Remarks by Mildred T. Aristide
First Lady of the Republic of Haiti
Congressional Black Caucus Health Braintrust Washington, DC March 5, 2003
First, I'd like to join Ron Dellums, Dr. Paul Farmer and the other panelists in thanking the Congressional Black Caucus for organizing this important forum. I'd like to also thank everyone here for their concern and commitment to equity and justice in healthcare for all Haitians.
In the ideal world, today's discussion on the health crisis in Haiti would be all about healthcare. There should be dozens of Paul Farmers talking about the impact of HIV/AIDS and Tuberculosis on the Haitian population, two leading causes of adult deaths in Haiti. There should be teams of pediatricians proposing strategies for universal vaccination campaigns against the preventable childhood diseases which continue to kill Haitian children. We should be questioning experts on the latest methods of water purification, because unsafe water is still a leading cause of morbidity and mortality in my country.
In short, a discussion about healthcare should be about just that: healthcare. Unfortunately, we live in a less than ideal world, and so, such is not the case. Before we can talk about the pressing health crisis that Haiti faces, we must first talk about a series of issues so apparently unrelated to healthcare -- elections, OAS resolutions, multiparty democracy, macro-economic governance measures -- and I could go on.
We must because the provision of healthcare today in Haiti is inextricably linked to these issues. Exactly 2 years ago, in the Spring of 2001, Haiti and the Inter-American Development Bank finalized all the elements of four loan agreements totaling $146 million. $22.2 million of that amount was for the national healthcare system. The people of Haiti, through their duly elected government, agreed to borrow this money at the terms set by the Bank in order to extend the reach of the Ministry of Health so that the 60% of the population living beyond the capital of Port-au-Prince would have greater access to healthcare.
In order to activate these loans, the government of Haiti was told that it had to pay the Bank $5 million in arrears. The government did so, knowing that because these loans for healthcare, education, potable water and secondary roads would respond to the needs of the people, this immediate payment of so large a sum from the national reserves was justified.
But instead of releasing the loans, the loans were blocked. The healthcare needs of 8 million people have become embroiled in a political fight fueled by the political ambitions of a tiny minority coalition of opposition political parties, and the push to impose on Haiti a notion of multiparty democracy that does not reflect the electoral choices of the majority.
The New Partnership for Haiti Resolution, introduced by the CBC on April 18, 2002, demands that humanitarian assistance not be linked to a political accord. It paved the road for Resolution 822 of the Organization of American States which was adopted by unanimous consent in September of last year. Resolution 822 officially de-links the humanitarian loans and assistance to a political accord, calls for the normalization of Haiti's relationship with the international financial institutions, and it reaffirms the absolute necessity for Haiti to adhere to the electoral process -- the voice of the majority -- as it moves forward to resolve the political crisis. Exactly 6 months after Resolution 822, and a year and a half after the resignation of the seven senators elected in May 2000, supposedly at the genesis of the crisis, the loans still have not been released.
The requirement of a political accord has been replaced, or is now masked, by another set of pre-requisite conditions, payment of arrears now totaling $21 million to the IDB alone, and approximately $60 million globally. In addition, the elimination of subsidies on gasoline prices and other macro-economic governance measures which they tell us are "really not that onerous." The gas subsidies were dropped at the end of last year, the price of gas nearly doubled, and as predicted, the cost of living has skyrocketed. The move has indeed proven onerous for the people of Haiti.
Before we can gain access to credit to invest in our healthcare system, we are told that, at all cost, we must close the deficit in the national budget. And a first step in closing the deficit is reducing government spending, in part through lay-offs. On paper, a reasonable and rational goal for any government. But in human terms, for a country like Haiti with a 70% unemployment rate, losing a job condemns a person to unemployment with no access to unemployment benefits or any other social safety nets. It reduces drastically one's chances of sending a child to school, and can very likely leave a person homeless. Closing the government deficit gap, now, by reducing government spending, with no social safety nets, is not so rational, if indeed the purpose of government is to guarantee the welfare and wellbeing of its citizens. If the government of Haiti does not employ its citizen, fund its literacy campaign, build public schools in our rural countryside, build public parks, and construct roads, who will?
