Haiti After the Earthquake

by Paul Farmer

  As 2009 drew to a close, there was a sense of progress elsewhere in Haiti, too. Some encouraging macro-economic indicators suggested a boost in agricultural productivity and the beginning of a recovery from the storms of 2008. Of course, there was brisk debate about priorities and an endless stream of criticism, but some endeavors seemed to be moving forward (though not on the scale of a Marshall Plan). Roads and bridges were in poor condition well before the hurricanes cut central Haiti off from the western coast the previous year, and several such infrastructure projects—deemed top development priorities by the government—had been launched.

  Many of us also wanted to focus on complementary public works, with reforestation and watershed protection at the top of the list. Our UN team included two specialists in disaster risk reduction, one Swiss and one Cuban; in the second week of January, they set about planning a conference on implementation. Our standing joke was that the field of disaster risk reduction was “eminently technical” but that old-fashioned elbow grease was necessary for implementation. To this end, I begged them to spend more time in Haiti than in Geneva or New York.

  Private investment in Haiti was not to be overlooked. It was for this reason that we’d taken Rolando and others to visit places such as Boucan Carré. But as physicians, we knew little about manufacturing, energy, or large-scale agriculture. To fill this gap, the Clinton Foundation seconded Greg Milne, an energetic and talented young lawyer, to the Office of the Special Envoy. Greg set to work with local businesses and institutions such as the Inter-American Development Bank to attract new investments and to “incubate” labor-intensive and environment-friendly enterprises. Denis OʹBrien (who, in addition to helping us with the bridge, had also invested in schools throughout rural Haiti) brought scores of Irish investors to Haiti and allowed us to announce a new award for young women entrepreneurs. These awards were to be given out with the help of the Ministry of Women’s Affairs—not just in Port-au-Prince but in each of Haiti’s ten administrative departments. A hastily planned investors’ conference in Port-au-Prince, headlined by Clinton, Préval, and Pierre-Louis, attracted people from across Latin America, the United States, and even Asia.28 During the last months of 2009, it was difficult to find a hotel room in the capital. The biggest hotel, the Montana, was fully booked weeks in advance.

  We weren’t the only ones to sense progress. An article by a journalist knowledgeable about Haiti appeared in the Miami Herald on December 8:As my plane came in for a landing during a recent trip to Port-au-Prince, I was surprised to see five different planes from five different airlines on what used to be a deserted runway. Surprised to see that the traffic signals downtown, which rarely worked because of an electricity shortage, now run 24/7, not because there is more electricity—which there is—but because they are powered by solar panels. Even more amazing, drivers slow down for yellow lights and stop when they are red. Whether real or perceived, there is a sense of order on the streets. Such minor advances may seem insignificant in a country where monumental leaps are critical to its survival. But small steps, collectively, could be the magic formula for a poor, relatively uneducated population not predisposed to making drastic lifestyle changes imposed by the outside.29

  Some didn’t think this added up to much. The lack of any social safety net in health, education, and sanitation was clearly holding Haiti back. But it did seem possible, just then, to hope for progress. The city of Port-au-Prince was calm, and I let the UN know (diplomatically of course) that it was not necessary to provide me with so much security; I would be in Haiti often (including for the upcoming holidays with my family), and the bodyguards and motorcades seemed a waste of resources.

  We hoped that Kim Bolduc, the new coordinator of nonsecurity-based UN activities in Haiti, would launch development projects like those she’d helped launch in Brazil, including conditional cash transfers for families in need. (The conditions on such transfers were that recipient families vaccinate and send their kids to school.) A similar program had helped millions of the poorest in Mexico and led to a national health insurance program.30 And Bolduc was a veteran of some tough postings, including Iraq. She and I clicked, and our families rang in the New Year together in Port-au-Prince.

