDC tells the AP, is “to eliminate transmission of cholera.”
Yet the $2.2 billion plan is almost completely un-funded, with just $5 million promised by the World Bank so far. Watts reports that, “The government will ask for more than $500m (£315m) for the next two years in a short-term emergency response to the epidemic. Another $1.5bn or so will be requested for the following eight years to eliminate the disease.”
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Hurricane Sandy dumped up to 20 inches of rain of parts of Haiti last month and, in addition to the immediate devastation on crops, people, roads and homes, it has led to an increase in the number of cholera cases throughout the country. On November 16, the International Organization for Migration confirmed that 3,593 new cholera cases had been counted since the hurricane. These numbers, however, lag far behind what the Haitian Ministry of Health (MSPP) has recorded since Sandy. There are now three weeks of data post hurricane, and as can be seen in Table 1, there have been over 9,000 new cases recorded by the MSPP.
Table I.
As can be seen, the increase has been dramatic; both in terms of the number of cases recorded (a 46 percent increase) as well the number of deaths (an 85 percent increase). In fact, since the passage of Hurricane Sandy, the death rate has increased as well, from 0.7 percent to 1 percent. While still much lower than the death rate in the immediate aftermath of the outbreak of cholera, this is nevertheless a worrying sign. As Dr. Juan Carlos Gustavo Alonso of the Pan American Health Organization noted after Sandy, the west department, which includes most of the remaining 370,000 IDPs, has seen the greatest increase in cases. In fact, according to MSPP data, since Sandy, over 37 percent of all cases were in Port-au-Prince, which includes Carrefour, Cité Soleil, Delmas, Kenscoff, Petion Ville, Port-au-Prince, and Tabarre. Given the declining humanitarian services in the camps, and the fact that funding for cholera is now running out, the increase in the capital is especially worrisome. Additionally, Sandy crippled the cholera response infrastructure in the country, destroying 61 cholera treatment units.
Since its introduction into Haiti by UN troops in October 2010, cholera has now killed at least 7,699 people and sickened over 615,000 more. Last year, Haiti recorded more cholera cases than the rest of the world combined. As has been pointed out previously, these are likely underestimates, as the MSPP cholera data is often lacking reports from many areas.
In recent weeks, a number of op-eds and editorials have been written calling on the UN to take responsibility for the introduction of the disease. Last week CEPR Co-Director Mark Weisbrot wrote in The Guardian:
If Haiti were any other country in this hemisphere, a human-created disaster of this proportion would be a big international scandal and everyone would know about it. Not to mention the institution responsible for inflicting this damage – in this case, the UN – would be held accountable. At the very least, they would have to get rid of the epidemic.
In this case, getting rid of the epidemic could be easily accomplished. Cholera is transmitted mainly through drinking water that is contaminated by the deadly bacteria. To get rid of it, you need to create an infrastructure where people have clean drinking water and adequate sanitation. The Pan American Health Organization estimates that this would cost about $1bn for Haiti. In fact, that is close to what the UN has been spending in just one year to keep its 10,000 troops in the country.
…
The UN is still denying its responsibility, despite studies published by the New England Journal of Medicine, the Centers for Disease Control and Prevention, and even by the UN itself (pdf) tracking the origin of Haiti's cholera bacteria to UN soldiers. A study by a team of 15 scientists last year produced even more conclusive evidence, using whole genome sequence typing and two other methods that matched the cholera strain in Haiti to a sample from Nepal that was taken at the time that the Nepalese UN troops arrived in the country.
In short, there is proof beyond reasonable doubt that the UN mission is responsible for bringing this disease to Haiti.
Adding their voices to the growing chorus calling for the UN to take responsibility was the Boston Globe editorial board and the Director of the International Human Rights Clinic at Western New England University School of Law, Lauren Carasik.
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After decades of bypassing the Haitian government in the provision of aid, after the 2010 earthquake there was an acknowledgement by international NGOs and donors that this time had to be different. The sentiment was summed up well by Nigel Fisher, the deputy special representative for MINUSTAH in Haiti when he told The Nation:
Tens of thousands, hundreds of thousands of people are here delivering aid, but they are doing functions that should be done by the Haitians…You cannot complain about failures of the Haitian state if you don’t support it to grow stronger. For decades, we have not invested in that very much.
And yet, as HRRW and other have documented time and time again, just as in the past, the Haitian government, civil society and businesses were largely bypassed again. Less than one percent (PDF) of humanitarian aid went to the Haitian government or Haitian organizations in the 18 months after the earthquake. Just over one percent of the $450 million or so in USAID contracts have gone to Haitian firms. Furthermore, there have been consistent complaints from government officials that they are not consulted by international partners. Nevertheless, donors continue to tout the “Haitian-led” reconstruction effort. Another quote from Kathie Klarreich and Linda Polman’s recent Nation article makes it clear this is nothing more than rhetoric:
A spokesman for one of the largest UN organizations in the country offered a stunningly blunt portrait of this dynamic. Asked whether the government of Haiti has ever told him what to spend donor money on, the spokesman, who insisted on remaining anonymous, said: “Never. They are not in the position, because they are financially dependent. Recently, there was a government press conference. There was nothing ‘government’ about it; we organized it and told them what to say.” He chuckled, then added: “Very sad, really.”
As for the aid community’s claim that it has been playing a supporting role and letting the Haitian government lead the reconstruction effort, he said, “It’s a lie. It’s tragic, but it’s a lie.”
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