A recent concrete example. Two Saturdays ago President Aristide inaugurated a health clinic constructed in downtown Port-au-Prince with the cooperation of the Canadian government. The Government of Haiti and the President expressed their great appreciation to the Canadians for this assistance with the construction, which cost approximately $400,000. But I know that this sentiment of appreciation was immediately followed by a great sense of concern and urgency: where will the government find the funds needed from the national treasury to staff this new clinic and buy the medications required to deliver the healthcare so urgently needed? In short, without access to additional funds, how do we expand desperately needed health coverage while we reduce the government budget?
Some argue that the gap can be filled and is indeed being filled by non-governmental organizations. Indeed, in Haiti's Global Fund project on AIDS, the NGO community, working in partnership with the public sector, plays an important role. However, with the deep appreciation that I have for much of the important work performed by NGO's, funding NGO's exclusively is not the right strategy. As many NGO's will tell you, the government's role in the provision of social service is central and cannot be delegated. Only the Ministry of Health is mandated to provide national health coverage; Haiti's highly privatized education system has failed to school 45% of the school age population, and only the Ministry of Public Works will build the roads linking our isolated countryside. The national infrastructure must be strengthened, if indeed the work of NGO's is to have any impact. These are the responsibilities of the state, all states, rich and poor, because the right to healthcare and education are the human rights of all individuals and should not be treated like commodities for sale on the open market.
Yes, economic reform by the government is needed; it is underway, it must happen. The Haitian government must work hard to combat the legacy of corruption left behind by the 31-year Duvalier dictatorship. But as this reform goes forward, the international community -- which turned a blind eye to years of pillage and theft during the Duvalier dictatorship -- should not sit on the sidelines exacting more from the government while the people suffer. Even the IDB was forced to acknowledge that the major factor behind economic stagnation in Haiti is not inflation or government spending, but the withholding of both foreign grants and loans of up to $500 million, associated with the international community's response to the political impasse.
In 1995, the amount of international aid that Haiti received(bilateral, from the international banks and from the United Nations system) was $430 million. By 2001 the total dropped to $120 million, with the bulk of this money going to non-governmental organizations, and not the government. Before the onset of this crisis, Haiti averaged $75 million annually in loans from the IDB, today that number is zero. This, in a country that the world is so quick to label the poorest in the Western Hemisphere. A country living with the horrific health indicators that Dr. Farmer just described to us.
Something is wrong. Something is terribly wrong.
What is wrong, they tell us it is the government -- that it has not done enough to guarantee security, to fight impunity, to combat corruption, to fight drug trafficking and to create political stability. Yet as they speak, the international community continues to withhold assistance -- technical and monetary -- targeted at precisely these areas. As one member of the OAS recently described it, Haiti has been thrown in the water, hands bound, and asked to swim.
An embargo on the lawful purchase of side arms and other standard police equipment has kept an already undermanned police force, under-equipped. Right now Haiti is experiencing an assault on its young democracy that is being largely ignored by the international press. In fact, when the assaults first began, they were even denied by representatives of the international community in Haiti and by mainstream human rights organizations. Heavily armed commandos dressed in army fatigues, declaring themselves to be former members of the military and now aligned to the opposition, are attacking police stations and killing police officers.
Two rented helicopters are hardly enough to patrol Haiti's coastline for drug traffickers. Yet Haiti is deploying much effort with limited resources available to it, to stop the flow of drugs primarily destined for this country. And indeed since President Aristide took office, the flow of drugs from Haiti to the United States has dropped. The judicial system, imbued with decades of corrupt practices, will not change overnight. Long term and sustained efforts to train magistrates and judicial personnel, construct adequate courthouses -- as are underway -- must be expanded. The successful prosecution of the coup regime's military high command for one of many horrific massacres perpetrated during the coup and the imprisonment of police officers accused of a brutal act of multiple murders, proves that it is possible.
