Haiti and the UN: To promote social progress and better standards of life?

The UN belongs in a museum next to the League of Nations

By Rebecca Theodore

Not even Dante Alighieri in the Divine Comedy can sum up the magnitude of Haiti’s nightmare.  Yes!   Hell has a local existence in today’s day. Hell is the doomed misery of Haiti.   ‘Prisons built with stones of law... Brothels with bricks of religion...’ Excess sorrow magnified in multitudes dying the death of common worms in a great age of modern medicine where cholera is akin to a common cold in the west.

Reluctantly enough, the occupants of that hell are also the UN with pitchforks, drinking blood sweetened with tears, embellishing their corporate wants in bureaucratic inefficiency and waste.  And like the great whore of Babylon arrayed in purple and scarlet, beckoning with golden pitchers filled with abominations and filthiness, their babbled voices penetrating thick billows of smoke - ‘ we need $164-million (US) more in special aid’ to treat a disease which was reported about two months ago, while a people and culture plummet into eternal dust.

Lurching from flood to earthquake to hurricane and now epidemic in the space of mere months, Haiti has not only emerged as the richest poorest state on the planet but it is now the raging cries of critics everywhere that ‘the UN belongs in a museum next to the League of Nations.’

This criticism no doubt must be widely hailed by people everywhere because in the same way the League of Nations failed to prevent the scourge of World War II, leading instead to added pain and suffering on all humankind, the UN has instead chosen to embezzle billions of dollars in fraud to satisfy their corporate ambitions, ignoring the perils of the Haitian people and humanity on a whole.

Judging from the incompetence and corruption in Haiti, it is easy to see why the UN is a testament of failure in calling for additional aid for a disease that can be treated with simple oral rehydration salts or antibiotics.  To ask why people are dying like flies in a modern age of medicine and why they waited so long impels our thoughts back to the Congo sex scandal that went on for more than a year, even after UN officials had knowledge of allegations that their peacekeepers were raping children as young as 12, soliciting prostitutes and engaging in child abuse.

Hundreds of images of child pornography involving Congolese and Haitian children are satisfying the wants and lust of pedophiles on the internet, having been placed there from the caches found on the laptop of French UN civilians.   Sadly enough, up to this day not one UN soldier has been charged, thus justifying their actions as good and righteous.

To add to this discontent, the UN also failed to act in Liberia’s seven year civil war in which hundreds of thousands were butchered.  UN peacekeepers sent to Rwanda failed to prevent the murder and torture of nearly one million Rwandans.   The UN failed to condemn slavery in Sudan, and failed miserably in Sierra Leone.   The UN failed in Angola, in Kashmir, and in Colombia.   The UN has failed to prevent genocide or provide assistance in Darfur and now we are summoned with the mother of all failures -- Haiti.   This is no genocide by natural selection as many choose to claim and Nepalese troops are not the scapegoats of the blame game.   It is the failed and corrupt administration of the UN.

Haiti will prove that the UN’s mission of maintaining international peace, advancing cooperation in solving economic, social and humanitarian problems, and promoting social progress and better standards of life in larger freedom is nothing but a charade… a metaphor swallowed in the bowels of political jargon to mask the passing of time.   Admonishing people to wash their hands and drink boiled or potable water defies human reasoning in a country where people haven’t had a proper meal in months -- how can they afford soap?

Educating the population on cholera prevention or learning the proper hygiene concerning any epidemic will be a big task in Haiti because mistrust of colonial representatives like the UN will forever deny the psychological and physical conditions needed to understand the destructiveness of the epidemic, as medical science and concern for health is imposed by an occupying order that makes it impossible for education to produce social change, because education grows out of a colonial environment in which the preservation of lives, and the maintenance of the social structure can never be maintained.

Not only did the UN ignore the fact that a perturbing effect in one part of the system has a disastrous and far reaching consequence, which is presently mired in an epidemic that now transgresses the Haitian boundaries, making the entire Caribbean at risk; but has now evoked a new wave of political violence for the poor and destitute in Haiti, who have seen nothing but hunger and death for more than 10 months.

As fate would have it, United Nation troops are protecting and fulfilling the duties of only UN workers as has been customary.   For this reason, Haitians must be obliged to seek solace in the leadership of Dr Mirlande Manigat in the upcoming presidential elections -- the first female who will ever to be elected to that office, as there must be change, not only from the corrupt dictators that have ruled Haiti for decades but also from the binding shackles and corrupt management of the UN.

