Tuesday, March 23, 2010

Dr. Marcelo Venegas, Conscious Based Solidarity: A report back from Haiti.

On January 12, 2010, a 7.0 earthquake struck the country of Haiti with an epicenter near the town of Léogâne, approximately 16 miles west of the capital city of Port-au-Prince and its 2 million residents. The earthquake resulted in over 52 aftershocks ranging from 4.2 to 5.9 in magnitude. The Haitian government estimates the death toll to be as high as 230,000 and is expected to rise, with an estimated 1.3 million people displaced. International response called for immediate assistance to the country in attempt to mitigate further catastrophic suffering. One of those individuals motivated to act, was Dr. Marcelo Venegas, a doctor who specializes in HIV/AIDS treatment in New York City. I originally met Marcelo in the mid 1990’s and was fortunate to go with him and his brother, Rodrigo aka RodStarz of the hip hop group Rebel Diaz, as well as dozens of others from Chicago,  to join thousands in Cuba for an international solidarity conference. When I learned that Marcelo was traveling to Haiti to offer his medical expertise as part of the answer to the call to provide immediate assistance in the aftermath of the earthquake, I wanted to offer him the opportunity to share his experiences with the Insight Arts community and all others interested in receiving firsthand accounts of what was experienced the first few weeks after the earthquake.

Dr. Marcelo Venegas, has traveled around the world, and provided medical assistance in the aftermath of an earthquake that hit El Salvador in 2001, has also traveled in solidarity trips to Chiapas, Mexico, Cuba and many other countries. Marcelo graciously allowed me to interview him in the midst of his busy schedule. We began with him illustrating how he arrived at the decision to travel to Haiti.

Dr. Venegas: I have been an HIV doctor now for 6 years and I was working with this group which is the largest HIV organization in the country, located in NYC, called Housing Works. Housing Works has been working with FEBS in Haiti, for approximately the last three years. As a result, there has been an ongoing exchange of people from Housing Works going to Haitian HIV clinics and HIV community organizations already there. After the January 12th earthquake, we mobilized right away. There was actually a Haitian doctor whom I’ve worked very closely with for a long time, who lost her parents. After I heard of that loss, which hit very close, I decided to go and help set up a clinic that had been demolished by the earthquake. About five days after the earthquake, I arrived in Haiti, and created a make shift clinic that we stocked and propped up in one day, and started seeing patients right away.

So this was in Port-au-Prince?

Yeah, this was in Port-au-Prince, in this area called Delmas. We actually worked in two clinics. One is called Diaspora, it was actually a clinic that was run and supported by people in Brooklyn. There was another clinic that we set up outside one of the HIV community organizations there. They call them the HIV Associations and that’s the FEBS Plus clinic. I was there for a total of ten days. We began by announcing on the radio that the two clinics were open. I worked with a whole team including pediatrician who came down from Mass General of Harvard whom I had worked with before. We both belong to a group called Doctors for Global Health which is an organization for which he is the vice president and which I used to serve on the Board member. Doctors for Global Health does work in Central America. With them, I have done relief work in 2001 in El Salvador after an earthquake.  Planning for the trip to Haiti, we originally had a big group of like 8 doctors who were coming. We had a UN charter plane that, because it was really disorganized, ended up not leaving and finally had to pay for our tickets. In the end, only two of us, the pediatrician, Dr. Jen Kasper, and I went. As I don’t see children and she does, it was a perfect fit. We flew down into the Dominican Republic because the airport in Port-au-Prince was primarily taken over by US military flights for the first couple of days. So, we flew into the Dominican Republic, which was how most aid groups were getting in, and we crossed the border into Haiti and that’s how we got there.

At the height of the US military presence in the aftermath of the earthquake, there were approximately 20,000 US troops occupying Haiti. I don’t think the count was quite that high, by the time that you arrived. Did you have any interaction with the military? Did it impede the work?

