Black Immigrant Daily News

Executive Directors of the World Bank Group last week completed an official visit to Belize where they saw first-hand the challenges and opportunities faced by the Caribbean Community (CARICOM) country.

During the visit, the 10 Executive Directors met with the Prime Minister John Brice?o, and Cabinet Ministers, visited World Bank-supported projects, and met with the private sector and the Economic Development Council.

As a small state, Belize’s challenges are multifaceted and these are exacerbated by overlapping crises – climate change, the COVID-19 pandemic, and Russia’s invasion of Ukraine, among other shocks. The World Bank’s work in Belize supports the country in recovering robustly from these impacts, addressing resilience to climate change and protecting the most vulnerable. Belize is highly vulnerable to natural disasters and approximately half of the country’s population is poor.

“Belize is making progress, particularly in addressing climate change and protecting the most vulnerable, as outlined in the country’s newly launched medium-term development strategy,” said Ayanda Dlodlo, Group Spokesperson and Executive Director for Angola, Nigeria and South Africa.

“Seeing World Bank’s support to the energy, blue economy, health and agriculture sectors – and how that support has positively impacted and benefited tens of thousands of households – is encouraging. We look forward to continuing our support to help Belize meet its development objectives.”

During the official visit, Prime Minister Brice?o, remarked on the necessity of support to countries like Belize. “We are on the right track and have made great strides towards achieving our development objectives, but we need to do much more, particularly as one of the most vulnerable countries on earth,” he said.

“For that, we need the continued support of our development and knowledge partner, the World Bank, and we look forward to future engagements with the International Finance Corporation and the Multilateral Investment Guarantee Agency.

“Belize and the World Bank Group are companions, co-travelers on the road to achieve Belize’s great aspirations — for our country, for our people, for our climate,” the Prime Minister added, while advocating for Belize’s need for affordable finance to fight the multidimensional impacts of climate change, particularly given the country’s vulnerabilities.

The World Bank’s Executive Director for Belize, Antigua & Barbuda, The Bahamas, Barbados, Canada, Dominica, Grenada, Guyana, Ireland, Jamaica, St. Lucia, St. Kitts & Nevis and St. Vincent & the Grenadines, Katharine Rechico, noted the difficulties faced by Small States. “Though classified as a middle-income country, the realities of the multidimensional challenges faced by Belize were made clear during this visit. I am pleased that the World Bank Group is rising to the challenge and helps addressing the needs of Belize and other Small States. The institution will continue to do so.”

This visit to Belize was the first ever under the World Bank’s Executive Directors Group Travel, who also visited two other countries in the region.

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Black Immigrant Daily News

When machine gun fire erupts outside the barbed-wire fences surrounding Fontaine Hospital Center, the noise washes over a cafeteria full of tired, scrub-clad medical staff.

And no one bats an eye.

Gunfire is part of daily life here in Cit? Soleil – the most densely populated part of the Haitian capital and the heart of Port-au-Prince’s gang wars.

As gangs tighten their grip on Haiti, many medical facilities in the Caribbean nation’s most violent areas have closed, leaving Fontaine as one of the last hospitals and social institutions in one of the world’s most lawless places.

“We’ve been left all alone,” said Loubents Jean Baptiste, the hospital’s medical director.

Fontaine can mean the difference between life and death for hundreds of thousands of people just trying to survive, and it offers a small oasis of calm in a city that has descended into chaos.

The danger in the streets complicates everything: When gangsters with bullet wounds show up at the gates, doctors ask them to check their automatic weapons at the door as if they were coats. Doctors cannot return safely to homes in areas controlled by rival gangs and must live in hospital dormitories. Patients who are too scared to seek basic care due to the violence arrive in increasingly dire condition.

Access to health care has never been easy in Haiti, the poorest nation in the Western Hemisphere. But late last year it suffered a one-two punch.

One of Haiti’s most powerful gang federations, G9, blockaded Port-au-Prince’s most important fuel terminal, essentially paralyzing the country for two months.

At the same time, a cholera outbreak made worse by gang-imposed mobility restrictions brought the Haitian health care system to its knees.

The U.N. high commissioner for human rights, Volker T?rk, said this month that violence between G9 and a rival gang has turned Cit? Soleil into “a living nightmare.”

Reminders of the desperation are never far away. An armored truck driven by hospital leaders passes by hundreds of mud pies baking in the harsh sun to fill the stomachs of people who can’t afford food. Black spray-painted “G9” tags dot nearby buildings, a warning of who’s in charge.

