by Paul Farmer
6.
FROM RELIEF TO RECONSTRUCTION
(Building Back Better?)
Two months after the quake,Haiti was still struggling to transition from disaster relief to reconstruction. There were still many acute needs: injured and sick people needing medical attention, children without food and water, families living in burgeoning tent cities who needed safer shelter. As in February, many of us split our time between assisting with direct relief and trying to resume whatever it was we were doing when the quake hit.
As we struggled to recapture a sense of normalcy, continuing tragedies kept pulling us back to the making of grim lists. Most such tragedies occurred in Haiti, but no one was really spared. One of our hardest working members of the Office of the Special Envoy, Aaron Charlop-Powers, lost his mother (whom I’d known as a Partners In Health supporter) in a bike accident in New York on March 17. Everyone in the UN offices stopped work and tried to let Aaron and his grieving family know that we were there with them. But, as with Haiti, it seemed too little and too late.
President Clinton and his staff were gearing up for the March 31 donors’ conference. I wouldn’t have to speak at the conference, which was a relief for reasons ranging from stage fright to epistemological anxiety (how could we be sure about the numbers?). As his deputy, I would be responsible for questions about medicine and health, but could refer questions about other aspects of recovery to the Special Envoy himself. Clinton wasn’t shy about discussing any of Haiti’s dilemmas, including structural problems with deep historical roots; nor did he mince words about our country’s role in worsening Haiti’s plight, unwittingly or otherwise. A few weeks after my Senate testimony, the former president was in the same room giving his. He offered a brave mea culpa about the role of U.S. food imports in undermining Haitian agriculture. He could have blamed the Foreign Assistance Act of 1961 or ecological decline or the inferior productivity of Haitian farmers, or any old thing, as politicians often do. But here is what he said to the Senate Foreign Relations Committee on March 10:Since 1981, the United States has followed a policy, until the last year or so when we started rethinking it, that we rich countries that produce a lot of food should sell it to poor countries and relieve them of the burden of producing their own food, so, thank goodness, they can leap directly into the industrial era. It has not worked. It may have been good for some of my farmers in Arkansas, but it has not worked. It was a mistake. It was a mistake that I was a party to. I am not pointing the finger at anybody. I did that. I have to live every day with the consequences of the lost capacity to produce a rice crop in Haiti to feed those people, because of what I did. Nobody else.1
This sort of candor meant a lot to me and to many others; it helped start a conversation about needed reforms to the machinery of foreign assistance and global trade.
I next left Haiti with Claire Pierre and Garry Conille for a March 15 conference in the Dominican Republic. This was yet another meeting about a meeting, but one in which the broad outlines of the upcoming pledging conference were to come into view. Flying from Haiti into the more developed Dominican Republic was always startling, but the differences—economic, ecological, infrastructural—between these two countries, sharing a single landmass and once inhabited by a single people, had never been more jarring than after the quake. The border visibly instantiated the divergence between the two countries’ fates: where the Haitian side was stripped bare of trees after decades of unchecked deforestation for charcoal production, the Dominican side retained a healthy forest cover. (I’d recently learned that bakeries, laundromats, and household cooking fires were three of the largest consumers of charcoal in Haiti.) Infrastructure and construction quality were noticeably more robust after crossing the border. One could not help but wonder how much less damage there would have been—and how many fewer lives lost—had the earthquake struck a few hundred miles east (though no one would ever wish such a fate upon any country or people).
The three-day meeting in Santo Domingo aimed to help the Haitian government develop its national reconstruction plan and to coordinate donor activity leading up to the March 31 conference in New York. This meeting was, after Montréal, the second public step in the process of aligning the goodwill of the international community to help rebuild Haiti and one of the last steps before a more scripted agenda was set for New York. Without much to contribute, I listened and watched, often disquieted, as foreign ministers, international organization representatives, and disaster relief experts improvised in what often felt like political theater. Different players—some powerful, some less so—tried to get a word in edgewise, taking turns sitting and standing in a dance that seemed to reassert an unspoken hierarchy of power and prestige. The more interesting conversations occurred dans les coulisses—“in the hallways”—where it was possible to be frank and find those who were deeply committed to Haiti.