And if anyone asks where hell is -- there you have it... beyond Dante's imagination --
Lasciate ogne speranza, voi ch’intrate (Abandon all hope ye who enter here)
Through Haiti you pass into everlasting pain
And into the darkness of daylight
But to the UN I say --
Better to reign in hell than serve in heaven

November 24, 2010

caribbeannewsnow

Should Haiti become a UN Protectorate?

By Winston D. Munnings



With presidential elections to be held in Haiti on November 28, if there was ever a time to revisit the concept of Haiti becoming a UN Protectorate State is now. And why not? There is no other nation in the Western Hemisphere that has endured the adversities and misfortunes as that of the Republic of Haiti and its people. No other country!

Haiti’s problems and the problems of the Haitian people, however, did not start on Tuesday, January 12, 2010 at 10:53 pm, when a 7.0 magnitude earthquake devastated Haiti, killing more than 250,000 and leaving 1.5 million of its people homeless. Haiti’s problems started more than a half century ago under a merciless dictatorship, a poorly planned economy, greed, corruption, isolation … and the list goes on and on for this long neglected nation, which achieved its independence in 1804.

Fast forward all this now to 2010 (as Haiti is finally the focus of the world’s attention) and just one week shy of national elections there to elect a new president. There are undoubtedly more questions than answers by all concerned (Haitians included) about Haiti’s future and (perhaps) more suggestions than ever before as to how the new leaders might proceed to bring this ravaged nation into the 21st century.

The question of a UN protectorate status for Haiti is relatively old news, but one that shows promise for Haiti in the long run. In fact, some in the international community have already called for the creation of a UN protectorate for Haiti to provide this already fragile nation with stability and leadership as they recover and rebuild from the devastation of the last eleven months.

Others, of course, are strongly rejecting this option, viewing it as a threat to Haiti’s autonomy and sovereignty. What autonomy, one might ask? How is the current situation in this island nation benefitting the republic and its people? How long must the Haitian people continue to suffer while we intellectualize about their future?

Before the January earthquake, Haiti was still the poorest country in the western hemisphere. Given what has happened since (an assault last month by Hurricane Tomas and a deadly cholera outbreak that followed) the people of the Republic of Haiti are worse off now than ever before. The people of Haiti are hurting as never before.

Haiti needs help. Haiti needs guidance. Given the republic’s present dilemma, Haiti needs to be taken care of as a parent would take care of a child until that child is in position to take care of himself.

CARICOM, France, the United States and the future president of Haiti need to come together early 2011 under the auspices of a UN sponsored conference (now that Haiti is finally the focus of the world’s attention) to take a review of Haiti’s future and the future of its people. Critical to that review should be to assess the short, medium and long term impact on Haiti under UN Protectorate Status similar to that (perhaps) of the Kosovo model. To this end, it might be a good idea for the special envoy to Haiti (President Bill Clinton) to invoke the fundamentals of the UN Charter and let this world assembly take serious charge of Haiti’s monstrous predicament.

It is not unusual for the United Nations to play a significant role is matters of this kind. Although the circumstances vary in each case, take a look at Protectorates under direct UN administration since the early 1960s: (1) United Nations Temporary Executive Authority (UNTEA), 1962-1963 - United Nations Transitional Authority in Cambodia (UNTAC), 1992-1993 - United Nations Transitional Authority for Eastern Slavonia, Baranja and Western Sirmium (UNTAES), 1996-1998 - United Nations Interim Administration Mission in Kosovo (UNMIK), 1999 – Current, and United Nations Transitional Administration in East Timor (UNTAET), 1999-2002.

This is not the time to talk of Haiti’s autonomy as a sovereign entity. This is the time to talk of Haiti’s survival and the survival of its industrious and hardworking people who deserve, like other peoples, the opportunity to live and to be recognized and treated as human beings.

November 22, 2010

caribbeannewsnow

Bahamas Blog International

Why Caricom needs to know of T&T's illegal spying politics

By Rickey Singh





PRIME Minister Kamla Persad-Bissessar of Trinidad and Tobago would have done herself and her Government a whole lot of good by going public last Tuesday with an apology to Caricom partners for her recent unfortunate and insensitive statements that linked emergency disaster aid to likely benefits to her country.

Without any rhetorical choreography, she declared during Radio Jamaica's Beyond the Headlines: "I do apologise for the statements that have been taken in this regard. I remain committed to regional integration and to our Caricom brothers and sisters."

What she now needs to consider — bearing in mind that her domestic opponents will continue to exploit that careless political stance — is to sensitise Caricom governments to the uncovering of an illegal spying network with the lists of unsuspecting victims reaching the highest political office to ordinary law-abiding citizens.

