By Andre Paultre and Sarah Marsh
PORT-AU-PRINCE (Reuters) - Haitian pastor Burel Fontilus feared for his life in late March when he contracted the new coronavirus.
It wasn’t the COVID-19 respiratory disease that frightened him, he said, rather gun-toting vigilantes in his neighborhood near Port-au-Prince who were threatening to lynch him.
Word that Fontilus, 42, had fallen ill while traveling quickly morphed into accusations on social media that he was carelessly spreading it.
"They were gathering to kill me," Fontilus told Reuters. "Neighbors said they had seen groups preparing."
Reuters was unable to verify independently Fontilus' claims that an armed mob in his suburb of Carrefour was organizing to harm him.
Carrefour Police Commissioner Charles Maunaude said authorities took the alleged threats against Fontilus seriously. Police were dispatched near his home to pre-empt any potential aggression, Maunaude said, while a squad car escorted the ambulance that took Fontilus to the local hospital.
Around the world, sufferers of coronavirus and health professionals have faced stigma due to fear and ignorance. Medical workers in the Philippines have had bleach thrown at them. Doctors in India have been forcefully evicted by their landlords over infection fears.
In Haiti though, the poorest country in the Americas, that stigma has become a major concern among health authorities trying to contain the outbreak. Haitians have long been distrustful of their institutions, wariness that a corruption-fueled political crisis, food insecurity and a surge in gang crime have only exacerbated. Now fear of contracting coronavirus has some taking matters into their own hands.
"The only way they feel they can be saved from COVID-19 is by eliminating those who have it," Fontilus said. He said he has recovered. But he refuses to return home, instead relocating with his family from the home of one friend to another so that his would-be attackers can’t track him down.
Fontilus has good reason to be cautious.
Violence erupted during the last major epidemic, a nearly decade-long cholera outbreak that began in 2010; more than 800,000 people were sickened and around 10,000 died. At least 45 priests of Haiti's voodoo religion were killed, some hacked to death, by mobs who blamed them for causing it with their spells, the government said at the time.
Coronavirus so far has proven far less lethal that cholera. Haiti has registered just 182 cases to date and 15 deaths. But harassment of patients such as Fontilus poses a major challenge to authorities trying to get those who contract COVID-19 to come forward for treatment.
"The fight against stigmatization is our greatest battle," said Laure Adrien, General Director of Haiti's Health Ministry and co-chief of the commission managing the outbreak.
President Jovenel Moise said in an April 27 address to the nation that the government would not tolerate violence against coronavirus sufferers. Yet Haitians say the state is too weak to stop the perpetrators.
One of Haiti's few well-equipped hospitals, the Bernard Mevs in Port-au-Prince, canceled plans to open a center for treating coronavirus patients due to opposition by local residents who feared it would be a vector for contagion, an administrative staffer told Reuters.
Other Haitian hospitals and clinics face similar opposition, according to Carissa Etienne, director of the Pan American Health Organization (PAHO), an international body devoted to improving public health in the Americas.
People "are actually obstructing the access to be able to set up COVID health facilities, and threatening to burn them and to attack the healthcare workers," Etienne said during a weekly regional briefing on Tuesday. "The lack of security at those facilities is a huge issue."
COVID-19 survivor Gyliane Woel told Reuters the state ambulance service recently sent her home in the dead of night from the hospital that treated her in Mirebalais, just north of the capital, stressing it was for own safety.
Didie Herold, director of Haiti's National Ambulance Centre, denied that. He said some drop-offs occur at odd hours because the service has only four or five ambulances devoted to transporting COVID-19 patients in the area around Port-au-Prince.
NOWHERE TO BURY CORPSES
Haiti’s relative isolation and last year’s political unrest have helped keep its case count low to date, health experts said, as international travelers have stayed away. But they said the outbreak could yet explode in the vulnerable, densely populated Caribbean island nation of 11 million.
Thousands of Haitian migrant laborers are now returning from the neighboring Dominican Republic, one of the worst-affected regions in Latin America, after losing their incomes during lockdown.
