Neomodern Insecurity in Haiti and the Politics of Asylum

The term ‘asylum’ has a dual connotation that generates opposing but related forms of intervention: providing sanctuary and protection vs. imposing confinement and quarantine. The proliferation of “neomodern insecurity”—intrastate violence and the specter of transnational terrorism, arising within many postcolonial, postauthoritarian and postsocialist states—generates intervention practices that reflect the dual connotations of asylum. In fragile states like Haiti, national insecurity (ensekirite) often results in the flight of traumatized populations across and within national borders. For these individuals, ‘asylum’ connotes the attainment of political recognition and inclusion outside Haiti’s space of ensekirite. Ironically, these vulnerable persons may be viewed as threats to the nations they seek to enter. In so-called secure states like the United States, the threat of insecurity often engenders interventions to contain, manage and rehabilitate states of disorder, as well as their disordered subjects. By chronicling the case of a young Haitian refugee who sought asylum in the United States, was detained and then repatriated after manifesting the disordered signs of insecurity, I argue that the Haitian trope of ensekirite captures and prefigures the subjective experience of neomodernity, one for which there is no asylum.     

Dengue Virus Infections among Haitian and Expatriate Non-governmental Organization Workers — Léogane and Port-au-Prince,Haiti, 2012

In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves.     

Fighting for survival.

The political crisis in Haiti has had a severe impact on the health of the population. Mortality among Haitians is 13 per 1000, much higher than the Latin American rate of seven per 1000, and the incidence of AIDS, tuberculosis, and malnourishment is increasing among children. Although food and medicine are exempt, United Nations sanctions have had a negative impact on most of the population. In particular the embargo on fuel has limited most people''s access to health care. The difficulties of distributing aid and health care without softening the embargo on fuel are immense, and the health of Haitians is not likely to improve until the political crisis is resolved.     

Obesity and Awareness of Obesity as Risk Factors for Breast Cancer in Six Ethnic Groups

Objective: To document BMI and knowledge regarding obesity as a risk factor for breast cancer among subpopulations of African‐, Caribbean‐, and European‐American women and to consider the variables predicting obesity in these diverse groups. Research Methods and Procedures: A stratified cluster‐sampling plan was used to recruit 1364 older women from Brooklyn, NY, during 2000–2002. Two groups were born in the United States (African Americans and European Americans), whereas others were from the English‐speaking Caribbean, Haiti, the Dominican Republic, and Eastern Europe. Participants provided demographics, height and weight measures, and estimates of the risk obesity posed for breast cancer. Results: Women from all groups were significantly overweight (BMI > 25 kg/m²), although European Americans were lowest, followed by Dominicans and Haitians; African‐American and English‐speaking Caribbean women fell into the obese range, even when background variables were controlled. Knowledge of obesity as a breast cancer risk factor was also poor across groups, but Dominicans and Haitians had the lowest scores on knowledge. Importantly, knowledge was not associated with BMI in the overall sample, even when controlling for demographics and ethnicity, although logistic regressions comparing normal weight women with overweight and obese groupings suggested some knowledge of breast cancer risk in the overweight, but not the obese, group. Discussion: The findings remind health professionals of the need to consider more specific ethnic groupings than has hitherto been the case, as well as consider how ethnic and cultural variables may influence perceptions of obesity and its relation to cancer risk.     

Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis

Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country’s population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access to services influences outcomes.     

