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5. Medical Humanitarianism and Health as a Human Right on the Haitian-Dominican Border
- University Press of Florida
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5 Medical Humanitarianism and Health as a Human Right on the Haitian-Dominican Border Pierre Minn In December of 2001, the Dominican Republic’s Ministry of Public Health and Social Assistance published a 116-page report entitled “Incidence of Demand of Health Services by Foreigners,” which tracked the frequency and cost (down to fractions of pesos) of visits to government hospitals and clinics by foreigners during a three-month period in the same year. The document reported that over 98 percent of these foreigners were Haitians (SESPAS 2001: 14). The report was widely disseminated and frequently referenced by Dominican media in the months that followed. Many Dominicans consider the presence of Haitians in their country to be a major social problem, and the report confirmed suspicions that Haitians were using up scarce resources in the form of public health care services. This paper examines the discourses and practices that accompany the provision of medical services to Haitians in the Dominican Republic. My analysis draws from research I conducted during the summer of 2003 in a Dominican government hospital adjacent to the Haitian-Dominican border , which Haitian patients regularly cross in search of health care.1 While individuals traveling outside of Haiti for brief periods are not generally considered to be part of the Haitian diaspora, an examination of their encounters and interactions with foreign governments and populations helps to illustrate the diversity of transnational processes that shape life for Haitians in Haiti and abroad. Over the course of my research, I identified two coexisting but contrasting rhetorics, that of health as a human right, and that of medical humanitarianism .2 While I examine these rhetorics in a specific geographic and temporal setting, they have gained prominence on a global scale in recent decades. Anthropologists have called for grounded and contextualized studies of human rights in recent years (Wilson 1997) and the subject now appears prominently in a variety of the discipline’s subfields. In contrast, 104 / Pierre Minn anthropological studies directly addressing humanitarianism have emerged only recently. Although humanitarianism and human rights stem from distinct philosophical traditions and can at times be contradictory in nature, they have converged significantly in recent years, a phenomenon which I witnessed frequently over the course of my research. This convergence has important consequences for international medical projects, shaping their form, substance, and the subjective and interpersonal dynamics involved in their implementation. Methodology The research for this thesis was conducted in the Dominican town of Dajab ón (capital of the province of Dajabón), the neighboring Haitian town of Ouanaminthe, and their surrounding areas. I carried out participant observation research and interviews in a variety of settings on both sides of the border, including hospitals, rural health clinics, marketplaces, private homes, and the offices of non-governmental organizations (NGOs). The majority of my research was carried out at the border hospital in Dajabón, where I observed the interactions between Dominican hospital staff and Haitian patients seeking health services. When necessary, I acted as an interpreter between hospital staff and patients, whose level of proficiency in each other’s languages varied considerably. I was careful to inform patients that I was not a member of the hospital staff, and that I was not a medical professional. My ability to communicate with patients in Creole as well as prior experiences working and conducting research in Haiti contributed significantly to establishing rapport with Haitian patients. I carried out eleven formal, tape-recorded interviews and held many more informal interviews and conversations in settings not conducive to taped conversations. Of the formal interviews, three were with hospital staff, one with a foreign aid worker, and the rest with Haitian patients, former patients, and their family members. I also benefited from significant contact with hospital employees, members of local human rights and humanitarian organizations, and religious leaders from churches in both countries. In addition to the time spent in the border hospital, I traveled to rural health clinics , consulted archival material at government offices and research centers, and met with social scientists in Santo Domingo and Port-au-Prince. [54.197.64.207] Project MUSE (2024-03-29 03:15 GMT) Medical Humanitarianism on the Haitian-Dominican Border / 105 The Setting The two nations that share the island of Hispaniola have had a strained but close-knit relationship since their inception as Spanish and French colonies in the sixteenth and seventeenth centuries. The Haitian-Dominican border has been the site of battles, commerce, massacres, and partnerships. For the majority...