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Paul Farmer and Brian Concannon

Change Haiti can believe in

By Paul Farmer and Brian Concannon
January 25, 2009
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THE INAUGURATION of a US president committed to reversing "the failed policies of the past" provoked sighs of relief around the world. Few were more relieved than the citizens of Haiti, because few have suffered so much from failed US policies. But Haitians are still waiting to see whether the "past" that is to be reversed extends beyond the illegal and destructive policies of the last eight years to include over two centuries of US policies that have failed both our oldest neighbor and our highest ideals.

Our treatment of Haiti was bad enough during the Bush administration. We imposed a development assistance embargo in 2001, because we did not like the elected government's economic policies. The embargo stopped urgently needed government programs - a Partners In Health study found that cancelling water projects in just one city had a devastating impact on health in the area. In 2004, US officials forced Haiti President Jean-Bertrand Aristide aboard a clandestine flight to Africa and placed a Bush supporter from Florida at the head of Haiti's government. Thousands were killed in the ensuing political violence. Years of hard-won progress toward democracy were erased overnight.

But our mistreatment of Haiti started earlier, as soon as Haiti became independent in 1804, when we refused to even recognize the new republic run by freed slaves. We invaded Haiti in 1915, to ensure repayment of a debt to Citibank. We propped up ruthless dictators in the name of fighting communism. In the 1980s, we decimated Haiti's agricultural base by forcing subsidized US rice on Haitian markets.

These policies failed Haitians terribly. They cost thousands of lives lost in political violence. Millions more suffered because Haiti's governments could not or would not provide clean water and basic healthcare. The policies have also failed the United States, by requiring us to mount expensive military interventions, respond to repeated waves of refugees, and deal with the drugs that transit easily through an unstable Haiti on their way from South America.

Haitians are hoping that America will reverse the failed policies of the past. Their hopes are grounded not just in President Obama's promise, but in their own country's brief, but successful, experiment with democracy from 1994 to 2004, and in America's important contributions to that success.

Haiti's democratic interlude included contested elections, and struggles to provide basic justice, education, and healthcare - the predictable challenges of a poor, emerging democracy. But it also included Haiti's first transfer of power from one elected president to another in February 1996, and its second in February 2001. Democratic progress included extending AIDS retroviral therapy to rural areas that had never before had a simple clinic. It included two historic trials that brought powerful figures from Haiti's former army and current police force to justice.

These successes were due, in part, to US government investments. US troops intervened to restore the constitutional government in 1994. USAID helped craft Haiti's successful application for financing from the Global Fund to Fight AIDS, Tuberculosis and Malaria. US judges, prosecutors, and police officers trained their Haitian counterparts, and we helped equip Haitian courts with basic legal resources and materials.

We now have a historic opportunity to work with Haiti's current constitutional government to build a stronger, more prosperous Haiti. Seizing this opportunity will require restraint, and faith in democracy: We will need to allow elected Haitian leaders to make their own policy decisions, even if we would have decided otherwise.

We will also need to invest in democracy. Three days' spending in Iraq or two weeks' interest on the bank bailout could fund Haiti's entire government for a year. Prudent, depoliticized investments in Haiti's democracy will yield dividends of prosperity and stability to Haiti, and will save US taxpayer dollars in the long run by reducing the flow of refugees and drugs to our shores. Perhaps most important, by helping rebuild a better Haiti, we will show the world how, in President Obama's words, "we are ready to lead once more."

Paul Farmer, MD, is Presley professor of social medicine at Harvard Medical School and a co-founder of Partners In Health. Brian Concannon Jr. is director of the Institute for Justice and Democracy in Haiti.

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