Food For Thought

The Rights of Women are the Foundation for Development

“Investing in women is the best investment we can make in any country. And investing in the Haitian women will fuel the long-term economic recovery and progress, not only for them, but for their families.

— Hillary Clinton, Haiti Donor’s Conference, United Nations, New York, March 31, 2010

By Donna Shaver

On January 12, 2010, Haiti experienced a catastrophic earthquake measuring 7.0 near the capital city of Port-au-Prince.  An estimated 316,000 people died and three million were affected.  An estimated 250,000 residences and 30,000 commercial buildings collapsed or were severely damaged.  Three years have passed, and there is little progress.  According to a recent report in The New York Times, “despite billions of dollars spent – and billions more allocated for Haiti but unspent – rebuilding has barely begun and 357,785 Haitians still languish in 496 tent camps”.

Haiti’s record with regard to protecting women and girls, much less investing in them, has been dismal.  Traditional roles are still the norm, and gender-based violence is common.  Little is done to protect women or to bring the perpetrators to justice.  Discrimination and violence against women are exacerbated in the wake of disaster. It is a prime opportunity for sex trafficking in the chaos that leaves many women and children without family protections.  And because the reconstruction pace is glacial, women continue to be especially vulnerable to violence in the camps. Of the $7.5 billion disbursed so far, only $215 million has spent on the most pressing need for women:  safe, permanent housing.

According to the United Nations Population Fund (UNFPA), “Before the quake, Haiti was the most dangerous place to be pregnant in the Western Hemisphere, with the lifetime risk of dying in childbirth 1 in 47.”  While all women and girls are at greater risk during the disaster and its aftermath, pregnant women are perhaps the most vulnerable.  This month, Dining for Women turns its attention maternal health in Haiti.  We will be providing support for Midwives For Haiti, an organization working hard to expand the number and accessibility of trained midwives, especially in the more remote areas of the country.   (To find out more about this wonderful program, see the “Midwives For Haiti, Program Fact Sheet for February 2012.)

UN Millennium Development Goals



Goal 4:  Reduce Child Mortality

Target:  Reduce by two thirds, between 1990 and 2015, the under-five

mortality rate


According to the UN Millennium Development Goals Report 2012, the under-five child mortality rate (number of child deaths per 1,000 live births) in Latin America and the Caribbean has declined from 54 in 1990 to 23 in 2010.   But according to UNICEF, the child mortality rate in Haiti has gone up, from 151 in 1990 to 165 in 2010.  Haiti now has the 7th highest rate of child mortality in the world.




Goal 5:  Improve maternal health

Target 5.A:  Reduce by three quarters the maternal mortality index


According to the UN MDG Report 2012, the maternal mortality rate (number of maternal deaths per 100,000 live births) in the Caribbean as a whole for 2010 was 190.  However, the figure for Haiti was 350—the highest rate in the western hemisphere.  It is quite likely that the actual figure is higher yet, given the disruption in the country following the earthquake and the fact that much of Haiti is rural, with little in the way of skilled birth attendants or midwives, and poor infrastructure such as roads.


Target 5.B:  Achieve universal access to reproductive health


  • Increase the proportion of women (15-49 years old) attended at least once by skilled health personnel during pregnancy:  Health care during pregnancy is vitally important in detecting and managing conditions that may complicate pregnancy and childbirth.  Basic antenatal care provides women with a package of preventive interventions, including nutritional advice.  In Haiti, as noted above, basic care is difficult to access, especially in the rural areas.  These needs are unlikely be addressed by the Haitian government in the near term because resource constraints brought about by the earthquake will continue for many years to come.


  • Reduce the number of births per 1,000 women aged 15-19:  In Haiti, it is legal for girls to marry at age 15, so there is no impediment to marriage in this age group–inadvisable though it may be.  According to UNICEF, 30% of Haitian women between 20 and 24 were married before age 18.  With little or no access to contraception, the exceedingly high rate of rape, and the necessity for many girls to engage in survival sex, the likelihood is that births are actually going up in this age group.