The reason such an initiative should be considered is not a matter of courtesy but because the national security interests of Trinidad and Tobago's community partners may well have been compromised by the spying epidemic that involved State-funded intelligence agencies.

Let the following account help to inform what went so terribly wrong when illegal spying on law-abiding citizens, pursued under the guise of battling crime and ensuring "national security", got out of control:

If the problem were not as nationally and regionally challenging, a relevant news item last week could have been dismissed as perhaps an error, or a joke.

Some quick checking by this columnist with the Caribbean Community Secretariat in Georgetown and Caricom's Implementation Agency for Crime and Security (IMPACS) made it clear that it was neither an error nor a laughing matter.

The dust had not yet settled on a parliamentary exposure on November I2 about very extensive and intrusive spying activities of State agencies under the previous People's National Movement Government of ex-Prime Minister Patrick Manning, when there came a surprising press release last Monday from the Community Secretariat.

It announced the holding of a five-day training workshop -- which was then currently occurring in Port-of-Sain, involving 20 immigration officers from 11 Caricom countries, in addition to seven law enforcement officers from the Special Anti-Crime Unit of Trinidad and Tobago (SAUTT).

Under normal circumstances, such a news release from the Community Secretariat would simply have been taken as notification of another work programme of IMPACS. This is the agency which was established to serve the security needs of the region when we hosted Cricket World Cup 2007.

However, given the grave implications of the violations of the fundamental rights of citizens across all races, political parties, social classes and professions by the illegal spying network, it was ironic that SAUTT was involved in the so-called 'train-the-trainer' workshop then underway in Port-of-Spain.

Money and arms


Granted, the arrangements for the workshop would have preceded the November 12 statement in Parliament by Prime Minister Persad-Bissessar about the shocking illegal spying operations in which SAUTT was initially involved.

There also came the exposure of even more disturbing illegal activities by an uncovered Secret Intelligence Agency (SIA) that was out of control, with millions of dollars and a quantity of sophisticated weapons at its disposal.

It may perhaps have been too late for either the Caricom Secretariat and/or the Trinidad and Tobago Government to pull the plug on the five-day 'train-the-trainer' workshop at SAUTT's Camuto-based training facilities.

Nevertheless, it's difficult to ignore the insensitivity on the part of those who have collaborated on the training project with SAUTT as a core partner, as if oblivious to the negative image of this State agency now facing a doubtful future.

Unlike the alarming details the people of Trinidad and Tobago and the region in general came to learn by Prime Minister Persad-Bissessar's disclosure of the SIA's illegal spying activities, the public had already been alerted to the disturbing functioning of SAUTT.

For instance, that the six-month-old People's Partnership Government (PPG) of Prime Minister Persad-Bissessar felt compelled, on the basis of controversial reports received, to terminate the services of the former director of SAUTT as well as to significantly overhaul its mode of operations, pending further decision on its future.

The Workshop


This, then, is the same security body that was involved with IMPACS for last week's training programme.

Involved in collaborative efforts for the workshop are CARICAD (Centre for Development and Administration) and DIFID (British Department for International Development).

While SAUTT remains under the microscope with a doubtful future, and the more controversial SIA has been shut down while the Government finalises plans for a structured probe, a formal request is to be made to the director of public prosecutions to pursue actions he deems legally relevant.

There remains, of course, another dimension to the saga of Trinidad and Tobago's "spying politics" in relation to the security interest of Caricom as a whole.

It is simply not easy to accept that the implications of the gross human rights violations involved in the illegal spying politics in Trinidad and Tobago may have been overlooked in relation to their consequences for Caricom partners.

The reality is that whoever is the prime minister of Trinidad and Tobago also holds lead responsibility for "crime and security" in Caricom's quasi-cabinet.

That was the case under Patrick Manning's watch during the past five years in particular when the now recognised 'spying epidemic' was spreading with all the negative effects of illegal interceptions of telephone, e-mail and other forms of communication.

In the circumstances, it is felt that Prime Minister Persad-Bissessar, who currently shoulders lead responsibility for crime and security in Caricom, has a moral obligation to share as much as possible of the illegal spying activities with her community counterparts.

Question of relevance is: How can a Caricom prime minister, with lead portfolio responsibility for crime and security, be depended upon to be competent and committed in fulfilling his/her mandate, when at home there are a multiplicity of examples involving illegal spying activities that violate the basic rights and dignity of law-abiding nationals?

November 21, 2010


jamaicaobserver

Bahamas Blog International

Chinese take away?

By Sir Ronald Sanders


Problems have emerged in the Bahamas over the number of Chinese workers on a project funded in part by the Export-Import (Ex-Im) Bank of the People’s Republic of China.