In a February report, the U.N. documented 263 murders between July and December in just the small area surrounding the hospital, noting that violence has “severely hampered” access to health services.

That was the case for 34-year-old Millen Siltant, a street vendor who sits in a hospital hallway waiting for a checkup, her hands nervously clutching medical paperwork over her pregnant belly.

Nearby, hospital staff play with nearly 20 babies and toddlers — orphans whose parents were killed in the gang wars.

Normally, Siltant would travel an hour across the city by colorful buses known as tap-taps for her prenatal checkups at Fontaine. There she would join other pregnant women waiting for exams and mothers cradling malnourished children in line for weigh-ins.

All the clinics in the area where she lives have closed, she said. For two months last year she couldn’t leave the house because gangs holding the city hostage made travel through the dusty, winding streets nearly impossible.

“Some days, there’s no transportation because there’s no fuel,” she said. “Sometimes there’s a shooting on the street and you spend hours unable to go outside … Now I’m worried because the doctor says I need to get a C-section.”

Health care providers told the Associated Press that the crisis has caused more bullet and burn wounds. It has also fueled an uptick in less predictable conditions such as hypertension, diabetes and sexually transmitted infections, largely because of slashed access to primary care.

Pregnant women are disproportionately affected. Gynecologist Phalande Joseph sees the repercussions every day when she leaves her hospital dormitory and pulls on her light blue scrubs.

The young Haitian doctor snaps on a pair of white surgical gloves and makes an incision into a pregnant patient’s belly with a steady hand that only comes with practice.

She works swiftly, conversing with medical staff in her native Creole, when a burst of wailing erupts from a baby girl nurses swaddle in pink blankets.

Operations like these have grown more common, Joseph explains in between C-sections, because the very conditions that have intensified amid the turmoil can turn a pregnancy from high risk to deadly.

This year, 10,000 pregnant women in Haiti could face fatal obstetric complications due to the crisis, according to U.N. data.

Those risks are only compounded by the fact that many of Joseph’s patients are sexual violence survivors or widows whose husbands were killed by gangs. Permeating the struggle is an air of fear.

“If they start having contractions at 3 a.m., they are terribly scared of coming here because it is too early, and they are scared something might happen to them because of the gangs,” Joseph said. “Many times when they arrive, the baby is already suffering, and it is too late so we need to do C-section.”

That became most evident to Joseph last October when four men came rushing to a hospital carrying a woman giving birth stretched out on top of a door. Because of gang lockdowns, the woman couldn’t find any transportation to the hospital after her water broke.

“These four men were not even her family. They found her delivering on the street … When I heard she lost the baby, it shook me,” she said. “The situation in my country is so bad, and there is not much we can do about it.”

Started as a one-room clinic to provide basic medical services to a community with no other resources, Fontaine Hospital Center was opened in 1991 by Jose Ulysse.

Ulysse and his family have worked to expand the hospital year after year. They fight to keep their doors open, Ulysse said.

Even when firefights arrive at the doors of Fontaine, the hospital reopens few hours later. If it were to close for longer, administrators worry that it could lose momentum and would be hard to reopen.

Today, it’s the only facility to perform C-sections and other high-level surgeries in Cit? Soleil.

Because most of the people in the area live in extreme poverty, the hospital charges little to nothing to patients even as it struggles to purchase advanced medical equipment with funds from UNICEF and other international aid providers. Between 2021 and 2022, the facility saw a 70% jump in the number of patients.

The hospital possesses a certain level of protection because it accepts all patients.

“We don’t pick sides. If the two groups face off, and they arrive at the hospital like any other person, we treat them,” Jean Baptiste said.

Even the gangs understand the importance of medical care, he added. Yet the walls still feel like they’re closing in.

Rising carjackings of medical vehicles have made it impossible for Fontaine to invest in an ambulance. When ambulance operators are called from areas like Cit? Soleil, they offer a simple response: “Sorry, we can’t go there.”

Fontaine’s mobile clinic can now travel little more than a few blocks outside the facility’s walls.

Doctors worry, but they keep working, just as they’ve always done.

“You say, well, I have to work. So let God protect me,” Jean Baptiste said. “As this situation gets worse, we go out and decide to face the risks. … We have to keep pushing forward.”

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Black Immigrant Daily News

Three countries, this week alone, have reported outbreaks, WHO cholera team leader Philippe Barboza told reporters at a press conference on Friday.

For the first time, WHO is asking donors for help to fight the outbreaks, he said.

