Mistrust in state-provided information about COVID-19 has characterized citizen responses to the pandemic in Haiti, preventing the effective management of the virus. This article shows that this mistrust is rooted in a number of historical, political, and social factors, including the perceived mismanagement of past crises. In the wake of resistance to pandemic measures and failure to adhere to regulations, local organizations can play an important role in contexts with low institutional trustworthiness.
To date, Haiti has managed to register a relatively low number of COVID-19 infections and related deaths. Initial concerns regarding the potential devastation COVID-19 could cause in Haiti were related to insufficient sanitary standards and medical facilities necessary to prevent the spread of the virus and ensure the proper treatment of infected patients. However, it turned out that the misunderstanding of COVID-19-related information was another major challenge that prevented people from taking preventative measures and going to hospital when infected.
Some studies conducted during the cholera outbreak in 2010 have pointed out that extreme poverty and low levels of education can cause mistrust in information on health instructions (Cénat, 2020). Nevertheless, these narrow explanations disregard the historical and socio-political background that has nurtured the mistrust of the population in public institutions that is also visible in responses to the COVID-19 pandemic. Local organizations have played a central role in addressing the Haitian community’s disbeliefs around COVID-19, stepping in as interlocutors in the fight against the spread of the virus.
Over the past few years, discontent with the performance of the state has led to extensive protests. On many occasions, people have called for the resignation of the president and the dissolution of the government, denouncing its inability to manage past crises, claiming a lack of accountability, and citing worsening inequality. Furthermore, the community’s anger has been extended to international institutions, particularly the Core Group[i], the Organization of American States (OAS), and the United Nations Integrated Office in Haiti (BINUH). They are blamed for intervening in Haiti’s internal politics and supporting the current regime, thus keeping the president from resigning (AFP, 2019).
Such anger at, and mistrust in, people in power has been constructed historically. The importation of cholera to Haiti by a UN agent in 2010 as well as successive governments’ mismanagement of the consequent outbreak, the lack of accountability for and the dissatisfaction with the 2010 earthquake responses, the exposure of PetroCaribe fund-related corruption, and the widely reported sexual abuse scandal are just some of the cases that have led to widespread mistrust of those in power.
Damage already done?
When the first COVID-19 infection was confirmed, the government immediately declared a health emergency, imposing restrictive measures and undertaking information campaigns to raise awareness of the pandemic and the necessary sanitary measures to be taken through broadcasts on television, radio, and social media, or by means of vehicles circulating in suburbs with speakers mounted on their roofs[ii]. Despite these efforts, due to the general mistrust and lack of legitimacy of the current government, not only protests against ‘lockdown’ measures and the refusal to adhere to them, but also disbelief surrounding the disease led to the spread of rumours and misinformation (See also Dorcela and St. Jean, 2020). “People think of COVID-19 as a political matter”, said a head of a local youth group.
Hearsay varied from the government having invented the virus to receive money from international aid agencies or diverting attention from the internal political issues[iii] to the hospitals testing a new vaccine on the Haitian population. The disbeliefs were such that people ended up claiming that those showing the same symptoms of COVID-19 were not infected by the virus, but with a different disease that they called ‘Ti lafyèv’ (‘small fever’)[iv], which was assumed to be easily treatable with ‘te anmè’ (bitter tea), therefore ensuring that hospital visits (and testing) were ‘not necessary’.
Given the misinformation, on the one hand people have not taken the virus seriously and therefore failed to follow preventative measures, while on the other hand panic was created and people stigmatized, which prevented them from going to the doctor and accelerated the spread of the virus. Additionally, some acts of sabotage of medical services were reported.
Countering disbelief, panic, and stigma, some local leaders and organizations took important initiatives to disseminate correct information and to help the communities cope with the government measures. For example, Doctors Without Borders and Gheskio, a leading Haitian healthcare institution, trained volunteers as field officers to spread information about the virus by visiting people (what it is, how to protect oneself, which hospitals to go to, etc.). In this regard, Dr. Pape, a founder of Gheskio, argued that “poor people are not stupid. [They] want to make sure that what you’re telling them is real.”[v]
Other civil society organizations (CSOs) also took various initiatives to communicate with people. While some initiatives used campaign music or held quiz contests with questions about COVID-19, allowing participants to learn about the virus while having fun, others visited street vendors and residents, going door to door with information leaflets to clear up the misunderstanding, to remind people that the virus is still present, and to ask them to wear face masks and wash their hands even if others do not follow the measures. Also, the CSO Ekoloji pou Ayiti established hand-washing stations in Furcy and its members stood at the stations to explain to the users which precautions and preventative measures to take, as well as how to make homemade sanitizer.
Thus, in places where the legitimacy and credibility of the government is disputed, such as Haiti, interlocutors such as CSOs and other local organizations can significantly contribute to effective crisis management. The above examples once again highlight the vital role of local actors in articulating and ‘narrowing down’ key messages and practices among the population that are central in managing the spread and effects of the virus.
AFP (2019) “Haïti: l’opposition manifeste contre « l’ingérence internationale » (Haiti: the opposition manifestes against the « international interference »”. Available at: https://5minutes.rtl.lu/actu/monde/a/1413480.html (Accessed: 14 December 2020).
Cénat, J. M. (2020) “The Vulnerability of Low-and Middle-Income Countries Facing the COVID-19 Pandemic: The Case of Haiti”, in Travel Medicine and Infectious Disease 37 (101684). Doi: 10.1016/j.tmaid.2020.101684
Dorcela, S. and St. Jean, M. (2020) “Covid-19: Haiti is Vulnerable, but the International Community Can Help”. Available at: https://www.the-hospitalist.org/hospitalist/article/224836/coronavirus-updates/covid-19-haiti-vulnerable-international-community-can (Accessed: 19 July 2020).
[i] Refers to a diplomatic group composed of the UN Secretary-General’s Special Representative, the ambassadors of Brazil, Canada, the EU, France, Germany, Spain, the US, and the OAS.
[ii] Telephonic conversation with a physician in Port-au-Prince on 4 July 2020 and with a health professional in Les Cayes on 20 July 2020.
[iii] Telephonic conversation with a physician in Port-au-Prince on 4 July 2020.
[iv] Telephonic conversation with a health professional in Les Cayes on 20 July 2020.
[v] See Feliciano, I. and Kargbo, C. (2020) “As COVID cases surge, Haiti’s Dr. Pape is on the frontline again”.
This article is an outcome of research conducted by the authors between June and August 2020 as part of the International Institute of Social Studies (ISS) of Erasmus University Rotterdam’s ‘When Disaster Meets Conflict’ project. The research aimed to analyze the tensions between top-down measures implemented to face the COVID-19 emergency and the bottom-up responses and mechanisms seen among local leaders and institutions in Haiti. Methodologically, it was conducted by doing a secondary sources review and remote interviews with a number of Haitian health professionals.
About the authors:
Angela Sabogal is a sociologist who graduated from Pontificia Universidad Javeriana in Bogotá, Colombia. She is currently finishing an MA degree in Development Studies at the International Institute of Social Studies ISS of Erasmus University Rotterdam. She has six years of working experience in social project management in Colombia and Haiti.
Yuki Fujita is MA degree student in Development Studies at the International Institute of Social Studies (ISS) of Erasmus University Rotterdam. Her major at the ISS is the Social Policy for Development. Before coming to the ISS, she worked in the diplomatic corps in Haiti for two years from 2017 to 2019.
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