by Paul Farmer
7 See “Rwanda Vision 2020.” (Updated July 2000.) Available: http://www.gesci.org/assets/files/Rwanda_Vision_2020.pdf (accessed April 15, 2011).
8 For more on the interim government’s anti-corruption campaign see Frederick Golooba-Mutebi, “Collapse, War, and Reconstruction in Rwanda: An Analytical Narrative on State-making.” Crisis States Working Paper No. 28 (2008), p. 31. Available: http://www.dfid.gov.uk/r4d/PDF/Outputs/CrisisStates/wp28.2.pdf (accessed April 15, 2011).
9 For more on the immediate responses of the international community to the genocide and the interim governments, see Gérard Prunier, The Rwanda Crisis: History of a Genocide (New York: Columbia University Press, 1994), pp. 336–345.
10 As noted, see the Internal Displacement Monitoring Centre’s 2011 report “Internal Displacement: Global Overview of Trends and Developments in 2010.”
11 See, for example, D. Hilhorst and M. van Leeuwen, “Emergency and Development: The Case of Imidugudu, Villagization in Rwanda,” Journal of Refugee Studies 13 (2000): 264–280; E. Brusset, “Imidugudu and Humanitarian Aid: The Influence of NGOs on Post-war Conditions in Rwanda.” Autrepart 26 (2003): 107–121.
12 Stephen Kinzer. A Thousand Hills: Rwanda’s Rebirth and the Man Who Dreamed It (New Jersey: John Wiley and Sons Inc., 2008), p. 199.
13 This topic is explored in greater detail by Jason K. Stearns in Dancing in the Glory of Monsters: The Collapse of the Congo and the Great War of Africa (New York: PublicAffairs, 2011), which details Mobutu’s assistance to Juvénal Habyarimana’s government, including its armed forces, before and after the genocide: “The army’s flight across the border did not end the civil war in Rwanda but constituted a hiatus in the hostilities. The Rwandan Armed Forces (FAR), as the Hutudominated army was called, used the protection provided by the border to regroup, rearm, and prepare to retake power in Kigali. One of their leaders, Colonel Théoneste Bagosura, said in an interview that they would ‘wage a war that will be long and full of dead people until the minority Tutsi are finished and completely out of the country.’ Crucially, they enjoyed the support of Zaïre’s ailing president, Mobutu Sese Seko, who had sent troops to support the FAR against the RPF [Rwandan Patriotic Front], and who had been close friends with President Juvénal Habyarimana. In part, what was to play out over the next decade in the Congo was a continuation of the Rwandan civil war, as the new government attempted to extirpate the génocidaires and the remnants of Habyarimana’s army on a much broader canvas” (Stearns, 2011, p. 15).
14 Kinzer. A Thousand Hills, pp. 203–204.
15 Dorothea Hilhorst and Mathijs van Leeuwen. “Villagisation in Rwanda: A Case of Emergency Development?” Wageningen Disaster Studies Disaster Sites No. 2 (1999).
16 Saskia van Hoyweghan. “The Urgency of Land and Agrarian Reform in Rwanda.” African Affairs 98 (1999): 353–372.
17 Minh Day. “Alternative Dispute Resolution and Customary Law: Resolving Property Disputes in Post-conflict Nations, a Case Study of Rwanda.” Georgetown Immigration Law Journal 16 (2001): 235–256.
18 See, for example, Chris Higgins and Herman Musahara. “Land reform, land scarcity and post-conflict reconstruction: A case study of Rwanda.” In: Chris Huggins and Jenny Clover, eds. From the Ground Up: Land Rights, Conflict and Peace in Sub-Saharan Africa. (Nairobi and Pretoria: African Centre for Technology Studies and Institute for Security Studies, 2005), pp. 269–346. Available at: http://www.iss.co.za/pubs/Books/GroundUp/6Land.pdf. (See pp. 287, 313–314 for the actual citations.)
19 The extent to which the government directed such efforts is debated. For example, Pottier’s Re-imagining Rwanda, pp. 186–190, describes land allocation as an organic process that was determined principally by local actors.
