An editorial in the Christian Science Monitor today begins:
The third anniversary of Haiti’s devastating earthquake on Jan. 12, 2010, has not drawn much attention. This is despite the fact that 1 out of every 2 Americans donated money to the relief and thousands of people from around the world volunteered to rebuild the Caribbean nation.
The reason is that the hope of “rebuilding Haiti better” after this particularly big natural disaster is, well, still largely a hope.
It is true that the sad anniversary has received less attention this year; there have been fewer TV crews flying down to Haiti, for one thing, and apparently less attention on Haiti this time by national and local radio programs. Other “three years later” pieces have already run in papers such as the New York Times and the Miami Herald.
Here’s a sampling of some of the news, reporting and commentary posted today and yesterday.
First, the European Union announced today that it would provide an additional €30.5 ($40.69) million to Haiti, saying “This new money will mainly help those still homeless as a result of the earthquake, cholera victims and those badly affected by Hurricane Sandy.”
The U.S. State Department issued a statement celebrating what it described as “more than three and a half years” of “work[ing] closely to be a good partner to the government and people of Haiti.”
Among these are that
The United States and other donors supported the Government of Haiti’s free and fair presidential and legislative elections in late 2010 and early 2011. These elections paved the way for the complete re-establishment of all three branches of government. The U.S. provided capacity building support, including the provision of experts to work within the Government of Haiti and the provision of temporary office space.
Members of the U.S. Congress also issued statements today, with Rep. John Conyers (D – MI) saying in part:
Moving forward, the United States needs to recommit itself to ensuring that all aid funding to Haiti is allocated in a transparent manner and in close consultation with Haitian authorities and civil society beneficiaries. It is also incumbent upon the international community to fulfill its commitments to the people of Haiti made in the months following the earthquake.
Port-au-Prince – The origin of Haiti’s deadly cholera outbreak is not much in doubt, at least not to anybody outside the U.N. A host of scientific studies have all pointed to UN troops whose waste made it in to the largest river in Haiti as the source. While the U.N. has yet to accept responsibility, it has announced an initiative to raise funds for a $2.2 billion 10-year cholera eradication plan. At this point however, no official plan even exists, at least not publicly. Meanwhile, pressure continues to build for the U.N. to do more, and put up its own funds rather than just relying on notoriously unreliable donor pledges. The U.N. said it would chip in $23 million for the plan, a mere 1 percent of what is needed. This compares to the nearly $1.9 billion that the U.N. has spent since the earthquake on the troops that brought cholera to Haiti.
As we have previously noted, Haitian President Martelly recently added his voice to the chorus, saying that “certainly” the U.N. should take responsibility and that “[t]he U.N. itself could bring money to the table.” Grassroots pressure both within Haiti and outside has also increased. More than 25,000 have signed an online petition created by Oliver Stone calling on the U.N. to take action and secure the needed funding. And while it has been over 14 months since over 5,000 Haitians demanded reparations for those affected and for the U.N. to invest in the needed infrastructure, as of yet there has been no formal response from the U.N.
Cholera Not “Under Control”
In the meantime, cholera continues to wreak havoc throughout the country. Although the number of cases and deaths has dropped this year, the epidemic still sickened over 110,000 and killed 900, making cholera more prevalent in Haiti than anywhere else in the world. Nevertheless, the Haitian Health Minister took to the radio a few days ago to talk about the “success” of the cholera response; the Prime Minister has previously declared the epidemic to be “under control”. The U.N. recently lauded the efforts of the government and humanitarian actors for managing “to contain the spread of cholera in 2012.”
But despite the statements of success, the ability to respond to the epidemic continues to decrease. From August of 2011 to August of 2012 the number of cholera treatment centers has decreased from 38 to 20, while the number of treatment units has decreased from 205 to 71. Funding to respond to the outbreak is decreasing as NGOs struggle to get donors interested in an epidemic over two years old. While funding comes in fits and starts after a hurricane or devastating storm, the response needs consistent support so as to be prepared for those emergencies rather than just a response to them.
As one health expert who asked to remain anonymous noted, while the number of cases may slow slightly next year because of the natural progression of the disease, “2013 will be even worse than 2012.” With the number of health facilities dwindling and humanitarian actors pulling out, it is likely that the mortality rate could actually increase in 2013, according to the expert.
