Originally: testimony in France before the Regis Debray Commission established by President Jacques Chirac to investigate Haiti’s claim for restitution

Dr. Paul Farmer’s testimony before French Commission on Haiti’s claim

Dr. Paul Farmer’s testimony in France before the Regis Debray Commission established by President Jacques Chirac to investigate Haiti’s claim for restitution.
Paris, November 3, 2003

Twelve points in favor of the restitution of the French debt to Haiti
By Paul Farmer,
Medical professor at Harvard Medical School
Medical Director, Bon Sauveur Clinic Central Plateau, Haiti

I thank you for inviting me to speak with you. I believe the Haitian government is pressing France to refund the indemnity given by Haiti, starting in 1825, twenty years after the Haitian revolution, that began in 1791 and led to the country’s independence.

Haiti, maybe more than any other nation, can give powerful arguments in favor of the restitution of the French debt. First, let me specify a few things. It is your invitation I answer today and not an appeal from any government. I am a doctor and American anthropologist and I have been working in Haiti’s central region for twenty years. I am here in front of you today because I believe that the terrible suffering I see in our clinics and hospitals mainly have social causes, most of them rooted in slavery and in the foreign policy of great powers. In order to put an end to this unnecessary suffering, there must be social answers such as restitution of the debt and reparations. And so it is a great honor for me, being a doctor worried about the immediate as well as historic causes of suffering and sickness, to speak before you.

In a perspective of public health, capital movements that are displayed in parallel of deep inequalities (from a former slave colony devastated by war to one of the world’s most powerful nations, for example) are one of the main causes of today’s misery. These transfers from the poor to the rich still take place today, although they are a little more subtle. They have the benediction of some international financial institutions. But I am convinced that it is possible to stop or at least to minimize these unhealthy and inopportune practices. I wouldn’t be here if I didn’t think that there is still a small hope that the French authorities take into account the history in this case and that they do what’s right.

The health situation in Haiti today

To those who argue that all this is history, we can say in opposition that it is the weight of history that leads to the present situation in Haiti. I will give a short overall view in six main points of this situation in my fields of competence, public health and medicine.

First, nobody denies today that Haiti has the worst health indexes of the American continent, and in fact, these indexes are among the worst in the world. That is not new but many things could have been done to improve this situation. My own clinical practice reminds me every day that we can prevent and cure almost all the main causes of deaths in Haiti, as long as we act in time. In Haiti’s central region, we made it because we imported tools of modern medicine and we work in collaboration with public authorities to give treatment to sick destitute people. But the national situation is deplorable. A few figures: the infant mortality rate is 81%, a number that keeps going up; in comparison, it is 4% in France and 7% in Cuba. The child mortality death rate, meaning the number of Haitian children who die before their fifth birthday, rise to 125%; in France, it is 5%.

The maternal mortality rate, which means women who die giving birth, is very low in developed countries. Almost all those deaths occur among poor women in poor countries. Once again, Haiti has some of the most disastrous figures in the world: official reports state a rate of 520 deaths for 100,000 births. A few years ago, an investigation among the population in the southeast of the country estimated that rate at over 1,400. In Cuba, the neighboring country, this figure is at 33; in France, at 10.

HIV quickly became the major infectious disease to cause death among adults. The World Bank estimates that 5% of the Haitian population is infected. This number is only at 0,1% in Cuba. Despite its important infection, Haiti is the country that has the least resources in the American continent to fight this pandemic. On the exception of our work in the Central Plateau, the country has no structure for appropriate prevention nor global taking in charge. With an original approach, including both prevention and appropriate care, already adopted in the Central Plateau with the support of the public health care system, this procedure could be extended throughout the country. Unfortunately, this system cannot play this role at all because it has no financial means. So the NGOs benefit from all the resources.

Haiti also seems to be the country where there is the most malaria in the region, a disease eradicated in its neighboring countries, Cuba and Jamaica. Concerning tuberculosis, we have completed a study in the center of the country where we found a rate of 357 cases for 100,000 persons, which is once again the highest rate on the American continent. The problem of tuberculosis is even more serious in Haitian cities where HIV infections are concentrated: indeed, the virus revives the latent infectious tuberculosis and epidemic tuberculosis is now progressing very quickly in shantytowns.

Malnutrition is at the heart of many of these problems. According to the World Bank, Haiti is indeed the country where there is the most hunger in the world, after Somalia and Afghanistan.