Basic sanitation is a challenge in Haiti’s vast slums and rural hinterlands. Health care services were already collapsing before the pandemic due to lack of financing. The country had just some 100 ventilators before the crisis, according to Adrien of the health ministry, although it just received 100 more from China.
Fear and loathing, however, are not in short supply.
In the northeastern coastal city of Fort Liberte in early April, a bereaved man asked city officials to help him find a burial spot for his wife who had died of COVID-19, after a mob armed with stones, machetes and guns tried to prevent her internment in an old cholera graveyard on the outskirts of town, according to Mayor Etienne Louis Jacques.
Louis Jacques said a spot was secured in the city's cemetery, but authorities had to fire warning shots to scare off stone-throwing locals so the family could lay the woman to rest. He said the grave was dug 30 feet deep and covered with concrete to allay contagion fears.
In Saint-Michel de l'Atalaye, a town on the central plateau, an orphanage was stoned after its Belgian director was diagnosed with coronavirus, said Michelot Dorcenat, a local health ministry official for Saint-Michel and neighboring Marmelade.
"They were furious, saying the Belgian brought the illness to Haiti," said Dorcenat, adding that Saint-Michel residents were barred from attending a popular market at the nearby town of Saint-Raphael by residents there.
A person at the orphanage, who declined to be named, confirmed Dorcenat's account of events.
The International Monetary Fund and the U.S. government have respectively announced $111.6 million and $16.1 million in funding to help Haiti tackle the outbreak and its financial fallout.
Some Haitians suspect the government and local authorities are inventing coronavirus cases to rake in more financing, leading some citizens to ignore health precautions such as wearing masks and engaging in social distancing.
"They do believe the pandemic is political gimmickry and they do not appreciate the severity," PAHO's Etienne said.
Secretary of State for Communication Eddy Jackson Alexis denied allegations that public officials were seeking to profit off coronavirus. He said Haitians were beginning to acknowledge the illness thanks to efforts to raise awareness by the government, civil society and the media.
Yet three weeks ago, in southeastern Côtes-de-Fer, the family of a 41-year old COVID-19 sufferer refused to believe his diagnosis and insisted on removing him from the local hospital where he was in a coma, the facility's epidemiologist Jean Daniel Laguerre told Reuters.
The hospital did not have sufficient security to fend off some 50 people who arrived to take the patient away, he said, highlighting the weakness of the state. Mayor Francoeur Dalexis told Reuters he had reinforced police patrols since the incident but resources were tight.
Laguerre said the man died the following day and his family held a large wake.
"I fear there will be a massive outbreak” in the area Laguerre said. "But until now, none of those in (the victim's) entourage have wanted to be tested, and they have even put barricades on the road."
With the attacks on voodoo priests over cholera fresh in their memories, leaders of that religious community are appearing on radio and television to dispel any notions that they may have conjured the coronavirus.
Health experts agree more education is needed to explain the virus. The United Nations Children’s Fund (UNICEF) said it has helped the government produce 500,000 flyers, 250,000 leaflets and 100,000 posters as well as videos and audio spots.
But nearly half the population is illiterate, and many rural residents have no access to the internet, television or radio.
Popular musician Jean Jean Roosevelt, who recorded a song with UNICEF called "Corona Can Cause a Lot of Damage," said he travels to remote regions with around 40 volunteers and megaphones.
"We try to help people understand that someone who is infected with the virus is not necessarily a danger for the rest of the community if this person follows the rules," he said.
But even these messengers are at risk. In the mountainous northern town of Marmelade, a young man trying to educate the community about the virus was beaten by locals and had his wrist cut, said Dorcenat, the local health ministry official.
Fontilus, the recovered COVID-19 patient, said he’s trying to set up a foundation to raise awareness. But with death threats still coming in, the pastor said he’s looking to relocate to the United States.
"I'm impatiently waiting the day embassies are working again," he said, "so I can apply for visas for my family and save my skin."
(Reporting by Andre Paultre in Port-au-Prince and Sarah Marsh in Havana; Editing by Marla Dickerson)