This past February the rebellion in Haiti gripped the world. Journalists from Spain, England, and Japan, not to mention a battalion of American media might -- the New York Times, CNN, the Washington Post, NPR, and more -- camped out at swank Port-au-Prince hotels like the Montana, El Rancho, and the Villa Creole (the only ones with reliable Internet connections), drawn largely by the startling images of gunmen run amok in a godforsaken land just a 90-minute plane ride from our shores. Ultimately President Jean-Bertrand Aristide was forced to flee the country.
And then, as quickly as they descended, the journalists up and left, except for the Associated Press, which got busy setting up a permanent bureau there.
It is Haiti's misshapen luck that even when a civil war breaks out, perversely bringing needed attention to the perennially suffering nation, something else comes along to erase it from the international community's consciousness -- namely, a bombed-out train in Madrid, followed by rocket-toting rebels in Fallujah.
It is Haiti's lot, like mother Africa's, to suffer in silence.
Writ large, this also reflects America's foreign policy toward Haiti: a compressed orgy of intervention (1994's "immaculate invasion," to steal the title from Bob Shacochis's book, in which 20,000 American troops descended to restore Aristide to the National Palace after a coup) followed by long stretches of neglect. Conventional thinking holds that the place just isn't important enough to warrant sustained attention -- it has no resources or money to speak of, and its offshore location keeps it somewhat isolated.
But it could be argued that Haiti's strategic importance to the U.S. is in reverse relief. If stability doesn't take root there, Haiti could be the Caribbean Afghanistan, a lawless state that provides haven to an array of outlaws from drug dealers to, potentially, terrorists. We ignore her at our own peril.
Those are fine arguments if you need them. In the end, though, the only justification required is that the place suffers amid poverty unequaled in this hemisphere, and arguably beyond.
Ellen Powers has just returned from an April trip to Haiti. She is the executive director of Project Medishare, a healthcare program founded in 1995 by two University of Miami doctors, Barth Green and Arthur Fournier, and funded primarily through the Green Family Foundation with the help of other nonprofits. Medishare, headquartered on NE Second Avenue in Little Haiti, maintains a clinic in Thomonde (which is the equivalent of a county), nestled in the remote mountainous region known as the Central Plateau (the equivalent of a state).
This might possibly be the most unfortunate place in a thoroughly luckless land. It suffers a child-mortality rate of 187 infants per 1000, versus 138 per 1000 for the rest of Haiti, and has a ten percent higher rate of child retardation. By contrast the U.S. infant-mortality rate is 8 per 1000.
Only one dusty track leads from Port-au-Prince through the mountains to the town of Thomonde and its outlying villages, which together have a population of about 35,000. That "road" is so rough and strewn with so many sharp rocks that flat tires are inevitable. But at least vehicles can traverse it. The villages outside of Thomonde are accessible only by foot, horse, or motorcycle. To get basic healthcare information and services out there, Medishare trains some of the villagers to detect signs and symptoms of sicknesses such as malnourishment and dehydration. These workers are also trained to dispense desperately needed vaccinations against tuberculosis, diphtheria, polio, and measles.
In November 2003, Medishare's workers completed a health census of Thomonde's residents and found that 63 percent of the children up to age five were suffering some level of malnutrition. Apart from stunted growth, this can lead to mental retardation. Severe malnutrition leads to that pathetic state in which children have distended bellies and orange hair. It is the last stop before death.
Medishare's census was taken before violence closed the ports, airport, roads, and schools, and led to the suspension of salaries for everyone from teachers to police officers. It also sent gas prices skyrocketing. Essentially Thomonde was cut off from the world for a couple of months. Today basic government services are more or less running again, but residents of the Central Plateau barely sustain themselves in the best of times. Even a slight disruption creates "a crisis within a crisis," as program manager Marie Chery told Powers.
Medishare workers are currently updating their census, and Powers does not expect the news to be good. "The things children are dying from there are the things we got rid of or controlled a long time ago," she says. "Things like diarrhea."
Thomonde is primarily agricultural. Villagers wield medieval-era hoes to plant fields of cassava, plantains, rice, and beans, providing them with a diet that consists almost entirely of starch, with the occasional bit of goat meat. They eat very little fruit and few green vegetables. What greens they do eat regularly, like legumes, are traditionally boiled, which tends to wash out the vitamins. "The only time they get enough Vitamin A is during the mango season," Powers explains. Vitamin A is essential for growing children; without it their eyesight is underdeveloped. In extreme cases they go blind.
In June Powers will return with some surgeons and a team of volunteer medical students from UM for a healthcare blitz in the region they call a "health fair." The surgeons will go to the provincial capital of Hinche.
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The continuing crisis in Haiti offers lessons for the conflicts in Iraq and Afghanistan. The U.S. cannot simply charge into a country with guns blazing, then leave a few months later and expect life there to proceed normally. A long-term commitment is required. That's a conclusion many have reached, a conclusion recently supported with extensive research published by the San Antonio Express-News.
Powers doesn't need a newspaper to tell her that. "Haiti has been suffering forever," she says. "The last time we as a country went there, it was short-term. Haiti needs more than three or four months of intervention. And they deserve it -- they're one of our closest neighbors."
Not surprisingly, she says what the place needs most is money. Haiti is full of nonprofit organizations, and there are thousands of competent Haitians who can keep programs running. But now U.S. aid is going to Iraq, which threatens to become a black hole for spending. Meanwhile Haiti is pushed to the back of our minds.
At least until they begin killing people in the streets -- again.