In a city of ruins, five fully functional hospitals have been allowed to close, facing financial under-support and over-scrutiny. In many cases, the bureaucracy of international aid is protecting people to death.
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Here's today's testimony before the Senate Foreign Relations Committee. Please continue to support our neighbors in Haiti. - Sean Penn

Mr. Chairman, members of the committee, my name is Sean Penn. I have been in Haiti as Director and CEO of my NGO J/P Haitian Relief Organization, and have been on the ground in Haiti since the first week following January's earthquake. Since that time, my team and I have lived in a tent camp in the Bourdon area of Port au Prince, adjacent to and administering aid to a 55,000 person IDP camp, one of the largest ad-hoc camps in the country. My organization has been designated by the UN International Office of Migration as camp management for this IDP camp.

From our first days in Haiti, my team and I witnessed amputations without anesthesia or IV pain medication, things we soon were able to supply to hospitals and clinics throughout the city and the country. Limbs severed in spontaneously raised tent operating rooms, dusty and mosquito ridden. Limbs severed from children with tools more familiar to our local hardware store than to those we traditionally expect in the hands of surgeons. It is true that this stage of post quake trauma and drama has largely subsided.

Only 2 weeks ago however, a less tangible, visible or fundable emergency raised its head. Our camp clinic diagnosed what became the first confirmed case of diphtheria. I rode in the back of the ambulance while the patient was refused from several hospitals because the 15-year-old boy, Oriole Lynn Peter, was diagnosed with a disease for which those hospitals had no treatment capability. In this city of ruins, 5 fully functional hospitals have been allowed to close despite these emergent disasters, facing financial under-support and over-scrutiny. In many cases, the bureaucracy of international aid is protecting people to death. Diphtheria is among the first five things that an American traveling to Haiti is inoculated against, and yet, in this devastated country with hundreds of millions of American donated dollars of dedicated emergency aid and billions pledged for reconstruction, there were no isolation wards, few ventilators, and despite the all out last minute efforts of the American Red Cross, the administrations of every major hospital in the city, the dedicated and beyond job description effort of the commander of the US military forces in Haiti (Major General Trombitas), the WHO, USAID, and the CDC, along with a fractured Haitian Ministry of health, it took 14 hours between all of these organizations to locate a single patient dose of the immunoglobulin that would likely have saved this 15 year old boy's life had it been readily available.

As we rode through the rubble and traffic blocked streets in search of his care I held the ankle of an animated and normal 15-year-old boy who to his own knowledge was merely suffering from a sore throat and a bit of a fever. He couldn't have known that the grey hued bacteria would kill him within a day and a half and it did. Since that day, a series of diphtheria cases have come to light, including another one in our camp brought to our hospital four days ago. But diphtheria is only one of many diseases that threaten, in particular, the 1.8 million displaced today, living in compressed and unsanitary camps, where tent to tent construction would take one match to create the inferno that could incinerate thousands. In a city with nearly no access to electricity there is little fuel to run generators, few lights to generate, and the rapes of women and children occur at will. It will be the rain of this season that spreads the diarrheal diseases that globally finds its victims - 80% among children under 5. There are hundreds of thousands of them in Port au Prince alone. It should be said that while there are claims to grand programs of immunization it is the simple truth that most Haitians remain unprotected and that there is little evidence that those that have been immunized have records or access to establish boosters and follow up necessary with all immunizations. It should also be said that in a city the size of Port au Prince, as with all the densely populated areas in Haiti, the idea that, as in the case with the diphtheria immunoglobulin, a single warehouse maintains what little supply may exist is an unacceptable acceptance.

Prevention is difficult to get people excited about. But cold chains for the transport and preservation of these necessary immunizations and treatments must be established throughout Port au Prince and Haiti, as must stockpiles of the necessary remedies for the dehydration that comes with diarrheal diseases. It must also be said that the quality and training of pre quake health care in Haiti was already at a minimum and that with the death and flight of so many among the most capable in the Haitian medical community, that it will be some time before the international medical staff will be relieved of the humanitarian and training demand.

I come here today as a witness not only to a state of current emergency but also to the heroic efforts of United States and international doctors, soldiers and relief workers, of the NGOs in partnership and service with the great Haitian people and their government. I come here today in the hope that we will address, with bold clarity, the razor's edge upon which Haiti lies, so that all that our own country has given in sacrifice and service will not be washed away with this rainy season and leave bright and dancing Haitian eyes to go still in death from disease and flood, and God forbid the man made disaster of violent unrest. From President Obama, Secretary of State Clinton and Secretary of Defense Gates and throughout the policies and generosities offered to this situation to date, the United States can hold its head very high. The compassionate and no nonsense posture of our military has been moving and inspiring. But, with the official "emergency phase" declared over, as most of them redeploy into other struggles, we owe it to all of them and to ourselves in re-establishing the character of American foreign policy to stay the course in Haiti.

Make no mistake, this is a war against our ally and neighbor, and we have only this chance to show the world that we are willing to fight that war to save its victims and are not dependent on hating and killing their assailant. It is a war against the diseases and preventable disasters caused by nature and poverty. We must also not underestimate the likelihood, known to all of us on the ground in Haiti, of violent social unrest. As Americans, we should call on the Government of Haiti and on our own government, to acknowledge that a state of emergency still exists. To demand FULL TRANSPARENCY in the way that aid is distributed and accountability for how aid organizations advertise themselves in the solicitation of funds. Full and total transparency. Now is the time for all concerned parties to acknowledge that an "emergency phase" is simply an economic determination, and that the prevention of foreseeable human tolls on massive levels, in particular young children, cannot be summarily dismissed by the aspiration of a monumental reconstruction, offering empowerment, demanding independence and governance, or claiming it as a distraction from the rebuilding of a country that in many ways was never built in the first place.

The Haitian people are as strong and resilient as any I have ever seen. There are great lessons of character for our country to learn from Haitians. President Preval and his administration have proven in their pre-quake efforts the will of Haiti to overcome its devastating legacy. But to demand of them, or encourage their demand of a fractured society's independence prematurely, will be murder by another name. Issues of equity in distribution of aid are a fine aspiration, but when the emergency room has got a line out the door and the hospital pharmaceutical stockpile has not been inventoried, we have to find a way to treat patients while the counting is done and not leave them at the door to die on the street.

I am, and I believe I speak for all responsible aid workers, in full support of parallel planning in reconstruction and the nurturing of an independent peoples self reliance. But as we punish those who are lazy, punish those who are corrupt, so shall we kill the innocent and the willful. In an emergency, donors offer money and expect it to be spent helping people. I hope we are here today to encourage just that. Thank you.

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