On November 12, 2010, in the bright afternoon sun in front of Ste. Catherine Hospital/CHOSCAL in Cité Soleil, where Médecins Sans Frontières has set up a cholera treatment center, a young woman staggered, keening, tears running down her face, eyes wide with shock. She was in the throes of a kriz, a crisis, a public act of grief and mourning that one displays after losing a loved one. Her child had just died in the hospital, but, she insisted, as a crowd gathered around, it was not cholera. “It was poison! Someone put poison in the water.”
Cité Soleil may be an extreme example: its recent history has been particularly violent; its reputation sordid. It has been at once a particular target of international intervention and a particular case study of neglect and incompetence. But these characteristics, while more starkly illustrated in Cité Soleil, typify the broader Haitian situation. What happens in Cité Soleil should therefore be of interest not only to people who work there, but to anyone concerned with international intervention and its stigma in Haiti.
As cholera spreads in Cité Soleil, and throughout Port-au-Prince, so do rumors about its origins and transmission. While waiting to talk to an MSF representative inside CHOSCAL, my friends Damilove Gorguette and Herold Charles, who work for the DINEPA (the government water and sanitation authority) office in Cité Soleil, and I began to talk with the Haitian security guards on duty, who wore MSF or Ministry of Health vests. “It’s being spread through the air,” the guard in the Ministry of Health vest said. “That’s not true,” replied Damilove archly, handing him a packet of Aquatabs. “If that were the case, we’d all have cholera.”
As we talked, a new cholera case arrived, a limp man in a grey T-shirt and jeans, being carried in by three others, each of them supporting him while touching him as little as they could. His head lolled to the side, and it was hard to tell if he was conscious, though a certain tension in his body suggested he was still alive.
“It’s something they’ve released in the water,” ventured one of the MSF-vested guards.
“Who’s ‘they’?” I responded.
“Those people, moun sa yo! The international community! Why do you think it’s the poor who are getting it?”
“Because they have a harder time accessing clean water,” I replied.
“What are you talking about? It’s the poor who take more precautions with their water than the upper classes do! No, this is something else. We grew up here, the sun kills the germs and we don”t get sick. Mikwòb pa touye ayisyen. This cholera is something else.”
This proverb, mikwòb pa touye ayisyen, has been repeated a lot these last weeks. It means germs don’t kill Haitians, and I’ve heard it from residents of Cité Soleil as they gesture toward the stagnant pools of garbage-filled water, teeming with mosquito larvae, tiny fish, and blooms of green algae, that can be found throughout the Cité on the ruined lots where houses once stood. “We were raised here, amid garbage. We grew up in it.” Of course the proverb was never true; germs have always killed Haitians – especially those Haitians who don’t have access to health care, adequate sanitation, or clean water. But the idea, however wrongheaded, that Haitians are particularly resistant because of their continuous exposure to unsanitary conditions, is now cited as proof that the emergence of cholera is something other than just a “germ,” something outside the natural order, and something intentional.
At first, the rumors were that cholera itself was merely a rumor, a fundraising ploy. On Tuesday, November 9, as the first reports of cholera in the Cité began to surface, I encountered skepticism. “There’s no cholera here,” said Mirlande, who runs a small restaurant where she serves up plates of rice, beans, and okra with sauce. She waved her hand dismissively and confidently. “It’s in the provinces, in the Artibonite.” Even Herold, a Cité Soleil resident who, as a DINEPA employee, is charged with coordinating the distribution of free Aquatabs in the community, told me last Tuesday, “I hear things about cholera, but I can’t verify it until I see it with my own eyes.” But by that Friday morning, Herold had seen it with his own eyes. “We have people in the hospital now. I know two people have died,” he said, while constantly squirting his hands with instant sanitizer. In three days, as the extent of the outbreak became visible and people saw cases in their own neighborhoods and camps, word on the street in Cité Soleil evolved from denial and disbelief to increasing fear and paranoia: cholera is real and was deliberately inflicted.
