JACMEL, Haiti -- Medicine time approaches quickly at St. Michel Hospital and the 100 patients get ready: They sit up in their beds, prop up the pillows and begin singing.
There is no more medicine at the hospital. Singing now is the substitute cure.
"The people come to the hospital because they came to believe," says Jean-Claude Delval, whose "Hope for Health" group from the French Caribbean island of Guadeloupe supports the facility. "If they know there is no medicine, if they know there is no medical care, they will no longer believe."
Medical aid and humanitarian supplies are exempt under the tough U.N. embargo that went into affect May 21.
The reality on the ground is that the embargo's harshest effect has been on those needing help the most:
-- Sanctions grounded all non-commercial aircraft. That left dozens of charter airplanes, used to ferry food, medicine and other humanitarian items, sitting idle on runways in south Florida.
-- Increased fuel prices have skyrocketed operating costs for aid groups, prevented local employees from getting to work and sometimes spoiled medications when refrigerators stopped running during electrical shortages.
-- Import and export licenses have been revoked from Haitian companies helping humanitarian groups here.
-- Parents, whose incomes were wiped out by sanctions, are abandoning children at health clinics.
"Those who say we exempt humanitarian aid and that by saying this it (the embargo) has not a detrimental effect, are dreaming," says John Yates, a physician with International Child Concern.
One example: the ICC's program battling tuberculosis, Haiti's second leading killer.
Prior to the 1991 military coup, when Haitian president Jean-Bertrand Aristide was ousted, Yates says "significant progress" was made against tuberculosis, especially in rural areas and for young children: "If you do anything that affects the constant flow of medication, it increases the possibility of the disease continuing." That's happening now:
-- Drugs to battle tuberculosis sit in clinics unused because parents cannot afford to transport children for treatment.
-- Children fall off the program, letting the tuberculosis inside them grow strong again and mutate into a more resistant strain.
"It means the next line of drugs that will provide treatment are more expensive and more difficult to get," Yates says. "If you extrapolate that all over the country, you're talking (about) many problems."
One need only travel to the local Cite Soleil slum to see the impact of withering health care.
"It takes longer now to receive the medicine, even when a container comes," says Yves Laborde, medical director of the Chapi health center in Cite Soleil. "And they don't give us what we really need."
Even ships carrying medicine and aid are now stopped.
"We have not received anything by sea since the embargo," says Robert Nadal, whose family runs much of Haiti's shipping.
"Anyway, no ship will come here with 15 or 20 containers (of medicine), and then go back empty," Nadal says.
Ships still come to Jacmel's but carrying the more lucrative contraband fuel. It is only a 17 minute walk from the docks to St. Michel Hospital, where the singing has now stopped.
After a few seconds of quiet, patients begin praying aloud, the volume rising until it too abruptly halts.
Again come a few moments of silence, then the next sound: coughing from most of the beds. For now, this is the only answer to the prayers.
