Primum non nocere is a Latin phrase that means, “first, do no harm”. I’ve been thinking about these three words over the past couple of weeks, not because of anything in the world of health and medicine, but because of political events in nations near the US.
On 7 July, Jovenel Moïse, the president of Haiti, was shot and killed in his home in the country’s capital of Port-au-Prince. Officials have since arrested a suspect they believe organised the assassination. Multiple individuals are claiming that they are now the legitimate leader of Haiti. Haitian authorities asked for US and UN troops to protect the country’s infrastructure, a request US President Joe Biden at first rejected, but then reportedly decided to examine more closely. Protesters have taken to the streets in Port-au-Prince as citizens grapple with insecurity, lack of access to basic goods, and, now, fuel shortages.
In Cuba, meanwhile, a combination of food and medicine shortages, blackouts, and inflation has pushed people to the streets. The Cuban government blames the US, which has a decades long trade embargo that was strengthened under the Trump administration. But experts say that, while the embargo does hurt, so, too, does the Cuban government’s refusal to implement economic reforms. The Cuban regime and police responded violently to the protesters, detaining dozens of people.
These two situations are not the same. They are different countries, with different people and political contexts, and I do not mean to conflate them. But in both cases, the US has a long history of actively harmful foreign policy. Whatever steps it does or does not take with respect to its neighbours’ crises should be especially careful to first minimise the amount of pain felt. Past US interventions and present policy has already inflicted enough.
Haiti declared independence from France in 1804, after slaves fought off their French owners. In response, slave owners in the southern states of the US tried to prevent their own slaves from learning of the revolution, and then pressured the US government not to recognise an independent Haiti (which it did not do until the Civil War in 1862, when southern states seceded). Later, in 1915, the US invaded Haiti and occupied it until 1934. During the Cold War, the US supported the father and son Duvalier team, a pair of brutal dictators who killed their opponents and stole Haiti’s money for themselves, but who had US backing because they were anti-Communist. In the late 1980s, faced with growing opposition, the younger Duvalier finally fled, and, in 1990, Haiti held democratic elections. Jean-Bertrand Aristide, a Catholic priest, was elected. The next year, the Haitian military removed him from office. The US military then returned to occupy the country in the mid-1990s. He was elected again in 2000 and ousted again in 2004, and he argues that the US was directly involved in his removal. Also, the US has been repeatedly criticised for the food aid it gives to Haiti, which is subsidised by the US government to the benefit of American farmers, flooding the market with cheap food and driving Haitian farmers out of business.
Cuba had its own revolution in 1959 — in this case, a communist revolution. After the revolution, in 1961, the CIA and Cuban exiles tried to invade the country and push Cuba’s then-president, Fidel Castro, who had governed the revolution that led some to celebrate and pushed others to flee the island, from power. President John F Kennedy’s administration launched a full trade embargo the next year. Cuba’s economy lost an estimated $130bn over the next six decades. The US has also, for decades, applied economic sanctions that limit the amount of currency that can be traded with the country. During the pandemic, a lack of foreign tourism plunged Cuba’s economy further into crisis.
None of this is to say that the recent crises are the immediate or exclusive responsibility of the US. The US did not assassinate the Haitian president, and, whatever one might say about US policy toward Cuba, it is not the US that is blocking the internet or arresting protesters on the island.
It is instead to say that the US, given its track record and very recent history, should think carefully on how to proceed. We have seen, time and time again, that flag waving, sending troops and declaring our love of freedom can have long-term disastrous consequences for people whom we are purporting to try to help.
What would it mean to try to first, do no harm? In Haiti, it could mean resisting the calls to get involved militarily, recognising that previous interventions have not provided the stability or security they were ostensibly intended to. In Cuba, it might also involve resisting calls to lead an intervention. So, too, could it mean ending the embargo and lifting sanctions that, even if they are meant to squeeze the Cuban government, are also making it more difficult for people to get essential resources. Even Gregory Meeks, the chair of the House of Representatives’ Foreign Affairs Committee, and a fairly moderate Democrat, has urged the Biden administration to lift the sanctions on Cuba. (Absent of an embargo, the Cuban government would arguably have only itself to blame for its people’s economic pain.)
And in both cases, it could mean establishing the US as a refuge for people who feel it is no longer safe to remain. Alejandro Mayorkas, the secretary of the US Department of Homeland Security, who himself emigrated to the US from Cuba with his family after the Cuban Revolution, said this week that Haitian and Cuban migrants and asylum-seekers who attempt to enter the US by boat will be denied entry. Instead, he said, even those who can prove they are legitimately fleeing persecution will be resettled in third countries.
The US has a responsibility to let asylum seekers in according to its own immigration law and international agreements. But even if it did not have to do this under the law, this current instability cannot be separated from past US policy in the region. And while the Biden administration cannot turn back the clock, it can try to not inflict any more harm and to minimise that which exists. Giving a place to heal to those in need would be a start.