Yeah. First of all they closed the airport, so, it really was like an occupation. They took over the airport and then sent away the aid groups like Doctors Without Borders and others that wanted to land there, like the Red Cross, etc. They essentially took over the airport and allowed only their military to have priority. So my first encounters with the military were with the airport. When we went to the airport to try to pick up supplies, it was fully militarized with US troops everywhere. They let us in because we had US passports when we went to get our supplies, which was a pallet of stuff that we had sent to us. But what impressed me from being in the airport was how much aid was there and not being distributed. I had patients that needed crutches, I had patients that needed other items that we didn’t have or had access to, that were all there in crates. To this day, the big question remains, where is the aid? It was all in the airport, in these huge crates. I’m talking about rows and rows, almost like a mile of crates that was not getting to the people.

What were the people on the ground saying?

Well the people were still in shock, but I just would have expected this massive immediate tent distribution. To this day, people are using sheets for makeshift tents. They’re not real tents. So the question remains, where the heck are the tents? Where’s the food? There’s a lot of criticism, especially from France and Venezuela and Cuba saying that the United States is taking over the relief coordination, and yet it’s so horribly organized. Then on January 28th, you have Bill Clinton at the World Economic Forum in Davos, Switzerland, with the world’s top business leaders and powers, and he’s there asking for trucks, which is ridiculous. With all the aid that countries were sending, the telethons and so on, you would have expected more. It’s understandable that there is a lack of infrastructure because, first of all, there was a complete lack of government presence. And I understand that the UN was hit, the compound was almost destroyed and they lost a lot of their key workers and people who were in charge of a lot of logistics. But the inaction was just horrible. The issue of Haiti is a longer issue, where there was already a disaster before the earthquake in terms of hunger and poverty. I mean severe, severe poverty, where you read these stories with people eating these mud cakes to have their stomachs filled. Before the earthquake, you would have seen kids in a regular clinic that hadn’t eaten in two days, depending upon what sector you worked. But seeing these children still there after the earthquake, in addition to the horrible trauma that people had from facial lacerations to broken bones, to everyone still in shock… I would see patients in the morning and I would see them for 12 hours a day, nonstop. We’d see like a hundred patients a day. I remember everyone was in shock as a result of losing relatives. This one guy I saw for a pelvic fracture showed me a picture of his daughter who had been killed as a result of their house falling on top of them. You can’t even fathom the extent of human pain, you know? So yes, going back to the military question, we’d see military guarding the main hospital shooing people away that would show up for care. It’s the typical kind of the arrogance characteristic of all military. We saw these UN soldiers shoving people away and we actually saw people throw rocks at them.

Oh wow.

Yeah, they’re just so arrogant and the thing is it just doesn’t make any sense. You have this military, that doesn’t even speak the language, in somebody else’s country and just acting extremely arrogant. We went in a motorcade and were separated by the UN who was on the same road. They were passing and told us to go take a different route. I tried to explain to them that our convoy was going one way and if we turned another way we would break up. They were just very, very, arrogant. So they were arrogant to us, imagine how arrogant they are to the people there. The military have just a complete lack of cultural training. They were giving instructions in one place, and giving out food in English. They didn’t know how to work with people. They were trying to read instructions in Creole and got scared when the people began to come, so they packed up and left. That almost caused a riot.

Based on news reports, we knew that the presidential palace was destroyed. Was there any communication from some of the municipal governments in response to what was going on? What was the organization on that level, if any?

The response was almost absent. The one thing that they did have before I left, was this program where they paid people, particularly women, $2 a day to help remove the debris and clean the streets. They wore yellow shirts, so that seemed to at least work; at least people were getting paid, because see the problem was lack of income. Daily life was destroyed. Jobs people previously held were just destroyed. A lot of people would receive money through Western Union. You’d have these huge lines at banks and at Western Union for those getting money from abroad. But I had this sense that the government was just missing, especially the President René Préval government. Préval did this one radio announcement at the beginning and that was it. The coordination, at least from the health field, the main hospital specifically, was passed on to Partners in Health designated by the World Health Organization, not by the Haitian Ministry of Health. I knew the people from Partners in Health and I asked one main guy, “So you guys are running this?” He responded, “No, we’re running this on behalf of the Haitian people,” and I responded, “Yes, but you guys are still running it.” You would expect the Ministry of Health to be coordinating the healthcare and they were just absent. We had this guy at our HIV clinic, who is in charge of HIV representing the Ministry of Health, who pretty much sat in our clinic and said that people had access to HIV medications, which wasn’t true because when we drove down to the main site where the distribution points are, they were all demolished. We even went to the main hospital where he said they were also distributing medication, but people didn’t have access into the main hospital.   This guy would just sit with us in the clinic; he asked if he could eat some food, would hang out, you know, typical bureaucrat giving a bureaucratic answer. He was a doctor too, so I asked him, “Why don’t you help us see patients as opposed to just sitting there?” I felt kind of bad for him even after he asked for some cream for his feet when we were leaving one day. I don’t really condemn him, but how can someone in that position not play a more active role? This is the guy from the Ministry of Health who is responsible for HIV/AIDS. I said to him that these patients really needed their HIV/AIDS medication because what happens is that when you don’t take your meds for a window period, you build resistance to them. And that’s the issue right now in Haiti. You have all these people who are HIV positive, who were on medication, and who haven’t had access in the last two months, and who probably built resistance to re-starting their meds.

