News from the Front line

Partners in Health:

Wednesday morning, a strong aftershock earthquake rocked Port-au-Prince, temporarily shutting down operations at the general hospital in Port-au-Prince, as well as several other PIH sites outside the city. Since then additional smaller quakes continue to disrupt efforts on the ground.

Here's a quick update on our work in Haiti despite these challenges.

PIH's surgical teams continue to race against time to provide surgical care to earthquake victims in Port-au-Prince. Operating rooms at the central general hospital (HUEH) in Port-au-Prince are fully operational again after being temporarily evacuated on yesterday in response to the aftershock. PIH is still coordinating the relief efforts at HUEH and reports having 12 operating rooms opened 24 hours per day. Across the country, we have a total of 20 operating rooms up and running.

To date, PIH has sent 22 plane loads with 144 medical volunteers - orthopedic surgeons, anesthesiologists, surgical nurses and other medical professionals - and several thousand pounds of medical supplies to support the more than 4,500 PIH health care providers already in Haiti.

Despite these accomplishments, our teams throughout the country continue to report a great need for additional medicines (antibiotics, anesthesia and narcotics), medical equipment (anesthesia machines and x-rays), medical supplies (IVs, tubing, irrigating saline), and water.

"There are very sick people and too little space and time," reported PIH Women's Health Coordinator Sarah Marsh from our hospital in St. Marc. She added that we will lose more patients to infection in the coming days if we don't find additional medications, and explained that is only for lack of supplies - not patients - that the surgical team risks performing more operations. A volunteer orthopedist also working from St. Marc stressed that we will need full medical teams on site to manage dressings, skins grafts and other post operative care for another 6-8 weeks.

Sopudep school:

Just two days ago, at day eight, starvation in SOPUDEP's area (as I'm sure is the same in the rest of the city) started to take a real [toll]. The generosity of a local grocer is now ensuring at least some are staving off hunger. Réa, because she has bought from him for the duration of the school's food program has developed a good working relationship with this vendor and he has given food to Réa on credit. 150 to 250 are being fed right now, but countless others could be included with some cash.

We are working on paying down that credit so she can continue to expand her food program. Right now we can only send down $500 a day through Western Union, but once the limit is lifted and the banks are open we hope that with your support we can expand the food program. This is just the beginning of this crisis!!!

[...]

We do know some numbers now! Twenty one students and two teachers have been confirmed dead and many more are still missing.

I travelled with Réa just before the disaster, and she's pretty incredible.

MSF:

On their first day in the capital MSF mobile clinics located around 200 patients who needed help cleaning their wounds, changing dressings, putting in stitches or getting more specialized care in one of MSF's hospitals. In areas around Léogâne and Grand-Goâve MSF teams identified dozens of injured people who needed surgical care and referred them to hospitals.

In one of the poorest parts of Port-au-Prince, the Cité Soleil slum, MSF is performing up to 30 surgical operations a day, including an increasing number of people being admitted with injuries caused by bullets or machetes. Though tension is rising in the area, the number of violence-related injuries is still relatively low, with an average of only three a day. Marie-Christine Ferir, one of MSF's emergency coordinators, says that this must be seen in perspective. "Well before this earthquake, this was a very deprived area with many social problems and a history of violence. Clearly, tensions will be further amplified by the stresses from this quake."

and:

Every functional operating theatre is being used night and day, while logistical staff are racing to set up new ones or rehabilitate damaged ones. MSF surgical teams have been carrying out an average of 130 operations per day for the last few days and this is increasing as new surgical teams start work. There are now 10 operating theatres, seven in Port-au-Prince hospitals (Choscal, Trinité, Carrefour and Chancerelle hospitals) and three in towns in the west of the capital (Léogâne and Jacmel). In addition, minor surgical procedures like cleaning and removing dead tissue from wounds are taking place in small operating theatres in Trinité and Pacot hospitals.

Capacity will continue to increase as additional operating theatres are being set up in Port-au-Prince and in the west of the island in Léogâne and Grand-Goâve. MSF is setting up an inflatable hospital with two operating theatres and 100 beds on a field in Port-au-Prince. The team expect to have it functioning Friday morning.

It's taken a while for international aid to get into areas like Site Soley and Kalfou; I'm glad that groups like MSF seem to be leading, here.

NDP actually talks about Haiti

There's going to be a major international conference in Montreal about post-earthquake Haiti, organized by the Canadian government. It's worth mentioning that the last big conference we held on Haiti ended up with the 2004 coup. So, there's that. The NDP seems to have issued a surprisingly concrete press release:

OTTAWA – New Democrat Foreign Affairs Critic Paul Dewar (Ottawa Centre) is calling on the Canadian government and the international community to commit to a long-haul, large-scale redevelopment process in Haiti, starting with fully forgiving Haiti’s debt and offering grants for redevelopment.

