Human rights abuse and
other criminal violations in Port-au-Prince, Haiti
The Lancet (firstname.lastname@example.org)
Please mention The Lancet as the source of this material
Issued by Udani Samarasekera, Press Officer, The Lancet
Telephone: +44 (0)20 7424 4949/4249 EARLY ONLINE PUBLICATION:
Thursday August 31, 2006 EMBARGO: 00:01H (London time)
Thursday August 31, 2006
HUMAN RIGHTS ABUSES FREQUENT IN HAITI’S CAPITAL
Human rights violations—including murders, sexual assaults,
and kidnapping—were common in Port-au-Prince, Haiti’s
capital city, after the departure of the democratically elected
President in 2004, according to an Online/Article published by
In February 2004, armed rebels overthrew Jean-Bertrand Aristide.
Since then, reliable evidence of the frequency and severity of
abuses has been scarce. Neither the UN nor the Haitian government
have had a firm estimate of the numbers or perpetrators of violations,
with claims ranging from several hundred to more than 100000 incidents.
Supporters of Aristide, the interim government, and foreign peacekeeping
troops were accused of abuse.
Royce Hutson and Athena Kolbe of Wayne State University, Detroit,
USA, did a random survey of households in the greater Port-au-Prince
area of Haiti. Participants were asked if they or anyone in their
household had suffered any human rights violations such as murders,
rapes, extra-judiciary arrests, larceny, or physical assaults
in the 22-month period from February 2004 to December 2005. They
were asked the date and location of incidents, as well as the
perpetrator. The results showed human rights abuses were frequent
occurrences. The estimates suggest about 8000 individuals (around
12 per day) were murdered during the period, and sexual assault
was common, especially against children, with the data suggesting
35000 women and girls were raped in the greater Port-au-Prince
area. Criminals, the Haitian National Police, and UN peacekeepers
were frequently identified as perpetrators.
The authors conclude: “The frequency of human-rights violations,
and especially the prevalence of sexual violence against women,
demands a serious and thorough response from the international
community, the new Haitian government, and non-governmental organisations
working in the region. The new administration should take steps
to stop any ongoing human-rights abuses through various domestic
and international systems.”
Human Rights Abuses Frequemt
in Haiti's capital after ouster of Aristide - Lancet research
study shows 8,000 murders in Haiti's capital alone, with 35,000
rapes and sexual assault in the greater Port-au-Prince area during
the US-backed regime, after Aristide's ouster, more than hald
of the victims were Haitian children
by Athena Kolbe and Dr. Royce Hutson of Wayne State University
of Detroit, USA (The Lancet, www.thelancet.com)
Published on-line, August 31, 2006
Human rights abuse and other criminal violations in Port-au-Prince,
Haiti: a random survey of households
by Athena R Kolbe, Royce A Hutson
Published Online August 31, 2006
DOI:10.1016/S01406736(06)69211-8 Wayne State University, School
of Social Work, Thompson Home, 4756 Cass Avenue, Detroit, MI 4802,
USA (R A Hutson PhD, A R Kolbe MSW)
Dr Royce A Hutson email@example.com
Background Reliable evidence of the frequency and severity of
human rights abuses in Haiti after the departure of the elected
president in 2004 was scarce. We assessed data from a random survey
of households in the greater Port-au-Prince area.
Using random Global Positioning System (GPS) coordinate sampling,
1260 households (5720 individuals) were sampled. They were interviewed
with a structured questionnaire by trained interviewers about
their experiences after the departure of President Jean-Bertrand
Aristide. The response rate was 90·7%. Information on demographic
characteristics, crime, and human rights violations was obtained.
Our findings suggested that 8000 individuals were murdered in
the greater Port-au-Prince area during the 22-month period assessed.
Almost half of the identified perpetrators were government forces
or outside political actors. Sexual assault of women and girls
was common, with findings suggesting that 35 000 women were victimised
in the area; more than half of all female victims were younger
than 18 years. Criminals were the most identified perpetrators,
but officers from the Haitian National Police accounted for 13·8%
and armed anti-Lavalas groups accounted for 10·6% of identified
perpetrators of sexual assault. Kidnappings and extrajudicial
detentions, physical assaults, death threats, physical threats,
and threats of sexual violence were also common.
Our results indicate that crime and systematic abuse of human
rights were common in Port-au-Prince. Although criminals were
the most identified perpetrators of violations, political actors
and UN soldiers were also frequently identified. These findings
suggest the need for a systematic response from the newly elected
Haitian government, the UN, and social service organisations to
address the legal, medical, psychological, and economic consequences
of widespread human rights abuses and crime
Published online August 31, 2006 DOI:10.1016/S0140-6736(06)69211-8
In February, 2004, an armed insurrection overthrew Jean Bertrand
Aristide, the democratically elected president of the Republic
of Haiti. Since that time, supporters of Aristide and Haitians
who align themselves with the movement of which he was part (Lavalas),
have accused UN troops, the Haitian National Police (HNP), personal
militias hired by private citizens, and military irregulars associated
with the disbanded Haitian army, of mounting a campaign of human
rights abuses aimed at members of the Lavalas political party.