The original number of Chinese workers appears extraordinarily high – 8,150 even though there is an undertaking from the owners of the project that the peak number of foreign workers, at any given time, will not exceed 5,000 non Bahamians.

Rightly, Bahamas’ Prime Minister, Hubert Ingraham, has raised concerns about the large number of Chinese workers. His concerns are particularly relevant against the background that, according to the International Monetary Fund “tourist arrivals declined by 10 percent and foreign direct investment fell by over 30 percent, leading to a sharp contraction in domestic activity and a large rise in unemployment” in the Bahamas in 2009.

Construction is a critical engine of growth in any economy, but especially so in small economies where payments to local workers and suppliers keep money in circulation over a wide area including supermarkets, transport providers, clothing and footwear stores, real estate rentals and banks.

If 8,150 Bahamians – or close to it as possible – could be employed in this project, it would definitely be a fillip to the Bahamian economy and help to expand domestic activity and create jobs directly and indirectly.

The issue troubled Ingraham enough for him to travel to China to raise the matter with the Chinese government and return to the Bahamas with the news that he had succeeded in securing $200 million dollars more for construction workers and for Bahamian sub-contractors, raising the total that would be allocated to them to $400 million.

How this translates into jobs for Bahamians and a reduction in the number of Chinese workers is unclear, but note should be taken that, not surprisingly, the opposition Progressive Liberal Party (PLP) has characterised Ingraham’s journey to China as “a failure”. To be fair, it should also be pointed out that it was the PLP which introduced this project, known as Baha Mar, when it served as the government.

Baha Mar, projected to cost $2.5 billion, is a very large tourist project. On completion it is expected to rival the Bahamas’ biggest tourist plant, Atlantis, which was developed by Kerzner International. The operator behind Baha Mar is Caesars Entertainment Inc, a private gaming corporation that owns and operates over 50 casinos and seven golf courses under several brands. Prior to November 18, the Company was called Harrah’s Entertainment.

Ceasar’s, like every commercial business, puts its profitability first. In seeking financing from Ex-Im Bank of China, they apparently agreed that the work force, in effect, would be 71% Chinese and 29% Bahamian – a bitter pill to swallow in the best of economic times and certainly indigestible in the present economic climate.

No one in the Bahamas or elsewhere doubts the contribution that Baha Mar will make to the Bahamas economy in the short and long term, but the conditions of the Chinese loan rankles on the requirement for such a large number of Chinese workers.

After all, this is not aid. It is not even emergency or disaster aid when a high component of Chinese material and people would be acceptable. It is purely and simply a commercial contract, lending money that will have to be repaid.

The only reason one can surmise for the insistence on such a large number of Chinese workers, vastly outnumbering Bahamian ones, is that the Chinese will work for less and trade union conditions, and rights, would not apply in their case thus reducing the cost of the project.

This commentary is less concerned about the local politics of the Bahamas that are involved in this issue; more qualified people can comment on them. It is more concerned with the present and future relations between Caribbean Community (CARICOM) countries and China.

The experience of African countries, notably Angola recently, in relation to China’s use of an overwhelming number of Chinese workers, shows a strain in their relations with China. In 2006, the former President of South Africa Thabo Mbeki famously remarked: Africa must guard against falling into a "colonial relationship" with China.

I have long argued that CARICOM countries should negotiate with China at least a long-term framework treaty that covers aid, trade and investment. It should be a treaty along the lines of the Lomé and Cotonou Agreements that existed with the European Union.

As in all their bargaining with third countries, the CARICOM states would secure better terms if they negotiated with China as a collective than if each of them tried to bargain alone. And, if they succeeded in settling a treaty with China, issues such as the paramountcy of local labour in commercial projects and in loan-funded projects could be settled upfront, as would issues such as the supremacy of labour laws and respect for human rights in the countries where such projects are undertaken.

To negotiate such a Treaty with China, however, CARICOM countries have to do one of two things: those who now recognise Taiwan over China will have to drop that stance so that there is a united CARICOM recognition of China only; or those that recognise China should proceed to negotiate the Treaty with China leaving the others to join when they can.

There is a small window of opportunity left to negotiate a meaningful treaty with China. As China grows more powerful economically crowding out CARICOM’s traditional aid donors and investment partners, it will become very difficult for small Caribbean countries to bargain for the best terms even on commercial projects.

Beggar thy neighbour policies will get CARICOM countries nowhere in the long term and the time is right for all CARICOM countries to strengthen their relations with China on the basis of a structured and predictable treaty.