Secondly, these appalling figures have nothing to do with the Haitian culture since the country has an epidemiological profile very different from that of close former French colonies such as Guadeloupe and Martinique, where life expectancy and the prevalence of epidemic diseases are very much like the ones in metropolitan France. What a sour paradox it would be to conclude that Haitians would be better off if they had never freed themselves from the yoke of slavery! Not one Haitian who respects himself or herself would say that, but the fact is that we can easily see a continuous chain of causes and consequences between the country’s situation the day after the revolution and the situation today — as if Haitians continue to be punished for their ancestors? rebellion. Since 1804, two centuries ago, Haiti has suffered under embargoes and punishing politics which I will recall in details later.

Thirdly, the health situation in Haiti will certainly worsen more if substantial investments are not quickly made in the public health system. It is now time that resources flow back to Haiti, towards the country’s public institutions. We call that “international aid” but the word “restitution” would be more appropriate. By sharing a little of its wealth with its former colony, France could act in complete fairness in favor of literacy, access to drinking water, infrastructure renovation and health care. But international aid is not abundant. At this time when I am speaking with you, an embargo with no name is pressing on humanitarian aid and development aid meant for Haiti. Here are the facts, new in a sense, but well known to Haitians.

Let us look at the case of the loans blocked by the Inter-American Development Bank which I mentioned recently in Le Monde Diplomatique. I learned that these loans were approved three years ago both by the Haitian government and by the Bank?s central committee. But no payment has been made so far. One of these loans was intended for the public health system, and the other three for teaching, for the improvement of access to drinking water and the rebuilding of roads. Being an American doctor working in Haiti, it seemed right to me to try to understand why. The loans are suspended for “political reasons,” they tell me. In May 2000, in Haiti, general elections (legislative, senatorial and local) took place. The election of eight senators was contested and some people demanded the organization of new elections. Well, according to what I?ve learned from Haitian sources as well as American ones, the United States asked the Inter-American Development Bank directly to block the loans as long as the dispute is not resolved.

It is tragic that France and other European countries followed the United States in their decision to block the aid to Haitian public authorities, while this procedure is a violation to the Inter-American Development Bank’s charter, which stipulates that the Bank is forbidden to intervene in the State members? political affairs. A report from a French colleague working for the Bank summed up the situation as follows: “On the whole, the main reason for the economic stagnation is the cancellation of subsidies and loans from foreign countries that came with the international community?s answer to the political situation dead-end.” These funds are estimated at over 500 million dollars.

Fourthly, there are many debates on the issue of the blocked aid intended for Haiti. If leaders of the powerful countries that impose these sanctions think they present their own point of view, I can assure you that the facts are clear and they show a deep hypocrisy from the creditor States. Look at my own government?s declarations stating that there is no embargo. I maintain that all you have to do is look in which direction money is circulating (or rather is not circulating) between Washington and Port-au-Prince. During the last decades, when the Duvalier or military governments were in power, hundreds of millions of dollars flowed into the Haitian power?s coffers. Today, the elected government, unpopular with the government of the United States as well as with the Haitian elite, has to content itself with sums close to zero.

The Inter-American Development Bank pretended that the funds had been blocked after a consensus reached by the Organization of American States in its “Declaration of Quebec.” But this document is dated April 22, 2001, while the United States? representative?s letter to the Inter-American Development Bank asking for the loans not to be given is dated April 8, 2001. It is clear that the United States put pressure on the Bank so that it backs their own political choices. To quote one of the few journalists who considered that this scandal deserved to be investigated “it seems that there was a consultation about that decision only after it had been taken.”

Presently, international financial institutions? schemes against Haiti are discriminating and probably illegal. The press remained relatively silent regarding this: the powerful people of this world can say what they want without any risk of being questioned when the stakes are considered unimportant.

That?s not all. The Inter-American Development Bank demanded, among other things, that Haiti, a ruined country, pay crushing arrears always increasing because of increasing interest. The main part of those arrears concerns loans granted to the Duvalier dictatorship and the military governments that governed the country so brutally from 1986 to 1990, and after a brutal coup d’etat, from 1991 to 1994. In July 2003, Haiti transferred 90% of its reserve currency to Washington to pay these arrears. To date, not one cent of these four loans has been given, despite the many guarantees given by the Bank.

In the fifth place, this astounding repeat of illegal schemes of the 19th century (lawyers as well as poor Haitians will see that the payments to the Inter-American Development Bank are an echo of the indemnities given to France starting in 1825) is in a straight line with other discriminating practices against Haiti and its population. I recently made a list, for a medical magazine, of the many boycotts imposed to the Haitian people after it refused to respect the rules of the game, rules that accepted, even during the period of enlightenment, the trade of human beings. This medical article, titled “The unfair embargo on the aid to Haiti,” is among the documents I put together for the Commission.