Number of people killed in the earthquake in 2010: over 217,300
Number of cholera cases worldwide in 2010 and 2011: 906,632
Percent of worldwide cholera cases that were in Haiti in those years: 57
Days Since Cholera Was Introduced in Haiti Without an Apology From the U.N.: 813
Percent of the population that lacks access to "improved" drinking water: 42
Funding needed for U.N./CDC/Haitian government 10-year cholera eradication plan: $2.2 billion
Percent of $2.2 billion which the U.N. pledged to provide: 1
Amount disbursed by bilateral and multilateral donors to Haiti from 2010-2012: $6.43 billion
Percent that went through the Haitian government: 9
Amount the Haitian government has received in budget support over this time: $302.69 million
Amount the American Red Cross raised for Haiti: $486 million
Amount of budget support to the Haitian government in 2009, the year before the earthquake: $93.60 million
The American Red Cross has issued a new progress report on its work in Haiti since the earthquake, describing how it has used the $486 million USD that it has raised. The report, while brief, and still vague in some places, seems to be intended in part as a response to recent criticism the organization has received over the pace and efficacy of its spending. ARC President and CEO Gail McGovern writes:
At this point, virtually all of the money donated to the American Red Cross has been spent, committed or allocated for planned housing and neighborhood recovery, health, clean water and sanitation and disaster preparedness projects. A relatively small amount of unallocated money—or 4 percent of all donations received—is held in reserve for unanticipated or emerging needs. That’s because even as we focus on long-term recovery, we must at the same time respond to cholera outbreaks and disasters in Haiti such as Tropical Storm Isaac and Hurricane Sandy.
By “virtually all,” McGovern means 85 percent, or $415 million, 33 percent of which it says it has “spent and committed” to “housing and neighborhood recovery”; 16 percent each to emergency relief and health, respectively; 12 percent to water and sanitation; 11 percent to disaster preparedness and risk reduction; 8 percent to “livelihoods” (undefined in the report, but previously described as including “grants, jobs and other help”); and 4 percent to cholera.
The report contains several anecdotal stories, but also some additional useful information. For example, the ARC says “We provided more than 72 percent of the funds needed for the distribution of a cholera vaccine, which more than 90,000 Haitians received this year.” It also notes that “we helped fund the construction of Mirebalais Teaching Hospital and partnered with the International Committee of the Red Cross (ICRC) to rebuild a prosthetics and physical rehabilitation center.” Less useful is the statement “the American Red Cross has also spent more than $50 million on projects that have improved access to clean water and sanitation for 545,000 people,” where “improved access” is not further defined.
The ARC notes that “we have helped build, upgrade or repair more than 14,000 transitional and permanent homes for more than 70,000 people, and have helped more than 20,000 people transition out of camps by subsidizing rents,” but does not differentiate between the “transitional” and “permanent” dwellings, nor does it provide additional information on what people who have “transition[ed] out of camps” have done after leaving, how they live and whether their new situations are sustainable and will allow them to have a dignified, safe and healthy quality of life – even in the near term. The lumping together of “transitional” and “permanent” dwellings is especially problematic since, as so many residents and observers have noted, in many cases “transitional” shelters have become de facto “permanent.”
Over the next month, Haiti Relief and Reconstruction Watch blogger and CEPR International Research Associate, Jake Johnston will be in Haiti following up, on the ground, many of the issues this blog has covered since the earthquake nearly three years ago.
Port-au-Prince – In the last thirteen months, the “official” total of displaced persons in Haiti has decreased by 35 percent and over 300 camps have been closed. One could be forgiven for thinking the decrease was even larger. The sprawling tent camp near the airport, for everyone entering Haiti to see, as well as the Champ de Mars camp, are no longer. With their closure, some of the most visible signs of the stalled reconstruction effort have been erased. As the three-year commemoration of the earthquake approaches, the reduction in the IDP population will undoubtedly be touted as one of the great successes of the relief and reconstruction effort. And yet an estimated 360,000 Haitians remain in official tent camps.
Those who remain may not be as visible; many are tucked behind high walls and off main streets but their situation remains just as dire and continues to deteriorate. The most recent OCHA Humanitarian Bulletin notes that those who remain in the camps “face worsening living conditions, as humanitarian partners pull out as a result of lack of funding.” It is estimated that at least 230,000 will still be in the camps at this time next year.