My friend and fellow writer, Anthony Hall, wrote recently that Hubert Ingraham’s “challenge to China” on the issue of the 8,150 Chinese workers “is precedent setting... and it behoves all leaders in our region to support, and be prepared to emulate, the stand he’s taking: for together we stand, divided we fall”.

China has itself faced the challenges of division; it might – just might - respect Caribbean unity.

November 19, 2010

caribbeannewsnow

Bahamas Blog International

Of Sir Edwin, CARICOM and regional integration

by Carlos James, Esq.


CARICOM Secretary General Sir Edwin Carrington has had his share of work cut out for him. However, after nearly 20 years as head of the Caribbean Community, there is little to be excited about in terms of progress made towards full integration.

This, however, does not minimise the significance of the ceremonial activities held in Antigua last week to mark his knighthood, one of the highest honours of an individual’s contribution to national life. Some may rightly argue that a Caribbean Community Award would have been even more symbolic and appropriate, considering his contribution to the region spanning nearly two decades.

It was interesting to read Sir Edwin’s comments, admitting that the institution had failed to bring home its policies to the common Caribbean man, who simply does not see or understand the workings of CARICOM. If I may suggest, Sir Edwin’s comments on CARICOM’s failed public relations policy is more than just a lack of public awareness. What can CARICOM really put forward to the region and flaunt as effective integration policies?

Yes, the people of the region understand what CARICOM means to them, what it implies and what it requires of them, but what exactly is being done, where are the functional policies?

Frankly, there is not much to look forward to from CARICOM as a regional entity. It has lost its sparkle. No longer are we hearing the chorus of regional leaders, who once sang the same tune of regionalism, a single market and a single economic space.

Interestingly enough, Sir Edwin has admitted that the framework to make the CARICOM Single Market (CSM) and the CARICOM Single Market and Economy (CSME) fully operational is in place. In what can be considered a diplomatic cry for help, Sir Edwin confessed that more thrust is needed for both initiatives to take firm steps towards realisation.

In plainer language, for farmers in North Leeward and North Windward, and other rural communities across the region who want better regional access to markets for trade purposes, the vision of a Caribbean single market is failing because of the lack of interest from regional leaders.

CARICOM has become stagnant and cannot handle the surmountable challenges of our region’s changing political economy. It is swiftly withering into a failed institution lacking the energy, vision and the political will to carry forward its mandate which is central to regionalism - The Revised Treaty of Chaguaramas. In no uncertain terms can a framework for integration survive solely on the technical machinery of the CARICOM Secretariat without the political will of the region’s leaders. The structure for the integration process is merely skeletal, crippled, non-functional and hangs on life support.

No amount of media relations, as Sir Edwin envisaged, can connect the people of the region to something that lacks any form of functional capacity without coming across in an ostentatious way. The need for reforms at every faction of the CARICOM fibre is needed.

I must agree that formalising a single economic space is no easy task, the difficulties faced by the powerful European Union is evidence of this, but we must be reminded that the Caribbean Community is characterised by a people of common cultural and political identity. The socio-political dynamics of our region puts us in a more suitable position to establish and benefit from such a union.

Even the big capitalist countries are moving away from monopolistic ideals and trade protectionism. German Chancellor Angela Merkel, ahead of this week’s G20 meeting in Seoul, has warned that the greater danger facing the global economy is a return to trade protectionism. So why is CARICOM failing to further develop its single market and economic space? Where is the political will?

St Vincent’s Prime Minister Dr Ralph Gonsalves, and perhaps a few others, stand out as the lone batsmen at the crease, so vocal and tirelessly struggling to add to the score of the opening political giants of Eric Williams, Tom Adams, Errol Barrow, Michael Manley, et al.

It was Dr Gonsalves in 2003 who, while presenting a lecture in Trinidad to commemorate CARICOM’s 30th Anniversary, questioned:

-- What is the most advanced model of regional integration that the political market nationally can bear?

-- Do the leaders of the region -- political, economic, community and social -- and the people themselves possess the political will and readiness to go beyond the parameters of the individual nation-states and embrace a union deeper than that which currently exists?

-- What is to be done right now to construct, or prepare for the construction of a deeper union between CARICOM countries, or at least between those who are ready and determined, to go forward?

The Caribbean community has yet to answer. CARICOM is in retreat and this makes it hard for the region to get its voice heard. We need to reinvigorate the CSME process or CARICOM will suffer.

Instead of moving towards full integration as a region, we are seeing prime ministers becoming more nationalistic in their policies and utterances. These unreasoning allegiances are insensitive to the harmonisation efforts made by our leaders over the years.

