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.
Hillary and Bill Clinton arrived in Haiti today with a delegation of foreign investors and celebrities to showcase the Caracol industrial park, “the centerpiece of the U.S. effort to help the country recover from the 2010 earthquake,” reports Trenton Daniel for the AP. Government officials and international partners have touted the park’s potential to create thousands of jobs, but there have been a host of criticisms on social, environmental and labor issues. Speaking with the AP, sociologist Alex Dupuy notes:
"This is not a strategy that is meant to provide Haiti with any measure of sustainable development ... The only reason those industries come to Haiti is because the country has the lowest wages in the region," Dupuy said.
Sae-A will pay employees Haiti's minimum wage, which is $5 a day. Workers will be eligible for bonuses based on performance.
Reports from the ground indicate that the factory is not complying with the minimum wage law, however. Etant Dupain, writing on the Let Haiti Live website, notes:
Before the official inauguration, several thousand employees have been working in the Caracol park for the last three months at a wage of 150 gourdes ($3.75 US) a day. Since October 1st, the new minimum wage law has gone into effect, with the government setting the minimum at 300 gourdes a day. Despite this, the managers of the factory operating at Caracol aren't respecting the new official minimum wage.
The new minimum wage would be 200 gourdes, with piece rate employees earning 300. Caracol would be far from the only factory in Haiti not adequately compensating their employees. The most recent Better Work Haiti report, released last week, found that 21 of 22 factories covered in their analysis (Caracol is not covered yet) were non-compliant with minimum wage laws. This refers to the old minimum wage. Better Work is a joint program of the International Labor Organization, International Finance Corporation and the U.S. Department of Labor. Of course, whether employees are earning $3 or $5 a day, it is still far below what the AFL-CIO’s Solidarity Center determined to be a “living wage” for workers in the garment industry.
CEPR Research Associate Jake Johnston writes for AlterNet this week:
Over the past few decades, the U.S. Agency for International Development (USAID) has seen its staff level drop significantly at the same time as the amount of money under its discretion has rapidly increased. Over this time, USAID has stepped up its reliance on for-profit contractors to fill the void. The result, as Hillary Clinton stated in her confirmation hearing (USAID is part of the State Department), is that USAID has “turned into more of a contracting agency than an operational agency with the ability to deliver.”
To be sure, there are efforts are underway to slowly fix this. In the meantime, the status quo reigns, with perhaps nowhere serving as a better example of the pitfalls than Haiti. Since the devastating earthquake in January 2010, USAID has awarded some $450 million in contracts – with 70 percent of them going to DC-area contractors, the so-called “beltway bandits”. The largest USAID contractor in Haiti (and the world, for that matter), Chemonics has received some $177 million of this total. With such a large amount of resources going to one company, you might expect there to be vigilant oversight and strict guidelines. Unfortunately, you would be mistaken.
The USAID Inspector General released a report last week that shines some much-needed light onto the operations of USAID’s largest contractor. The report looks at the $53 million dollar Haiti Recovery Initiative run by Chemonics, the follow-up program to a $39 million program that began right after the quake. Among the findings in the audit: projects were “not on track”, the monitoring and evaluation system was weak and arbitrary, there was a lack of community involvement in project planning and they failed to get the appropriate environmental approvals before undertaking potentially damaging projects. This isn’t the first time Chemonics has been criticized for their work in Haiti . The same Inspector General found a host of similar problems with the original $39 million contract the year before, yet USAID turned around and gave Chemonics another $50 million anyway.
The same process had already played out before in Afghanistan. After USAID awarded a $100 million contract to Chemonics for work in the agricultural sector of Afghanistan, a 2005 Government Accountability Office report found significant problems with the program. Yet despite the documented problems, just like in Haiti, the next year USAID turned around and gave the same contractor another $100 million. The Inspector General also found numerous problems with that program.