For those that have left the camps, little is known about their current status. According to OCHA, over 250,000 have left the camps due to resettlement programs, yet there has been no systematic tracking of what has happened to them. The government’s flagship relocation program, “16/6”, began over a year ago, meaning the one-year rental subsidies offered to camp residents have already run out, or will in the next few months. One former resident of the Champ de Mars camp said that his subsidy will run out next month, and with no steady employment, he expects to be back on the street soon. If so, he, and others in similar situations, would likely fall outside of the “official” camp population.
January 1 was the anniversary of Haiti’s independence, and another marker – the third year since the earthquake – is coming up at the end of next week. Media outlets are examining what has been achieved - and what hasn’t - over the past three years.
The New York Times’ Deborah Sontag had a major, must-read feature article based on her investigative look at the shortcomings of the aid and reconstruction efforts, examining the Interim Haiti Recovery Commission, the agency and NGO coordination “clusters” and the Caracol industrial park, among other aspects. She also reports on contractors such as Chemonics, one that has been scrutinized by this blog repeatedly:
One American taxpayer-financed program, scrutinized by the Agency for International Development’s inspector general, was intended to provide short-term jobs for Haitians and to remove significant rubble. But the program, and in particular the work carried out by two Beltway-based firms, was less than successful on both fronts, the inspector general said: It generated only a third of the jobs anticipated and it appeared to demonstrate that using manual labor to clear debris was so inefficient as to slow the rebuilding effort.
One of the firms, Chemonics International, which was awarded $150 million in post-earthquake contracts, built a $1.9 million temporary home for the Haitian Parliament. The American ambassador presented it as a gift to Haitian democracy, but many legislators were more irked than thankful because the building was delivered devoid of interior walls and furnishings, as The Global Post reported, and it took almost half a year to scrounge together the money to finish it.
The New York Times editorial board weighed in yesterday with a lengthy editorial decrying the failures of the reconstruction process, and also highlighting the ongoing cholera epidemic caused by the UN, concluding:
A recently announced 10-year and $2.2 billion effort to rid Haiti and the Dominican Republic of cholera by improving water and sanitation will require close coordination among the Haitian government, the United Nations, United States and other partners. Senator John Kerry, who has paid astute attention to Haitian issues in the Senate, will be well placed to do so if he becomes the next secretary of state. As long as the miseries continue, the need for the world to get this right remains.
Tonight, in a ceremony presided over by U.N. Secretary General Ban Ki-moon, BBC correspondent Mark Doyle and producer Piers Scholfield will be presented with an award from the U.N. Correspondents Association (UNCA). The award, one of many to be handed out, is described by the UNCA as being for “the best coverage of the United Nations and its agencies.” Certainly by “best” they do not mean the most flattering. The BBC radio documentary that earned Scholfield and Doyle the prize was an investigation into the source of the cholera outbreak in Haiti, which over the past two years has killed over 7,800 and sickened over 625,000. A host of scientific evidence, as well as on the ground reporting, including by Doyle and Scholfield, has pinpointed a U.N. military base as the source of the outbreak.
Just last week, Ban Ki-moon announced that the U.N. would be starting a new initiative to secure funds for a 10-year, $2.2 billion plan, set to be formally announced in January, that aims to provide Haiti and the Dominican Republic with the clean water and sanitation infrastructure needed to eradicate the disease. Yet despite the U.N.’s pledge to support this plan, the U.N. has failed to ever accept responsibility for the epidemic. Despite a legal complaint filed with the U.N. on behalf of over 5,000 victims of cholera by the Institute for Justice and Democracy in Haiti and Bureau des Avocats Internationaux, U.N. officials continue to avoid their own role in its introduction.
Writing in Foreign Policy on the U.N. announcement last week, Jonathan Katz and Tom Murphy note:
One of the primary means by which the U.N. has deflected blame since the beginning has been to insist that efforts to find the source of the epidemic would detract from fighting it. By relaunching an existing Haitian-Dominican effort under the guise of a U.N. initiative, the world body can once again claim to be too busy saving Haitian lives to comment on how those lives were put in danger in the first place. It took no time for this to happen. When an AP reporter asked on Dec. 11 whether humanitarian coordinator Nigel Fisher thought the U.N. caused the cholera epidemic, he refused to comment, saying: "My focus is on today."