I note the recent tongue-tied comments by Trinidad and Tobago’s Prime Minister Kamla Persad-Bissessar while the hurricane ravaged islands lay open and vulnerable after the onslaughts of hurricane Tomas.

PM Persad-Bissessar, has made similar gaffes in the past, including her now infamous ATM reference at the CARICOM Heads of Government meeting in July. Her utterances on regional matters have been extraordinarily undiplomatic for someone holding the office of prime minister and Commonwealth Chair-in-Office. It is hard to distinguish her constructive utterances from insentient reasoning.

Common foreign policy?

Sir Edwin rightly pointed out that the region needs to develop a strategic foreign policy in order to represent itself on the international stage. I am in agreement with the position that co-ordination of such a framework is paramount, but it must be noted that, while some countries take an aggressive approach towards foreign relations, others are quite stagnant and remain passive in befriending new diplomatic allies. We must not be seen as chiding regional countries who take on new focus in forging diplomatic relations with emerging economies.

In fact, we are in trouble if we continue to sit on the laps of traditional allies, who themselves are going further East, seeking new trading partners and political friends. It is important to our sovereignty to move away from this docile form of diplomacy, no country owns us. We need to shift from this conservative foreign policy focus on bilateral relationships and focus on multilateral action.

Not surprisingly, we see foreign policies grounded on national interest, ignoring the obvious regional implications of which Sir Edwin is so concerned about. Relations with China and Taiwan among our regional states is a never ending game of diplomatic hopscotch, while some continue to act as political stooges to the US and other G8 countries.

A point of interest is the headlines this week where the US and Britain are courting both India and China. The West has turned to the East. So what is so wrong with diplomatic relations with Brazil, Russia, India and China (BRIC), Cuba, Venezuela and oil-rich Iran?

Caribbean countries need to let go of this erroneous belief of indirect dependency on the so-called powerful traditional allies and provide a common foreign policy agenda that can attract the courting eyes of industrialised and emerging economies.

We have made many strides as a region, let’s not turn the wheel back. Let us continue the process of region-wide engagement on the issue integration. There are obvious lessons that the OECS can offer the larger bloc.

November 18, 2010

caribbeannewsnow

Bahamas Blog International

The Haitian cholera outbreak: A preventable tragedy?

by Joseph Crupi, COHA Research Associate


On October 21, a case of cholera was identified in Haiti for the first time in at least 50 years. The disease spread rapidly through the Artibonite River basin, and by November 9, more than 580 people had died, and thousands more were gravely ill. The outbreak has raised questions about the international community’s efforts to prevent the spread of disease in post-earthquake Haiti, and many agencies and organizations have faced criticism for their failure to prevent the crisis. In order to evaluate the accuracy of these criticisms, it is important to carefully analyze the steps taken by health workers, governments, international organizations, and NGOs to prevent such a tragedy.

Health Workers Downplay Cholera Threat

In the aftermath of Haiti’s earthquake, the leaders of the international health community did not acknowledge cholera as a serious threat. On March 2, the Center for Disease Control and Prevention (CDC) published a report entitled “Acute Watery Diarrhea and Cholera: Haiti Pre-decision Brief for Public Health Action.” While the report recognized that water-borne diseases could easily spread through Haiti’s poorly-maintained tent cities, it also stated that an outbreak of “cholera [was] extremely unlikely to occur,” largely because the vibrio cholerae bacteria had not been observed in Haiti in over half a century. The report downplayed concerns that the bacteria could be introduced by foreign relief workers or aid shipments and failed to consider that the bacteria might continue to exist undiagnosed in rural communities. In a February radio interview, Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, expressed agreement with the CDC report, saying, “There is no cholera in Haiti, so it would be extremely unlikely that there would be an outbreak of cholera in Haiti, even though you don’t want to completely rule it out, it’s not the first thing that you think of when you think of an outbreak of waterborne disease.”

Health care administrators, trusting the consensus among experts that a cholera outbreak was unlikely, concentrated on more pressing health concerns. Trauma injuries received first priority after the earthquake, and health care specialists also devoted much of their time and resources to treating patients suffering from diabetes, heart disease, HIV, and tuberculosis. Health workers placed a high emphasis on immunization campaigns to prevent measles, rubella, diphtheria, tetanus, and pertussis. A cholera vaccine was available at a cost of only 50 cents a dose, but due to the perceived improbability of an outbreak, health care administrators did not seriously consider widespread distribution to be necessary. Hence, while health workers had the technical capability to prevent an outbreak, they did not have compelling reasons to implement such measures.

