Prisoners of poverty:

Haiti, the poorest country in the Western hemisphere, is in a particularly tough spot right now.

Millions of dollars in foreign aid earmarked for much-needed improvements in health care, education, roads, telecommunications, and other areas are being blocked as a result of a seemingly unresolvable political crisis.

That is the message Mildred Trouillot Aristide, wife of Haiti’s president Jean-Bertrand Aristide, delivered Friday (March 7) in a talk at the Center for Population and Development Studies.

Aristide, the daughter of Haitian immigrants, was born and raised in New York City and holds a law degree from the University of Pennsylvania. She served as counsel to President Aristide, a former Catholic priest, when he was living in exile in the United States after Haiti’s 1991 coup d’etat overthrew the country’s first democratically elected government. Democracy was restored to Haiti in October 1994, and President and Mildred Aristide were married in January 1996, at the end of his first term.

Scheduled to speak on “Health Challenges in Haiti,” Aristide apologized for having to talk first about other matters.

“In an ideal world, today’s discussion on the health crisis in Haiti would be about health care,” she said. “But before we can talk about the health crisis that Haiti faces, we must first talk about a series of issues apparently unrelated to health care – elections, OAS (Organization of American States) resolutions, multiparty democracy, macroeconomics – I could go on.”

Two years ago, Aristide said, the Inter-American Development Bank (IDB), an institution established in 1959 to help accelerate economic and social development in Latin America and the Caribbean, OK’d loans to Haiti totaling $146 million.

The release of these loans was contingent on Haiti’s payment of $5 million in arrears to the IDB. Haiti complied, taking the money from its national reserves.

But instead of releasing the loans, the IDB, whose headquarters is in Washington, D.C., has imposed a new series of requirements that, according to Aristide, have increased and prolonged the suffering of the Haitian people.

These requirements include paying additional arrears of $21 million to the IDB and $60 million to other development banks. In addition, Haiti has been asked to reduce its national deficit by decreasing government spending and eliminating subsidies on gasoline prices. The country’s attempts to comply with these conditions have increased unemployment, which is already at 70 percent, and caused the cost of living to skyrocket.

The delay is also connected to a political crisis stemming from Haiti’s national elections of 2000, which were monitored by observers from the Organization of American States (OAS). In these elections, candidates from Aristide’s Lavalas party received about 80 percent of the vote at all levels of government.

Out of 7,400 elections nationwide, the results of seven senatorial contests were challenged by the opposition parties, which called for run-off elections. But Haiti’s supreme court reviewed the elections and decided in favor of the seven senators. This decision failed to satisfy the opposition, a collection of small, disparate political parties that have coalesced under the name Democratic Convergence. Eventually, in an agreement brokered by the OAS, the seven senators resigned.

“But the crisis still went on. The political opposition is not interested in signing an accord,” Aristide said.

In September 2002, the OAS ruled that the release of the loans should not be linked to the resolution of the political crisis, but the ruling by the OAS also imposed a series of conditions that Haiti must meet in order to qualify for the loans. Six months later, Haiti has still not received the money.

According to Aristide, the international community continues to hold up the loans by “putting hurdles in Haiti’s path.” In addition to the condition that Haiti pay millions in arrears, these hurdles include demands that the government do more to guarantee domestic security, fight drug traffic, and eliminate corruption.

But Haiti’s poverty as well as other liabilities make it extremely hard for the government to comply with these requirements, she said. Its air force consists of two rented helicopters, hardly enough to control drug trafficking, while nearly 30 years of the Duvalier dictatorship has left a legacy of violence and corruption that continues to plague the country.

Not all Haiti-watchers agree with this assessment. Robert Rotberg, an adjunct lecturer in public policy at the Kennedy School of Government who has written two books about Haiti, said, “Haiti is about the size of Maryland, and it’s very densely populated. You can tell what’s going on in Haiti if you really want to.”

Rotberg, who was an observer at Haiti’s 1990 elections that originally brought Aristide to office and supported his return to power in 1994, said that many who had great hopes for the Aristide government feel that the regime has not lived up to expectations.

“Haiti has gone backwards. Those of us who hoped for major changes after 200 years of despotism are disappointed,” he said.

According to Rotberg, Aristide has become increasingly authoritarian and has refused to open up the economy. He has also been unwelcoming to members of the Haitian diaspora, a numerous and largely successful group located chiefly in New York, Boston, Miami, and Montreal.

“Harvesting the diaspora is the key to the future because there’s so much money locked up in these Haitian communities. Haiti needn’t be the poorest place in the hemisphere, but it still is,” he said.

Other observers believe that President Aristide has done nothing to disappoint his supporters, but has been doing his best under the circumstances.

Harvard Medical School Professor Paul Farmer, founding director of Partners in Health, which operates a large hospital in central Haiti, blames the United States for its role in holding up desperately needed loans.

In his forthcoming book, “Pathologies of Power: Health, Human Rights, and the New War on the Poor” (University of California Press, 2003), Farmer writes: “Although the [Democratic] Convergence has scant popular support within Haiti, it clearly has support in Washington. The Convergence is funded, at least in part, by the U.S. International Republican Institute, which is associated, to no one’s surprise, with the U.S. Republican Party and obtains funding from Congress through the National Endowment for Democracy.”

Yet as the stalemate drags on, Haiti’s health problems continue to mount. Only 46 percent of the population has access to safe drinking water, life expectancy is 55 years, compared with an average of 69 years in Latin America, and infant mortality is almost twice the average for the region.

More than 300,000 Haitians have died of AIDS, and many more are infected with the HIV virus. As first lady, Aristide has devoted much of her time to Haiti’s battle against AIDS, serving as chair of the country’s National AIDS Commission and speaking widely on the issue.

In speaking of AIDS, Aristide emphasized that the disease cannot be treated without also addressing other health conditions that stem from Haiti’s extreme poverty.

“You can’t isolate AIDS from the social context. You have to combat other conditions that make Haiti the poorest country in the hemisphere.”

As an example of the effect of poverty on the success of health-care initiatives, Aristide mentioned a rural clinic that was opened recently in Haiti with Canadian funding.

The opening of a new health-care center is a cause for celebration, she said, “but where will Haiti find the funds to staff and supply the clinic?”

Some have suggested that nongovernmental organizations (NGOs) do more to help Haiti, but Aristide said that more input by private institutions is not the answer.

“NGOs can’t do it alone. You lessen the impact of their work if you don’t strengthen the infrastructure.”

Aristide said that in some areas the government has been making progress, despite severe economic limitations. For example, the rate of illiteracy, once as high as 95 percent, has been reduced to 45 to 50 percent as the result of government efforts to prioritize education.

But in order to achieve further progress, Haiti needs the help of the international community, without having to meet unrealistic conditions.

“People say the government is not doing enough,” said Aristide. “Yes, there are weaknesses, but democracy is very new there. This is not the time for the world community to turn its back on Haiti.”