20 Here the Rwandan and Haitian national experiences diverge. Although Haitian prisons are overcrowded, leading to outbreaks of disease (including cholera, which immediately hit the prisons in Saint-Marc and Mirebalais), and most detainees had not enjoyed anything approaching due process, the Haitian prison population is small compared to that in Rwanda. For a comparison of various truth and reconciliation commissions, see Patricia Hayner’s Unspeakable Truths: Facing the Challenge of Truth Commissions (New York: Routledge, 2002).
21 Quoted in Kinzer. A Thousand Hills, p. 257.
22 The gacaca process, based in part on traditional law and in part on the exigencies of the moment, has been the subject of a great deal of commentary, much of it negative. Some have pointed out, for example, that RPF crimes went largely unjudged (Kinzer, p. 259). Peter Uvin sums up the freighted debate: the gacaca system “profoundly compromises on principles of justice as defined in internationally agreed-upon human rights or criminal law standards,” but respects the “spirit of international criminal and human rights law, if not the letter.” He ultimately concludes that it is the “locally appropriate form.” Quoted in Kinzer, p. 258. Also see E. Daly. “Between Punitive and Reconstructive Justice: The Gacaca Courts in Rwanda.” New York University Journal of International Law & Politics 34 (2002): 355; J. Sarkin. “The Tension between Justice and Reconciliation in Rwanda: Politics, Human Rights, Due Process and the Role of the Gacaca Courts in Dealing with the Genocide.” Journal of African Law 45 (2001): 143–172.
23 Jean Hatzfeld. The Antelope’s Strategy: Living in Rwanda After the Genocide (New York: Farrar, Straus and Giroux, 2007), p. 204.
24 Gender equity is another topic that is much discussed and little implemented. More money is spent on empty “empowerment workshops” than in making sure that women have fair pay, equal representation in government, and ready access to health care and education. Here again, Rwanda is ahead of the pack: by mandating equal representation in government, it soon boasted significant gender equity at the top levels of government (in the legislative branch and in cabinet-level positions). Today, more than half of its parliamentarians are women, as are many of the mayors of its larger cities. For more on this, see C. Devlin and R. Elgie “The effect of increased women’s representation in parliament: The case of Rwanda.” Parliamentary Affairs 61, no. 2 (2008): 237–254.
25 Peter Uvin. Aiding Violence (West Hartford: Kumarian Press, 1998).
26 The Rwandan campaign provoked a firestorm of criticism, of course, and was even labeled “double genocide” by some. A UN draft report released in September 2010 fanned these flames by underscoring crimes alleged to have been committed by Kagame’s armies (mostly Tutsi) in the Congo campaign. The report was leaked by Le Monde. See http://www.lemonde.fr/afrique/article/2010/08/26/l-acted-accusation-de-dix-ans-de-crimes-au-congo-rdc_1402933_3212.html (accessed April 15, 2011). See also the Rwandan government’s response: Official Government of Rwanda Comments on the Draft UN Mapping Report on the DRC. Geneva (October 1, 2010). Available: http://www.gov.rw/sub.php?page=print&id_article=112 (accessed April 15, 2011). See also Aldo Ajello’s interview with Colette Braekman on the topic. Available: http://www.newtimes.co.rw/index.php?issue=14415&article=34668 (accessed April 15, 2011).
27 Uvin. Aiding Violence, p. 127. Uvin writes, “The social and political are outside the game of development. Development is done through projects, that is, welldefined technical/financial packages with limited time frames as well as functional and regional scopes. Scant attention is paid to the national or international context or to the political background against which these projects occur” (pp. 154–155). Uvin’s argument builds on James Ferguson’s long-standing critique of the depoliticizing nature of the development enterprise. See J. Ferguson. The Anti-Politics Machine: “Development,” Depoliticization, and Bureaucratic Power in Lesotho (Cambridge: Cambridge University Press, 1990), for example, pp. 16–21.
28 “Our peculiar institution” was a common euphemism for slavery used in the American South before the Civil War. It was popularized by John C. Calhoun of South Carolina in his Speech on the Reception of Abolition Petitions (February 6, 1837). Available: http://www.wfu.edu/~zulick/340/calhoun2.html (accessed April 15, 2011).