Organic farming at local and landscape scales benefits plant diversity

Agri‐environment schemes (AES) have been suggested to counter negative effects of agricultural intensification and enhance farmland biodiversity, but evaluations have produced inconsistent results. We suggest that this is partly a consequence of scale‐dependence, i.e. that the consequence of organic farming will differ depending on the scale of uptake in a particular landscape. To test our hypothesis on diversity of forbs, we designed a landscape scale study using spatially explicit information about the Swedish AES for organic farming. The study system consisted of uncultivated field borders along paired fields (organic and conventional) in matched landscapes with either a high or a low proportion of organic faming, allowing separate tests of the effects of farming practice at the local and the landscape scale. The local effect of organic farming was consistently strong, with higher diversity in borders adjoining organic fields, most likely due to the lack of herbicide use on organically managed farmland. Thus, we show that not only the proportion of semi‐natural habitat is important for farmland biodiversity, but that also the management of cropland can influence the diversity in semi‐natural habitats. Furthermore, forb richness was also higher in borders situated in landscapes with a high proportion of organic land, irrespectively of local management, possibly as a result of dispersal of mainly annual plant species from the organically managed fields into the borders (mass effect). Our results demonstrate that farming practice at a local and a landscape scale independently can influence plant species richness, indicating that organic farming can influence diversity also at larger spatial scales and outside the organically managed land. Our study highlight the importance of studying multiple scales, including both local and landscape factors to provide a better understanding of biodiversity patterns.     

From Posttrauma Intervention to Immunization of the Social Body: Pragmatics and Politics of a Resilience Program in Israel’s Periphery

This article traces a critical change in the professional therapy of posttraumatic stress disorder (PTSD): from treatment of a disorder borne by individuals to treatment of an anticipated disorder to be prevented by fortifying the entire population. A community resilience program in the city of Sderot in southern Israel, which has been subjected to Qassam rockets by its Palestinian neighbors across the border, serves as our case study. Drawing on an ethnographic study of this new therapeutic program, we analyze how the social body that the professionals attempt to immunize against trauma was treated. In particular, we follow the various practices used to expand the clinical. We found that the population was split into several groups on a continuum between the clinical and the preclinical, each receiving different treatment. Moreover, the social body managed according to this new form of PTSD was articulated through ethnic and geopolitical power relations between professionals from the country’s center and professionals from its periphery, and between the professionals and the city’s residents. Finally, we discuss how this Israeli case compares with other national sites of the growing globalization of PTSD, like Bali, Haiti and Ethiopia, which anthropologists have been exploring in recent years.     

Ethnicity,assimilation and nation in plural Suriname

Insecurity theory states that religiosity is predominantly affected by insecurities experienced during childhood, instead of present insecurities. The empirical research of these aspects, however, has been hampered by the difficulty to disentangle past and present contextual effects. In this respect, first-generation migrants offer an interesting case study that allows us to discern: (1) contextual effects experienced during childhood (i.e. associated with the origin country); (2) contextual effects experienced during later life (i.e. associated with the destination country); and (3) individual effects experienced during later life in the destination country. We test hypotheses using the European Social Survey (ESS) in cross-classified multi-level analyses on 5,900 individuals within on the one hand twenty-five destination countries and on the other 146 origin countries. While insecurity theory offers interesting prospects of explaining origin country variance, the applicability of insecurity theory to migrants at the individual and destination level is questioned by the results.     

How much do we really lose?—Yield losses in the proximity of natural landscape elements in agricultural landscapes

Natural landscape elements (NLEs) in agricultural landscapes contribute to biodiversity and ecosystem services, but are also regarded as an obstacle for large‐scale agricultural production. However, the effects of NLEs on crop yield have rarely been measured. Here, we investigated how different bordering structures, such as agricultural roads, field‐to‐field borders, forests, hedgerows, and kettle holes, influence agricultural yields. We hypothesized that (a) yield values at field borders differ from mid‐field yields and that (b) the extent of this change in yields depends on the bordering structure. We measured winter wheat yields along transects with log‐scaled distances from the border into the agricultural field within two intensively managed agricultural landscapes in Germany (2014 near Göttingen, and 2015–2017 in the Uckermark). We observed a yield loss adjacent to every investigated bordering structure of 11%–38% in comparison with mid‐field yields. However, depending on the bordering structure, this yield loss disappeared at different distances. While the proximity of kettle holes did not affect yields more than neighboring agricultural fields, woody landscape elements had strong effects on winter wheat yields. Notably, 95% of mid‐field yields could already be reached at a distance of 11.3 m from a kettle hole and at a distance of 17.8 m from hedgerows as well as forest borders. Our findings suggest that yield losses are especially relevant directly adjacent to woody landscape elements, but not adjacent to in‐field water bodies. This highlights the potential to simultaneously counteract yield losses close to the field border and enhance biodiversity by combining different NLEs in agricultural landscapes such as creating strips of extensive grassland vegetation between woody landscape elements and agricultural fields. In conclusion, our results can be used to quantify ecocompensations to find optimal solutions for the delivery of productive and regulative ecosystem services in heterogeneous agricultural landscapes.     