Unmet Obligations and Broken Promises?

While health workers did not perceive cholera as an active threat in post-earthquake Haiti, other water-borne diseases did draw significant attention from health agencies. In February, the Pan American Health Organization (PAHO) reported, “Sanitation is a massive challenge that must be urgently resolved; an increasing number of diarrhea cases are being reported. If shelter and sanitation are not adequately addressed before the rainy season arrives, the risk of epidemic outbreaks of water-borne and other diseases will increase.” These issues, however, were not sufficiently addressed. In early September, PAHO conducted a survey of health systems in northern Haiti, where the first case of cholera was diagnosed, in order to “identify programs, needs, and gaps in coverage.” A report later released by the institution emphasized that “water and sanitation, provision of clean drinking water, and insufficient health care services” remained serious health issues in the region.

The persistence of these problems is due, in part, to the failure of foreign governments and international donor organizations to deliver aid efficiently. While a number of countries provided generous emergency relief immediately after the earthquake, many have been slow to fulfill promises of continued assistance for reconstruction and infrastructure development. Indeed, as of late September, only 15 percent of promised aid had reached Haiti. In many countries, legislative and bureaucratic processes have delayed further assistance. In the U.S., for example, Senator Tom Coburn has held up a five-year assistance authorization bill, and the State Department has delayed a USD 1.15 billion supplemental appropriations act that was signed by President Obama in late July.

However, the relevancy of these shortcomings to the current crisis is debatable, and it is not clear whether a more urgent allocation of foreign assistance would have significantly hindered the spread of cholera. Aid funds certainly could have been used to supply clean water and proper sanitation facilities, but it is unclear whether governments would have allocated funds to improve conditions in temporary settlements. Furthermore, given that donor institutions had primarily focused on areas directly affected by the earthquake, it is doubtful whether the funds would have been distributed effectively to close gaps in coverage.

Inadequate coordination between NGOs has also been detrimental to Haiti’s reconstruction effort. After the earthquake, various individual NGOs assumed responsibility for many of the tent cities occupied by those displaced by the earthquake, but there were no uniform standards or procedures in place to govern the distribution of resources among the camps. The capabilities of the NGOs in question varied widely, and as a result, some camps were adequately maintained, while others experienced catastrophic shortages of food and potable water. According to a joint study by the Institute for Justice and Democracy in Haiti, the University of San Francisco School of Law, and Lamp for Haiti, 44 percent of families in Haiti’s tent cities drink primarily untreated water, and only 9 percent received drinking water relief over a 30 day period. In most cases, clean water is only available to Haitians who can pay for it, and illnesses due to unsanitary water are common. The study also found that only 69 percent of Haitians in tent cities have access to basic toilet facilities, and toilets are often unclean, unsafe, and overcrowded.

While poor coordination among NGOs has exacerbated conditions in Haiti, it is unclear to what extent this shortcoming contributed to the cholera epidemic. Prior to the earthquake, much of the population lacked access to clean water and adequate waste management systems, and water-borne diseases were common. Thus, conditions were ripe for the spread of cholera even before the catastrophe. In the aftermath of the earthquake, over 160,000 Haitians were forced to resettle temporarily in the Artibonite region, where most of the cholera cases have been diagnosed. The increase in regional population has strained resources and compounded challenges in the removal of waste. While post-earthquake resettlement patterns certainly aggravated conditions that would facilitate the spread of cholera, it is difficult to determine to what extent the population shift has actually accelerated the spread of the disease. Cholera has just begun to infiltrate the tent cities,16 so conditions in the camps have not played a significant role in the outbreak thus far. However, cholera is now prevalent in Port-au-Prince, and it seems to be only a matter of time before the disease also becomes prevalent in the camps surrounding the capital. When the epidemic does make its way into the camps, the lack of a coordinated effort to provide clean water and proper sanitation will surely have devastating consequences.

Containment

Prior to the outbreak, the CDC had, in fact, developed a contingency plan to detect and respond to a cholera epidemic. The effort included the establishment of health monitoring sites to rapidly detect an outbreak of the disease. Proper methods of sample collection and analysis to confirm cases of cholera were also addressed in the plan, which provided several options for public health action should an outbreak occur. After the outbreak, the international community responded quickly to contain the disease. Soon after the first case was diagnosed, the CDC sent health experts to Haiti to conduct laboratory diagnoses. Cuba immediately dispatched several hundred doctors and nurses to administer antibiotics and assist those in need of treatment, and NGOs such as Médecins Sans Frontières set up cholera treatment centers and provided workers to staff local hospitals. Many of the public health options presented in the CDC report have been implemented, and containment objectives have been clearly defined.

