Former Haitian Prime Minister Yvon Neptune has been staging a hunger strike in jail for the last 15 days. He has refused medical treatment in the Dominican Republic until the interim government drops accusations that he organized a massacre:

“Mr. Neptune said he would accept to be evacuated only if all the charges brought against him were lifted,” Mike Joseph, a spokesman for interim Prime Minister Gerard Latortue, said in a statement late Sunday. “Such demands are absolutely unacceptable.”

Doctors from the United Nations’ peacekeeping contingent in Haiti said on Saturday that Neptune’s vital functions were seriously threatened and he was near death.

Interim President Boniface Alexandre’s chief of staff, Michel Brunache, said the government had done all it could to help the former prime minister “but we cannot force Mr. Neptune to live if he does not want to,” he told Reuters on Monday.

Neptune was arrested on June 27, 2004, and has been held at the Port-au-Prince national penitentiary without being formally charged by a judge.

Neptune served under ousted President Jean-Bertrand Aristide, who was forced into exile during a revolt in February 2004.

Neptune is accused of masterminding what Aristide’s opponents called a massacre on Feb. 11, 2004, in La Syrie, a village near St. Marc 60 miles (95 km) north of Port-au-Prince.

The accusations were brought by the National Coalition for Haitian Rights and a St. Marc group known as RAMICOSM, which opposed Aristide and his Lavalas Family party. The two groups said 50 people were killed by Aristide supporters.

A U.N. human rights envoy in Haiti, Louis Joinet, conducted an investigation in St. Marc last month and concluded that about 25 people — supporters and opponents of Aristide — were killed in clashes there in February 2004.

Joinet characterized the deaths as the result of a “confrontation” and not a massacre.

This comes amidst a stumbling international presence and a lack of imagination on the part of the US and French Governments. Conditions remain scandalous in much of the country while lawlessness continues:

Two small pits in the yard hold human bones ???????? the remains, local residents said, of people killed during gang fights in December. The children in this neighborhood aren’t among the 60 percent of Haitian youngsters who are able to go to school, and unemployment ???????? officially 80 percent in Haiti ???????? is the norm.

“Things are getting worse. This is all we have to eat,” said Rosemarie Fleurant, a 28-year-old mother of eight, gesturing toward the mud cakes she had laid out on the ground.

Haiti is patrolled in part by a U.N. peacekeeping force of more than 7,400 soldiers and police. The U.N. Security Council is expected to vote in June to renew the peacekeeping mandate for another six months. Some residents said the United Nations has made progress in thwarting gang shootings. But the rebels who promised to disarm after Aristide’s departure have not turned in all their guns, and residents of neighborhoods loyal to Aristide say they do not feel they are being protected.

The police appear no better than the rebels in this case, often firing indiscriminately into crowds of protesters. Those in the political and business classes–those most able to help their own country–look little past their own noses.

The nation still relies heavily on help from abroad, either through foreign aid or remittances of family members. The situation fosters a culture of dependency that has kept Haiti from genuine self-rule, said Larry Birns, director of the Washington-based Council on Hemispheric Affairs.

“Haiti has always been at the end of a leash. It has been treated as a second-class country with third-class policy ending up with fourth-class results in every respect,” Birns said. Some Haitians fear being left to fend for themselves; a U.N. official who asked not to be named said many Haitians have told him they do not want the fall elections because they are worried international forces will leave.

Elections are scheduled for the fall, although it is hard to find anybody who holds much hope for a peaceful transition of power. The interim government is showing itself to be unable or unwilling to control the police and Aristide’s Lavalas party is threatening a boycott while the exiled former president continues to exert a cult-like control over much of the country.