Livelihood diversification and implications on dryland resources of central Tanzania

The concern over sustainable livelihoods in African drylands is an issue that has received considerable attention from researchers and policy makers alike. Over the past two decades African rural areas have undergone rapid changes, whereby, rural income diversification has become the most salient feature. With a particular focus on dryland ecosystems, among the major challenges facing communities in these areas is recurrent drought leading to conditions of food insecurity. This paper draws on experience on coping mechanisms for food insecurity from an agro-pastoral community in Mvumi, located in the semiarid areas of central Tanzania. An understanding of livelihoods of people in this area has involved examining how communities have managed to adjust their livelihood in the midst of challenges resulting not only from drought but also from various forces such as socio–economic, political and ecological factors. It has been found out that, despite profound food crisis in this area, people are not always desperate and that there are possibilities for realizing some hidden potentials of dryland resources for livelihood diversification. The issue of sustainable natural resource management in such areas is, however, questionable because of some adverse environmental effects associated with some of the coping mechanisms.     

Dry land drowning or rip current survival? Haitians without status in the Bahamas

Recent scholarship contends that collective action emerges when human rights are violated. This article investigates why Haitians without status in the Bahamas have yet to mobilize collectively for basic rights and protections, despite discrimination and exploitation. The article examines two analogies to explain their immobilization. The analogy of dry land drowning utilizes Goffman's Stigma (1963) framework to describe how social prejudice hinders the ability of Haitians without status to act, while the analogy of rip current survival explains how institutional drawbacks pull Haitians without status away from movement activity through a political process analysis. The article contends that both interpretations are inadequate when taken alone and provides suggestions for future research into Bahamian-Haitian relations.     

Features of Child Food Insecurity after the 2010 Haiti Earthquake: Results from Longitudinal Random Survey of Households

Background

Recent commentary on the health consequences of natural disasters has suggested a dearth of research on understanding the antecedents prior to the disaster that are associated with health consequences after the disaster. Utilizing data from a two-wave panel survey of Port-au-Prince, Haiti, conducted just prior to and six weeks after the January 2010 earthquake, we test factors prior to the quake hypothesized to be associated with food insecurity after the quake.

Methods

Using random Global Positioning System (GPS) sampling, we re-interviewed 93.1% (N = 1732) of the original 1,800 households interviewed in 2009. Respondents were queried with regard to mortalities, injuries, food security, housing, and other factors after the quake.

Findings

Child food insecurity was found to be common on all three indices of food security (17.2%–22.6%). Additionally, only 36.5% of school-aged children were attending school prior to the quake. Findings suggest that prior schooling was associated with a substantial reduction on food insecurity indices (OR 0.62–0.75). Findings further suggest that several household characteristics were associated with food insecurity for children. Prior chronic/acute illnesses, poor living conditions, remittances from abroad, primary respondent mental health, and histories of criminal and other human rights violations committed against family members prior to the quake were associated with food insecurity after the earthquake. Earned household income after the quake was only associated with one of the measures of food insecurity.

Interpretation

Food insecurity for children was common after the quake. Those households vulnerable on multiple dimensions prior to the quake were also vulnerable to food insecurity after the quake. Remittances from abroad were leading protective factors for food security. Because Haiti is well known for the potentiality of both hurricanes and earthquakes, reconstruction and redevelopment should focus on ameliorating potential vulnerabilities to poor outcomes in these natural disasters.     

