Elections in the Time of Cholera, Part II

November 26, 2010

Leading up to the elections on Sunday we will be posting updates and commentary from CEPR’s Alex Main, who is in Haiti this week. The following is the second installment, click here for the first:

Every Tuesday morning at the UN Log base representatives of international agencies and relief organizations involved in post-quake relief operations meet in “cluster” meetings, where they share news regarding their various projects and discuss ways in which to coordinate and improve delivery of humanitarian assistance on the ground.  If there’s any place that can be considered the strategic hub of the relief effort, this is it.  We arrive at the base at 8am eager to learn more about how organizations are responding to the cholera crisis and what is being done, if anything, in relation to the November 28 legislative and presidential elections.  

Our first stop is the Protection cluster, which focuses on efforts undertaken to ensure security and provide special assistance to the most vulnerable sectors in IDP camps (children, women, the elderly and the handicapped, etc.)  The meeting is held entirely in French, in a hot, cramped conference room.  Most of the participants are pale, scruffy twenty-somethings, dressed in the loose, casual attire of young backpackers.  If it weren’t for the notepads and official ID badges around people’s necks, one could almost imagine that we were sitting in the common room of a youth hostel in Katmandu or Nairobi.  

However, when the sign-up sheet reaches us the organizations that participants mark next to their names read like a who’s who of Haiti’s international aid and “peacekeeping” community: American Refugee Service (ARC), International Rescue Committee (IRC), the UN Office for the Coordination of Humanitarian Affairs (OCHA), the UN High Commissioner for Refugees (UNHCR), the UN’s Joint Mission Analysis Center (JMAC), Catholic Relief Services (CRS), Project Concern International and several civilian representatives of the UN Stabilization Mission in Haiti (MINUSTAH). No Haitian organization or institution is represented and, as I look around the room of close to three dozen participants, I see only one or two faces that could potentially belong to Haitians, though I am told afterwards that they are probably also foreign aid workers.  

The elections are a concern to some of the organizations at the table, as there has apparently been an increase of violence linked to campaign activities, but otherwise the subject is barely touched on.  The real topic of concern is the cholera epidemic and several participants highlight the problem of access to medical facilities for those infected with the bacteria.  In this day and age, cholera is generally easy to treat (usually just requiring simple oral hydration salts) yet within a few weeks, by the low official count, over 1500 Haitians have died of dehydration, and the number appears to be increasing exponentially.  Meanwhile, as a result of the lack of decent sanitation and clean water throughout the country, cholera continues to spread like wildfire.  

Though the health infrastructure of Haiti is desperately inadequate, facilities do exist and many are being underused due to cholera victims’ inability to pay for transport.  One of the cluster participants asks why the MINUSTAH can’t mobilize their abundant reserve of vehicles to provide emergency transportation throughout the country.  All present agree that the military and police “peacekeeping” body has the foremost logistical capacity in Haiti, and Ben Majekodunmi from the MINUSTAH Human Rights section says that this proposal is under consideration.  However, as he reminds those present, MINUSTAH is responsible for elections logistics and security and, as a result, is fully mobilized for the time being.  Meanwhile, the American Red Cross, we are told, is providing vehicles for the dead.

We also learn that the elections are expected to lead to a spike in the number of cholera cases as a result of the movement and congregation of voters, and the peak in the progress of the epidemic is currently expected to occur the third week of December, though it is not clear what data and algorithms this information is based on.  

After the cluster meeting we have a brief conversation with Ben Majekodunmi of MINUSTAH. This foreign military and police force of nearly 12,000 is in charge of a “peacekeeping” mission in Haiti under the banner of the UN; though many Haitians we talk to see the mission as nothing more than a foreign occupation army focused on repressing the country’s poor majority.  

Ben tells us that MINUSTAH is planning on having troops distribute anti-cholera kits (mainly water purification tablets and soap) in voting centers.  This, he thinks, may not only be an effective measure in terms of slowing down the spread of the disease but could also increase voter participation.  Though apparently no publicity has yet been given to the measure.  

We ask Ben whether there is concern that many voters in IDP camps will be unable to vote due to the difficulty in reaching the voting centers where they are registered.  This is not necessarily a big problem, says Ben, as there is research that shows that at least 80% of IDP camp residents live within close proximity of their former neighborhoods.   

After we get out of the Protection cluster meeting we head over to the other side of the Log Base to catch the weekly camp coordination camp management (CCCM) meeting.  We walk along well-kept pedestrian lanes, lined with carefully trimmed and weeded plant displays being tended to by Haitian gardeners (the only confirmed Haitians that we see that day along with workers in the base cafeteria).

The CCCM meeting is held in a much larger room and its participants include representatives of various international NGOs involved in IDP camp management as well as police and military personnel from MINUSTAH and representatives of both UN, European Union and governmental humanitarian and development agencies (OCHA, IOM, USAID, etc.).  I am told that there are regular sightings of Sean Penn at these meetings, as the actor has taken on the management of a camp of 50,000 displaced people on a golf course terrain in the well-to-do Petionville neighborhood.

The discussion in this meeting is again focused mainly on the cholera epidemic.  A representative of the Health Cluster provides an update on what is being done in camps to minimize the spread of infection.  In general, in most of the camps they are dealing with, they believe there are now a sufficient quantity of latrines, that are kept clean. We are also provided with two hot line numbers of the Haitian Ministry of Health: one for emergency transport of infected patients (apparently vehicles from various NGOs are being pooled for this) and another for removal of dead bodies (a service provided by the American Red Cross).  One camp manager raises her hand and says that the hotline numbers have not been working. 

A Camp Management Officer (CMO) for IDP camps in Cité Soleil, one of Port-au-Prince’s poorest neighborhoods, says that efforts are being made to provide cleaner water and better sanitation conditions in the camps.  Another camp manager asks how she can get a hold of water purification tablets (aquatabs) and is told that the distribution of the bulk of these is in the hands of the Department of Water and Sanitation (DINEPA).  

We turn briefly to elections and are told by CCCM meeting facilitator Brad Mellicker, that “security incidents” in the camps are increasing in the last days of the campaign.  He also announces that Haiti’s Provisional Electoral Council (CEP) has set up voting centers in seven of Port-au-Prince’s biggest IDP camps.

After the meeting I ask Brad why he thinks there are no Haitian camp managers present at the meeting: is it because none of the big camps are being run by Haitians?  Brad seems uncertain of what proportion of camps may have Haitian managers, but explains that the CCCM is a space for international NGOs and that Haitian-run camps are more likely to coordinate directly with Haitian authorities.  

Next: visit to IDP camps in Champ-de-Mars and Cité Soleil

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