Collaboration and human rights must guide relief and development efforts

Loune Viaud

In recent testimony presented to the Inter-American Commission on Human Rights (IACHR), Loune Viaud, Director of Operations for Partners in Health’s (PIH) Haitian sister organization, Zanmi Lasante, highlighted the importance of ensuring that all post-earthquake relief and development efforts by the hundreds of non-governmental organizations (NGOs) in Haiti be done both in collaboration with the local people and in a way that respects and upholds Haitian’s rights throughout the rebuilding process.

“We have found that the best way to ensure that access to these services are both universal and sustainable is by partnering with Haitian public institutions that are ultimately responsible for ensuring that Haitians can access the right to health, water, food, and education,” said Viaud, “These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating—crucial infrastructure and services—are ultimately owned by the Haitian people,” she emphasized.

The IACHR is an independent arm of the Organization of American States (OAS)—an international organization that includes thirty-five Member States, all located in the Americas—and is one of two bodies in the inter-American system devoted to promoting and protecting human rights. The organization periodically hears testimony from both NGOs and government entities in an effort to bring potential human rights issues to light for the international community. Recommendations made by the IACHR in the past have influenced international policy.

Because she was accompanying patients being transported to hospitals out of Haiti, Viaud was actually unable to attend the March 23 hearing in Washington D.C. Her daughter, Maureen Plaisimond, delivered her presentation on the economic and social rights situation in Haiti on her behalf. In her testimony, Viaud warned that the international community's efforts could harm already vulnerable communities unless those organizations employ rights-based approaches which support the capacity and leadership of the Haitian government; defer to the experience of Haitians; and unconditionally respect human rights, including the rights to food, health, and potable water.

Viaud’s testimony was accompanied by that of other advocates from prominent human rights organizations, including: the Center for Human Rights and Global Justice (CHRGJ) at NYU School of Law; Bureau des Avocats Internationaux (BAI); the Institute for Justice & Democracy in Haiti (IJDH); and the Robert F. Kennedy Center for Justice and Human Rights (RFK Center). A petition from these organizations resulted in the only Haiti hearing granted during this IACHR session.  To read the organizations’ recommendations to the international community, a document that outlines a rights-based approach to aid delivery, click here. 

The IACHR hearing proceeds the much-anticipated March 31 International Donors’ Conference for Haiti at the United Nations headquarters in New York, where future international aid to Haiti will be discussed at length.

To illustrate camp conditions to the IACHR and the international community at large, the presenters included a short video as part of their testimony:

The New Media Advocacy Project prepared the video for the hearing on behalf of the hundreds of organizations involved in this initiative, including the Institute for Justice and Democracy in Haiti, PIH, and the Bureaux des Avocats Internationaux.

Below is the full text of Loune Viaud's testimony:

Testimony of Loune Viaud 

Delivered to the Inter-American Commission on Human Rights 

During a Hearing on the  Economic and Social Rights Situation in Haiti following the Earthquake and the Human Rights Obligations of OAS Member States 

March 23, 2010 

My name is Maureen Plaisimond.  I am here today to read a statement on behalf of my mother, Loune Viaud, the Director of Operations for Zanmi Lasante, the Haitian partner organization of Partners In Health.  My mother could not be here today, because the right to health care is not being adequately fulfilled in Haiti today and she is helping transport two severely injured children to receive additional medical care in the United States.

On behalf of Zanmi Lasante, I want to thank the Commission members for ensuring the voice of a Haitian woman is heard. I want to tell you about how international assistance has supported our work, and I will also share how such assistance can have—and has had in some cases—a detrimental impact on fundamental economic and social human rights such as access to water, adequate food and healthcare.