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Haiti’s leading human rights attorney Mario Joseph has been the subject of death threats and police surveillance and harassment in the past several months, along with other lawyers. As the Institute for Justice and Democracy in Haiti (IJDH) reports, Joseph, IJDH Managing Attorney and the director of its Haitian affiliate Bureau des Avocats Internationaux (BAI) has received as many as 3-4 death threats a day, while police in vehicles with tinted windows have monitored the BAI office in Port-au-Prince and harassed and searched people leaving. Threats against BAI and Mario have also been spray painted on walls nearby. While IJDH notes that Joseph has been the targets of threats in the past, it says “the current intimidation appears more organized, more persistent and more closely linked to the Haitian government than previous incidents.”
U.S. Congressman John Conyers (D – MI), the Ranking Member on the House Judiciary Committee, condemned the threats this week, saying:
“As a long-time supporter of Haiti in the United States Congress, I am concerned by recent reports that suggest that Haitian attorneys and human rights advocates, including prominent attorney Mario Joesph of the Bureau des Avocats Internationaux (BAI), are being targeted with political intimidation and threats of physical harm as a result of their legal representation of politically vulnerable individuals and groups," said Conyers.
"The ability of an attorney to provide legal assistance free of harassment to any client is a critically important component of a well-functioning justice system. All necessary steps should be taken to protect these attorneys and advocates, who help ensure that all Haitians have equitable access to justice and due process. My office has contacted the State Department to express my concern about these recent reports."
As the Miami Herald reported earlier this month, Joseph and other lawyers may be the targets of political persecution by the Martelly government. Chief Prosecutor of Port-au-Prince Jean Renel Sénatus claims Haiti's Justice Minister Jean Renel Sanon fired him after he refused to issue an arrest warrant for Joseph and 35 other “political opponents.” The Herald also reported that
Nearly three years after the earthquake of January 2010, durable housing solutions remain nonexistent while tens of thousands remain at risk of forced evictions. According to the International Organization for Migration, there are currently 369,000 individuals residing in 541 official IDP camps throughout Haiti. Yet over 20 percent of the remaining individuals are in constant risk of eviction. Fortunately, camp residents are organizing to fight back. Public Radio International’s The World reports:
Enter Patrice Florvilus. After the earthquake, the attorney formed an organization that represents residents of tent camps who’ve been threatened with eviction.
“Our strategy is to stop evictions by making landlords follow the law, which can mean a lengthy legal process. And that’s what the landlord wants to avoid,” Florvilus said.
It doesn’t always work, but a legal defeat can sometimes turn into a de facto victory. In one case, the mayor of Delmas ordered families off government land. A court upheld the eviction order. But then the mayor backed off — locals say because of organized opposition.
But activists have faced many difficulties, including intimidation and jail time. Meena Jagannath reported last month on the case of David Oxygène, an activist who was imprisoned for over two months. He was arrested during one of his group’s weekly protests against the Martelly government calling for improved social policies, including adequate housing.
More recently, a protest organized by camp residents to protest the lack of adequate housing was cancelled following threatening phone calls and other forms of intimidation. GlobalPost reports:
She [Alexis Erkart of Other Worlds] says fear and fatigue run high in the camps, and residents are consistently faced with the prospect of forced evictions, but have nowhere else to go.
Erkert told GlobalPost yesterday via email that yesterday’s protest was being organized by a number of camps, but that “a number of camp residents reported receiving threatening phone calls and thugs coming to the camps telling people not to participate in the protest. There was enough fear that they decided to hold off.”
“More and more camps are evicted with no housing plan in place, without viable options for the future,” said Erkert. “They have no access to the government, and limited access to the media. It makes me deeply sad that today they were stripped of one of the only means available to them to make their voices heard.”
The USAID Inspector General (OIG) released an audit this weekend of Chemonics’ Haiti Recovery Initiative II program (HRI-II), funded by USAID. HRI-II, the successor to the HRI program which began right after the earthquake, aims to “help Haiti strengthen its economy and public institutions in the three strategic development corridors of Port-au-Prince, Saint-Marc, and Cap-Haitien,” according to the OIG. But, as the Associated Press reports today:
A newly released audit says the largest U.S. contractor working to stabilize Haiti after the 2010 earthquake is “not on track” to compete its assignments on schedule, has a weak monitoring system and is not adequately involving community members.