Status competition,inequality, and fertility: implications for the demographic transition

The role that social status plays in small-scale societies suggests that status may be important for understanding the evolution of human fertility decisions, and for understanding how such decisions play out in modern contexts. This paper explores whether modelling competition for status—in the sense of relative rank within a society—can help shed light on fertility decline and the demographic transition. We develop a model of how levels of inequality and status competition affect optimal investment by parents in the embodied capital (health, strength, and skills) and social status of offspring, focusing on feedbacks between individual decisions and socio-ecological conditions. We find that conditions similar to those in demographic transition societies yield increased investment in both embodied capital and social status, generating substantial decreases in fertility, particularly under conditions of high inequality and intense status competition. We suggest that a complete explanation for both fertility variation in small-scale societies and modern fertility decline will take into account the effects of status competition and inequality.     

The exotic and the mundane

The HIV/AIDS epidemic in Haiti has often been referred to as a “mystery,” and “striking similarities” between patterns of disease in Haiti and in sub-Saharan Africa are often underlined. The occurrence of AIDS in Haitians has also led to the postulation of a number of theories positing a Haitian origin for AIDS and linking the syndrome in Haitians to voodoo. A review of the epidemiological data gathered and published in the early years of the pandemic suggests that these “exotic” theories are not necessary to explain the Haitian epidemic, which is clearly linked not to Africa but to the United States. Patterns of risk identified among many of the first Haitians with AIDS are similar to risk factors identified in North America and Europe (same-sex contact with an HIV-infected individual and blood transfusion). The Haitian epidemicsubsequently came to resemble patterns seen in sub-Saharan Africa, where AIDS is predominantly a heterosexually transmitted disease. Similarly shifting patterns are described for several other Caribbean nations, underlining the importance of a historical analysis of the Caribbean pandemic as well as the necessity to link analysis of local epidemiology of AIDS/HIV to larger considerations of political economy.     

Food Insecurity as a Barrier to Sustained Antiretroviral Therapy Adherence in Uganda

Background

Food insecurity is emerging as an important barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, but little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions.

Methodology

We conducted in-depth, open-ended interviews with 47 individuals (30 women, 17 men) living with HIV/AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interferes with ARV therapy regimens. Interviews were transcribed, coded for key themes, and analyzed using grounded theory.

Findings

Food insecurity was common and an important barrier to accessing medical care and ARV adherence. Five mechanisms emerged for how food insecurity can contribute to ARV non-adherence and treatment interruptions or to postponing ARV initiation: 1) ARVs increased appetite and led to intolerable hunger in the absence of food; 2) Side effects of ARVs were exacerbated in the absence of food; 3) Participants believed they should skip doses or not start on ARVs at all if they could not afford the added nutritional burden; 4) Competing demands between costs of food and medical expenses led people either to default from treatment, or to give up food and wages to get medications; 5) While working for food for long days in the fields, participants sometimes forgot medication doses. Despite these obstacles, many participants still reported high ARV adherence and exceptional motivation to continue therapy.

Conclusions

While reports from sub-Saharan Africa show excellent adherence to ARVs, concerns remain that these successes are not sustainable in the presence of widespread poverty and food insecurity. We provide further evidence on how food insecurity can compromise sustained ARV therapy in a resource-limited setting. Addressing food insecurity as part of emerging ARV treatment programs is critical for their long-term success.     

Managing Managed Care: Habitus, Hysteresis and the End(s) of Psychotherapy

In this paper we examine how clinicians at acommunity mental health center are respondingto the beginnings of changes in the health caredelivery system, changes that are designatedunder the rubric of ``managed care.' Wedescribe how clinicians' attitudes about goodmental health care are embodied in whatsociologist Pierre Bourdieu calls theirhabitus, i.e., their professional habits andsense of good practice. Viewed in this light,their moral outrage and sense of threat, aswell as their strategic attempts to resist orsubvert the dictates of managed care agencies,become a function of what Bourdieu terms thehysteresis effect. The paper is based onethnographic fieldwork conducted by a team ofresearchers at the mental health and substanceabuse service of a hospital-affiliated,storefront clinic which serves residents ofseveral neighborhoods in a large northeasterncity. Data consist primarily of observationsof meetings and interviews with staff members. We describe four aspects of the clinicians'professional habitus: a focus on cases asnarratives of character and relationship, animperative of authenticity, a distinctiveorientation towards time, and an ethic ofambiguity. We then chronicle practices thathave emerged in response to the limits on careimposed by managed care protocols, which areexperienced by clinicians as violating theintegrity of their work. These are discussedin relation to the concept of hysteresis.     

