Building Partnerships in the Americas: A Guide for Global Health Workers

7 | Haiti

Haiti Natasha Archer and Phuoc Le In this chapter, we elucidate the geopolitical determinants of Haiti’s poverty, and how it and other factors such as water insecurity and the lack of access to medical care have contributed to the development of a chronically debilitated healthcare system. We also illustrate how the hiv/aids epidemic , the 2010 earthquake, and the ongoing cholera epidemic have exerted, and still do exert, devastating effects on the state of health in Haiti. Global health workers will be addressing health issues related to these three disasters in the decades to come. Knowledge of the past and an open mind to the future will serve all those who choose to work in this fascinating country. Brief History The first recorded European contact with present-day Haiti was in 1492, when Christopher Columbus landed near what is now the city of Cap-Haïtien, on the northern coast. The events that ensued over the next several hundred years in Haiti are similar to those that played out in other Caribbean colonies : in the first few decades of European rule, smallpox and other infectious diseases decimated the indigenous populations (in Haiti’s case, the Taínos people). African slaves were then imported to create a new labor force, and colonial powers grew rich from exports off the backs of slave labor. But in 1791, Haiti’s history diverged from that of its Caribbean neighbors. A slave revolt against Haiti’s French rulers that consumed the colony in a brutal war for thirteen years proved too much for a weakened Napoleon. In 1804, Haiti became the first black-led republic in the world and the second colony to become a sovereign nation (the first was the United States) when it gained its independence in a successful slave revolution. The first 100 years of Haiti’s history as a nation were mired by repeated political upheaval. The fact that between 1844 and 1914, power changed hands a total of thirty-two times, and the majority of Haiti’s rulers were either assassinated or forced from office, indicates how unstable the political environment was for the fledging country. In 1915, US president Woodrow Wilson sent an occupying military force ostensibly to reestablish peace and order among the many foreign nationals living in Haiti involved in anarchy; but in reality, this was an attempt to 186 | 7 Haiti | 187 prevent a possible German invasion of the country and the United States’ precious Panama Canal. During the nineteen-year US occupation of Haiti, the United States assumed complete control of Haiti’s finances and public works projects, thousands of kilometers of roads were paved, and hundreds of bridges, schools, and clinics were built. However, this time of tremendous improvements in Haiti’s infrastructure came with profound costs, as repeated popular uprisings against the occupation were put down with lethal force by the US military. The expensive US military occupation of Haiti grew more unpopular among US citizens during the Great Depression. As a result, US president Franklin Delano Roosevelt withdrew from Haiti in 1934. Since World War II, Haiti’s modern history has been dominated by a combination of political oppression and violence. François “Papa Doc” Duvalier, most infamously known for his security team, the TonTon Macoutes (Volunteers for National Security), became dictator of Haiti in 1957. During his time in power, Haiti made no advancements in agriculture, health, education, or commerce. At his death in 1971, his son Jean-Claude Duvalier, also known as “Baby Doc,” assumed power and only increased Haiti’s debt further. During his reign, the hiv/aids epidemic began, further debilitating the economy. He was ousted in 1986. At that time, the Government of Haiti (goh) wrote the 1987 Constitution of Haiti, which aimed to foster Haiti’s independence, establish democracy, and restore equality among the Haitian people. In 1990, Jean-Bertrand Aristide became Haiti’s first democratically elected president, but in 1991, he was overthrown and forced into exile by a military coup d’état. On his return to power in 1994, he disbanded the Haitian Army, which to this day leaves Haiti exceptionally vulnerable. Aristide’s presidential term ended when he ceded power after a coup in 2004. Since then, two presidents , René Préval (1996) and Michel Martelly (2011), have been elected and assumed power. To help ensure a stable environment, the United Nations has had peacekeeping missions in Haiti since 1994, now known as minustah (United Nations Stabilization Mission in Haiti). Geography and...