1 Leaders in the interim Haitian government, members of the Civil
Convergence political movement opposing the Aristide government,
and other political groups have countered with claims of rampant
human rights abuses by Lavalas partisans and pro-Aristide gangs
in the country’s impoverished urban neighborhoods. 2
The number of people in Haiti who experienced human rights violations
since the departure of Aristide on February 29, 2004, was uncertain.
Claims ranging from several hundred to more than 100 000 have
been made. 3 Neither the UN, which has had a peacekeeping presence
in the country since mid-2004, nor the Haitian government, had
a firm estimate of the human rights violations that have been
committed or the identity of the perpetrators. 4 Qualitative studies
from the US State Department, 5 Human Rights Watch,6 Amnesty International,
Freedom House, and the University of Miami indicated that gross
human rights abuses had occurred and perhaps even increased in
frequency and severity under the interim Haitian government. The
human rights abuses reported included extrajudicial killings,
prolonged illegal detentions, politically motivated executions,
and physical and sexual attacks.
We aimed to use survey research to estimate the number of victims
and patterns of perpetration of human rights violations in the
population of the greater Port-au-Prince metropolitan area between
Feb 29, 2004 and December 2005.
Sampling techniques Standard random sampling techniques for survey
research, such as stratified and cluster sampling, often cannot
be used in developing countries because they require publicly
available census data or address lists. This challenge can be
overcome through advances in geographical information systems.
The availability and affordability of Global Positioning System
(GPS) locators enable random sampling of households in communities
without address lists, telephone numbers, or other household identifiers
commonly used in sampling methods. GPS locators allow the user
to identify the latitude, longitude, and altitude of their location.
GPS coordinate sampling is increasingly being used in geology,
seismology, and botany research. 10 It has also been used as a
sampling method in marketing studies and in public-health research
in rural areas 11 and war-torn countries. 12 Random GPS coordinate
sampling differs substantially from more traditional selection
techniques in that lists of addresses or other such identifiers
are not used in the selection process. Instead, selection is based
on randomly determined spatial location. The geographical boundaries
of the area examined are determined before selection, and then
GPS locations within the specified boundaries are randomly generated.
We wished to achieve a 95% CI of about plus or minus 1000 households.
Because no reliable estimates of the average size of Port-au-Prince
households were available at the time of the survey, the precision
of the sample size was calculated at the household level. Assuming
a Poisson distribution and a 10% response rate for any given violation
during the 22-month period examined (crude rate 5455 per 100 000
per year), about 1100–1200 randomly selected households
were deemed necessary. We assumed that about 15% of randomly generated
points would be uninhabited, and that 10% of the sample would
be non-responders. We therefore selected 1500 random GPS coordinates
within the boundaries of the greater Port-au-Prince area.
Simple random sampling was chosen as the preferable sampling method
for this study. Reliable data on population numbers were not available
at the time of this survey, making probability proportion to size
cluster sampling unfeasible. When a single unit dwelling was located
at the randomly generated GPS point, that household was selected.
The GPS locators were accurate to within 10 feet. When the GPS
location was not a residence, but more than one residence was
located within 20 yards, all household within 20 yards were identified
and the location to be surveyed was randomly chosen from among
all identified households. Randomisation was achieved with a technique
commonly used to choose randomly in Haitian culture (jwèt
chans). A rock was put in a bag for each household identified,
with one rock demarcated as the selector. A rock was chosen for
each household until the selector was chosen. The household whose
turn was up when the selector rock was chosen was then chosen
for the survey. When the GPS location was a multi-unit dwelling,
all households within the dwelling were identified. Random selection
was then achieved with the aforementioned technique.
For the purposes of this study, residence was defined as the permanent
home of a household. Households living in substandard structures
consisting of tin or cardboard shacks were included regardless
of whether they had a legal right to reside on the land, but only
if the structure was their primary residence, they intended to
continue living in the structure, and the structure had existed
for at least 30 days. In the event that several households were
located in one structure, the participating household was chosen
randomly using the method described above.
During a 1-month period ending Dec 24, 2005, a research team visited
each location up to four times until an adult (18 years old or
older) household member was located. The research teams consisted
of at least two people. An attempt was made to include at least
one female researcher with each team, although this was not possible
on some occasions; a male-only research team interviewed 283 of
the 1260 households (22·5%). Interviewers were university
graduates who spoke fluent Haitian Kreyol. All but one of the
interviewers was Haitian. Because of the politically polarised
nature of the human rights situation in Haiti, none of those chosen
to be research team members were politically active beyond voting
in elections. None of the interviewers were a current or past
member of the Lavalas or Lespwa political parties. Interviewers
assisted in field-testing and revision of the survey instrument.
At each residence a researcher requested an interview with the
head of the household to whom he or she explained the purposes
and risks of the study. Informed oral consent procedures were
completed for all adult household members who were present. The
survey was administered to whichever adult household member present
had had the most recent birthday. In the event that a household
member did not know his or her birthday, the adult surveyed was
randomly chosen. No material incentives were given to participants.
A researcher orally administered the survey. Respondents were
reminded periodically throughout the survey that they had the
right not to answer a question if they did not want to. Respondents
who did not feel comfortable speaking freely enough to complete
the survey at their home were allowed to choose an alternative
location in which to meet. Four respondents took advantage of
this option. This study was approved by the Wayne State University
Human Investigations Committee.
