Haiti Could Face a ‘Perfect Storm’ With the Pandemic

At a clinic at La Fossette Health Center in Cap-Haïtien, Haiti, nurses vaccinate babies, among other health care services. The pandemic could further erode Haiti’s stability, experts say, given its precarious economic and political state. DANIEL LANARI/USAID
As Covid-19 continues to ravage many parts of the world, the effect of the virus in Latin America and the Caribbean region has been particularly devastating. The situation in Haiti, for example, has alarmed international humanitarian groups, as the country lacks sufficient virus-testing ability and has limited health-care infrastructure, among other serious problems.
On top of these deficiencies in combating the pandemic, Haitian migrants returning from neighboring countries like the Dominican Republic are believed to be spreading the virus significantly.
Michael Ryan, the World Health Organization’s executive director for health emergencies, said of Haiti, “We are very concerned about Haiti at the moment because of its unique circumstances, unique fragility and the fact that the disease is accelerating in a highly vulnerable population.”
Haiti has been struggling to recover ever since the 2010 earthquake that killed more than 220,000 people and injured 300,000 others. The country has relied on international aid to provide hospital services and food for decades. With the coronavirus outbreak, Haitians are more likely to face difficulty securing even these basic necessities. Dr. Carissa Etienne, director of the Pan American Health Organization, has warned that spread of the virus could result in famine. “The situation has been described as a perfect storm approaching,” she said. (More literally, a busy Atlantic Ocean hurricane season has been predicted for 2020, creating more challenges for the region.)
The United Nations fields 19 agencies in Haiti, having closed the 13-year stabilization mission (Minustah) in 2017 to transition to a smaller operation designed to help the government improve rule-of-law institutions, further develop the Haitian national police and enhance human-rights work.
Haiti only recently recovered from a nine-year cholera outbreak that killed 9,792 and sickened 820,000 people. The UN acknowledged in 2016 that its peacekeeping mission played a major role in the outbreak and has provided some assistance to Haiti to combat the disease, but it continues to deny legal liability.
The Boston-based Institute for Justice and Democracy in Haiti (IJDH) has fought for the UN to admit fault and compensate victims of the cholera outbreak. The institute, a nonprofit partnership of Haitian and US human-rights advocates, supports Haitians’ efforts overall “for a just system of law, a society without violence, social justice and a democratic government.”
In light of Haiti’s vulnerabilities in the pandemic, PassBlue asked Sandra Wisner, a senior staff lawyer at the institute to help assess the “perfect storm” heading to Haiti.
The comments from Wisner, sent by email in July, have been edited and condensed for clarity and represent the position of the institute. — FIONA SHUKRI
PassBlue: Reports indicate that it’s difficult to ascertain an accurate rate of Covid-19 infection in Haiti because the public health system is unable to test widely, and many Haitians so distrust the government they avoid the health system. It’s also been reported that tens of thousands of Haitians working in the Dominican Republic, which shares the island of Hispaniola, have returned since March without screening upon re-entry. (The Dominican Republic currently has 73,117 confirmed Covid-19 cases.) What is your understanding of how widespread the virus is in Haiti and how the country is coping?
Wisner: Prior to the arrival of Covid-19 in Haiti, there were concerns about the spread of the virus, the health care sector’s capacity to effectively respond to the pandemic and effects of the pandemic on vulnerable populations. Since the first cases of Covid-19 were reported in March 2020, there have been 7,315 confirmed cases and 157 deaths attributed to the disease. [Current rate is 7,511.] It is difficult to determine how widespread the virus is due to significant challenges with the scope of and access to testing due to limited testing sites and reports of price gouging for rapid screening tests by private laboratories. In addition to challenges with unofficial border crossings and limited screening measures at official crossings at the Haiti-Dominican Republic border, there are concerns the virus is also being exported to Haiti through deportation flights from the United States.
The Haitian government issued public health orders, including the requirement of masks, social distancing and curfew, which in some contexts was not enforceable and not practical, given the living conditions of many Haitians, who reside in communities with congested housing, have inadequate access to potable water and sparse economic means to go without working for extended periods of time.
It’s important to remember that there are other critical and impactful crises happening in Haiti, spanning from the growing protest movement against corruption and increasing gang violence to increasing food insecurity to the continuing effects of the UN-introduced cholera epidemic in 2010. It was recently reported that cholera is still a serious public health concern in the country. Haiti is grappling with poverty, penal code reforms, the resignation of high-ranking government officials and a push for elections that does not reflect the desires and needs of the population. Moving forward, the country should acknowledge and respect its responsibility to the people in fulfilling their right to accessible and quality health care.
PassBlue: Covid-19-related lockdowns and restricted movements are reportedly increasing domestic and gender-based violence globally. How are women in Haiti being affected?
Wisner: Like women across the world, women in Haiti face increased domestic and gender-based violence due to Covid-19’s stress on an already dire situation. Covid-19 has increased the number of Haitians crossing the Dominican Republic and Haitian border, and past evidence points to the extreme vulnerability of Haitian women to sexual and gender-based violence (SGBV) when navigating this border. Médecins Sans Frontières, the main medical institution offering trauma care to survivors of SGBV in Haiti, has reported an increase in patients during the pandemic. Women also face sexual harassment at work. Survivors continue to face barriers to justice created by antiquated SGBV laws in Haiti and limited institutional access due to geography and economic status and live in a climate of heightening electoral tensions in a state with a documented history of using sexual violence as a political weapon.