Much is possible since the foundation of democracy was established with Haiti's first free and fair elections in 1990. But it is a process that must be supported and strengthened. Now is not the time for the international community to turn its back on Haiti. A repressive army has been demobilized, a civilian police force created. An unparalleled level of free speech exists in Haiti and is unrestricted by any government censure.
Schools are being built in communities that have never benefited from the public school system. For the first time in Haiti's history we have a public school lunch program. Just last month the executive submitted to Parliament a bill increasing the minimum wage. Roads and bridges are linking communities long isolated from regional markets. Literacy is a national priority and the government seeks to significantly reverse the 55% illiteracy rate in this year leading up to the bicentennial of our independence.
These efforts are being sustained by the revenues collected from the national treasury by a government committed to investing in its people. I have, inevitably strayed from the topic of the health crisis facing Haiti today -- just as the international financial institutions, charged with the mandate of bringing development assistance to the poorest people of this earth -- have strayed from their mandate to do so. The false images of the so-called political crisis and insecurity in Haiti have been allowed to obfuscate the true human crisis in health, nutrition and literacy that engulfs Haiti.
The challenge of poverty in Haiti and globally are great. 1.5 billion people in the world living on less than a dollar a day, the developed world far from meeting its commitment to set aside .07% of its GNP for foreign development assistance, and the gap between the rich and the poor growing. Perhaps it is frustration with these growing challenges that lead some to demonize the victims of this global poverty, rather than combat the poverty itself.
It is a sad commentary on the vision of the international financial institutions, that at a recent public meeting on Haiti, a high-level bank official described Haiti's Central Plateau as a "lunar landscape". With no peasants tilling the soil, this Bank official chose to blame the situation not on the lack of irrigation systems, erosion, or access to seeds and farming tools, but on insecurity; attributable of course to the government's insufficient efforts in this area.
This rush to ignore the root causes of misery in Haiti and to tie every event to the "political crisis" is being echoed by so-called political leaders in the opposition. It is not new. Exactly 110 years ago in Jackson Park, Chicago, former U.S. Ambassador to Haiti, Frederick Douglass, had the following to say about Haiti: "The fault is not with the ignorant many, but with the educated and ambitious few. Too proud to work, and not disposed to go into commerce, they make politics a business of their country. No president, however virtuous, wise and patriotic, ever suits them when they themselves happen to be out of power."
The vast majority of the people of Haiti voted for President Aristide to make "the business of their country" the task of feeding the people, providing healthcare, potable water, education, land reform, and roads. This is the will of the people that must guide Haiti. Yet those desperate to short-circuit the electoral process seek to by-pass this most fundamental element of democracy, the voice of the people.
I left Haiti yesterday afternoon as the country was awakening from a second day of carnival and preparing to fill the streets for a final night of dancing, music and revelry. Up to one million people, thousands from the diaspora community, on the parade route in downtown Port-au-Prince, in open defiance to the exaggerated and false images of "violence and insecurity" painted by international press reports. A powerful demonstration of the true unity and peace that is in the hearts of the majority of Haitians.
We appreciate very much the efforts of several numbers of the House and Senate in coming to Haiti during the past six weeks to see this true side of our country. The bill granting favorable trade status to Haiti and President Bush's pledge of increased funding for Haiti in its fight against AIDS were some of the important issues raised. These are significant initiatives for which we are grateful.
President Aristide sends his warm greetings. As we prepare to celebrate next month the 200th anniversary of the death of our founding father Toussaint Louverture and the bicentennial of our independence in 2004, we urge you to come to Haiti and to continue to support the people of Haiti.
Thank you very much.