In the sixth place, your committee should be extremely cautious with regard to the notices published in French and in English when those notices can make people think that Haitians refused in any sort of way the restitution of indemnities extorted by France many generations ago. French is not all Haitians? mother tongue. We estimate that only 10% of the population speak French while all Haitians speak Haitian Creole. Some Haitians are opposed to the restitution, which can seem staggering. If we listen to Haitian radio, we can soon guess that the only Haitians opposed to the restitution are part of the political opposition, weak in number, not very appreciated in the country but nevertheless with a great influence on the international level. There are of course a few bitter intellectuals who also declare they are against the restitution ? which is in accordance with the sociology of a country where social classes are so deeply divided. However, the great majority of the population, desperate with the country?s terrible situation, is in favor of this process.

Much of the analysis, notably those of French and American journalists, presents Haiti?s current problems as if they have nothing to do with slavery, with racism, with war and two centuries of interior and exterior hostility to popular democracy. The battle Haiti continues to fight against hereditary or military dictatorships and against the brutal neo-conservatism privileged by some international financial institutions, is also a battle against the voluntary eclipse of history.

Historical roots of the current situation

Historians, and probably members of this committee know the facts: These facts are hard to exonerate, even though many people have tried. In the way it treats the Haitian issues, contemporary journalism shows total irresponsibility. Let me underline, once again, six essential facts, before I speak about the consequences of the 1825 indemnity on Haiti?s later development and its current suffering. I will of course stress on the roots of the sanitary crisis the country is going through today.

First of all, Haiti is mostly a creation of France. By the Treaty of Ryswick, signed in 1697, the western third of Santo-Domingo island was given to France, who made it its most profitable colony within sixty years. The main editor of the time, Moreau de Saint-Méry, described it as follows: “The French part of the Santo-Domingo island is France?s most important possession in the New World because of the wealth it gives to its metropolis and because of the influence it has on its agriculture and its trade.” In his book published in 1981 on the end of the Former System, Olivier Bernier recalls what the source of this great profit was: “French products were sent everywhere in the world, but very few products made in foreign countries went into France. Most of the trade was based on food products, tobacco and colonial products, sugar, spices, rice, tea and coffee. That allowed some merchants, most of them from Bordeaux, to make profit on a merchandise extremely profitable, called “black gold” — it was Black slaves. Most of the ships’ managers participated in the vile triangular trade, based on slaves, sugar and rum. They prospered. The city of Bordeaux was almost completely rebuilt at the end of the 18th century and it still cuts a fine figure. The money came from the sale of human beings.”

Second point, the French part of the Saint-Domingue island is known by historians of slavery to be the most merciless colony of history. During the second half of the 18th century, it was the main call for boats carrying slaves. When they had lived through the crossing, one-third of the newcomers died a few years later. Slaves were the great majority of the population and the masters lived in continuous fear of a rebellion.

Third point, Haitians conquered their independence with arms. We saw masters free their slaves towards the end of the French revolution but only after slaves themselves took their situation in hand, in 1791. As proven in the archives, Napoleon thought later of restoring France?s power on the colony and reestablishing slavery.

The fourth point, almost all of the world?s powers took France?s side against Haiti, the first nation to declare itself as a hiding country for fugitive slaves but also for native people (Haiti?s native people had died long before the Treaty of Ryswick, in a holocaust caused by infectious diseases and Spanish pro-slavery). The first independent nation in Latin America and second in the “New World,” Haiti was surrounded by slave colonies. The country had only one independent neighbor, the United States, owners of slaves themselves. They refused to recognize Haiti?s sovereignty. The diplomatic recognition took a long time to come. A senator in South Carolina, speaking in front of his peers in 1824, declared, “Our politics towards Haiti is simple: we will never recognize its independence [?]. The peace and security of a great part of the Union prevents us from even considering it.” At the end of the 19th century, the United States took France?s place and the American military occupation, from 1915 to 1934, made my country become the dominant power in Haitian affairs in the 20th century. These are the facts.

During the first decades of the independence, the Haitian economy in ruin continued to depend on coffee, sugar and other products, none of which were intended for local consumption. As long as the great powers refused to recognize Haiti?s sovereignty, the leaders of the country saw the national economy trapped in inequitable commercial relations.
It is also important to underline, like Moreau de Saint-Méry did before the revolution, the irreparable ecological damage caused by single crop farming practiced by French planters during the 18th century. As for the sanitary situation after the independence war, Dr. Ary Bordes summed it up as follows: cities and large villages were unhealthy, lacking drinking fountains and latrines; refuse was accumulating in the streets. Most of the plantation hospitals were destroyed; only military hospitals in Port-au-Prince and Cap-Haitian were running. Almost all doctors, surgeons and pharmacists had left the island. Only Black people who had worked in the destroyed hospitals, midwives, healers and bonesetters still gave rare health care. With very little training, they were facing a population just freed from slavery, generally living in primitive huts, without water or latrines, weakened and decimated by contagious diseases against which it was badly protected. And the doctor concluded: “Overwhelming legacy left by our former masters, craving for profit and caring very little for the native population?s life or health conditions.” The current sanitary situation shows a disturbing similarity with this legacy of the past.