The most prevalent accusation is that cholera is a plot by “the NGOs” or “the international community” to profit even more from the misery of Cité Soleil’s people. As Herold says, “These NGOs are mafia, they are professional thieves. They’re all the same. Except Médecins Sans Frontières, because you actually see them in the community, giving free care. The rest of them are just lining their pockets.”
Lucienne Estimé, one of the coordinators and residents of the camp at Place Fierté in Cité Soleil, says of the International Organization for Migration, “IOM is a cancer. A cancer is what it is for Camp Fierté! IOM has given us, nothing, nothing, nothing for the last ten months… The man who works for IOM, he doesn’t need to know if your house was destroyed in the earthquake, he just says you have to return to your house. What houses can we return to?” According to Estimé, the camp has no showers. Between last Wednesday and Friday, she told me, they had had thirteen cases of cholera in the camp, some of whom have died.
And cholera rumors are not limited to Cité Soleil, nor is suspicion about the intentions of international organizations. On November 16, a friend from the Port-au-Prince neighborhood of Christ-Roi told me she’d heard that the UN peacekeeping mission, MINUSTAH, had released a box of dead rats into the water in Cap Haitien with help of “the Americans.” “Where did you hear that?” I asked her. “On the radio,” she told me. Cholera itself may have first appeared in Cité Soleil, but rumors about its origins are spreading throughout the city. Those rumors feed on Haitians’ experiences with NGOs and international aid.
Checkered Experience of International “Aid”
Cité Soleil – like much of Haiti – is an alphabet soup of NGOs and international organizations; it is no wonder that residents cannot keep them straight. Signs and murals throughout the community advertise projects funded by several acronyms in collaboration. Humanitarian, development and peacekeeping agendas become intertwined and, at least from a ground-up point-of-view, largely indistinguishable. For this reason, and because of several particularly deleterious interventions, “the NGOs” and the “international community” have all become painted with the same brush.
From November 2004 to December 2006, MINUSTAH waged an offensive in Cité Soleil in order to root out and apprehend chimères, local gang leaders believed to be supported by ex-President Aristide. This MINUSTAH “war” alienated much of the community. Some Cité residents felt loyalty to particular gang leaders, who at least provided a semblance of local governance in the absence of state-sponsored infrastructure. Moreover, while the community had suffered violence under gang rule, it suffered even more in the years of the MINUSTAH offensive. Building facades remain scarred with bullet holes; houses are still in ruins. Civilians were killed; others still bear injuries such as bullets lodged in their bodies. The young people who grew up in this setting of war and insecurity associate the UN with violence and suffering – an association that now taints MINUSTAH’s more recent non-peacekeeping activities (i.e., economic and community development).
In 2007, after the most intense violence had ceased, the US Department of State, with support from Department of Defense, launched a Haiti Stabilization Initiative. USAID undertook a project of paving roads in Cité Soleil in an attempt to stimulate jobs and rehabilitate the community. Most of these projects (road and small projects) were executed by IOM. The program encompasses a security component, including re-training of local police and active gang dismantlement groups. The Embassy/USAID produced posters celebrating these roads, showing before-and-after pictures: in muted sepia tones, the photos of old muddy roads are followed by bright and sunny images of clean, paved thoroughfares. However, in several areas these roads were built higher than the homes that surrounded them, slightly convex, without adequate drainage. Cité Soleil, which is built at sea level, has always been prone to flooding; the USAID-built roads worsened this situation, so that now, when it rains, people’s homes (and the abandoned lots) flood with run-off and garbage. Trash accrues and mosquitoes breed.