Right now, 22 countries across the world are fighting outbreaks of the acute diarrhoeal infection caused by eating or drinking contaminated food or water. Cholera cases climbed in 2022, following years of falling numbers of cases, and the trend is expected to continue into this year, he said.

He said cases have been reported in five of the six regions where WHO operates. The latest WHO global overview published in early February showed the situation has further deteriorated since 2022.

Poverty, disasters, conflict and climate change consequences continue to be driving factors alongside a lack of access to safe water and sanitation, Dr. Barboza said.

Limited vaccine supplies

“An unprecedented situation requires an unprecedented response,” he said, drawing attention to the limited availability of vaccines, medicines, and testing kits.

Only 37 million doses are available in 2023, he said. More doses are expected to be available by next year.

As a result of the current global surge, WHO is, for the first time ever, appealing to donors to support a $25 million fund to help to address cholera outbreaks and save lives, he said.

Prevention is key, he said, noting that nearly half of the world lacks access to safely managed sanitation.

“Access to safe drinking water and sanitation are internationally recognized human rights,” he said. “Making these rights a reality will also end cholera.”

Outbreak in Africa

An exponential rise in the number of cholera cases in Africa includes an outbreak in Mozambique, which is also grappling with severe storms brought on by cyclone Freddy. The first case of cholera in the current outbreak was reported to the Ministry of Health and WHO from Lago district in Niassa province in September.

As of 19 February, Mozambique reported a cumulative total of 5,237 suspected cases and 37 deaths. All six cholera-affected provinces are flood-prone areas, and WHO anticipates that more will be affected as the rainy season continues.

Considering the frequency of cross-border movement and the history of cross-border spread of cholera during this outbreak, WHO considers the risk of further disease spread as very high at national and regional levels.

An estimated 26,000 cases and 660 deaths have been reported as of 29 January 2023 in 10 African countries facing outbreaks since the beginning of the year, WHO said. In 2022, nearly 80,000 cases and 1,863 deaths were recorded from 15 affected countries.

Multiple countries affected

Neighbouring Malawi is facing the deadliest cholera outbreak in two decades, and cases are being reported in other countries, including Ethiopia, Kenya and Somalia, WHO reported.

The UN health agency said challenges include climate change, which has led to drought or flooding in parts of Africa, resulting in increased population displacement and reduced access to clean water.

Worldwide, people in Haiti, India, Pakistan, the Philippines and Syria, among others, are also affected by outbreaks.

Global threat

Cholera remains a global threat to public health, WHO said. In 2017, affected countries, donors, and partners of the Global Task Force on Cholera Control launched a renewed global cholera control strategy, Ending Cholera: A Global Roadmap to 2030. It aims at reducing cholera deaths by 90 per cent over the next decade.

While the number of cases had been declining, WHO remains concerned about the current surge. Researchers estimate that every year, there are between 1.3 and 4 million cases and 21,000 to 143,000 deaths worldwide due to the infection.

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Former president of the Caribbean Hotel and Tourism and Association (CHTA) Patricia Affonso-Dass believes the 41st annual Caribbean Travel Marketplace, to be held in Barbados May 9-11, can be a defining moment for the travel trade body.

The Barbados-based hotelier, who runs Ocean Hotels Group on the island, said Caribbean Travel Marketplace has special significance this year because “it represents and showcases our region’s and association’s ability to transform, change and reinvent to meet the ever-changing needs, demands and realities of this dynamic industry.”

For only the second time in its history, the event will be hosted in the Eastern Caribbean.

Affonso-Dass noted that the new format of the event provides the opportunity for hoteliers and tourism stakeholders not only to connect with hospitality buyers and suppliers across the region, but also to “highlight the link with artisans, manufacturing, agriculture and the smaller but critically important players that make up the fabric of Caribbean tourism.”

Affonso-Dass, who served as CHTA president from 2018 to 2020, stated that the 33 Caribbean destinations comprising the association reflect different cultures, languages, cuisines and a phenomenal collection of experiences.

“Caribbean Travel Marketplace allows us to bring this all together and showcase the region to our partners and the world in a way that is very difficult to do individually,” said Affonso-Dass, who was born in Dominica, raised in Guyana, and now lives in Barbados.

“Each of our members is unique, special and compelling, but all together this region represents tremendous value and importance not just to our individual economies, but also to the revenues of the partners who sell the Caribbean – both land-based and cruise,” remarked the respected hotelier, as she invited the world to come and do business at Marketplace 41 in Barbados.

Marketplace will be preceded by the second annual Caribbean Travel Forum and will be held at the Lloyd Erskine Sandiford Centre.

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