  It would never have occurred to me that my new ally, badly injured in the explosion that killed seventeen UN staff in Iraq, would face such a violent affront to her survival only twelve days later.31 Of the eight officials with whom we’d worked, seven, including Annabi and da Costa, would perish in the quake, as would Dr. Mario Pagenel and solar-power guru Walt Ratterman. Bolduc survived. So did the young specialist in disaster risk reduction, who had arrived in Port-au-Prince (to represent our office) two hours before the quake. One minute he was inside the UN headquarters and the next minute—the minute that mattered—he was not: he had stepped outside for better cell-phone reception.

  3.

  JANUARY 12 AND THE AFTERMATH

  The matter of minutes,the matter of time and place, was everything when the quake hit. Anyone in Haiti, or involved deeply with Haiti, can tell you exactly what they were doing at 4:53 P.M. on Monday, January 12, when a magnitude 7 earthquake ripped through the most heavily populated part of the country. I was in Miami, reading The Best and the Brightest, David Halberstam’s cautionary tale about the United States’ entanglement in Vietnam.1 I had just spent Christmas and New Year’s—a day the Haitians celebrate as Independence Day—in Haiti with my family. The century-old National Palace had been festooned with Christmas decorations. Nobody imagined that less than two weeks later, it would lie in ruins along with almost all of Haiti’s federal buildings.

  That morning, my family was preparing to leave for Rwanda, and I was ready to shut off my phone and read Halberstam’s book. The problems we’d faced in Haiti the previous year had left me convinced that I needed to think harder about the tension between policy and praxis. Some of the implementation failures in Haiti were linked to a simple lack of follow-through, but others stemmed from misguided policies from Port-au-Prince and abroad. Although events in Vietnam during the sixties and seventies were distant, U.S. foreignpolicy misadventures there seemed relevant when thinking about the failure of aid in Haiti at the beginning of 2010. After my family had boarded their flight, I was planning to finish The Best and the Brightest uninterrupted.

  But shortly before 6:00 P.M., I received a call from a Washington, D.C., area code. It was Cheryl Mills, Hillary Clinton’s Chief of Staff and a friend who had made several trips to Haiti in the past few months. The new U.S. administration was aware of the difficult relations between the two oldest countries in the Western hemisphere, and Mills was one of those charged with improving them. She was taking the job seriously. Because Haiti is not seen by many in the U.S. foreign policy establishment as a region of strategic importance, and because it had been subject to erratic policy shifts under different administrations, I was grateful for Mills’s interest. But I had no idea why she would be calling that evening.

  “Are you and your family in Haiti?” she asked.

  “No, we just left. I’m in Miami and they’re en route to Rwanda. I won’t be going back to Haiti until the week after next. Why?”

  “Thank God you’re safe,” she said. “There’s been an earthquake in Haiti. A big one.”

  “Where?”

  “Looks like the epicenter wasn’t too far from downtown Port-au-Prince.”

  This is what Haitians call “news that demands a chair.” I was already sitting, but felt faint nonetheless. Port-au-Prince is the most fragile city I can think of: with a population of three million, it runs from mountaintops down steep hillsides to the harbor and waterfront slums. It is one of the most densely inhabited parts of the Caribbean and infamous for sloppy, makeshift, and almost entirely unregulated construction. In November 2008, a three-story school had collapsed without warning, killing almost a hundred students and injuring many more.2 Mudslides occurred every year, sometimes consuming entire hillsides covered in houses and shacks. And the
frequency of these incidents seemed to be accelerating with every rainy season, as the last of Haiti’s forests were felled for charcoal, and as Port-au-Prince’s crumbling infrastructure groaned under the weight of rapid urbanization and persistent poverty.

  But an earthquake? A big one? This seemed unfair and statistically improbable. Could this happen after the hurricane season of 2008, when tropical storms Fay, Gustav, Hanna, and Ike had struck Haiti in only four weeks? It was impossible, just then, to take in another mental image of ruined infrastructure and injured and stranded people. And then, a second later, it hit me: What about our friends and family and coworkers in Port-au-Prince? We ran a dozen hospitals, and perhaps three times as many schools. Most of our patients and providers would be in Central and Artibonite Haiti, some hours outside Port-au-Prince, but all of them have family in what Haitians call “The City.” And as on any weekday, many of our coworkers would be there. Hadn’t I just asked a number of colleagues and friends to go there for meetings that day? Wasn’t my brother-in-law there, along with three or four members of our small UN team?