In advance of the Montreal conference, Dewar emphasized the importance of complete debt forgiveness and assistance in the form of grants, not loans, to jumpstart the economy. He stated that the IMF’s decision to covert its US$ 100 million emergency loan for Haiti into a grant is an encouraging sign that the international community is moving to support Haiti for the long run.

“Redeveloping Haiti must be much more ambitious than just reconstructing the country to its pre-earthquake status,” said Dewar. “From day one, investments should support the capacity of Haitian civil society to respond to the needs of the nation. Haitian ownership of the redevelopment process is of the utmost importance.”

Dewar recommended the immediate expansion of cash-for-work programs to support the Haitian labour force in the short-term, and restart an economy that has been totally devastated by the earthquake in the long term.

Dewar emphasized that a successful conference will demonstrate a commitment to the development of:

• An effective state: investments in health, education, housing, water and sanitation, the establishment of an equitable tax system, and the training for its police force.
• An active citizenship: support for Haitian non-governmental organizations so that an active citizenship can hold governments to account; leveraging Canada’s expertise in democratic capacity-building to ensure Haitian ownership of the redevelopment process; and mechanisms to ensure that both emergency aid and long-term reconstruction respond to the needs of women and girls.
• A vibrant economy: beginning with debt forgiveness and providing grants for investments in micro-enterprise, rebuilding the economy bottom up with investments in agriculture and reforestation to stem the accelerating migration to the capital, as well as to address food security issues.

“The success of the Montreal Conference will not be measured by the introduction of an urgent plan for Haiti’s reconstruction,” concluded Dewar. “The Montreal Conference will be a success if Haiti’s debt is entirely forgiven and an international commitment is made to the long-term redevelopment of country with direct Haitian civil participation.”

I think Paul Dewar is helping to change the NDP's stance on Haiti for the better. Pity we had to suffer so many years of McDonough-inspired silence on the topic of Haiti.

Voices from the Past

Transgriot reproduces an interesting speech by Frederick Douglass about Haiti:

Haiti is a rich country. She has many things which we need and we have many things which she needs. Intercourse between us is easy. Measuring distance by time and improved steam navigation, Haiti will one day be only three days from New York and thirty-six hours from Florida; in fact our next door neighbor. On this account, as well as others equally important, friendly and helpful relations should subsist between the two countries. Though we have a thousand years of civilization behind us, and Haiti only a century behind her; though we are large and Haiti is small; though we are strong and Haiti is weak; though we are a continent and Haiti is bounded on all sides by the sea, there may come a time when even in the weakness of Haiti there may be strength to the United States.

[...]

But a deeper reason for coolness between the countries is this: Haiti is black, and we have not yet forgiven Haiti for being black or forgiven the Almighty for making her black. In this enlightened act of repentance and forgiveness, our boasted civilization is far behind all other nations. In every other country on the globe a citizen of Haiti is sure of civil treatment. In every other nation his manhood is recognized and respected. Wherever any man can go, he can go. He is not repulsed, excluded or insulted because of his color. All places of amusement and instruction are open to him. Vastly different is the case with him when he ventures within the border of the United States. Besides, after Haiti had shaken off the fetters of bondage, and long after her freedom and independence had been recognized by all other civilized nations, we continued to refuse to acknowledge the fact and treated her as outside the sisterhood of nations.

No people would be likely soon to forget such treatment and fail to resent it in one form or another. Not to do so would justly invite contempt.

22 years after this speech, the U.S. invaded Haiti.

Failed States

In fact, Haiti holds, or ought to, a pre-eminent place, historically and culturally, in its part of the world, much the way Newfoundland should, compared to the rest of Canada. Haiti's victorious slave revolt, from 1791 to 1803, was one of three revolutions that ushered in the modern era. The others were in France and the United States. But both France and the U.S., ironically, made Haiti pay a heavy price in reparations that burdened it for a century. The U.S. occupied the country from 1915 to 1934. From 1957 to 1986, it propped up the brutal Duvalier regime.

I suppose some would say this amounts to blaming your problems on ancient history. But they often don't mind doing that with individual history (I was abused/deprived as a child etc.) and, in "real" history, a century or two isn't so ancient. The U.S. is still struggling with the problems of its own slave past and the venomous race relations that lingered long after the Civil War.

The legacies persist. After Haitians made Jean-Bertrand Aristide their first elected president in 1991, a U.S.-backed coup overthrew him. When the Americans brought him back in 1994, they demanded suffocating economic policies. Then, in 2004, they basically abducted him from his country and his post.

Besides, there's a good reason not to be patronizing toward "failed states." The dirty secret is that all states are failed in some respects; there are, at most, differences in degree. Take even the U.S., as Noam Chomsky has. It didn't just fail the test of Hurricane Katrina. It alone among developed nations still can't work out a basic health-care system for its people. We have our own failed relations with native peoples. Lucien Bouchard gave up on being premier of Quebec because he found it an ungovernable society.

— Rick Salutin, "We all fail the failed state test", The Globe and Mail

Wow. More than I expected of the Globe.

This language of "failed states" has dominated just about every major government paper about Haiti since 2004.