Before January 12, Zanmi Lasante already provided comprehensive primary care, regardless of ability to pay, for more than half a million impoverished people in the Central Plateau and Artibonite departments in Haiti.  We employed about 4,000 Haitians, many of them community health workers; that number is now over 5,000 throughout Haiti.  I can list the many services that Zanmi Lasante carries out in the Central Plateau—in collaboration with the Ministry of Health—we support 12 health facilities, including 7 hospitals, in rural Haiti, including a Sociomedical Complex with 104 beds, a full-service hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center, an outpatient clinic, a women’s health clinic, ophthalmology and general medicine clinics, a laboratory, a pharmaceutical warehouse, a Red Cross blood bank, and radiographic services. Because health and other basic economic and social rights are so closely related, we have also founded a dozen schools, numerous water projects, and an agricultural project.

All of these services are the fruits of years of our work, but that alone would be insufficient if it was done without ensuring that it is sustainable, that it is really here to stay.  We have found that the best way to ensure that access to these services is both universal and sustainable is by partnering with Haitian public institutions that are ultimately responsible for ensuring that Haitians can access the right to health, water, food, and education.  These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating—crucial infrastructure and services—are ultimately owned by the Haitian people.

Our partnerships have endured through times of political conflict.  And our partnerships have been especially important in the midst of this disaster.

As one of the largest health care providers in Haiti, Zanmi Lasante has been a central partner in the international community’s response to the earthquake.  Because all of our sites were—before the earthquake—outside of Port-au-Prince, most of our workers were, at least physically, unharmed by the earthquake, though they—like their fellow Haitians—suffered the trauma of losing family members, friends, and homes.

Despite their losses, our staff has been working around the clock to provide medical services to those affected by the catastrophe.  Zanmi Lasante has helped to get the government-owned General Hospital in Port-au-Prince running again by working side-by-side with the existing medical staff and channeling important donated materials and staff to the places where they are needed.  And we have committed, for the long-term, to improving and expanding the services that this public hospital provides.  We have set up mobile medical clinics to provide services to those living on the streets in Port-au-Prince.  And we have treated many people who fled the city for the countryside in our hospitals in the Central Plateau and lower Artibonite.

Our work has been assisted by the massive outpouring of support and solidarity from people around the world and from the contributions of donor countries.

However, I can tell you that—based on our experience—the international community’s efforts could have unintended consequences, failing to truly improve the ability of Haitians to realize their fundamental rights, and in some cases, harming already vulnerable communities.

It is easy for international assistance to bypass the government and create parallel structures for social services.  We have seen this time and again in the healthcare sector, where private clinics once run by NGOs stand empty when the funding dries up and the NGO leaves the country.  The Haitian doctors, nurses and other staff members who worked in these clinics with higher than average, albeit insufficient, salaries struggle to find work.  These parallel structures not only take scarce human resources from the indigenous Haitian institutions, but they also present serious issues of accountability because they are not accountable to Haitians. I represent a non-governmental organization.  NGOs are our partners and our friends and we have a key role to play in strengthening and complementing Haitian infrastructure.  But implementation must be done through partnerships with the public sector.

Let me give you one more cautionary example: food aid.  This lifesaving assistance has plainly saved the lives of severely malnourished Haitians in the aftermath of the earthquake.  However, food aid has also been known to displace Haitian food producers and merchants, and has often been lacking in quality and cultural acceptability.  Large imports of food aid from abroad, if not coupled with support to rural communities and their agricultural needs, lead to rising food prices.  This is all the more urgent today as the time for planting and the rainy season are upon us.  Emergency food aid is a necessity, but over time, food security must be obtained by supporting Haitians’ sustainable access to durable food sources.  This means that the international community should fund agricultural infrastructure and support for rural communities.  The right to food means the right to both procure and produce adequate food; taking a rights-based approach means that the international community must do more than donate food.

As Haitians, we are proud and grateful for the solidarity of OAS Member States, but we need Haitians to lead the rebuilding.  And we need our partners to take a rights-based approach to engaging in the construction of a new Haiti. This means supporting the capacity and the leadership of both the Haitian government and Haitian communities; it means deferring to the experience of Haitians; and it means unconditionally respecting all of our human rights—including the right to food, the right to health, and the right to potable water.