  “Paul, you there?” I realized that I was still holding a phone.

  “Yes. But I have to get through to my coworkers and family.”

  Mills warned me that landlines were down, as were the cell towers that linked most Haitians, even the poor, through mobile phones. That alone was startling: how big an earthquake could take out both landlines and cell towers? But she invited me to join a conference call linking Port-au-Prince and Washington later that evening, and let me know that President Clinton would call shortly.

  As soon as she hung up, I tried all the Haitian numbers on my cell phone. Nothing. I called my coworkers in Boston, including Ophelia Dahl, and learned that they’d had no more success getting through. The only word from Port-au-Prince came from Louise Ivers, who (as I later learned) had been in a meeting when the building cracked and fell around her. She got out one text message: “SOS. SOS.”

  Claire Pierre was, as chance would have it, in Boston. If anyone could get through to Haiti, it was Claire. She’d already reached her mother, who was alright and had promised to help connect me to Prime Minister Jean-Max Bellerive. (She didn’t tell Claire that her childhood home had been flattened.)

  I knew Bellerive pretty well. The previous October, when the Global Fund was considering cuts to their AIDS treatment programs in Haiti, Michèle Pierre-Louis agreed to help us attend to the Fund’s concerns at a meeting later that year. The reason for the proposed cuts, as far as we could tell, was recurrent mismanagement at the central level of the program’s administration since the departure of First Lady Mildred Aristide, the chair of Haiti’s National AIDS Program until 2004. Although not involved at the central level, Partners In Health and Zanmi Lasante were among the largest implementers of Global Fund–supported programs, and our doctors and nurses and community health workers had patients who depended on these funds. We all wanted high-level government support, as we’d enjoyed under Aristide, in spite of the chronic central management problems.

  Pierre-Louis, one of the early investors in such efforts, promised to help shepherd a unified response. But shortly before the meeting was due to take place, she was replaced by Jean-Max Bellerive, previously the Minister of Planning and External Cooperation.3 The implementers (mostly health providers) insisted that the new government, now to be led by Bellerive, move the Global Fund grants higher up the official agenda. At a Christmas dinner hosted by Bellerive’s sister, a few of us entreated Bellerive to reschedule the Global Fund meeting, and he agreed to help.

  The date was set for January 12; the time, 4:00 P.M. Its significance was suggested by the attendees: the senior leadership of the Ministry of Health, including the Minister; leading AIDS researchers and care providers; AIDS activists and patients; and representatives of the French and U.S. development agencies. Loune Viaud and Nancy Dorsinville were representing Partners In Health and Zanmi Lasante, (and were among those I’d been calling repeatedly after hearing the news from Cheryl Mills). If I could talk to Bellerive, I could find out if my friends were okay—and also get his take on the dimensions of the quake before I spoke to Clinton.

  Claire Pierre and her mother promised to keep trying Bellerive until they got through, and less than an hour after speaking to Mills, Claire’s mother connected me to Bellerive by passing him her cell phone. I heard about every other word, but thought I got the gist: Yes, Bellerive had been at the AIDS meeting, and yes, my friends were unharmed. But much of the lower city lay in ruins, he said; “Downtown?” I asked. Yes—the palace and the ministries had been damaged or destroyed. Casualties would be high.

  “Thousands?”

  “Tens of thousands. Maybe more. We’re in the dark. Tell President Clinton that we’re going to need his friendship now more than ever. Port-au-Prince is ruined.”

  The restoration of telephone service was slow and spotty, but it was also responsible for many of the survival stories in the days following the quake. (Although the technology was introduced recently, Haitians from all stations of life seemed to have cell phones.) But most of the calls I received in the hours after the quake left me feeling helpless. A few were from survivors calling from under the rubble. (I wasn’t always sure how they had obtained my number.) A couple of early calls came from friends who assumed I was still in Haiti. One was from an airport employee who rushed home to find his house destroyed and his seven-year-old son trapped under the rubble. The boy, Richardson, would perish, but not for three hours—and not without begging his parents and younger sister for a sip of water.