29 Trouillot describes the proces
s by which the poor rural population became subject to a tiny urban élite: “The chronic instability of Haitian political life,” he writes, “as manifested in the rhythm of political succession, numerous constitutional crises, and recurring armed feuds is so obvious that Haitian and foreign observers alike have tended to inflate the role of politics in shaping the course of the country’s history. They often see the stages of historical evolution in terms of changes to the regime, to a degree that masks underlying continuities. The point is that the state’s importance came not from the power vested in individual regimes but from its role in the extraction and distribution of peasant surplus… At the bottom of the social scale, but vitally important for the entire nation, was a peasantry divided into several strata: landless people, sharecroppers, small proprietors, and rich peasants. Together, these men and women did the work and furnished almost all the country’s wealth. But their techniques of production stagnated…. Statistically, peasant productivity today is only equal to that of 1843, if not lower. The touchstone of Haiti’s socioeconomic system has thus been a peasantry that worked more and more but produced less and less, as population increased and the availability of fertile land decreased…most of the fruits of the peasantry’s toil were seized by the alliance of rulers and merchants and transferred abroad… [T]he socioeconomic structures, and the historical and cultural context in which their effects were felt, implied a separation between the peasantry and the urban world. This separation produced two contradictory tendencies: the political marginalization of the peasantry and the concentration of urban demands in the narrow sphere of governmental decisions.” Michel-Rolph Trouillot. Haiti, State Against Nation: The Origins and Legacy of Duvalierism (New York: Monthly Review Press, 1990), pp. 83–85.
30 Haitian farmers may also benefit from a rise in global food prices. A report published by the UN’s International Fund for Agricultural Development on December 6, 2010, suggests that poor farmers around the world may receive an income boost from the surge in food prices, giving them greater income to reinvest in irrigation, better fertilizers, new farming equipment, and other means to increase yield in future seasons. See Rural Poverty Report 2011. Available: http://www.ifad.org/rpr2011/report/ (accessed April 15, 2011).
31 A December 2010 news story estimates that Haitian rice production may be compromised due to consumer fears about crops grown in cholera-affected areas. See “Cholera Outbreak Could Hurt Haiti’s Rice Production.” CNN (December 30, 2010). Available: edition.cnn.com /2010/WORLD/Americas/12/29/Haiti.cholera/ (accessed April 15, 2011).
32 The connections between economic growth and social safety nets, including those that would protect the most vulnerable from want, are not linear. Amartya Sen has often underlined the links between freedom, on the one hand, and socioeconomic conditions (what has been termed here “human security”), on the other. See, for example, Development as Freedom (New York: Anchor Books, 1999). “Growth of GNP or of industrial incomes,” Sen writes, “can, of course, be very important as means to expanding the freedoms enjoyed by the members of the society. But freedoms depend also on other determinants, such as social and economic arrangements (for example, facilities for education and health care) as well as political and civil rights (for example, the liberty to participate in public discussion and scrutiny).” (Sen. Development as Freedom, p. 3)
Epilogue
1 Aristide remained in South Africa when the narrative of this book concluded. But on March 18, 2011, Aristide returned home. For an account of his reception and the implications of his return, see Jeb Sprague. “Haiti’s Movement from Below Endures.” Al Jazeera (March 27, 2011). Available: http://english.aljazeera.net /indepth/features/2011/03/2011322143841972574.html (accessed April 15, 2011).
2 Stephen Smith. “Year after Haiti Quake, Agency Asks How Far It Can Go.” Boston Globe: January 11, 2011. Available: http://www.boston.com/lifestyle/health/articles/2011/01/11/soaring_need_fuels_agencys_growth_in_haiti/ (accessed April 15, 2011).
3 See “Haiti One Year Later: The Progress to Date and the Path Forward.” Interim Haiti Recovery Commission Report (January 12, 2011). Available: http://www.cirh.ht/sites/ihrc/en/News%20and%20Events/News/Pages/12janv11.aspx.
4 See, for example, the article about my former student, Dr. Megan Coffee, who has worked with few resources and a handful of public employees to improve care for patients with HIV and tuberculosis at the General Hospital. Bob Braun. “Maplewood Doctor Volunteers at Haiti’s Largest Hospital after Devastating Earthquake.” Star-Ledger (July 20, 2010). Available: http://blog.nj.com/njv_bob_braun/2010/07/doctor_from_maplewood_voluntee.html (accessed April 15, 2011). Nick Lobel-Weiss from Global Emergency Relief also did yeoman’s work at the General Hospital. One of the more significant developments was, as noted, the American Red Cross grant to provide “performance-based” salary support for the hospital’s underpaid (and overworked) staff. It is our hope that the Red Cross’s commitment to accompanying the General Hospital may become a model for how nongovernmental organizations and private groups can partner with the public sector to strengthen the Haitian health system.