Some participants had experience rebuilding cities and regions after disasters natural and unnatural. Most relevant, perhaps, were the teams who’d worked in Indonesia after the 2004 tsunami as part of the Multi Donor Fund for Aceh and Nias (two of the hardest-hit provinces). They shared experience of disaster-resistant construction, resettlement of refugees, and the resolution of property disputes—all challenges Haiti was already facing and ones that would only grow in importance on the long road to reconstruction.
A number of Haitians expressed—not impolitely—doubts about the relevance of such examples and overly prescriptive advice. Prime Minister Jean-Max Bellerive said, dans les coulisses, “Look, I don’t want my country to look like the Dominican Republic or Indonesia or some other place. We’re searching for a genuinely Haitian way of rebuilding.” Haitians from “civil society” were already grumbling that they weren’t getting much of a say in the recovery process. But they’d been invited to Santo Domingo, which is more than most of our patients in central Haiti could say. We hoped, of course, that Michèle Montas’s testimony (based on the Voices of the Voiceless project) would help fill this gap at the March 31 donors’ conference, which by the end of the Santo Domingo meeting had been titled, “Towards a New Future for Haiti.”
Attendance at the preparatory meetings—in Montréal and Santo Domingo—suggested that significant commitments would be made. It did not mean, however, that all promises would be kept, nor did it mean that resources would be deployed fairly or wisely. The New York convocation was slated to be much larger than the previous meetings, drawing representatives from an estimated 150 member states and international institutions. It remained to be seen whether having so many participants would mean much to the people cobbling a life together in Port-au-Prince, but it would have been worse than cynical not to give it a try.
Past experience tempered naïve optimism. Meetings like these were common coin after natural disasters. We’d witnessed the flimsiness of aid promises since the Washington, D.C., International Donors’ Conference in April of 2009, a meeting to generate support after the 2008 storms rocked Haiti, leaving Gonaïves under water and causing billions of dollars worth of damages.2 During that meeting, labeled “A New Paradigm,” Ban Ki-moon and others spoke of a “new juncture” and pledged long-term support for Haiti. (Some of the new was redolent of the old, including the idea of turning Haiti into the “Taiwan of the Caribbean.”3) In any case, not enough came of the financial pledges made in Washington: of $402 million promised for the Haitian government’s Economic Recovery Program, only about $61 million, or 15 percent of the pledges, was disbursed.4 And, to risk repetition, of the money that did reach Haiti, little went to the public sector.5 (Isnʹt the government an important player when trying to rebuild a country or prepare for future storms?) Donor conferences, it seemed, needed to be “built back better,” too.
Jean-Max Bellerive was slated to introduce the Action Plan for National Recovery and Development of Haiti, which drew on the Post Disaster Needs Assessment launched in Montréal. The action plan and the needs assessment were drafted by the government of Haiti in collabora
tion with foreign technical assistance (a clutch of consultants, some working pro bono and others seconded from various agencies); they sought to lay out a vision for reconstruction and identify funding gaps. These documents drew on a wellspring of development and recovery initiatives proposed by previous Haitian governments after upheavals (such as the 2004 coup) and disasters (such as the 2008 hurricanes).6 The new action plan introduced a number of schemes to build back better, from political restructuring to massive housing plans to scaling up an ambitious education agenda. There was a profusion of plans, but little in the way of implementation.
Was this giant March meeting to yield more of the same? Sometimes it seemed that the quake had changed everything, but as the history of chronic problems revealed, much had not changed. Uneven development, the gap between rich and poor, the ongoing exclusion of most of the latter, the unseemly quest for control of the frail apparatus of the state, the ecological crisis, the reliance on fractured foreign aid, and the privatization of basic services (when they were available at all)—all were longstanding problems worsened by the quake. It was tempting, at times, to give an ivory-tower shrug of inevitability and assume that it was all too hard to improve, much less to fix. The donors’ conference would be bigger, but surely it could also do better. Garry, Claire, and I were physicians, and we were there to give reconstruction our best good-faith effort, knowing full well that we would fall short of our aspirations and those of the Haitian people. But we had to try.