  President Clinton did call that night; he asked me to come to New York. The next day, he would address an emergency UN session on Haiti. His Haitian counterpart, Haiti’s Envoy to the UN office, was Leslie Voltaire, an architect and urban planner who had served in most of Haiti’s democratically elected governments. Voltaire was already in New York. We’d been friends for two decades, and I knew that his duties as a diplomat were vying for space in his mind with the deep anxiety that gripped millions of other Haitians who lived abroad, or who, like Voltaire and Claire Pierre and my wife Didi, found themselves outside Haiti on January 12.

  “Port-au-Prince is ruined.” Bellerive’s words rang through my head all night. We’d been speaking Creole, but the words mean pretty much the same thing in English, I thought. But I wasn’t sure. Did “ruined” mean damaged or destroyed? Did he mean that a certain part of the city was down? And was it true that other cities to the south had been damaged?

  It wasn’t easy to find out what was going on, even if by midnight the quake was the lead story on every television channel. Rumors about massive loss of life circulated widely on the Internet, but it was hard to credit them in the first hours. My mother and Jennie Block were with me, and together we packed our bags for New York. It was a relief to make an unplanned trip there, even if only to find out, more or less, what had happened.

  We found President Clinton in a small room with a few members of his staff and with Ban Ki-moon, the UN Secretary-General. They were, in a sense, meeting to prepare their remarks. It was only fifteen hours after the quake, but they were probably working with better data than anyone else. We learned that some of the rumors were likely true: the temblor had leveled most Haitian federal buildings (soon we would know that it wasn’t most but rather almost all) and the UN headquarters had collapsed completely. This last bit of news weighed heavily on those assembled in UN headquarters, though a heavier dread mantled the Haitians in the meeting. I still didn’t have news of my wife’s family, whom I hoped were safely in central Haiti. I still had little clue about my friends and coworkers, except for those who’d attended the same meeting as Bellerive.

  The UN meeting was, of course, unscheduled, and I wasn’t sure what role to play. Beyond my association with the Office of the Special Envoy (meaning President Clinton), few of those gathered knew how I fit into the puzzle any better than I did. Sitting in the small room, we heard Clinton and Ban Ki-moon a
gree that all energies needed to be focused on rescue and relief. This much was uncontroversial. But what else needed to be said? When Clinton asked that something be done to preserve the bodies of the Haitian dead so that they could be given proper burial, no one replied (although the theologian in the room was nodding vigorously).

  The two leaders then left the room to deliver a grim set of public declarations at the official UN session. It was my job to sit behind President Clinton as his “plus one” (a term I’d never heard before 2009). He gave a brief statement that acknowledged the UNʹs losses but put the emphasis on the huge toll taken—we didn’t have numbers, but it was clearly many thousands—on the Haitian government and civilian population. Pained but confident, Clinton struck a note respectful to the Haitians and apposite to the UN setting:Yes, Haiti is the poorest country in our hemisphere. Yes, 70 percent of the people or more live on $2 a day or less. Yes, they have had a long and tortured history. But they are good people. They are survivors. They are intelligent. They thrive in their diaspora communities. They desperately want to reclaim their country and give it a better future. And they need your help now. A lot of us at the UN, we believe in them. And a lot of us today are pretty low, because we know that some of our colleagues have died because they believed in Haiti. These people deserve a chance to bury their dead, to heal their wounded, to eat, to sleep, to begin to recover, and they can’t do it just with government help alone.4

  On January 13, Clinton’s mix of idealism and pragmatism buoyed me. He had dealt with natural disasters before: he spearheaded recovery efforts for the 2004 tsunami and for Hurricane Katrina, and had called for more help for Haiti after the storms of 2008. Then, too, he’d pushed for immediate rescue and relief followed by a massive reconstruction response. But were these disasters of comparable magnitude? We had no idea, just then, but it couldn’t hurt to have an experienced hand on deck.