What were the rates of HIV infection prior to the earthquake in Haiti?

It’s one of the highest. I believe it’s upwards of 5%. It’s one of the highest in the world. It’s the highest in the Western Hemisphere, which goes right along with poverty. Haiti also has one of the lowest amounts given by the world, by the global fund for combating HIV/AIDS, even though they get a lot of Pet Fund money. The big criticism of Pet Fund is that, it’s a lot of money but it’s a lot of money for the drug industry and the makers of HIV medication, like Phizer, etc. They’re not for generics, there are still many, many, many, I would say nearly a million others that who don’t have access to medication.

What do you think are the political implications of how the earthquake emergency response has been to this point, to the 230,000 who died, and their families who are now living through the aftermath and rebuilding Haiti?

Well, you know, a friend who just came back, this doctor that I have worked with here in New York, came back with some impressions. One was that he said that what he experienced was like a re-colonization. His other impression was that it was like another Katrina. That may explain a lot of this militarization by the United States. He is this very mainstream Jewish guy from New York, Dr. Weinstein, who doesn’t have a lot of politics, but I was touched by his impressions. One thing he was very sharp with, was how all these NGOs are involved in this power play to see what region each organization will take over, in terms of whether it’s the healthcare field, or whether it’s distribution of food, etc. Who should really be responsible, who should really be organizing all this is the government and they’ve taken a back seat to the United States’ role there. I think the political implication is first of all, what’s going to happen with all of these people who are homeless? People who have pitched up their homes in tents and pretty much any plaza, any green area in the city, in the street even, they have blocked off streets, on the sidewalks, anywhere that can be set up with tents. You see these tent cities, refugee camps set up everywhere. The immediate issue is infectious disease. The immediate issue is protection of the vulnerable, like children and women, you know, in particular where there are accounts of rape going on, there are these 5,000 prisoners that escaped from the penitentiary and only 400 who were collected and picked up again. The streams are being overrun with human excrement. There are infectious diseases like dengue and cholera that are huge issues requiring immediate attention. Dysentery, you know, diarrhea, I’ve seen in children, lack of actual access to food. You have these coupons that were given out by the United States for 55 pounds of rice, which is ridiculous, which women couldn’t even carry, and that was a flop. The distribution of food is just immediate. People are still going hungry. So what’s going to happen with these people? There’s really no plan in terms of whether to re-distribute them into the rural areas or some kind of plan for the building of homes or alternate places for them to live. It’s a political issue because the question is, where is the money going to come from and how soon can it be done? The thick rainy season is just right around the corner and it’s really going to be a situation of chaos, where in a lot of areas it is already chaotic.

The Haitian people also have an amazing resolve and it amazes me. I think they are some of the most patient, calm people whom I have ever met. They have a lot of spirituality and they have been through a lot already. Many other people I worked with that were from countries like the Dominican Republic, were saying that if this happened in their country there would be riots, and so forth. Really the Haitian people have been very calm till now. So, in terms of political implications I think there are going to be both short-term and long-term effects where you are going to really see a massive exodus of people, some of which has already started to happen through a small program into the countryside, and into the rural areas. You’re going to end up with massive either shantytowns spreading, or refugee camps, like that which exists in other parts of the world, where you’re talking about a year plus, where people are not re-located and just stay there. Of course that leads to another broader issue related to living in refugee camps and so on. Which then leads to the question of what role will the United Nations play? What role will the United States play and other humanitarian agencies that are currently competing with each other? This is where my friend’s comment returns regarding the NGO power plays and their struggle to see who can get the bigger piece of the pie. Because obviously, a lot of these agencies are getting money to do the work in Haiti, and I don’t know how accountable that money is in terms of direct care to the Haitian people.