In announcing this new initiative the U.N. pledged just $23.5 million of their own funds, less than four percent of what they are spending on keeping MINUSTAH troops in the country this year; the same troops that introduced the disease in the first place. As Mark Doyle commented after last week’s announcement, “The United Nations is good at launching appeals for aid. It is less good at admitting its own faults.”
As expected, the U.N. launched a new cholera eradication initiative yesterday at a press event in the late afternoon featuring U.N. Secretary General Ban Ki-moon and other speakers. The Miami Herald’s Jacqueline Charles leads off her article on the announcement by noting the U.N.’s own relatively small contribution toward funding the $2.2 billion plan (which also calls for an additional $70 million for the Dominican Republic):
The United Nations will provide support and $23.5 million in funding to help Haiti and the neighboring Dominican Republic eliminate a deadly cholera epidemic that has sickened more than 600,000 and killed more than 7,700, U.N. Secretary General Ban Ki-moon said Tuesday.
In addition to the U.N.’s contribution, Ban said donors will provide $215 million. But the money still falls short of the $600 million Haitian Prime Minister Laurent Lamothe said is needed to implement the plan over the next two years focusing on improving water and sanitation services.
AP’s Alexandra Olson reports:
Ban promised to "use every opportunity" in the next months to advocate for more funding for the plan.
"We know the elimination of cholera is possible. Science tells us it can be done," Ban said. "It can and will happen in Haiti."
Ban also announced he was enlisting Partners in Health founder Paul Farmer as a “Special Advisor” who will help raise funds for the initiative, including from “governments, multilateral organizations, the private sector and individual philanthropists.”
Ban did not refer to the cause of the epidemic – U.N. troops from Nepal, according to several scientific studies.
Dozens of Haitian and international organizations have marked UN Human Rights Day today by calling for an end to forced evictions, which, as Oxfam notes, “infringe on other rights in addition to the right to adequate housing” due to “the inter-relationship and interdependence of all human rights.” In a statement calling “on the international community to act against the human rights abuses taking place in Haiti in the form of arbitrary and illegal forced evictions,” groups gathered under the Under Tents campaign note that “Haiti’s displaced face not only the challenges inherent to living in tent camps, but one in five are currently at risk of forced eviction.”
A briefing note [PDF] released by Oxfam today notes that “the right to decent housing” is enshrined in both Haitian and international law:
The right to private property is acknowledged and guaranteed by the Haitian constitution of 1987, but the constitution, as well as many international legal instruments, also recognizes the right to decent housing. These include the International Covenant on Economic, Social and Cultural Rights, whose ratification by the Haitian parliament on 31 January 2012 was hailed as an important step in broadening the scope of human-rights protection in the country.
But it also notes that “By the end of October 2012, the displaced population was estimated at 358,000 people, living in 496 camps and informal sites.” Oxfam presents some of the scale of those whose rights have been violated in forced evictions and precarious IDP camp situations so far:
Up to August 2012, around 61,000 people had been evicted from 152 camps. Another 78,000 people housed in 121 camps are currently threatened with eviction. Of the 121 camps currently under threat of forced evictions, around 96 per cent of these camps are located on private property. According to Oxfam’s latest survey, 86 per cent of the people in the camps lack the financial resources to leave, and the majority do not have jobs in the formal economy. The internally displaced persons (IDPs) who remain in camps live in extreme poverty, with 60 percent reporting that they ate one meal or fewer per day.
The Under Tents statement also notes the failings of the Haitian government and private landowners to protect these rights:The level of violence involved and the disregard for the rights of the displaced demonstrated during these evictions are a scandal. The Inter-American Commission of Human Rights recommended in November 2010 that the Government of Haiti issue a moratorium on all evictions from IDP (Internally Displaced People’s) camps. The Commission’s precautionary principles recommend that those who have been unlawfully evicted be transferred to places with a minimum of sanitary and security conditions, and have effective recourse before tribunals and other competent authorities. The Haitian government has not complied with the Commission’s binding recommendations to date.
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.
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:
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.”
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.
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.
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.”
