A Miami review finds Haitian patients whose immune systems have stopped working

By early 1981 a group of faculty physicians at the University of Miami had worked back through every Haitian patient admitted to Jackson Memorial Hospital over the previous year. What they found fitted neither tuberculosis nor poverty nor hunger. The patients were young, had lived in the United States for a few months to a few years, held ordinary jobs and had been well nourished before falling ill. They arrived with fungal infections in the nervous system, viral infections of the gullet, parasites in the brain, yeast in the mouth, swollen glands in several places and Pneumocystis in the lungs, frequently two or three of these in one person. Pneumocystis appears only where immunity has already failed. One of the group, Margaret, connected the pattern to reports of the same infections in previously healthy gay men. The Miami patients included women and heterosexual men. The condition had no name yet outside a billing category.

In July 1981 the government signed a protocol with the Inter-American Institute for Cooperation on Agriculture providing for the killing of every pig in Haiti within two years, so that African swine fever should not reach the North American mainland. Peasants were to be compensated and foreign animals brought in afterwards. What the countryside saw was the forced sale, often at distress prices, of the one asset a family could turn into cash in a bad month. Some hid their animals. Others killed them as offerings to the lwa rather than hand them to the blan, and such sacrifices were reported from every part of the country. Within a year registration at rural schools had dropped by thirty percent. On 29 September 1981 Ronald Reagan announced that a Coast Guard cutter would be stationed permanently off Haiti, with other vessels rotating through, to stop boats carrying Haitians toward Florida. The United Nations questioned whether it was legal. Haitian officials spent October in Washington settling their price, and in November American aid was increased.

Drought settled over the Sahel from the early 1970s and held, from Mauritania and Mali east to Sudan and Ethiopia. Famine followed, and it fell on countries already fighting civil wars or moving their own farmers by force. By the 1980s agriculture sat at the centre of the crisis. Several states had become net importers of food and depended on aid to buy it. Land grew scarce, farmers pushed into pasture and into ground that made them ill, and herders and cultivators fought over what was left. The young left for the cities, and slums spread around Lagos, Addis Ababa, Nairobi and Dar es Salaam. Political sovereignty had arrived without economic sovereignty. Populations watched their governing elites take what there was, welcomed the coups of the 1960s and 1970s, then watched the soldiers fail as well. By the early 1990s governments were accepting structural adjustment from the IMF and the World Bank: shrink the state, free trade and currency, and take instruction on the rest.

For roughly two decades after 1958, archaeologists working in the Caribbean sorted the earliest island material into stages taken from North America and from Old World sequences. The schemes of Gordon Willey, Philip Phillips and Irving Rouse became the standard way to name what came out of the ground, and the islands acquired a Lithic age and an Archaic age on that authority. A classification is an argument about what a society was. Categories designed for stone using hunters on a continent make island people look like a rough opening chapter waiting for something better to arrive. Keegan and Hofman note that the rigid schemes survived long after specialists agreed they had stopped working, and that they survived because so few researchers cared about the oldest periods. The Greater Antilles, Haiti among them, are where the newer evidence keeps landing. This is the machinery that lets a timeline of the Caribbean begin in 1492 and call everything before it prehistory.