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To put pressure on violent or oppressive regimes the international community has increasingly resorted to economic sanctions. These may achieve long-term benefits, but they also cost livesusually those of the poor and vulnerable.
Following the military coup in Haiti in September 1991, the United Nations imposed economic sanctions in an effort to restore democracy and human rights. Over the three years of sanctions, the rate of malnutrition for children under five increased from 27 per cent to over 50 per cent in many health institutions; thousands of children more may have died.
Before the overthrow of Haiti's first democratically elected government in 1991, the health of the nation's children was already among the most fragile in the western hemisphere, and most of the island's people, almost 7 million, lived in poverty. Sanctions caused employment and food production to plummet and also provoked inflation, which pushed up the cost of drugs and other essential items. Primary school enrolment dropped almost 25 per cent, as parents could no longer afford to send their children to school. Many of the wealthy and powerful were sheltered by overseas bank accounts and could buy what they needed on the black market. The poor, however, had no cushion against additional hardship.
Photo: Barefoot children run though water contaminated by garbage and sewage in a Port-au-Prince shanty town. ©
A six-member mission from the Harvard Center for Population and Development Studies went to Haiti in July 1993 and included a visit to Maissade in the Central Plateau. Save the Children had already reported from this rural area of 45,000 people that from 1991 to 1992, when sanctions were being enforced, child mortality increased by up to 64 per cent. They also reported that between 1990 and 1993 there had been a parallel increase in the proportions of children who were moderately and severely malnourished.
In addition to shortages of food, people also suffered from the deterioration in health services. Field interviews by the Harvard team revealed that shortages of drugs, supplies and electrical power had led to breakdowns in primary health care. Bottlenecks in public transportation also reduced access to health facilities. This led, among other things, to a decline in immunization coverage and a rise in deaths from measles and other infections. Between 1991 and 1992, the proportion of total deaths attributed to measles increased from 1 per cent to 14 per cent.
With the lifting of sanctions and the return of Haiti's President Jean-Bertrand Aristide in October 1994, a six-month-long measles eradication campaign, supported by UNICEF, immunized almost 3 million children between the ages of 9 months and 14 years, raising coverage to 95 per cent of children by August 1995. In comparison, only 20 per cent of children were covered in 1993. Many of those immunized also received vitamin A capsules and a dose of polio vaccine provided by Rotary International.
The Harvard team recommended that the international community sharpen its approach to sanctions. First, it should focus more precisely on the real targets: the military and their élite supportersfreezing overseas bank accounts, withdrawing commercial air traffic and denying visas. Second, it should take measures specifically to protect the poor. These would include guaranteeing free movement of life-saving supplies, especially of food and medicines; ensuring access to water, shelter and clothing for vulnerable groups, particularly for mothers and children; closely and impartially assessing and monitoring the welfare of innocent populations; and safeguarding aid from misuse and diversion.