Vaccination cuts infant deaths while the schools lose their money

After independence most African governments put money into schools, primary enrolment rose sharply, and there was deliberate effort to get girls into classrooms. The gains were uneven and then partly reversed. Adult illiteracy south of the Sahara is higher than in any other region of the world, the economic crisis that began in the 1970s cut state education budgets, and the gap between boys and girls is widest in the countryside. Health followed a similar curve. Malaria remains the heaviest disease burden on the continent and sleeping sickness was spreading again by the 1990s. More than two thirds of the world's HIV cases are African, with about 34 million people infected since the early 1980s and over 11 million dead, concentrated in the east and the south. Illness tracks poverty, thin food, bad sanitation and dirty water. Clinics decayed and trained staff left for better pay abroad. Vaccination programmes still cut infant mortality sharply after the 1960s and life expectancy rose, which shows what small sums can buy.

Francois Duvalier died in office in April 1971, having already named his nineteen-year-old son Jean-Claude president for life. Observers abroad expected the country to come apart within weeks. It did not. The army accepted the transfer, the United States accepted it, and the government carried on with the same ministries and the same militia. What the succession settled was the character of the state. Haiti now had a presidency that passed by inheritance, and no mechanism remained by which anyone outside one household could compete for it. Michel-Rolph Trouillot reads the moment as the end point of a process rather than a rupture, the formalisation of a crisis already under way. Every step that made the handover possible had been taken earlier, when the constitution was rewritten to suit one man, the parliament reduced to an audience, and the militia built as a private force answering to the palace. A system arranged for permanence produced an heir because that is what it was for.

By 1980 some two hundred thousand Haitians were living in the Dominican Republic, some for a season and some for good. Movement across that border is old and has taken three forms. The first people to go were maroons, escaping slavery on the French side during the colonial period for the Spanish side, where treatment was often better. After independence in 1804 the pattern changed. Haitian occupation of the Spanish part of the island and the invasion attempts that followed emptied the border districts on the eastern side, and Haitians filled the space. The third and largest movement came from sugar. American and other foreign firms built plantations and mills in the Dominican Republic towards the end of the nineteenth century and could not find enough local labour. In the 1950s the two governments signed an agreement that formalised the traffic. Observers compared the cane workers' conditions to slavery, and expected earnings there still beat those on a Haitian farm.

The Aristide administration collapsed on 29 February 2004, the culmination of a four-year campaign that intensified after the contested legislative elections of May 2000. Smith argues CARICOM misread the situation badly, partly because it had been the only foreign presence at the internationally boycotted 2000 elections, which opponents mistook for an endorsement and which Colin Granderson said did tremendous damage to the organisation's credibility. After the removal CARICOM took firm positions on Aristide's Jamaican exile from March to June and on the interim government, and objected that the appointment of Gérard Latortue as interim prime minister had been initiated by Washington without regional consultation. Its own decision to suspend Haiti in March 2004 has not helped, Smith writes, since the isolation coincides with the damage of tropical storm Jeanne in Gonaïves and deepens Haitian cynicism about the region. Where this account departs from the standard one: Smith argues that CARICOM's suspension of Haiti after the coup was counterproductive and that a hard line endangers future relations, a position he notes was already contested among heads of government.