COVID-19 and Conflict | Between myth and mistrust: the role of interlocutors in managing COVID-19 in Haiti

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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.


References

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).


Footnotes

[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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Eight years after Haiti shook: where has all the money gone? by Avagay Simpson

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UntitledAbout the author:

Avagay Simpson is a recent graduate of the International institute of Social Studies with a Master’s degree in Development Studies specialising in Governance and Development Policy. Prior to studying at the ISS, she worked with Office of the Contractor-General, one of Jamaica’s key anti-corruption organisations. She also worked for several years in project implementation focusing on enhancing governance locally and nationally in Jamaica and the Caribbean. She also holds a graduate degree in International Relations.


Eight years after the earthquake that in 2010 crippled the small country of Haiti, scores of Haitians still have not been able to rebuild their lives despite billions of dollars pledged in the form of humanitarian aid. Recent research on the dynamics of the Dutch partnership SHO for humanitarian assistance in post-disaster Haiti shows that an overreliance on trust within partnerships decreases operational effectiveness and transparency, and that more checks and balances are needed to ensure that financial aid reaches those Haitians still in need.


The struggle continues

Eight years have come and gone since an earthquake measuring 7 on the Richter scale on 12 January 2010 devastated Haiti and ripped apart its community. The earthquake caused the displacement of millions of Haitians and the death of over 300,000 people, although this number remains inconclusive. It was labelled as the first major urban disaster in recent history, leading to humanitarian aid pledges totalling over US$13 billion.

While eight years have passed since this tragic event, the United Nations reported that by 2017, many Haitians were still residing in camps and more than 2 million people were still in need of humanitarian assistance. Given the disjuncture between the total amount of aid pledged and those Haitians still requiring help, a burning question that scholars, journalists, and humanitarian practitioners have sought to answer is: “Where has all the money gone?”

Partnerships: Too untransparent?

Multiple explanations have arisen for why responses to the Haitian disaster were ineffective and produced a chaotic post-disaster environment. One of the many views is that the coordination of international relief efforts posed a major challenge to relief efforts, in addition to the lack of accountability in the disbursement of received donations. Partnerships forged between NGOs and international organisations have become commonplace particularly in the humanitarian relief sector due to the belief that such partnerships could maximise economic benefits for partners and strengthen organisations’ individual efforts through collaboration.

However, a number of scholars, such as David Lewis in his book Non-Governmental Organisations, Management and Development, have suggested that civil society partnerships receive less respect than intended due to the degradation of the term ‘partnership’ following extensive scrutiny over the past years. Considering this tainted image of partnerships, Lewis argues that the management of NGOs and the inter-agency partnerships they create need to be reviewed.

With this in mind, my recent research* attempted to provide some answers to questions pertaining to this ‘black hole’ of humanitarian aid in Haiti by reviewing partnerships among civil society NGOs and organisations, with particular attention paid to partnership dynamics such as transparency and accountability. It comprised an analysis of the Dutch NGO emergency relief efforts in Haiti during 2010 by exploring the collaborative processes of Dutch NGOs through the Stichting Samenwerkende Hulporganisaties (SHO) partnership. Network governance theory allowed for a closer look at the governance of this network and the effect of governance dynamics on upward transparency and accountability.

The SHO: Too large to handle?

The SHO is a Dutch platform comprising nine development organisations such as Oxfam Novib, UNICEF and Save the Children that calls for and manages public donations for humanitarian aid following disasters. Following the Haitian earthquake, the SHO raised €112 million through public donations following extensive media campaigns. The Dutch Ministry of Foreign Affairs donated approximately €41 million, or one-third of the total, to the SHO for disaster relief efforts.

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However, the Dutch public and government, like the international community, questioned the efficiency and effectiveness of the use of donated money for the benefit of disaster-affected Haitians. The Netherlands Court of Audit (Algemene Rekenkamer) with its mandate of checking the efficient and effective spending of public funding in its 2010 expenditure report found that “the funding flows in Haiti are not sufficiently clear and it cannot be determined what part of the aid funds is received by which international umbrella organisations, fellow aid organisations and the organisations’ own field offices” (Court of Audit 2011: 5). This report, alongside the IOB Evaluation Assisting Earthquake Victims: Evaluation of Dutch Cooperating Aid Agencies (SHO) Support to Haiti in 2010 by the Policy and Operations Evaluation Department (IOB – Inspectie Ontwikkelingssamewerking en Beleidsevaluatie) of the Ministry of Foreign Affairs, were the key foci of this study.

The research found that the SHO in its relief efforts in Haiti made use of a network of 36 organisations that excluded local Haitian civil society organisations, NGOs and government organisations. The member organisations operated in five different modalities. This resulted in a number of issues related to the coordination and implementation of programmes and relief efforts, including: extensive management chains; increased transaction costs; the duplication of activities; value clashes resulting in operational challenges; and multiple accountability disorder due to the presence of multiple principals and agents. This made it difficult to trace the funds and to assess whether they were effectively and efficiently expended.

Overreliance on trust

The SHO network and the independent functioning of each participating organisation in implementing their activities created a complex system that resulted in major challenges related to oversight and a lack of transparency regarding the spending of public funding.

The SHO and its member organisations relied on trust in each other to ensure that each activity was implemented in accordance with the principles of transparency and accountability and to the standards governing emergency humanitarian aid. This strong level of trust ignored the fact that individuals are rational beings that in group settings will not necessarily act in the common interest of the group, but may pursue certain objectives based on self-interest.

The study found that the interests of not only individual actors is of concern, but also those of the individual organisations in the extended network, as their interests may differ from that of the SHO and its members. The lack of strong oversight mechanisms by the SHO to determine if there was a breach and its inability to hold actors accountable or apply sanctions weakened the veracity of the reports and work done, resulting in the questions of transparency and accountability of the aid given in Haiti.

Conclusion

MILITARY RELIEF EFFORTS IN HAITI

The SHO’s example shows that heavy reliance on trust is a major issue requiring a thorough review by all organisations working in the humanitarian aid sector. The recent disclosure in October 2017 by the International Federation of Red Cross and Red Crescent Societies (IFRC) of instances of fraud by officials involved in combating the Ebola outbreak in West Africa from 2014-2016 amounting to €5.2 million heightens the need for NGOs as well as international organisations to review their approaches and to recognise the need for adequate checks and balances.

In an emergency humanitarian relief context that is complex, uncertain, and often political in nature, sound policies and transparent processes contribute to sound governance. Such measures also control unintended meanings and consequences while simultaneously acting as barriers against the purposeful exploitation of resources that ultimately prevents aid from reaching those in need.


Picture credit: RIBI Image Library


*In partial fulfilment of a recently attained MA degree in Development Studies at the ISS.
REFERENCES
Dutch Court of Audit (2011) ‘Accounting for Haiti Aid Funds 2010’, November 2011, The Hague: Netherlands.