The fifth point, even if it is impossible to evaluate the cost of slavery (three and a half centuries of destruction of lives and families, but also of cultures and languages), the “French debt” can perfectly be quantified. In 1825, Charles X accepted to recognize Haiti?s independence on the condition that the new republic pay 150 million francs to France — the annual budget of the French government at the time — and cut its customs taxes in half. Other people than me will give you precise information on the amounts that were actually paid, but you must know that such a demand was illegal with regard to the French law. Indeed, the French ultimatum came with explicit threats to use force and to reestablish slavery. But France had already signed a treaty (Treaty of Vienna, 1815) in which, even though slavery was not abolished in places where it already existed, it was expressly forbidden to establish it on new territories or to reintroduce it where it had been abolished, like in Haiti. And so the threat that had presided in the negotiations was completely outside of the law.

The sixth point, the consequences of the payment of the debt on the Haitian society of the 19th century was devastating. In Haiti, the results are heavy: anthropologist Jean Price-Mars denounced in 1953 the Haitian leaders who had given in to French demands: “The incompetence and thoughtlessness of the men in power made a country where expenses and revenues were balanced up until then, become a nation overburdened with debts and tangled up in financial obligations impossible to respect.” In France, opinions on the issue were different at the time, according to the people?s political convictions. Victor Schoelcher, who fought to abolish slavery, considered that to impose the payment of an indemnity to victorious slaves was just like asking them to pay with money what they had already paid with their blood. Even those who benefited from the agreement knew that it was a fatal blow to the Haitian economy. Alexandre Delaborde, former colonist in Saint-Domingue, admitted in 1833 that these 150 million francs represented three times the value of the entire colony. And so, where does the payment of the indemnity and customs concessions stand in the long list of tragedies that weigh down the Haitian people? Very high up, in my opinion.

Restitution and reparations

While Haiti is getting ready to celebrate the bicentennial of its independence, it seems fair to me to wonder if the “international community” will continue to cut off the country or will it choose to make amends to the longest succession of abuse towards this one and only nation in history? France and the United States are the two countries where that question should be asked with the most strength.

I cannot conclude without a word about the reparations for slavery itself. Experts tell me that the procedures for reparations, undertaken these last few years by slaves? descendants, come up against two obstacles: slavery was not illegal in France at the time and, second difficulty, these reparations represent enormous amounts for rich countries (comparable, at the very least, to those that American cigarettes makers were condemned to pay, not including interest). Reparations should be extended to the entire American continent and the African continent. Beyond the easy legal arguments, let?s underline that the restitution of the debt is a much less complicated issue than the reparations, and that it is quite manageable for France. The amount can be calculated without great difficulties and the beneficiaries are easy to name. It is a lot less complicated than trying to estimate a reparation for a Central African country, for example, that lost part of its population when an African slave trafficker took away inhabitants to sell them to a Portuguese trafficker who then sold those captives in Haiti.

Our world will become a better world if we pursue the idea of reparations. Legal obstacles can be by-passed, and that is known by everyone with good intentions who, by the coincidence of their birth, have power today. But these are circles where good intentions are rare. And we have every reason to fear that if reparations are paid one day, they will go to slaves’ descendants who are relatively rich who live in the United States, in France or in England, a country who, with Spain and Portugal, were the main architects of slavery in the New World.

I am going back to Haiti tomorrow and I am not very optimistic about my capacity, as a doctor, to significantly change the sanitary crisis I described here and elsewhere. I brought with me ten files with documents that detail and support what I told you today, because justice must be done. For a doctor, working in Haiti, in a country that continues to suffer from abuses from the most powerful nations in the world, is a little like trying to stop a sea wall with fingers. But I have a great debt towards this country that made me a better doctor, at least I hope, and that taught me to think in a more critical way. The medical team I am part of will never stop treating sick poor people. Public teachers, teachers, lead a similar battle in their field. We do not represent the Haitian State but we work together with the Ministries of Health and of Education, which must become responsible again for the access to health care and teaching for everyone. We need allies and an answer to the following question: will the happy winners of the world?s history settle in their distressing routine or will they finally break off from cruel, corrupted and racist politics? Will they finally give back to Haiti the price of its blood? Haitians are getting ready to commemorate the bicentennial of their country?s independence but they believe that they have been punished, for two centuries, for daring to shake their chains. The past and present history prove they are right.

Once again, thank you for asking for my advice.