The survey began with a list of household members and their birth
year, employment status, education level, student status, and
relationship to the respondent. Interviewers also asked about
the status of the individual in the household, to ascertain that
the individual was still a part of the household and whether he
or she had resided in the home before Feb 29, 2004, or had become
part of the household after that date. Because the concept of
household is not readily understood in Haitian culture, interviewers
defined the term for respondents by saying, “Your household
is you and all the people who live in the same home with you and
with whom you share finances, food, and living space. This includes
people such as a boyfriend or girlfriend who lives with you all
the time and a friend or relative’s child that lives with
you and that you care for.”
Individuals were not included as a member of the household if
the home was not their primary residence. Household members working
as domestic servants in another location who were provided with
housing and required to live at that other location as a condition
of their employment were included in the household only if the
majority of their belongings were stored at the surveyed location,
if they had a permanent sleeping space such as a mat or bed available
to them at the surveyed location, if their income was part of
the household income, and if they intended to return to the household
at the conclusion of their employment.
Household members were only included if they resided in the house
during the 22 months studied. Murder victims were not included
in the calculation of rates of other violations. The questionnaire
queried whether the member had exited, entered, or re-entered
the household after Feb 29, 2004. However, the date of entry or
exit was not established. For the purpose of calculating crude
rates, all members were considered conservatively to be household
members for the full 22 months examined.
The main section of the survey asked respondents for retrospective
information about his or her experiences and the experiences of
other household members with human rights and crime in the 22
months since the departure of Aristide on Feb 29, 2004. Researchers
attempted to reduce errors in subject recall, particularly with
the dates of incidents, by asking probing questions and referring
to a calendar that had been filled in with the dates of significant
events that could be used by respondents to pinpoint the exact
time during which the human rights violation occurred. Categories
of acts that took place during the incident (eg, beating on the
soles of the feet) were taken from a standardised list provided
by HURIDOCS. 13
For each question regarding events experienced by the respondent,
a standard set of information was collected including the date,
the perpetrator of the violation (if known), where the event took
place, and the circumstances of the violation. For the sections
on murders, physical assaults, sexual assaults, arrests, and detentions
of household members, the same information was obtained. Additionally,
the respondent was asked what his or her relationship was to the
victim (eg, cousin, wife). The incident was then linked to the
victim, assuring that only information about people residing in
the household during the study period was recorded (and not, for
example, information about extended family members living elsewhere).
For each section of the survey, space was allocated to record
several events for the same individual.
The respondent was asked whether any household member had been
the victim of a property crime since Feb 29, 2004. Property crimes
were defined as larceny, robbery, vandalism, destruction of personal
property, and the expropriation of land or land deeds. Breaking
and entering was not recorded as a property crime unless the respondent
also reported a theft during the incident. Each respondent who
said yes was asked to provide details, including the value of
stolen or destroyed property.
Next, the respondent was questioned about arrests or detentions
by members of the Haitian National Police or foreign military.
Although being arrested is not necessary a violation, preventing
access to legal representation, not releasing those who have been
ordered free by a judge, and patterns of arbitrary arrests and
prolonged detentions can be indicative of systematic human rights
violations. Respondents who claimed that they or a member of their
household had been detained by the police or foreign soldiers
were asked to provide specific details about the event, including
whether the arrested person saw a judge within 48 h, as is mandated
by the Haitian constitution, 14 had been released, and had been
allowed to see an attorney.
Amnesty International and other international human rights organisations
described extrajudicial detentions in parts of Haiti where ex-soldiers
and armed anti-Lavalas leaders acting as de facto government agents
were arresting their opponents by abducting them and then holding
unofficial trials. 15 Respondents were asked if they or a member
of their household had been detained by anyone other than the
Haitian National Police or foreign military. Those who responded
yes were questioned about the circumstance, including the length
of time the person was held and whether they had been released.
The householder was then asked if they or a household member had
actually been physically attacked. Physical attacks were defined
for the respondent as “incidents where someone physically
harms or tortures another person on purpose”.
Respondents were also asked to detail the specific content of
the assault such as whether instruments (eg, a machete, gun, or
lit cigarette) were used and the method (eg, beating the soles
of the feet) used to hurt them. Respondents were also asked if
the assault took place while the victim was under arrest or in
Respondents were asked if they had been forced to do something
sexual or watch something sexual that they had not wanted to do
or see. Those who said yes were asked about the exact acts committed
during the sexual assault. The householder was then asked if any
household member had been sexually assaulted and the standard
questions regarding the incident.
Respondents were asked how many members of their household had
been killed since Feb 29, 2004. Only household members who were
murdered were included. Deaths due to accidents or attributable
to illness were not included. For each murdered household member,
the respondent was asked the method by which the person was killed
and the circumstances surrounding the death.
Respondents were also asked if they had been threatened with death,
physical injury, or forced sexual contact. For each section, the
number of separate incidents was recorded for each perpetrator.
Incidents of death threats that included other physical threats
were excluded from the physical threats section. In the event
that several threats had been made during the same incident, only
one threat was recorded. The same format was used for questions
about threats of death, physical injury, or forced sexual content
made to other household members.