The Haitian government, often criticized as corrupt and incompetent, has also done its part in responding to the outbreak. The Haitian Ministry of Health was first to detect the disease, and it has since played an active role in the containment effort. In addition, the government took decisive steps to help Haitians prepare for Hurricane Tomas and minimize the spread of cholera due to flooding from the storm.20

Conclusion

While the damage from the epidemic could certainly have been lessened by more anticipatory actions, it is unlikely that it could have been prevented completely. Health workers, operating under the assumption that a cholera outbreak was unlikely, understandably focused on more pressing concerns. While they may have had the capacity to significantly reduce the risk of an outbreak through vaccinations, health workers acted logically given the information they had. Although the failures of national, international, and nongovernmental organizations did not cause the outbreak, they may be partially responsible for the rapid spread of the disease. Whether or not poor coordination or delays in assistance actually facilitated the spread of the epidemic, as more Haitians are affected, increased (and long overdue) scrutiny of these shortcomings is inevitable. Reasonable preparations to contain a possible cholera epidemic were made in the months following the earthquake, and although it is premature to evaluate the international response, the effort to contain the disease seems to be well-coordinated.

According to PAHO deputy director Jon Andrus, cholera is not likely to be eradicated in Haiti for several years,21 and health workers have begun to prepare for a prolonged campaign against the disease. Speculation that Nepalese peacekeepers may have introduced the bacteria has led to protests and widespread anti-UN sentiment, which will likely inhibit the UN’s ability to operate effectively in the country. There are also fears that the flooding brought by Hurricane Tomas could expedite the spread of the disease, which is expected to eventually move across Haiti’s porous border with the Dominican Republic.22 Clearly, the international community must be fully committed to controlling the spread of the epidemic. While it is important to hold institutions accountable for any fault that may exist, excessive criticism at this juncture may be an overreaction. There is simply not enough available information to demonstrate the culpability of any one organization. Furthermore, attempts to assign blame for the crisis distract from and may even impede efforts to contain the disease. Given Haiti’s already unbearable suffering, it is imperative that the international community, the Haitian government, and its people are unified in their response to the cholera outbreak, which, if allowed to become a point of division, has the potential to make a dreadful situation even worse.

References for this article are available here

The Council on Hemispheric Affairs, founded in 1975, is an independent, non-profit, non-partisan, tax-exempt research and information organization. It has been described on the Senate floor as being "one of the nation's most respected bodies of scholars and policy makers." For more information, visit www.coha.org

November 17, 2010

caribbeannewsnow

Bahamas Blog International

Bahamas: ...a lack of swift justice is a hard pill to swallow

The need for swift justice
thenassauguardian editorial



Is there such a thing as swift justice?

The idea behind swift justice is to capture, prosecute and take immediate action on those found guilty of serious crimes. Once that is done, the trend of thought suggests it would make would-be criminals think twice about their actions.

Swift justice will also go a long way in helping members of the public feel a little safer. Police officers have often complained about having done their part in capturing criminals, but they feel that the system betrays them by giving bail to individuals accused of serious crimes like murder.

They’ve complained that even individuals charged with crimes such as housebreaking or assault are given bail too easily and too quickly.

For police officers who are committed to cleaning up the streets, a lack of swift justice is a hard pill to swallow.

No doubt swift justice would help to clean out the backlog of cases that are currently before the courts. Some believe that once the courts can quickly deal with small matters before them, by handing out swift justice, it would give them more time and effort to concentrate on solving serious matters before the courts.

Why should a petty theft be a matter before the courts for months or even years? If all of the evidence and facts are there to convict, then why hold up the court by putting off the case?

That is where swift justice must prevail.

Of course, in all of this the key element would be having all of the evidence and facts to prosecute a case and get a conviction. While justice must be swift, it must also be just.

There must be no room for doubt or guessing, especially when it comes to serious matters like murder, attempted murder, kidnapping or assault. The evidence must be crystal clear.

Perhaps it is this inability of the system to present credible evidence and facts that forces cases to be pushed back or be held before the courts for an extended period of time.

More work must be done by prosecutors in presenting evidence that would expedite swift justice.

A delay in justice forces the hand of the people to seek their own justice, which leads to more problems.

Because of delayed justice many Bahamians have chosen to attempt to take the law into their own hands, seeking their own justice.

Swift Justice must work in the best interest of all. Victims must feel that the system and the law is there to protect them, not frustrate them.

11/15/2010

thenassauguardian editorial

Bahamas Blog International