Species' borders and dispersal barriers

Range limits of species are determined by combined effects of physical, historical, ecological, and evolutionary forces. We consider a subset of these factors by using spatial models of competition, hybridization, and local adaptation to examine the effects of partial dispersal barriers on the locations of borders between similar species. Prompted by results from population genetic models and biogeographic observations, we investigate the conditions under which species' borders are attracted to regions of reduced dispersal. For borders maintained by competition or hybridization, we find that dispersal barriers can attract borders whose positions would otherwise be either neutrally stable or moving across space. Borders affected strongly by local adaptation and gene flow, however, are repelled from dispersal barriers. These models illustrate how particular biotic and abiotic factors may combine to limit species' ranges, and they help to elucidate mechanisms by which range limits of many species may coincide.     

Immunologic findings in healthy Haitians in Montreal

To investigate the occurrence of acquired immune deficiency syndrome in Haitians, a health status questionnaire was administered and selected studies of immune status done in a randomly chosen sample of 189 healthy adult Haitians living in Montreal. The study group was comparable to a large sample of Haitians in Montreal interviewed in the 1981 census with respect to age, sex, number of persons per household and year of immigration, but the proportion of currently married people in the study was larger (60.8% v. 42.6%). The results in the study group were compared with those in a sample of 189 non-Haitians matched for age, sex and neighbourhood of residence. Persons with known causes of impaired immune function were excluded. The participation rate was 87.5%. The study and control groups both reported few symptoms and chronic health problems and had comparable demographic data, including rate of employment and income. The mean total numbers of lymphocytes, OKT3 and OKT4 (helper) and OKT8 (suppressor) cells were significantly higher in the Haitians than in the controls, though still within normal limits. There was a borderline elevation of the lymphocyte response to phytohemagglutinin in the Haitians. The ratios of helper to suppressor T cells in the two groups were, however, not significantly different. The Haitians, in comparison with non-Haitians living in the same community, had no demonstrable abnormalities of cellular immune function.     

Mansonelliasis,a neglected parasitic disease in Haiti

Reported in Haiti as early as 1923, Mansonella ozzardi is still a neglected disease ignored by the health authorities of the country. This review is an update on the geographic distribution of the coastal foci of mansonelliasis in Haiti, the epidemiological profile and prevalence rates of microfilariae in people living in endemic areas, the clinical impact of the parasite on health and the efficiency of the transmission of the parasite among three Culicoides biting-midge species identified as vectors in Haiti. Additionally, interest in establishing a treatment programme to combat this parasite using a single dose of ivermectin is emphasised.     

Beekeeping practices and geographic distance,not land use,drive gene flow across tropical bees

Across the globe, wild bees are threatened by ongoing natural habitat loss, risking the maintenance of plant biodiversity and agricultural production. Despite the ecological and economic importance of wild bees and the fact that several species are now managed for pollination services worldwide, little is known about how land use and beekeeping practices jointly influence gene flow. Using stingless bees as a model system, containing wild and managed species that are presumed to be particularly susceptible to habitat degradation, here we examine the main drivers of tropical bee gene flow. We employ a novel landscape genetic approach to analyse data from 135 populations of 17 stingless bee species distributed across diverse tropical biomes within the Americas. Our work has important methodological implications, as we illustrate how a maximum‐likelihood approach can be applied in a meta‐analysis framework to account for multiple factors, and weight estimates by sample size. In contrast to previously held beliefs, gene flow was not related to body size or deforestation, and isolation by geographic distance (IBD) was significantly affected by management, with managed species exhibiting a weaker IBD than wild ones. Our study thus reveals the critical importance of beekeeping practices in shaping the patterns of genetic differentiation across bee species. Additionally, our results show that many stingless bee species maintain high gene flow across heterogeneous landscapes. We suggest that future efforts to preserve wild tropical bees should focus on regulating beekeeping practices to maintain natural gene flow and enhancing pollinator‐friendly habitats, prioritizing species showing a limited dispersal ability.