For each section, perpetrators were grouped into seven main categories
and interviewers asked probing questions as needed to ascertain
to which group the perpetrator belonged. The categories included:
HNP, former members of the Haitian Army that was disbanded in
1995, members of an organised anti-Lavalas paramilitary group
(eg, Lame TiMachete), partisans of the unarmed anti-Lavalas political
movement (eg, Democratic Convergence, GNB, or Group of 184), members
or partisans of Lavalas, criminals, unidentified masked armed
men, foreign soldiers, and others (including neighbours, friends,
and family members). Perpetrators from the HNP were further grouped
under three subcategories: HNP officers who were wearing uniforms;
specialised security agents including HNP riot police, CIMO (Special
Forces Crowd Control), the palace security, and the HNP anti-gang
unit; and HNP officers not wearing uniforms. Foreign soldiers
were grouped on the basis of their country of origin, if known.
CIVPOL officers (blue-helmeted civilian police serving with the
HNP as part of the UN force) were coded as foreign soldiers rather
than as police officers.
Criminals were defined as individual perpetrators who were not
associated with or acting on behalf of any government or political
group. Although human rights violations are criminal acts, for
the purposes of this study human rights abuse was defined as crimes
committed by political actors. The assumption of this definition
is that these criminal acts are for political purposes. This definition
presents challenges because the motivation of an individual perpetrator
is unknown. However, whereas isolated incidences of crimes by
individual political actors might occur, when patterns of abuse
by various political actors emerge it could be concluded that
systematic human rights abuses are occurring.
Data were entered with SPSS (version 13.0). A third of all cases
were randomly selected to be double entered and then compared
with the first file to check for systematic data entry errors.
Each individual case file was then examined and compared with
the original paper documents to check for accuracy. Data examination
and organisation was done with SAS (version 9.1). Data were analysed
with SAS (version 9.1) and SPSS (version 13.0). We calculated
the number of reported homicides, physical assaults, sexual assaults,
property crimes (theft, looting, and vandalism), death threats,
threats of sexual violence, detention by government authorities,
and kidnappings. Data were calculated at both the household and
individual level. Percentages stated in the text represent proportions
of the random sample; 95% CIs are provided for the purpose of
extrapolation to the overall population. For calculating all crude
rates the following equation was used: number of incidents/number
of person-months lived in household*12*100 000. For murders, victims
were only included in the overall sample for calculation of the
crude murder rate, and not for calculations of rates of other
types of crime. Property crimes were reported at the household
level due to the structuring of the question. To estimate the
total number of victims in the region, we applied crude rates
to the estimated population of the greater Port-au-Prince area
in 2003 (2 121 000). 16 For all rates, a Poisson distribution
was assumed for the purpose of calculating the confidence intervals.
Because the sampling method was not self-weighting, households
in denser neighbourhoods might have been undersampled. Reports
suggest that a substantial proportion of human rights violations
occurred in the more densely populated regions of Port-au-Prince.
If more violations occurred in the denser communities, the sampling
method used in this survey could have resulted in an undercount
of violations. We therefore did a post-stratification analysis
to assess whether rates of victimisation for murder, sexual assault,
and physical assault differed between so-called popular zones
(dense communities in Port-au-Prince) and other zones. Rates of
adult high school graduation, age, and income were also compared
between the two types of zone.
Role of the funding source
The sponsor of the study had no role in study design, data collection,
data analysis, data interpretation, or writing of the report.
The corresponding author had full access to all the data in the
study and had final responsibility for the decision to submit
Of the 1500 sites, 32 were invalid because the location was impassable.
Another 79 sites were invalid because they were located more than
20 yards from a currently occupied residence. A final list of
1389 valid locations was established. At 51 locations, an adult
household member was present when the researchers approached the
residence but he or she refused to participate in the study. At
77 locations the residence was visited at least four times and
an adult household member was never located. One household was
removed from the dataset because the research team paid for the
medical treatment of a household member who had been sexually
assaulted. The remaining 1260 households were successfully surveyed
and remained in the dataset, giving a response rate of 90·7%.
The 1260 households interviewed accounted for 5720 residents during
the survey period. The average household size was 4·5 individuals
(95% CI 4·4–4·7). Of residents surveyed, the
median age was 25 years old with an average age of 27·0
years (SD 16·3). Residents aged younger than 16 years accounted
for 28·3% (n=1618) of the sample, while those younger than
20 years accounted for 38·4% (2198). 52·7% (3014)
of the overall sample were female.
The educational attainment of this sample was limited. Of adults
(18 years old and older), 23·2% (870) had graduated from
secondary school. However, only 15·9% (596) passed the
state graduation exam. Of school-aged children (5–17 years
old), 53·5% (910) were not currently enrolled in school.
Most of the sampled households had low incomes. The median yearly
household income was 62 400 gourdes per year (US$1543 per year).
Of the sample, 62 households (4·9%) had incomes of less
than 15 000 gourdes per year ($371), 270 households (21·4%)
less than 30 000 gourdes per year ($742), and 412 households (32·7%)
less than 45 000 gourdes per year ($1112).
On the basis of anecdotal reports from social services providers,
the sample seemed to be demographically and economically representative
of the population of the Port-au-Prince metropolitan area. However,
no reliable quantitative data on the demographic characteristics
of Port-au-Prince were available at the time of this study to
compare with our sample.