5 One of the reasons that Claire’s job is hard is that too little of the reconstruction funds end up in Haitian hands. The December Associated Press investigation cited in Chapter 5, note 40, page 382, found that only 20 of 1,583 U.S. contracts for recovery aid went to Haitian-run enterprises. That’s $1.60 out of every $100. See Martha Mendoza “Would-be Haitian Contractors Miss Out on Aid.” Associated Press (December 12, 2010). Available: http://news.yahoo.com (/s/ap/20101212/ap_on_re_us/cb_haiti_outsourcing_aid_1 accessed April 15, 2011).
ACRONYMS AND INITIALISMS
CHAI: Clinton Health Access Initiative
CHOP: Children’s Hospital of Philadelphia
DART: Disaster Assistance Response Team
GHESKIO: Le Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes (The Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections)
GSD: get stuff done
HELP: Haitian Education Leadership Project
HUEH: l’Hôpital Université d’Etat d’Haïti (Haitian State University Hospital)
HUP: Hospital of the University of Pennsylvania
IDP: internally displaced person
IHRC: Interim Haiti Recovery Commission
IMC: International Medical Corps
MASH: Mobile Army Surgical Hospital
MINUSTAH: UN Stabilization Mission in Haiti
MSF: Medécins Sans Frontières
NGO: nongovernmental organization
OCHA: Office for the Coordination of Humanitarian Affairs
OSE: Office of the Special Envoy
PDNA: Post-Disaster Needs Assessment
PIH/ZL: Partners In Health/Zanmi Lasante
PIH: Partners In Health
RTHC: Right to Health Care
UNICEF: United Nations Children’s Fund
USAID: United States Agency for International Development
WFP: World Food Program
WHO: World Health Organization
CONTRIBUTORS
Jennie W. Block, O.P., currently serves as Paul Farmer’s Chief of Staff and was his Chief Advisor at the UN Office of the Special Envoy (OSE) for Haiti overseeing the start-up and management of the OSE. She is a theologian and a disability rights activist and was a management consultant to nonprofit organizations for more than twenty years. She spent six months in New Orleans leading a disaster relief team after Hurricane Katrina. She is the author of Copious Hosting: A Theology of Access for People with Disabilities and Are You Ready? A Guide to Preparing for Disasters.
Edwidge Danticat was born in Haiti in 1969 and came to the United States when she was twelve years old. She graduated from Barnard College and received an M.F.A. from Brown University. She is the author of many books, including the novels Breath, Eyes, Memory, The Farming of Bones and The Dew Breaker, the short story collection Krik? Krak!, whose National Book Award nomination made Danticat the y
oungest nominee ever, and the memoir Brother, I’m Dying, which won the National Book Critics Circle Award and the Dayton Literary Peace Prize. She recently published a collection of essays, Create Dangerously: The Immigrant Artist at Work, and Eight Days, a children’s book about a young earthquake survivor illustrated by Alix Delinois. A recipient of a MacArthur Genius grant, Danticat lives in Miami with her husband and daughters.
Nancy Dorsinville is currently the Advisor for NGOs and Civil Society at the UN Office of the Special Envoy for Haiti, where she focuses on policy issues for vulnerable populations, namely internally displaced populations and in particular gender mainstreaming, orphans and vulnerable children and the handicapped. She is the liaison for the OSE and the government of Haiti ministries responsible for these transversal issues. Originally from Haiti, she is an anthropologist and prior to joining the OSE was a research associate at the Harvard School of Public Health. She served as director of HIV prevention education for the city of New York and has a long standing affiliation with the Clinton Health Access Initiative, under whose umbrella she conducted a country-wide diagnostic of the health system in Haiti in conjunction with the Haitian Ministry of Health and Partners in Health. She has done extensive field work with Paul Farmer and continues to be part of his Global Health teaching team at Harvard University.