The audit is the second since the earthquake to find significant problems with Chemonics’ work in Haiti. The AP reported in December 2010:
And an audit this fall by USAID's Inspector General found that more than 70 percent of the funds given to the two largest U.S. contractors for a cash for work project in Haiti was spent on equipment and materials. As a result, just 8,000 Haitians a day were being hired by June, instead of the planned 25,000 a day, according to the IG.
Nevertheless, Chemonics has been the largest single recipient of post-earthquake funding from USAID. For the two HRI programs, Chemonics has received $103.8 million. This same process played out in Afghanistan, where despite consistently failing to produce results, Chemonics continued to receive hundreds of millions of dollars in contracts.
Weak Monitoring and Evaluation
One consistent pattern that has clearly emerged in the aftermath of the earthquake is the lack of oversight of contractors by USAID. As we have described before, after years of hollowing out USAID, it has “turned into more of a contracting agency than an operational agency with the ability to deliver,” in the words of Hillary Clinton. In turn, much of the monitoring and evaluation is actually the responsibility of the contractor itself. USAID’s contract with Chemonics contains numerous reporting requirements, yet allows the contractor to fulfill most of them without any oversight. Chemonics is required to keep an “activity database,” but the contract notes that Chemonics is responsible “for ensuring that the database contains accurate, complete, and up-to-date information.” Additionally, the contract states that USAID and Chemonics “are expected to jointly develop a system of processes and tools for the monitoring and evaluation of the country program.”
As the newly released audit finds however, both the database and the evaluation tools were poorly implemented and “made it difficult to measure the program’s impact,” as well as contributed to delays which have made the program “not on track to complete all activities.”
In an interview following his meeting with UN Secretary General Ban Ki-moon, Haitian Prime Minister Laurent Lamothe told Reuters that cholera is “really under control.” Well, that certainly depends on your definition of under control. Since tropical storm Isaac swept across Haiti last month, some 83 Haitians have reportedly died from cholera and this is almost certainly an understatement, as the surveillance system has become increasingly unreliable. Over the same time, more than 8,200 Haitians have been sickened. Since April of this year, when the rainy season began, 514 have died and over 63,000 have been sickened by cholera.
As for the government’s response, according to the United Nations, “national capacity to respond to potential outbreaks, especially during the rainy season, remains very weak.” From May to June this year, just as the rainy season was beginning, three cholera treatment centers and 13 cholera treatment units were closed down, leaving just 17 and 61 left open, respectively. This is down from 38 and 205 last August. Additionally, as CCO Haiti pointed out last month, “many public health workers in the Cholera Treatment Center (CTCs) have not received salaries for several months and there are reports of strikes by front line medical staff to redress this situation. This is a serious issue negatively affecting the effectiveness of the cholera response and it needs to be urgently addressed.”
Of course, this is not entirely the government’s fault. Most of the cholera response bypassed the government entirely and now, as NGOs pull out of the field, the government has been left to pick up the slack without adequate resources. Nevertheless, to the hundreds of Haitians falling ill every day with cholera, Prime Minister Lamothe’s assertion must ring especially hollow.
Update 9/27: The post has been updated to reflect newly posted data on cholera deaths and cases.
This past weekend, USAID Administrator Rajiv Shah said that by 2015 the goal is to have 30 percent of aid funds going to local groups. This is in line with the goals put forth in the USAID Forward reform agenda, which aims to reach this target agency-wide by 2015. Shah also made a surprising announcement regarding local procurement in Haiti, as reported in the Miami Herald:
Before the January 2010 earthquake, Shah said less than 9 percent of USAID money was going to Haitian organizations. “We’re over the pre-earthquake level now,’’ said Shah during an interview with The Miami Herald. He wasn’t more specific.
As we have noted numerous times before, according to the available data, it appears that far less than 10 percent of USAID funds have gone directly to local organizations. A review of data on USAID contracts for work in Haiti from the Federal Procurement Database System reveals that just 1.3 percent of USAID funds have gone directly to Haitian companies, as can be seen in Table I.
Table I: USAID Contracts by Recipient Location