A new human rights report reaffirms the United Nations Stabilization Mission in Haiti’s (MINUSTAH) responsibility for causing the cholera epidemic that has now killed over 7,600 and infected over 600,000. The Paris-based International Federation of Human Rights (FIDH) “Call[s] on MINUSTAH to acknowledge its responsibility with respect to the outbreak of the cholera epidemic and establish a permanent claims commission,” and “Request[s] the office of the UN Secretary-General to take measures to award individual or communal reparations, such as financial investment in water and sanitation infrastructure in Haiti.” These recommendations echo the petition filed by the Bureau des Avocats Internationaux (BAI) and the Institute for Justice and Democracy in Haiti on behalf of over 5,000 cholera victims, the demands of an international grassroots campaign, editorials in the New York Times, the New York Daily News and other major newspapers, and op-eds such as this one in The Guardian yesterday by CEPR Co-Director Mark Weisbrot. The Boston Globe is the latest major paper to call for the U.N. to act with “a massive investment in clean water and sanitation infrastructure. Such an effort would not just wipe out cholera, but also a host of other water-borne illnesses. Rather than merely get Haiti back to where it was before the outbreak, this effort would push the country ahead.”
The report, “Haiti: Human Security in Danger” was co-written and researched with the Haiti-based National Human Rights Defense Network and the Ecumenical Center for Human Rights and is one of the few such human rights reports on Haiti to be released in the years since the earthquake, despite the renewed international attention on Haiti that followed. In addition to a section on human rights abuses committed by MINUSTAH, including its culpability for the cholera epidemic, the report focuses on the conditions faced by IDPs, whom it describes as having been “Abandoned and left to fend for themselves,” lacking adequate housing and sanitation, safe drinking water, and cholera treatment, and subject to forced eviction and the threat of forced eviction, rape and gender-based violence, and general insecurity. Conditions in Haiti’s prisons are the focus of another section, in which the report notes that an estimated 70 percent of those in prison are in pre-trial detention (this percentage is 92 in the National Prison in Port-au-Prince) and where safe drinking water is also lacking, leading to at least 275 cholera deaths in the prisons since the outbreak began.
The report also examines Haiti’s flawed justice system, and the Haitian National Police (HNP), which it finds lacking in size, competence, and accountability. Still, the report is the latest to recommend a transition from MINUSTAH to the HNP for the purpose of maintaining national security and cut down on crime, saying, “Haiti needs an effective criminal justice system (including sufficient and competent police personnel) to combat organized crime – not a military presence,” but notes – as have previous reports such as this one from the International Crisis Group earlier this year – that plans to bolster and transform the HNP have fallen far behind stated goals, leading to a prolonged mandate for MINUSTAH.
The Wall Street Journal reported yesterday on Hurricane Sandy’s ongoing toll on Haiti. Ingrid Arnesen writes:
Poor roads and communications have hindered damage assessments and relief efforts. Haitian government and international agencies say Sandy destroyed or damaged at least 21,000 houses, affected the livelihood of some 200,000 people, many of them subsistence farmers, and caused at least $104 million of damage.
The final toll is likely to be much higher once relief workers reach hard-hit areas cut off by flooded roads and rivers, relief organization officials say.
The government said last week it would compensate victims by sending about $25 to victims' cellphones, and provide an additional $2 million in aid to the West Department, where Rivière Grise is, to help some 95,000 families with their losses.
Residents said the help hadn't yet arrived. "We've not gotten one cent nor seen any official here," Mr. Jean-Baptiste said.
AP reported Friday that Doctors Without Borders had noted an increase in cholera cases, with “at least 457 patients Monday,” 500 Tuesday, but down to 430 on Friday. Partners in Health has warned that such an uptick would come as CDC funding for cholera runs out, and at IDP camps such as Marassa, the Guardian reminds readers that “Aid groups such as Oxfam have helped, but humanitarian support has ebbed in the past two years.”
As the Haitian government appeals for new international aid in the wake of Sandy, reporter Kathie Klarreich and foreign aid investigative expert Linda Polman have a well-timed new article in The Nation that provides an important overview on the lacking international response to the cholera epidemic, Haiti’s housing crisis and the shortcomings of the relief and reconstruction effort since the 2010 earthquake:
Relief organizations and the Haitian government are still attempting to assess the extent of the damage that Hurricane Sandy left in its wake. The Haitian government belatedly declared a month-long state of emergency yesterday. The official death toll has been raised to 54, with 21 people still unaccounted for, as the AP reported today.
As with other recent storms to hit Haiti, Sandy’s arrival in Haiti might well have been just the start of the latest disaster. Heavy rains – let alone storms – always bring an increase in cholera infections. But as the Boston Globe reports:
…money for cholera prevention is running low.
