Survivors: Haitian Women, Violence, and HIV

The devastating January 12, 2010, earthquake in Haiti left an already impoverished country in even more dire straits. Two years later, despite international commitments to “build back better,” Haiti continues to face a string of severe issues: inadequate shelter and services in the temporary camps, a lack of safe housing for those outside of the camps, a lack of clean water, a cholera epidemic, piecemeal health care and education, intense poverty. Governments have failed to deliver much of the money they pledged following the earthquake, NGO funding and operations have been problematic, and often Haitians have been left out of the decision making when it comes to reconstruction planning.

The continued presence of the camps, and the possibility that camp life could become permanent for some, is of particular concern. Within the euphemistically named internally displaced persons camps, people live in inadequate makeshift shelters. Many camp residents live without proper sanitation, running water, or electricity.

Rape and Survival

The precarious conditions of life post-earthquake have exacerbated gender-based violence in the country. The lack of security in the camps—and by “security” I mean not just law and order or nighttime lighting, but also basic necessities such as food, shelter, water—has led to an epidemic of rape. MADRE et al.’s report Our Bodies Are Still Trembling: Haitian Women Continue to Fight Against Rape, released one year after the earthquake, explains,

          Women and girls are put at increased risk of rape by the collapse of social 
          infrastructures, the erosion of family and community networks, inequitable 
          access to social services, absence of law and order, lack of secure housing 
          or safe neighborhoods and dependence resulting from economic dislocation. 
          All of these conditions have been rife since the earthquake in Haiti, creating a 
          perfect storm of sexual violence that has raged across the camps.

Amnesty International makes a similar observation in Aftershocks: Women Speak Out Against Sexual Violence in Haiti’s Camps, noting that after the trauma and loss caused by the earthquake, girls and women “are living in camps in tents that cannot be made secure, with the constant threat of sexual violence. Without access to medical care and with little prospect of receiving any support or seeing their attackers brought to justice, survivors see no end to their plight.”

Just released is the report Struggling to Survive: Sexual Exploitation of Displaced Women and Girls in Port au Prince, Haiti, from a group of five agencies that includes MADRE and KOFAVIV. It notes that rape of girls and women in Haiti persists, and explores another dimension of the violence. Out of necessity, girls and women have engaged in survival sex: “Women and girls have reported exchanging sexual acts in return for food and benefits, including coupons, access to direct aid distributions, cash for work programs, money, or even a single meal.”

HIV in Haiti

Haiti’s rates of HIV are among the highest in the Caribbean. It was estimated before the earthquake that 1.9% of the population had HIV: 120,000 people, including 12,000 children. Less than half of those who need antiretroviral medication can access it. The number of deaths caused by HIV is high.

Data on HIV rates following the earthquake have been scarce, and there’s reason to be worried about an escalation in infections fuelled by the epidemic of rape and survival sex. For the more than 50% of people who can’t get the HIV treatment they need, viral loads aren’t being kept in check, facilitating transmission. Malnutrition and undernourishment are chronic problems, further weakening people’s immune systems. Girls and women face barriers to accessing medical care, including the cost of services and the cost of transportation to get to these services. Thomas Dunmore Rodriguez, of the International HIV/AIDS Alliance, writes,

          Health infrastructure was severely disrupted and damaged following the 
          earthquake and significant gaps still remain. As with the general 
          reconstruction efforts, the HIV response since 2010 has been dominated by 
          international assistance, rather than locally led responses, and it is likely that 
          this response will not be sustainable.

Community-Based Responses

Grassroots women’s groups in Haiti have responded to the violence with an amazing array of initiatives, including organized patrols, legal advocacy, medical care, and support for survivors. One such group is KOFAVIV (translated from Kreyol, this stands for The Commission of Women Victims for Victims), an organization run by rape survivors to provide support for others and put an end to the violence. However, they operate with very limited resources.

Similarly, there are some incredible health projects in Haiti, notably the work done by Partners in Health and its Haitian arm Zanmi Lasante, which launched the HIV Equity Initiative. The beauty of the work done by Partners in Health lies in its practice of empowering communities by training and hiring Haitians as community health workers rather than sending in foreigners. Zanmi Lasante (along with the Cuba Medical Mission) is a significant provider of health care in Haiti, but limitations in funding restrict the reach of its activities.

The proper resourcing of local groups and government so they can lead sustainable and long-term projects is needed to move Haiti away from dependence on the patchwork of NGOs in the country. Community-based responses are vital in addressing issues of violence, health, and HIV in Haiti.

- Erin