The crude rates and estimated numbers of victims of each type
of human rights violation are shown in table 1. 23 respondents
reported that someone in their household had been murdered, representing
0·4% of all individuals (95% CI 0·2–0·6).
The most common cause of death identified by respondents was by
gunfire with 15 households (65%) reporting this cause. Other causes
identified were beating or blow from an object (four), torture
(two), stabbing or wound from a knife or sharp object (one), and
All victims of sexual assault reported were female. 3·1%
(95% CI 2·5–3·7) of all female individuals
had been sexually assaulted during the period investigated (table
1). The majority of sexual assaults perpetrated involved penetration
of the victim’s mouth, anus, or vagina with the perpetrator’s
genitalia or some other object (92·1%; 95% CI 86·6–97·6).
The remainder of assaults involved sexual touching without penetration
and the forced watching of sexual acts. Sexual assaults reported
in this study often occurred against children and adolescents
(table 1). 53·1% of all victims (95% CI 38·4–67·8)
were younger than 18 years, 37·2% (95% CI 24·9–49·5)
were between the ages of 11–17 years old and 16·0%
(95% CI 7·9–24·1) were 10 years old or younger.
Overall, 4·6% (95% CI 3·4–5·8) of all
female children in the sample were victims of sexual abuse.
Restaveks, children (younger than 18 years, mostly female) who
work as unpaid domestic servants living in a household and are
unrelated to other household members, accounted for a substantial
proportion of all sexual assault victims (table 1). This group
of children represented 36·2% (95% CI 24·0–48·4)
of all sexual assault victims, and a large proportion (68·0%;
45·1–90·9) of child victims of sexual assault.
9·6% (95% CI 6·5–12·7) of all female
restaveks had been victims of sexual assault. Compared with girls
who were not restaveks, the relative risk of sexual assault for
restaveks was 4·5 (95% CI 2·5–8·1).
Table 1: Estimated crude rate and number of victims by type of
violation for greater Port-au-Prince area - go to Lancet
Of all individuals in the study, 1·0% (95% CI 0·5–1·5)
were identified as having been assaulted physically (table 1).
The most frequent types of assault were beatings without (34·2%)
and with (23·3%) an instrument. Six incidents (8·2%)
of stabbing or cutting with a sharp instrument and five incidents
(6·8%) each of gunshot woundings, beatings of the soles
of the feet, and burning with a cigarette were identified.
Detention and arrest by government or foreign soldiers were not
as frequently encountered as the other incidences examined (table
1). 0·6% of individuals (95% CI 0·4–0·8)
were reported as being detained by the police, HNP, or a foreign
Preventative detention, used in Haiti to detain juveniles who
have not been accused of a crime, accounted for 22·2% (95%
CI 14·8–29·7) of the arrests. Haitian law
stipulates that all arrestees are entitled to an appearance before
a judge within 48 h of detention. 14 Of all 36 detentions detected,
only one individual was reported as having seen a judge within
the stipulated period. Most Haitian detainees were not represented
by an attorney. 17 (47%) of detainees were reported as having
been allowed to see an attorney and 11 (28%) were not; five (14%)
did not ask to see an attorney, and only four (11%) reported seeing
an attorney. Nine (25%) were reported as still being imprisoned.
Kidnappings and detentions by armed groups were reported for 0·5%
of the population (95% CI 0·3–0·7; table 1).
Table 2: Perpetrators of human rights violations - go to Lancet
Property crimes were recorded at the household
level only. Theft, vandalism, looting, larceny, and destruction
of personal property were experienced by 6·8% (95% CI 5·4–8·2)
of households (table 1). Two households reported multiple incidences
of property crime. To estimate the number of households that were
victims of property crime (table 1), we estimated the number of
households in the greater Port-au-Prince area to be about 471
000 (95% CI 451 000–482 000) by dividing the population
estimate by the average household size.
Death threats, threats of physical violence, and threats of sexual
violence were also assessed. Of all households, 7·6% (95%
CI 6·1–9·1) identified as having someone threatened
with death. Eleven households (0·9%; 0·5–1·4)
reported that both the respondent and a household member had been
threatened with death at least once. Because of the structure
of the questionnaire, threats could not be linked to individual
family members, with the exception of the respondent. However,
taking the estimated number of households in the greater Port-au-Prince
area derived from this survey and assuming only one threatened
individual per household, or two individuals in the case of both
a respondent and another householder having been threatened, we
arrived at a conservative estimate of the number of individuals
threatened with death (table 1).
This formula was also used to conservatively estimate the numbers
of people who received threats of physical violence or threats
of sexual assault (table 1), both of which were frequently reported
by households. Of all households, 12·7% (95% CI 10·9–14·5)
reported that someone in the household had been threatened with
physical violence at least once. 26 households (2·1%; 1·3–2·9)
reported that both the respondent and another household member
had been threatened at least once. 4·6% (95% CI 5·8–3·4)
of all households reported that at least one person in the household
had been threatened with sexual violence. 15 households (1·2%;
0·6–1·8) reported that both the respondent
and another household member had been threatened with sexual violence.