In stark contrast with the earthquake in Chile, the loss of life in Haiti is currently

You know I’m from Chile right, Aislinn?

Yeah I know, that’s why I have to bring it up (laughter). The loss of life is significantly higher in Haiti compared to the enormous record-breaking earthquake that occurred on February 27th in Chile. Can you speak to some of the reasons to this immense variance?

Yeah, I think that the immediate response to the variance that comes to mind is the gross national product. Chile, the Jaguar of Latin America, is what it was called, is probably one of the wealthiest, most economically stable governments. With the recent economic downfall, the reason that Chile did so well is because they kept a lot of the industry, the copper, really going and they didn’t invest in the people. Chile continued the privatization of a lot of their resources, particularly copper. Chile has become very wealthy from the Pinochet years where there was complete control (On September 11, 1973, with active support from the Central Intelligence Agency (CIA),General Augusto José Ramón Pinochet Ugarte led a coup d’état against President Salvador Allende’s democratically elected government. Human right’s reports state Pinochet’s government killed at least 3,197 people and tortured about 29,000[1]). You had the Chicago Boys[2], coming in with the Milton Friedman Group[3] which was really the model for neo-liberalism[4], where you have no organized labor, no unions to fight the complete privatization of pretty much all of Chile; Chile where everything that used to be public from social security, to telephones, to water, to electricity all now privatized. The interesting thing about the earthquake in Chile is that it showed the contrast between the rich and the poor, which has been hidden, pretty much by the press and by the Chilean government. There’s a huge mass of poverty that still exists in Chile and has been hidden because of the popular illusion, and image of Chile as a wealthy country. In contrast with Haiti, what are not as affected are the buildings, mainly because of the history of Chile’s strict building codes. In the 1960, the strongest earthquake ever recorded with a magnitude of 9.5, hit Chile and ravished many, many, buildings and killed many Chileans. Chile has a history of earthquakes. So you have these strict codes in the 1960’s that required that every building built had to be earthquake-proof. From that point of view, Chile’s history of being in earthquakes line of the fault, resulted in building regulations that limited the amount of damage, unlike what you have in Haiti. You can still see the wealthier buildings standing, like the US embassy, and so forth that were built with strict codes. These buildings are still standing and being occupied while pretty much every other building, was destroyed or not left standing. In the affected areas, like 70% of buildings were destroyed. There is a long history of poorly constructed buildings in Haiti. For example, in 2008, two Haitian schools collapsed a week a part that had been poorly built killing almost a hundred students. Haiti is the poorest country in the Western Hemisphere, so obviously when you have natural catastrophes of any type, the poor are always going to be more affected, whether in Chile or in Haiti, and that’s exactly what you see in Chile. The poor are really, much more affected. Their homes are destroyed, and they are now homeless. There are tens of thousands of people homeless in Chile, particularly in the south where the epicenter of the earthquake hit. Obviously, the wealthy will shack up with their family members; or go to another home, or whatever. In the case of Haiti, where in Port-a-prince, the majority of the people were already poor, there’s really no hope, no alternative housing for them. The Haitian earthquake also affected some of the wealthier areas. When I went to this area called Pétionville, which is like where the wealthy are, after seven days of not having any real access to electricity or running water, in the middle of all this chaos, one of the guys who were working there at the compound said, “Marcelo, do you want to go and have a beer?” I was kind of shocked, I said, “OK”. We went to this restaurant which was like an oasis, with waiters and waitresses, electricity from a generator and running water. This was in Pétionville, and there were a whole bunch of white people there, French, a lot of relief workers too. Here was this restaurant that was open and running, and had the only light in the whole neighborhood. And this is in Pétionville which is like a wealthy neighborhood and suburb of Port-au-Prince. A lot of the houses were still standing. Everybody was still outside because they were scared to go in but it wasn’t as chaotic and crazy as other areas like Delmas or where we were working, where every building was pretty much destroyed.

