Dr. Jean Pape Speaks at the United Nations Security Council

Dr Jean Pape, faculty member in the Weill Cornell Center for Global Health and Director of the GHESKIO Clinic in Port au Prince Haiti, spoke at the United Nations Security Council on Wednesday November 20th about the insecurity in Haiti and the need for international support. The transcript of his talk is below.  

“Ladies and Gentlemen, 

My name is Bill Pape. I’m a professor of clinical medicine at Weill Cornell Medical College in New York and the Director of GHESKIO Centers in Port-au-Prince, Haiti. After completing my training in the United States as a specialist in infectious diseases, I returned to my homeland in 1979. 

My work in Haiti has always been both challenging and productive. I started at the State University Hospital, the largest in the country, tackling infantile diarrhea—a condition that, at the time, was the leading cause of death in Haiti and many developing countries. By introducing oral rehydration therapy and other innovative approaches, we managed to reduce in-hospital mortality from 40% to less than 1% in just a year. From there, we expanded the program nationally, with our unit serving as a training center, and this program is credited with a 50% reduction in national infantile mortality.  

In 1981, I was called in to consult on adult patients with chronic diarrhea at the same hospital. These cases turned out to be Haiti’s first recognized patients of what we now know as AIDS. This prompted me, along with eight other Haitian professionals, to establish GHESKIO on May 2, 1982—one of the world’s first institutions dedicated to fighting AIDS. Our mission was clear: to provide care, training, and research. Today, over 40 years later, GHESKIO is one of the largest centers for AIDS and tuberculosis in the Americas, providing free care to over 300,000 patients. 

Over time, we’ve made incredible progress. AIDS, which was the leading cause of death in Haiti for decades, is now the seventh, responsible for just 5.6% of fatalities. Meanwhile, cardiovascular disease has emerged as the number one killer, accounting for 28% of deaths. To tackle this, we established the largest center for cardiovascular care in the country, and identified hypertension as the main driver. 

In 2010, Haiti faced back-to-back disasters: a devastating earthquake and a cholera outbreak. GHESKIO stepped up, offering refuge to thousands of displaced people on our campus while introducing the oral cholera vaccine to control the epidemic. This was the first-time a cholera vaccine was used during a cholera epidemic. It was highly successful and changed the World Health Organization guidelines to promote cholera vaccine during cholera epidemic and has been used to quell cholera all over the world. We have learned that in environments of extreme poverty provision of health care alone while necessary is not sufficient. Global health that includes education and economic opportunities is a must.   Beyond healthcare, we expanded our reach with programs like microcredit loans, a chlorine factory providing clean water to 100,000 people in nearby slums, a vocational school for survivors of sexual violence, and an elementary school on our downtown campus. 

On June 1, 2023, I wrote an op-ed in The New York Times calling on the international community to help address the growing insecurity in Haiti. Unfortunately, the situation has only worsened since then. Haiti’s economy has seen negative growth for five consecutive years, the capital is completely cut off from the rest of the country, and we’re experiencing the largest exodus and brain drain in our history. Over 800,000 people have been internally displaced, and the rates of murders, kidnappings, rapes, and severe malnutrition have reached unprecedented levels. Most hospitals, including the State University Hospital, are now closed, and only 25% of medical facilities in the capital remain operational, placing overwhelming pressure on those still standing—ours included. 

 How has insecurity affected us? 

We’ve managed to survive by constantly adapting. We’ve developed a contingency plan, continuously refined through every crisis, which includes having a backup staff for critical positions and offering ongoing training in medicine, laboratories, and IT. Our strong ties to the local community have also been essential to our resilience. But the reality is grim: how much longer can we continue operating under these conditions? Without your support, all the progress we’ve made in combating infectious and chronic diseases will unravel. 

It’s easy to share grim statistics, but they don’t fully capture the human cost, what it feels, for the people who have to live through this hell every single day: 

I am here to tell you that the mission led by Kenya is not working. Together with the Haitian police and army, they are outgunned and outnumbered. I understand the controversies surrounding previous peacekeeping missions, but during their presence, insecurity did not exist at this scale. People could move freely, and farmers could transport their goods to market without fear. Nobody had to be in the streets because their house was put on fire.  

For a nation that once fought to abolish slavery and played a pivotal role in liberating South America, I trust that seeking your support to restore security is not asking too much. It is a difficult task for any Haitian to request foreign troops on our soil, but there is no other alternative. We sincerely hope this will be the last time such a plea is necessary. 

In conclusion, I cannot think of a single Haitian living in this hellish reality who would not welcome a more robust international intervention. If nothing is done, the alternative will be a massive genocide—something only you have the power to prevent.  

Thank you.”