Op-ed: "U.S. occupation of Haiti means health care is structured around extractive economic needs"
The story of a five-year-old girl’s quest for adequate care in Northern Haiti is continued proof that Haiti remains unfree from U.S. imperialism
By EqualHealth’s Campaign Against Racism
This article was originally published on Prism.
A five-year-old girl arrived at a hospital in northern Haiti on May 7 with loss of balance and incontinence. According to her parents, the girl’s problems began about five months prior, following a fall down the stairs at her home, which led her to experience seizures and more falls. The young girl recently died, though leading up to her death, it took months for her to access a CT scan that revealed the cause of her symptoms: a malignant tumor. She needed a neurosurgeon.
Unfortunately, when the girl needed help the most, she wasn’t in the capital city of Port-au-Prince, where the majority of specialty care lies; this was Cap-Haitian.
Previously known as the “Paris of the Antilles,” Cap-Haitian played a significant role in the Haitian revolution due to its proximity to Bois Caiman, where successful revolutionary battles were launched against the French army. Cap-Haitian—Haiti’s second largest city—is an example of the consequence of U.S. occupation and how it continues to drive vast inequities in the island republic.
In 1915, the U.S. took control of Haiti’s government and finances after the assassination of Haitian President Vilbrun Guillaume Sam. The U.S. confiscated Haiti’s gold reserve and ruled Haiti as a dictatorship until 1934. Seven percent of Haiti’s total territory was either given or sold to U.S. companies. Peasants in Haiti were forcefully removed from their land and deprived of their resources, leading to the collapse of rural communities. The wealth taken from the countryside was primarily put into foreign banks or otherwise used to develop infrastructure in the capital. This led to a centralization of resources, government buildings, and power in Port-au-Prince, as well as a mass migration of rural residents toward the capital. Now, everything is centered in Port-au-Prince: shipments, specialty care, and even education. Around the country, the region is commonly referred to as “the Republic of Port-au-Prince.” This centralization has prevented other cities, such as Cap-Haitian, from developing and utilizing their resources to the same extent—including the health care system.
Today, anything beyond a simple blood test must go through Port-au-Prince. From Pap smear results to blood transfusions, hospitals and clinics across the island must send samples—or in many cases, people—for analysis by the national government or private, better-resourced labs. Because of this long-lasting exploitation from the U.S., France, and other countries, Haiti was placed in a vicious circle of scarcity without the capacity to develop and sustain its health care system.
The dependence on Port-au-Prince has resulted in chronic under-resourcing of rural and other urban health care facilities, leaving patients without answers to their medical problems unless they travel or are transported. During Haiti’s more stable periods, transferring patients like the five-year-old girl for specialty care is common. But the violence imposed on Haitian citizens by external forces of white supremacy, particularly in Port-au-Prince, has created disruptions that interfere with meeting even these basic health care needs of the Haitian people. As the activist, scholar, and prison abolitionist Ruth Wilson Gilmore has taught us, U.S.-led centralization directly contributes to the organized abandonment of everyone who falls out of the “economic center,” as viewed by U.S. economic interests.
Never fully recovering from the 2010 earthquake, Haiti’s already fragile health care system is at the brink of collapse—and the externally funded paramilitary territorial roadblocks across neighborhoods further paralyze the health system. Within months, the 2021 assassination of Haiti’s President Jovenel Moise and yet another earthquake led to an escalation of imposed violence and the closure of 31 medical institutions and dialysis centers. The country’s largest public hospital was included, and its closure has further driven a mass exodus of health care professionals and specialists from Haiti.
The dilapidated infrastructure, depletion of medication, and human resources notwithstanding, families with critical health conditions continue to accrue debt or otherwise pay exorbitant amounts of money to travel to the capital city with the hope of receiving a certain level of care—only to find almost the same limited conditions they tried to escape. Even though Port-au-Prince has more resources than more remote regions, it still has limited health care infrastructure and resources compared with other countries in the region. The accessibility of these resources has also been compromised by this year’s surge of violence. While centralization created more resource availability in the capital, the consequences of the independence debt and U.S. resource extraction did not spare Port-au-Prince. Despite these limitations, the country’s remaining health care professionals still wake up, take a deep breath, and pray they arrive safely to their hospitals and clinics. They have few supplies and save lives anyway. Then they do it again the next day and the day after that because while some people can and need to flee Haiti, not everyone can or wants to.
Health workers in Haiti are among the many nonconsensual witnesses to a wide array of proposals from the United Nations on how to solve the “Haiti crisis.” Despite being at the forefront of violence and war in any context, rarely is the perspective of the health care worker elicited to help inform policy decisions affecting the most vulnerable victimized by the circumstances of the nation. No one is asking Haiti’s health care workers what is needed, though they have unique insight into the country’s needs because health care workers in any context are at the forefront of violence and war. Not only are health care workers invisibilized, but their pain and trauma are compounded by their inability to carry out their jobs due to lack of resources. This dynamic is a consistent structural violence that pushes health workers to the brink and to the periphery of the dialogue despite their vocation to the survival of the country.
For some reason, it is unimaginable to think that Haitians can save Haiti. We have done it before, but U.S. intervention makes it seem impossible today. The deployment earlier this summer of U.S.-funded Kenyan forces to Haiti, authorized by the United Nations Security Council, is proof that Haiti remains unfree from U.S. imperialism. The longstanding belief that an outside force is needed to “save Haiti” is a white supremacist project—and one that dehumanizes the Haitian people. This savior complex is deeply embedded into the U.S. imperialist agenda and leads to vicious cycles of violence, extraction, debt, and forced displacement. Haiti’s current upsurge in violence is largely due to the illicit trafficking of firearms and ammunition originating in the U.S.
What we are witnessing today is the continued U.S. occupation of Haiti. We urge you to remember that Haiti’s independence was seen by the U.S. and Europe as an obstacle to the globalization of white supremacy. Haiti still stands tall as an emblematic figure in the fight for the liberation of Black communities worldwide—and liberation also means care. A five-year-old Haitian girl not only deserves timely intervention but her Haitian doctors and nurses should also have the resources they need to provide her with care.
If health care is truly a human right, then health care access and infrastructure cannot remain at the mercy of the U.S. imperialist agenda and consolidated around its extraction economy.