Funding from the US Centers for Disease Control and Prevention is set to expire in February and will not be renewed, said Cate Oswald, [Partners in Health’s] director of programs in Haiti.
The impact of the storm on Haiti’s crops is also only now being assessed, and the news is worse than many had thought it would be: “More than 70% of crops - including bananas, plantains and maize - were destroyed in the south of the country, officials said,” as the BBC reported. As we noted earlier, Prime Minister Laurent Lamothe warned Reuters that “Most of the agricultural crops that were left from Hurricane Isaac were destroyed during Sandy," "so food security will be an issue."
The New York Times, Miami Herald and The Guardian have all cited the Haitian government in reporting that 200,000 people had been left homeless – or at least had their homes damaged – by the storm. Newly homeless means more people thrown into a state of vulnerability: vulnerable to cholera and other illness and disease, vulnerable to rape and gender-based violence, vulnerable to hunger, and vulnerable to forced eviction when/if these people move into displaced persons settlements.
Organizations with proven track records of doing important work in Haiti have mobilized and are raising funds to provide relief, respond to the increased risk of new cholera infections, and other lingering impacts of the latest unnatural disaster to hit Haiti. These include Partners in Health; Doctors Without Borders; the Institute for Justice and Democracy in Haiti, which advocates on behalf of IDPs and victims of rape and gender-based violence; and the Under Tents campaign which fights for the right to housing in Haiti.
"The whole south is under water," Haitian Prime Minister Lamothe told the AP this weekend. Four days of rain that saw accumulations surpass 20 inches have left over 50 dead and 20 missing throughout Haiti as floods hit the South and West departments especially hard. According to the most recent update from the Office for the Coordination of Humanitarian Affairs (OCHA), 52 are reported dead, with 20 and 18 in the West and South departments, respectively. OCHA notes that over 20,000 were evacuated and 90 camps damaged.
With some 370,000 Haitians still living in camps with nothing but tattered tarps to protect themselves, the rains were especially damaging. Kristen and Wawa Chege of the Mennonite Central Committee describe the situation:
whole camps flooded as streams emerged between tents, shelters fell under the weight of sitting water, dirt floors turned to mud, and precious possessions were ruined. Efforts to raise mattresses off the ground using cinder blocks, and string clothes from wires inside their tent made little difference as the rain poured in through holes in the tent, or seeped in below the walls. As one man succinctly put it, “everything is wet”.
In August, tropical storm Isaac inflicted massive damage to the agricultural sector in Haiti, resulting in an estimated $242 of damages. As food prices have risen, protests against the high cost of living and against the Martelly government have proliferated. The passing of hurricane Sandy will only exacerbate the problems. As Susan Ferreira reports for Reuters:
"Most of the agricultural crops that were left from Hurricane Isaac were destroyed during Sandy," he said, "so food security will be an issue."
A rise in food prices in Haiti triggered violent demonstrations and political instability in April 2008. Jean Debalio Jean-Jacques, the Ministry of Agriculture's director for the southern department, said he worried that the massive crop loss "could aggravate the situation."
"The storm took everything away," said Jean-Jacques. "Everything the peasants had in reserve - corn, tubers - all of it was devastated. Some people had already prepared their fields for winter crops and those were devastated."
In Abricots on Haiti's southwestern tip, the community was still recovering from the effects of 2010's Hurricane Tomas and a recent dry spell when Sandy hit.
"We'll have famine in the coming days," said Abricots Mayor Kechner Toussaint. "It's an agricultural disaster."
Ferreira adds that humanitarian workers are concerned because stocks of supplies have not been replenished since tropical storm Isaac.
As both Clintons and a coterie of celebrities and foreign investors flew into northern Haiti yesterday, some took the opportunity to praise Sae-A, the giant Korean garment manufacturer that opened a factory in the new Caracol industrial park. Hillary Clinton, for one, told reporters:
And I too want to thank Sae-A, because Sae-A took a decision that was something of a risk, never having worked in Haiti before, after a tremendous natural disaster that was so devastating. But they brought their expertise and they brought their commitment. And Chairman Kim, we thank you for everything that you and the leadership of Sae-A is doing.