  • Increase proportion of women who are using any method of contraception among women aged 15-49, married or in a union:  About 80% of Haitians rank as extremely poor, so without access to free contraception, this is likely to remain an elusive goal.


In post-earthquake Haiti, Human Rights Watch found that three types of delay contribute to pregnancy-related mortality:

  • Delay in deciding to seek appropriate medical care
  • Delay in reaching an obstetric facility
  • Delay in receiving adequate care when reaching a facility


Many women and girls didn’t recognize the early signs of labor, lacked familiarity with a location, were concerned with distance, security, or cost of transportation, or found inadequate facilities.  They didn’t know what services were available to them in the camps.    Over half of those who have given birth since the earthquake had done so outside a medical facility and without a skilled birth attendant.  According to UNFPA in January 2012, only 25% of all deliveries occur in health institutions.


Residents in the camps also told HRW that deaths in the camps went unregistered, regardless of cause.  Therefore, deaths, due to pregnancy and childbirth, as well as the deaths of newborns and small children, go unrecorded.


Food is scarce in the camps, and so another factor in maternal mortality in Haiti may be lack of enough food, and food of sufficient quality, for pregnant women and later for their babies.


Other issues related to reproductive health are the growing frequency of occurrences of obstetric fistula when skilled birth attendants are not available or accessible, and the health consequences of botched abortions.  (Abortion is illegal in Haiti, so almost all abortions are done without trained medical help.)


(To learn more about maternal health and maternal mortality, see “Healthy Women Bearing Healthy Children Build Healthy Communities”, Food for Thought, November 2012, pp1,3-4.)



Haiti:  Human Development and Gender Equality

Haiti was the first independent nation in the Latin America and Caribbean region, and the first black-led republic in the world, gaining independence in 1804.  According to the Human Development Report 2011 from the United Nations Development Programme, Haiti ranks 158th out of 187 countries on the Human Development Index, a measure for assessing long-term progress in three basic dimensions of human development: a long and healthy life, access to knowledge and a decent standard of living.  On the Gender Inequality Index, which measures reproductive health, empowerment, and economic activity, Haiti ranks 123rd out of 146 countries.


Women’s Rights

Over the years, Haiti has signed a number of international agreements on human rights:

  • International Covenant on Civil and Political Rights (1966)
  • Convention on the Elimination of All forms of Discrimination Against Women (1981)
  • Inter-American Convention on the Prevention, Punishment and Eradication of Violence Against Women  (1997).


But with regard to the status, rights, and treatment of women and girls, being party to these international agreements seems to have had little or no effect. Gender-based discrimination and violence have always been the norm. It is estimated that eight in ten Haitian women have been the victims of domestic abuse.


In 1994, Haiti established a Ministry for the Status of Women (now the Ministry for Women’s Affairs and Women’s Rights).


The 1987 Haitian constitution guarantees equal rights of citizenship for men and women, but does not specifically outlaw gender discrimination.  Haiti is a highly patriarchal society, and men and women have traditional social roles.  The man is the economic decision-maker.  The roles are especially entrenched in rural areas.   According to Haitian law, spouses have equal rights, but the husband’s views take precedence in the event of a conflict.   There are many consensual, but unregistered, unions.  Married Haitian women have legal rights of inheritance, but women in consensual unions are deprived of inheritance rights, even to property acquired jointly.


Gender violence of all kinds is incredibly common.  Rape did not become a crime until 2005.  Before that, it was considered a “moral offense”.  Shame kept most women from reporting rapes and from getting any follow-up medical care.   Shame and victim-blaming continues, and gender violence has skyrocketed in the camps.  Many women do not even have tents.  Women and girls are raped—sometimes gang raped, sometimes savagely beaten, and often threatened with their lives for reporting the violence.  Even toddlers have been raped.


In the earthquake, many thousands of prisoners either escaped or were released from prisons and jails.  Records were destroyed, and few of the felons have been apprehended.  Hundreds, if not thousands, of violent offenders are living in the camps.  Many rapes have been attributed to them.


However, there are Haitian grassroots women’s groups that have been working to support and advocate for rape victims in the camps.  They have been involved in installing lights near shower and toilet facilities, and setting up escort services for women to and from the facilities.