For murder, sexual assault, physical assault, detention or arrest,
and property crime, respondents were queried about the perpetrators
of acts to themselves and to household members. With threats,
respondents were questioned about the identity of the perpetrators
who had threatened them. Because of the structure of the questionnaire,
the perpetrators of threats to household members could not be
linked to an individual household member and was excluded from
the analysis. To address the potential for bias, respondent identification
of the perpetrators of threats against themselves were weighted
by sex and age using demographics derived from all adults sampled.
Criminals were most frequently cited as perpetrators of the acts
measured in this study (table 2). They were the largest group
identified as having committed sexual assaults, physical assault,
and kidnappings and extrajudicial detentions. For property crimes,
the proportion due to criminals was second to that attributed
to unknown perpetrators. Criminals were also reported as responsible
for about a third of all death threats, threats of physical injury,
and threats of sexual violence. (TABLE
Table 3: Post-stratification analysis )
Officers in the Haitian National
Police and members of other government security forces were identified
by respondents as committing a substantial proportion of sexual
assaults and murders (table 2). Respondents reported police officers
or government security forces as responsible for a fifth of all
physical assaults; this group was also reported to have made death
threats, threatened to hurt people physically, and threatened
Political groups on both sides of the spectrum were named as responsible
for violent and criminal acts (table 2). Ex-soldiers from the
disbanded Haitian army along with members of armed anti-Lavalas
groups (eg, Lame TiMachete) reportedly committed 26·0%
(95% CI 5·2–46·8) of murders, 23·8%
(11·3–36·3) of all physical assaults, 13·8%
(6·3–21·3) of sexual assaults and 37·9%
(15·5–60·3) of kidnappings and non-governmental
detentions. Lavalas members and partisans of the Lavalas movement
were also named as having committed such acts (table 2).
Foreign soldiers serving with the Multinational Forces (February
to June, 2004) and the United Nations Stabilization Mission in
Haiti (June, 2004, to present) were not named as responsible for
any murders or sexual assaults (table 2). They were identified
by respondents as having issued death threats, threats of physical
injury, and threats of sexual violence. For death threats, the
most commonly cited soldiers were from an unknown country (31·3%;
95% CI 6·2–56·4), from Brazil (31·3%;
6·2–56·4), or from Jordan (22·1%; 1·1–43·1);
for threats of physical violence, Brazilian soldiers (54·0%;
31·0–77·0) and foreign soldiers of unknown
origin (27·7%; 11·2–44·2) were most
commonly blamed; and for sexual threats, 30·0% (0–60·5)
of the foreign soldiers were from an unknown country, 33·1%
(1·1–65·1) were identified as Jordanian, and
23·1% (0–49·9) as Brazilian. Most UN troops
wear uniforms that have the flag of their country displayed either
on their blue helmet or on their uniform sleeve over the upper
arm. Other UN troops, particularly those with CIVPOL or working
within other units (eg, not on a regular patrol, but rather, working
as crowd control, trainers, etc) do not wear the same uniforms.
They are known to be UN because they have blue helmets, but witnesses
and victims might not know the country of origin of the troops.
Results of the post-stratification analysis (table 3) showed that
rates for murder were the same between the popular and the other
zones. Sexual assaults were more common in the popular zones than
in other zones, but this difference was not statistically significant.
The findings of this analysis suggested that residents of the
popular zones were significantly more likely to be victims of
physical assaults than were residents of less dense neighbourhoods.
Demographically, residents of the popular zones had lower per-head
income than those in other zones. Discussion
Our findings show that human rights violations were common in
the greater Port-au-Prince area in the post-Aristide period. Our
estimates suggest that about 8000 individuals were murdered, with
almost half of the perpetrators identified as political actors.
Sexual abuse, especially among children, was also a frequent occurrence.
Our data suggest that 35 000 women and girls were raped during
the time period examined; more than half of the victims were children.
Death threats, threats of sexual violence, and threats of physical
violence were also common occurrences.
Criminals, the Haitian National Police (and other governmental
security forces), and UN peacekeepers were the most identified
perpetrators of threats of bodily harm. Brazilian and Jordanian
peacekeepers were the most frequently identified among foreign
We did not assess changes in human rights violations over time.
There are no quantitative data that would allow us to compare
other rates with our findings during the same period or previous
periods. The period examined was chosen as an attempt to control
for the possibility of changes in rates of violations as a result
of the armed overthrow of the elected government.
Our study has several other limitations. Only households in Port-au-Prince
were studied. The geographical limitations of this study prevent
us from predicting the frequency of human rights violations in
the rest of the country. Statements from international human rights
organisations, 17 news reports,18 and data in this study indicated
that some respondents suffered human rights violations in other
cities before moving to Port-au-Prince. On the basis of these
statements, we surmise that some serious human rights violations
occurred in the areas of St Marc and Cap Haitian during early
2004 as rebel forces were seizing the country. However, in this
study, we did not examine human rights abuses occurring in the
areas where prolonged fighting took place during early 2004.
Additionally, some households that were subjected to human rights
violations in Port-au-Prince might have relocated to other parts
of the country to avoid further violence. No estimate of the number
of internally displaced families in Haiti exists, but anecdotal
evidence from human rights workers, non-governmental organisations,
and journalists indicates that a substantial number of households
who experienced human rights violations during March and April,
2004, fled Port-au-Prince for the provinces. If this is the case,
then the data presented in this study might under-report the extent
Because we used a single-stage spatial sample, households in denser
communities and those in multiunit dwellings are likely to have
been underrepresented, relative to households with larger parcels
of land or in single-unit dwellings. The rates of physical assaults
seemed to systematically differ between those who live in dense
areas and those in less dense areas, resulting in reporting bias.