In 2008, with the funds from USAID/HSI, IOM built a public market in Cité Soleil to replace the main public market that had been destroyed during the years of violence. However, with no community input, IOM sited the market on a vacant tract of land directly between two zones known as “Boston” and “Brooklyn,” which were competing gang territories with a history of enmity. At that time, the area was a kind of no man’s land, shunned by most people because of its bad memories and the threat of ongoing violence. Also, unlike the old market, the new market was located far from the main road (Route Nationale #1) which runs by Cité Soleil (at the time, there was no Boulevard des Americains, which now cuts through the Cité), so no one from other areas of Port-au-Prince would come to the market. Apart from issues of location, the market was poorly constructed. The roof was so high that the merchants could not hang sheets to protect their wares from the sun and the rain. In the summer of 2008, the first time I visited, the public market was completely empty except for two or three people sleeping inside. A month later, the Haitian National Police ordered the merchants to use the market against their will.
In light of situations like these, Cité Soleil residents’ misgivings about international organizations, and their relationship to the cholera outbreak, begin to look less like unwarranted paranoia and more like reasonable wariness, heightened by poverty and desperation. Add to this the very real possibility that cholera was introduced in Mirebalais by UN peacekeepers from Nepal (which would be the fault, not of the unwitting peacekeepers, who are but outsourced labor from another poor country, but of the MINUSTAH administration and the Haitian firms contracted to construct the sanitation facilities). The notion that cholera is something that “they” have released into the water appears less absurd.
People in Cité Soleil know full well the place that they occupy in the agendas of international organizations, as a community especially in need of aid, development, and redemption. They know that a lot of money is supposedly directed toward projects in the Cité, and yet – amid IOM-constructed basketball courts, which are not used by the local youth, a few public plazas now turned into camps, and a sea of tarps and tents from countless organizations – they see little enduring, positive change. This was the case long before the earthquake, and it is thrown into sharper relief now. They know these facts: that international organizations raise money to work in Cité Soleil; little change comes to Cité Soleil; NGO workers boast a quality of life, and a per diem, that they will never enjoy. And then they put those facts together.
How Poor Haitians Are Delegitimized
If residents of Cité Soleil distrust and sometimes hate NGOs, the feelings and gossip cut both ways. Rumors and jokes about Cité Soleil’s killers and cannibals routinely surface in casual conversation with NGO workers. Last week, a European NGO employee lightheartedly recommended that I leave some foreign visitors in Cité Soleil overnight, “then come back in the morning and pick up what’s left of them.”
I made an indelicate retort before I could catch the words escaping my mouth.
After an extended – and awkward – silence, he responded sheepishly, “It’s a red zone. I’m not even allowed to go there.”
In the eyes of the international community – and many Haitians – the whole of Cité Soleil is considered violent and criminal because of the presence and dominance of a few violent criminals. In turn, this delegitimizes Cité Soleil’s residents, so that their opinions and perspectives can be discredited or ignored. Interventions are designed based on the idea that Cité Soleil residents are criminals to be feared or victims to be pitied – but rarely agents, partners or legitimate speakers about their own situation or community. Most residents of Cité Soleil are, of course, decent and normal people trying to carve out a life for themselves amid considerable hardship – and often unable to do so. And when we look at the criminal elements in the Cité – the young men who turn to guns, who turn to stealing, who turn to those who offer them a bit of power and a sense of belonging – we should remember this proverb, which people from Cité Soleil told me the first time I went there: Chen grangou pa jwe. The hungry dog doesn’t play. If you are desperate enough, poor enough, you may do anything.
Perceptions a Real Barrier
The way NGOs are perceived by a community that they are supposed to serve can be an effective – and real – obstacle to communication, both in the time of cholera and in general. Seemingly “irrational” or “ignorant” beliefs about cholera and its origins, and about the intentions of the international community, are rooted in distrust and skepticism based on experience. One may argue that while “relativism” has its place, in this life-or-death situation, ignorance is not to be tolerated. I would argue the opposite: that the persistence and prevalence of rumor at this fatal and decisive moment illustrates the acute need to understand it. Subjective truths matter, because the supposed relationship between cholera and the international community is true to those who believe it, and therefore has a very real and powerful impact.
Laura Wagner is a PhD candidate in anthropology at UNC Chapel Hill.