  • KOFAVIV was founded by and for rape survivors in the poorest areas of Port-au-Prince.  With over 1,000 members working in the camps, they improve security and support victims–providing escorts, lighting and security patrols, and introducing a whistle alert system women can use to call for help. Trained women in the camp respond.  Reports indicate that the whistle alert system frightens away perpetrators and therefore decrease the incidence of sexual violence.


  • FAVILEK is another grassroots women’s group from Port-au-Prince, formed following the coup d’état in 1991, by women who were victims of sexual violence during the military dictatorship.  (Haiti has a long history of rape as a weapon against political enemies, done on an epic scale during the Duvalier dictatorships and in the conflict over the successor Jean-Betrand Aristide.)  FAVILEK continues to fight for equality and justice for Haitian women, using the medium of theatre to promote their cause.


The Institute for Justice & Democracy in Haiti (Bureau es Avocats Internationaux) works closely with Haitian partners in a variety of ways to exercise their rights, including help in pursuing legal cases.  They cite efforts to fight rape in the Internally Displaced Persons (IDP) camps.  In last summer’s trial sessions in Port-au-Prince, 22 were for rape.  Of the 14 publicly known verdicts, 13 were convictions and only one acquittal.   It is heartening to know that there are beginning to be some consequences for rape.


The Haitian Ministry for Women’s Affairs and Women’s Rights is in the process of finalizing draft legislation addressing violence against women, which may start to help women secure justice.


Survival Strategies

Many women were widowed by the earthquake–and may have dependent children to care for.  In addition they have had their means of livelihood destroyed.  Many girls were orphaned.  Women and girls can be driven to engage in survival sex—forming a relationship with a man who has some means of support or selling their bodies to buy food and other necessities.  In the former case, there are many stories of women being abandoned once they become pregnant.  But even before the 2010 earthquake, many women were on their own.  Some 42% of Haitian households were headed by women.

(Internally Displaced Persons (IDPs), such as the Haitian people in post-earthquake camps, are faced with issues much like refugees from armed conflict or natural disaster.  To learn more about these challenges for girls, see “Vulnerable Refugee to Confident Girl through Protection & Education”, Food for Thought, January 2013, pp1, 3-5.)



The practice of poor families giving children away, usually to more financially secure relatives–but sometimes to comparative strangers–is known in Creole as “restavek or restavec” from the French words rester avec, meaning “to stay with.”  This is a traditional practice in Haiti.  The intention may be to ensure that the child will be fed and educated, but the effect is to turn the child into a virtual slave.  Restaveks are often responsible for doing all the household chores, cooking, caring for small children, hauling water, etc.   Many are made to sleep on the floor, are not allowed to go to school, and frequently sexually abused.  Most of them are girls.  The International Labour Organisation estimates of the number of restaveks at 300,000—one in 10 Haitian children.  Children who were orphaned by the earthquake have been trafficked as restaveks, both within Haiti and abroad.  Restaveks are frequently malnourished.  The average 15-year-old restavek is 4cm shorter and 20 kg lighter than the average Haitian child.



Education has not been a priority for Haiti.  The following statistics, compiled by Partners in Health, illustrate that point clearly:

  • 50% of primary age children are not in school
  • One third of girls over six never go to school
  • Approximately 30% of children attending primary school will not make it to third grade
  • 60% will abandon school before sixth grade



Shortly after the earthquake, there was much discussion of the importance of addressing the issues of women and girls within the context of the reconstruction—that a gender component needed to be included in each facet of reconstruction, including such issues property rights.   Over time, those initial commitments were lost in the urgency of reconstruction, with an attitude that ‘we can deal with these issues later’.


UN Women is working with counterparts in Haiti to stop violence against women, expand economic options for women, and increase space for women to participate in decisions that affect them.  There is also a vibrant women’s movement in Haiti.  Efforts of a variety of NGOs, international organizations, and committed women in Haiti are the engine of change—in attitudes, laws, and behavior.  Midwives For Haiti is one of the contributors to improving the lives of women in Haiti.