In view of the post-stratification analysis findings, we have
probably undercounted the occurrence of physical assaults. Additionally
sexual assaults might have been underreported as a result of sample
bias, since they were reportedly more frequent in the denser neighbourhoods,
although this pattern was not statistically significant. Although
this sampling method might be viewed as a major limitation, it
seems that any bias that might have occurred as a result of single-stage
sampling would produce conservative estimates of physical (and
possibly sexual) assault, rather than overestimates.
We only studied eight types of human rights violations: property
crimes, arrests and detentions, physical assaults, sexual assaults,
murders, death threats, and threats of sexual or physical violence.
We did not investigate the violations to Haitians’ social
and economic rights during the post-Aristide period. From news
reports 19 we know that some Haitians have been expelled from
their homes, fired from their jobs, prevented from going to school,
and forced to become refugees; all these circumstances can include
human rights violations, but we did not address such violations
in this study.
The reliability of the respondents’ recollection and identification
of perpetrators might also be a limitation. It is likely that
some respondents did not report the correct identity of those
who violated their human rights. Respondents might have feared
repercussions or hoped to further their political cause by blaming
the violation on foreign soldiers or political groups that they
oppose. Additionally, recall might have been affected by the time
between the event and the survey (up to 22 months). We were unable
to verify information given by the respon– dents because
of the absence of reliable governmental health or crime reporting
Respondents were also asked to convey information about abuses
that occurred to household members. In such cases, the respondent
could have been mistaken about the circumstances of a particular
violation that he or she reported. Some abuses that household
members experienced might also have gone unreported to the respondent.
Published work suggests that victims of sexual abuse are often
reluctant to admit to being sexually violated. 20 Participants
who were interviewed by all-male research teams (22·5%
of all respondents) might have been less likely to report being
sexually assaulted. It seems likely that some sexual assaults
against household members could have remained unknown to the respondent,
or that respondents were reluctant to report sexual assaults against
themselves. Additionally, respondents might have been reluctant
to report sexual abuse of a restavek committed by themselves or
by another household member. Intrafamily violence, sexual or otherwise,
went entirely unreported, and was probably underreported.
Although we believe that all types of sexual abuse were probably
under-reported, the extreme frequency at which sexual abuse was
reported suggests that under-reporting might not be as severe
as could be expected. Restaveks are often viewed as property 21
and any violation of these children by others represents an attack
on the household’s assets. In these situations, we believe
that the respondent would probably have been forthcoming about
sexual abuse of a restavek in his or her home by a non-household
member. Because respondents might have been more likely to report
the sexual assault of a child than they were to report that of
an adult, the reported frequency of sexual assault by age may
Because data on dates of entry and exit from the household were
not collected, we assumed that all members of the household were
members for the full period examined. Statistically, this should
result in a slight under-reporting of the crude rates.
Our data suggest that about 12 individuals per day were murdered
in Port-au-Prince during the period investigated. Armed anti-Lavalas
groups and their partisans, along with the HNP and other government
security forces, accounted for almost half of all identified perpetrators,
with the other half identified as criminals. Regarding criminals
and anti-Lavalas partisans, establishment of a responsive police
and judicial system is tantamount if this rate of murder is to
be diminished. This task may be difficult, since elements within
the police department also seem to be responsible for some of
these killings. Stringent oversight and training for all current
and incoming police officers to prevent extrajudicial killings
seems to be necessary. Identification and vigorous prosecution
of the perpetrators might ameliorate this murder rate.
The rates of sexual abuse for all age groups are shocking. We
are particularly troubled by the very high rates of child sexual
abuse reported in this study. We estimate that about one in 40
girls younger than 18 years are sexually assaulted per year in
the greater Port-auPrince area. Further, the rate of sexual assault
for female restaveks is almost four and a half times greater than
that for girls who are not restaveks. Of female restaveks, we
estimated that one in 19 are sexually assaulted per year, compared
with one in 84 girls who are not restaveks.
Restaveks, in particular, are victims in two disturbing ways.
First, restaveks are often relegated to second-class citizenship
and in many ways could be considered modern-day child slaves.
Few attend school and many often work in labour-intensive activities
that would be judged as human rights abuses by international standards.
22 Secondly, this second-class status seems to make them more
vulnerable to sexual exploitation by others, although respondents
might have been more likely to report abuse of restaveks than
abuse of other children in the household, because of the restavek’s
perceived status as household property.
Criminals and unknown assailants were the most cited perpetrators
of sexual abuse. Improvements in law enforcement, vigorous prosecution
of perpetrators, and increased awareness about child sexual abuse
through public education campaigns could decrease the rate of
such abuse substantially. 23 Rapes by police officers present
a different challenge. HNP officers and other official government
security forces reportedly committed almost one in eight rapes.
As with murders, we believe that a reordering and retraining of
the police force in Haiti might be necessary to address this problem.
Identification and prosecution of police officers who commit sexual
offences should be a priority for the new administration.