But Sae-A’s decision to set up shop in Caracol could hardly be described as risky, as almost the entire cost of the project was borne by other actors. The New York Times, in an in-depth July investigation into the new park, reported that the land was provided free of charge by the Haitian government, the physical infrastructure was provided by the Inter-American Development Bank for around $100 million, and the United States government chipped in $124 million for infrastructure, energy and housing services. The industrial park tenants are also granted significant tax-exemptions, and will only have to pay docking fees, which are estimated to be just $17,500 a year, hardly a boon to Haiti’s coffers. Sae-A, which reported over $1.1 billion in export business last year, committed to spending just $39.2 million on the factory.
A press statement [PDF] released today, co-signed by CEPR and a number of other organizations, states:
On the second anniversary of the outbreak of the cholera epidemic in Haiti, human rights groups, faith-based organizations, policy institutes, and humanitarian organizations renew their call for the United Nations and U.S. government to help Haiti install the clean water and sanitation infrastructure necessary to control the ongoing epidemic.
The cholera epidemic in Haiti has received less U.S. attention during the presidential campaign season, but it remains a critical problem for this Caribbean neighbor that is not being adequately addressed and is undermining broader aid efforts. Last month, 260 new cholera cases were reported daily, and 2-3 children died a day. Since the epidemic broke out in October 2010, 7,564 Haitians have reportedly died from cholera and some 600,000 persons (6% of the Haitian population) have been infected. The number is undoubtedly much higher, as cases in more remote areas are often unreported. As the World Health Organization has stated, those without access to safe drinking water, proper sanitation, and hygiene constitute the majority of cholera cases.
Two years after the epidemic started, not enough action has been taken to assist the Government of Haiti in acquiring essential water and sanitation infrastructure. A regional coalition that includes the U.S. Centers for Disease Control and Prevention, and the World Health Organization is developing a plan with the Government of Haiti to build water and sanitation systems that will cost $2.2 billion. Despite this encouraging progress, the plan still needs to be finalized and funded before implementation can begin.
The U.N. especially has a legal and moral responsibility to play a leadership role in helping end the epidemic. Independent scientific studies have established that cholera was brought to Haiti by troops from the U.N. Stabilization Mission in Haiti (MINUSTAH) and that the waste disposal practices at the U.N. base allowed the bacteria to contaminate Haiti’s largest river system. The undersigned groups call on the U.N. to commit long-term resources to work with the Government of Haiti to build water and sanitation systems that are critical to halting the continued spread of the disease.
It has now been over two years since the first cholera death in Haiti after more than a century. Over 7,500 people in Haiti have died from the disease so far, and over 600,000 have been sickened. While there has been a drop in cholera cases in 2012 over 2011, Oliver Schulz, Doctors Without Borders’ Head of Mission in Haiti says, “We continue to see an average of 250 new cases each week in our facilities, but this is still a high number.”
Doctors Without Borders notes that
Reduced international funding is limiting the response of the humanitarian agencies working in the areas of medical care and providing access to clean water and sanitation.
“This year, MSF had to keep most of our CTCs open throughout the year because cholera is far from being controlled. The measures to prevent and treat cholera are still not enough,” lamented Schulz.
In fact, the response capability of the Ministry of Health remains extremely low two years after the onset of the epidemic. As a result, during the most recent peak last May, MSF treated more than 70 percent of the total number of patients registered in Port-au-Prince.
Despite the overwhelming evidence pointing to UN (MINUSTAH) troops as the cause of the disease outbreak, the UN has refused to accept responsibility. Notably, its own report on the origins of the epidemic attempted to place blame on Haiti’s poor sanitation and water infrastructure, rather than UN negligence. But BBC now reports that one of the authors of that report, Daniele Lantagne, is much more convinced that UN behavior is responsible:
The 2011 UN report - co-signed by [Lantagne] - acknowledged that inadequate toilets in the Nepalese UN camp in the mountain town of Mirabalais [sic] could have leaked the cholera bacterium into the nearby Meye River which flows into the country's main waterways.
But the report stressed that the outbreak "was not the fault" of any "group or individual".
The Panel of Experts added that the subsequent spread of the disease across Haiti was due to many factors - including the country's deeply inadequate water supply and almost non-existent sewage disposal systems.
Now, Dr Lantagne says the new genome data (in addition to other evidence) has changed her view since she had co-authored the UN report which effectively said no-one was to blame.