Camille Chalmers, the coordinator for the Platform to Advocate Alternative Policy, who is in Haiti now and has been there for a while, is communicating via blogs and email, states, “We call on people to found an international solidarity network in the same spirit as the Sandinista international brigades, to help us in reconstruction tasks and also in getting out of our social crisis.” What are some suggestions, you have, or ideas you have for people interested in building solidarity bases here in the States?

I think there is a wonderful opportunity now. I support this group of young women who are going from New York to this clinic on the border with the Dominican Republic in Haiti. My ex partner, who is also a doctor, she’s going down with them in April. They have this whole kind of holistic medicine, more conscious based solidarity approach to working with people. This clinic they are going to has been running for a while on the border. The opportunity is about building.  There is a wonderful opportunity to build international solidarity. The work now is the long-term. The crisis, the immediate crisis, in terms of the traumas, and the effect because of the earthquake has passed. It has experienced this kind of sequella, where either, surgeries have to be re-done or infections are discovered because of poor hygiene during the surgeries. Looking at the more long-term conditions, the concerns are going to be dealing with the poverty and the lack of resources. The opportunity for international solidarity is definitely there and you know, I think it’s always been there. There have been brigades of people who have gone to Haiti in the past, such as Housing Works. Housing Works is an NGO that works with HIV/AIDS at a very conscious and progressive level.  I think this is where people who are progressive and people who see the issue is one of a political nature can really have a tremendous impact in terms of really getting resources there, as has been done with the Cuban Solidarity Movement, or the caravans that go to Cuba in a similar vein. There’s an opportunity to do the same here with the Haitian people and really build a more continuous and pragmatic way to deliver resources but to also really work with the people.

One of the thoughts we were tossing around was, “What if we really kind of had a progressive military?” We would see these US marines, two in the front and two in the back with a US medic or a doctor walking around, (resulting in) teams of five. The group Doctors Without Borders has this sign on their cars that has a rifle with a circle around it and a cross through it, indicating that they don’t have guns. We were saying, “Why is there a need for military here? This is not a war. And if there are military, why are they going around with their guns?” From the UN military to the US military, we were saying, “What if there was a progressive military that was really dealing with aid?” You’d need maybe one military personnel per block in order to have them work with the people to really reconstruct, and to remove the debris. We ran into countless Haitians that were from the United States, working with their families to remove the debris from their homes, either to find dead relatives or to just start cleaning the mess that they had that was their home. So this is an opportunity where you can really have people provide solidarity, but a conscious solidarity that really understands the dynamics of what’s going on there, and understand the historic dynamics of Haiti. Haiti where you have a president that was pretty much kidnapped by the United States and taken to Africa (Jean-Bertrand Aristide)[5], Now is an opportunity to organize people who understand the historic conditions of Haiti in terms of the role of the IMF and the role international powers have played to stop Haiti prospering as a country. I think there is a wonderful opportunity now to build conscious international solidarity with the people of Haiti.

If you are interested in joining a solidarity brigade to Haiti, please send an email to info@insightartsliberation.org. To donate to organizations that Dr. Marcelo Venegas is a part of that continue to conduct work in Haiti, please visit the following link: http://www.housingworks.org/donate/. To learn more about Housing Works’ programs throughout the globe, please visit http://www.housingworks.org/.

[1] http://www.washingtonpost.com/wp-dyn/content/article/2006/12/10/AR2006121000302.html

[2] The Chicago Boys (c. 1970s) were a group of about 25 young Chilean economists who trained at the University of Chicago under Milton Friedman and Arnold Harberger.

[3] In October 1975 the New York Times columnist Anthony Lewis declared that “the Chilean junta’s economic policy is based on the ideas of Milton Friedman…and his Chicago School” http://reason.com/archives/2007/02/21/the-life-and-times-of-milton-f

[4] Neo-liberlism refers to economic policies based on neoclassical theories of economics that minimizes the role of the state and maximizes the rights of the private business sector.

[5] http://edition.cnn.com/2004/WORLD/americas/03/01/aristide.claim/

[Via http://undergroundinsight.wordpress.com]

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