Threats of death, bodily harm, sexual violence were common and
came not only from criminals, but also from both the HNP (and
other government security forces) and foreign troops. The most
commonly identified perpetrators of death threats, besides criminals,
were UN troops. Of the UN troops identified, half were from Brazil
or Jordan. Brazilian and Jordanian soldiers were also noted by
respondents for issuing the majority of physical threats and threats
of sexual violence by foreign soldiers. These findings support
media reports 24 of abuse by UN peacekeepers, particularly Brazilian
25 and Jordanian troops. 26 The retraining of some peacekeeping
soldiers seems to be necessary.
Non-governmental organisations, churches, and women’s organisations
might need to establish coordinated services to meet the needs
of sexual assault survivors. The number of rape victims shows
the overwhelming need for psychological, medical, and social support
services. Culturally appropriate therapeutic interventions should
be developed, especially for vulnerable populations such as children
and elderly victims.
Medical services should be offered to victims of torture and other
physical and sexual assaults. Extensive research already exists
on the most effective ways of providing such services to victims,
their families, and their communities through the establishment
of neighbourhood clinics, public-health programmes, and peer intervention
projects. Haitians should be able to access free or affordable
medical services to resolve problems caused by human rights violations.
The newly elected government of Rene Preval, the UN leadership
in Haiti, and social service non-governmental organisations need
to take concrete measures to investigate the extent of human rights
violations throughout the country. Understanding the extent and
severity of the abuses experienced by individuals and communities
can provide the necessary information for development of programmes
to address the health consequences and alleviate the emotional
suffering of victims.
The frequency of human rights violations, and especially the prevalence
of sexual violence against women, demands a serious and thorough
response from the international community, the new Haitian government,
and non-govermental organisations working in the region. The new
administration should take steps to stop any ongoing human rights
abuses through various domestic and international systems.
A Kolbe was principally responsible for survey instrument design,
hiring, training, and overseeing the interview staff, leading
the study teams, coordinating all logistical aspects of the study,
and data entry and organisation. R Hutson was principally responsible
for data analysis and data interpretation. The authors were jointly
responsible for sampling design and preparation of the manuscript.
Conflict of interest statement
We declare that we have no conflict of interest.
We thank the School of Social Work at Wayne State University for
their material support for this survey. Many thanks and rememberances
go to Marla Ruzika (1977–2005) for her technical assistance
with the GPS methodology and human rights investigation protocols.
We also acknowledge and thank the interviewers who risked grave
danger to complete the surveys in this troubled region, Bart Miles
at the Wayne State University School of Social Work for his insightful
editorial comments, Nomi Klein for her professional data entry
and organisation, and the United States Embassy-Political Section,
Port-au-Prince, Haiti, for assistance with the mapping of Port-au-Prince.
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Ezili Danto Note: For the full and complete pdf of the original
Lancet report with Table graphics go to Lancet
Lancet Editorial: UN Peacekeepers
The Lancet Editorial, on-line,
August 31, 2006 (www.thelancet.com)
UN peacekeepers in Haiti
6 months after democratic elections, Port-au-Prince has seen another
upsurge in violence. Staff at Médicins Sans Frontières
report treating more than 200 gunshot wounds in July, double the
previous month’s number of injuries. The fighting raises
questions about the effectiveness of the UN peacekeeping mission,
whose intermittent 15-year presence was extended for a further
6 months on Aug 15.
In today’s Lancet, Athena Kolbe and Royce Hutson report
human rights violations in Port-au-Prince. Central to their findings
is the fact that civilian welfare fails to attract the attention
it deserves from authorities in times of conflict, with neither
the Haitian government, nor the UN peacekeepers being able to
estimate the effect of the conflict on civilians. Yet in just
22 months—from the departure of President Jean-Bertrand
Aristide to the end of 2005—an estimated 8000 people were
murdered and 35 000 women sexually assaulted, half of whom were
under the age of 18 years.
Most perpetrators were identified as criminals, but police, armed
forces, paramilitaries, and foreign soldiers were also implicated.
Although UN peacekeepers have been investigated for accusations
of sexual misconduct in Haiti and elsewhere, Kolbe and Hutson’s
survey did not find evidence for their involvement in murder or
sexual assault. However 14% of the interviewees did accuse foreign
soldiers, including those in UN uniform, of threatening them with
sexual or physical violence, including death.
UN Secretary-General Kofi Annan has spoken out firmly against
exploitative behaviour by UN peacekeepers. In 2005, at Annan’s
request, Prince Zeid of Jordan, whose soldiers serve in Haiti,
proposed a number of measures to reduce sexual exploitation by
UN personnel. One result has been the active investigation of
allegations. Yet since 2004, only 17 peacekeepers have been dismissed
and 161 repatriated out of 313 allegations worldwide. Annan’s
stand needs to be followed by stronger action to restore both
international and local confidence, without which local security
cannot be assured. Severely traumatised populations remain vulnerable,
and as Kolbe and Hutson show, suffering does not stop when peacekeepers
arrive. UN peacekeepers must no longer add to that suffering.
? The Lancet UN peacekeepers in Haiti Published Online August
31, 2006 DOI:10.1016/S01406736(06)69295-7 See also Online/Articles