PassBlue: The UN Mission for Justice Support in Haiti (Minujusth) closed in 2019. The Security Council then reconfigured UN support to Haiti through 19 entities and set up the UN Integrated Office in Haiti (Binuh). How well is the configuration responding to the pandemic?
Wisner: From October of last year, in the context of a political stalemate and human rights crisis, the UN intended to operate a small political office with a mandate to promote political stability and good governance. It would have been challenging to effectively operate such a mission, given the circumstances, and wholly unrealistic when you consider the UN’s controversial peacekeeping legacy in the country. For 15 years, the UN deployed peacekeeping missions that committed human rights abuses. The organization introduced one of the deadliest cholera epidemics of modern times to the country and continues to deny victims their right to effective remedy; in addition, it has made it nearly impossible for the many victims of sexual exploitation and abuse by UN peacekeepers to obtain even modest support through child support claims.
As a result, the missions remain controversial in the country, with Haitians often equating the UN with impunity and abuse. For the UN to fulfill its mandate in the throes of this pandemic, it must first address its problematic past and re-establish its legitimacy. Moreover, public health is not part of Binuh’s mandate, and the office’s Covid-19 response has been seemingly limited to statements. [Editor’s note: Binuh says it has supported relevant health parties in Haiti to combat Covid-19. Additionally, the UN’s 19 agencies there coordinate with the WHO and the Pan American Health Organization.]
PassBlue: Jacques Létang, president of the Haitian Bars Federation and a founding member of the Human Rights Office in Haiti said in June that Covid-19 was eroding Haiti’s stability. He described Haiti as being at a “political impasse, with no Parliament, no local authorities and ‘no more legitimate Government.’ ” Do you agree with that analysis?
Wisner: Since Jan. 13, 2020, President Jovenel Moïse has ruled Haiti by decree as a result of the postponement of parliamentary elections scheduled for October 2019, due to failures to achieve a ratified government and budget since March 2019. As of Jan. 13, 2020, one-third of the seats in the Senate, all seats in the lower chamber of Deputies and all locally elected posts have expired. This has led to, among other things, the unconstitutional exercise of executive power, leading to further protests and instability in the country.
Over the past two years, the country has faced increasing insecurity and challenges to human rights and rule of law. Since Haiti’s Court of Auditors’ reports dating back to 2016 revealed government misappropriation of $1.7 billion in PetroCaribe funds, no significant progress has been made toward accountability. Acts of repression and violence against the population in response to demands for government accountability and calls to halt widespread impunity for human rights abuses, including deadly gang attacks in the neighborhoods of La Saline and Bel-Air, have been committed with impunity. [PetroCaribe is an agreement in which Haiti and other Caribbean nations can buy oil from Venezuela through long-term loans with favorable rates.]
PassBlue: The UN Economic and Social Council warned in May that the pandemic threatens to undo years of development in Haiti and could trigger a “humanitarian catastrophe.” The US has allocated $16.1 million to assist the Haitian government’s Covid-19 response. Is the US response enough?
Wisner: The international community needs to take responsibility for contributing to the underlying conditions of vulnerability that Haitians face today due to the Covid-19 pandemic. As a result of international interference in their country, Haitians have endured the devastating impacts of a cholera epidemic as well as a legacy of decades of international aid conditionality that has resulted in the government’s deprioritization of public investment in social services such as health care. . . . [which] has left Haiti increasingly vulnerable to health crises like the Covid-19 pandemic.
PassBlue: Haiti was struggling with health issues before being hit with Covid-19. What has the UN trust fund for victims of cholera accomplished? 
Wisner: While Haiti has officially reported no new cases of cholera since January 2019, the country is woefully unprepared to adequately respond to a new global health crisis. Cholera broke out in Haiti in 2010 after Minustah failed to take basic preventative measures and instead recklessly disposed of contaminated waste into Haiti’s main water source. After years of denial, in 2016 Secretary-General Ban Ki-moon publicly apologized for the UN’s role in introducing the disease to the country.
The UN launched a “New Approach,” promising $400 million to eliminate cholera and provide “material assistance” to those most affected by the disease. More than three years later, the UN’s efforts to meet its commitments are, according to its own experts, “pitiful.” The organization has raised only 5 percent of the $400 million that was promised and has delivered “little more than a spate of symbolic development projects” [as reported by the UN high commissioner for human rights].
PassBlue: For years, there have been calls for French and US reparations to Haiti. What are the respective likelihoods those will be paid? 
Wisner: The consequences of France’s “independence debt,” which amounts to $21 billion today, have affected every generation of Haitians since the country won its independence from France in 1804. The overwhelming debt, combined with Haiti’s marginalization in the international community due to its status as a free black nation that had abolished slavery, hardened structural injustices. These injustices persist as the international community, including the US, which occupied Haiti from 1915-1934, has subjected the country to political interference, occupation, racism and neoliberalism with impunity.
The overwhelming burden of the debt is one of the principal causes for Haiti’s underdevelopment and grinding poverty today. While the repayment of this debt — which would amount to more than twice Haiti’s current GDP — would not be able to undo the 200-year-old injustice, it would provide a strong financial foundation for Haiti to kick-start the development it missed out on for centuries.
Numerous academics, politicians, artists and public figures have called on France to repay the debt it unjustly gained from Haiti through a widely publicized petition in 2010. And in January 2020, Thomas Piketty, a French economist, recognized that France should repay at least $28 billion to Haiti to correct its past wrongs. Disappointingly, France has consistently dismissed calls for restitution for Haiti, pointing to its track record of providing aid to the nation.
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