And so on we went, organizing and cajoling and seeking to make New York not just bigger but better. The Office of the Special Envoy team had been working around the clock, as had President Clinton and his staff, official teams from the hosts (the UN and the U.S. government), and many Haitians who had worked on the needs assessment and action plan.
The conference was held on the second floor of the General Assembly Building of the United Nations. Security was tight at the UN and across New York because so many dignitaries were flying in for the meeting. The morning consisted of welcomes and introductions; all speakers underlined the need for long-term financial support for Haiti’s reconstruction (as they’d done in Montréal). Ban Ki-moon spoke, then Hillary Clinton, then René Préval. The Haitian president thanked those present for helping Haiti, but also noted that his government had received little support from the international response to date—a paltry $23 million of the $1.35 billion disbursed for immediate earthquake relief.7
My job was to sit behind Clinton, along with Laura Graham, and to brief him on the “civil society” session he would be chairing. He knew my views—that although the session brought in perspectives from certain NGOs, certain parts of the Haitian diaspora, and certain private sector groups, no poor people were present. During the plenary session, Michèle Montas would summarize the views recorded by the “Voices of the Voiceless” team. Because we couldn’t hear directly from those most affected by Haiti’s social and economic fragility, Michèle’s testimony was the part of the conference that mattered most to me.
Michèle knew the rural and urban poor as some of the sharpest critics of Haitian society and politics and the development enterprise. Her statement, not much more than ten minutes long, presented their suggestions about rebuilding Haiti. Although her elegant contribution to this book introduces the Voices of the Voiceless project in more detail, I’d like to underscore how her words, echoing this, challenged a number of assumptions about Haiti that persisted among those gathered in New York. In contrast to reports of Haitians passively accepting handouts in refugee camps, these interviews revealed that leaving the camps was a priority for almost everyone surveyed. Camp dwellers desired nothing more than to return to their homes—some of them little more than heaps of rubble—or to rejoin family in the countryside. Interviews far from the quake zone were also instructive. Rural farmers interviewed were adamant that Haiti needed to rebuild its agricultural base before it could reap the benefits of local and international trade; mothers and fathers demanded adequate food for their children and their neighbors’ children; many stressed the importance of aid independence and sovereignty after reconstruction was underway. During the few short minutes that Michèle spoke, I wondered if some new paradigms of foreign assistance and economic development might come out of all this.
Clinton’s optimism and Michèle’s testimony set a tone of hopeful pragmatism for the afternoon, when the pledging sessions took place. As in Montréal and Santo Domingo, the meeting had its share of posturing and grand promises. But for the most part, the concern and willingness to help expressed by foreign ministers, international organization representatives, and other delegates seemed genuine (as political theater often does). When Venezuela and the United States began vying for the biggest pledge, it seemed best to applaud politely. Even those from nations with divergent interests handled themselves with a certain comity. And the numbers—the amount pledged—kept going up.
A stunning $9.9 billion of reconstruction pledges were made on March 31.8 The funds were earmarked not just for rebuilding but for rebuilding better: $5.3 billion for the near term (2010–2011), $4.6 billion for the long term. Venezuela and its allies emerged as the largest contributors, pledging more than $2 billion; the European Union collectively pledged $1.6 billion; the United States pledged $1.15 billion. 9 It was an impressive show. “Today it has been demonstrated,” concluded Préval, “that the international community will continue to support Haiti in the long term.”10 Hillary Clinton noted in closing that after the Asian tsunami, some 80 countries pitched in with humanitarian relief, while about 20 pledged reconstruction assistance; in Haiti the numbers were more than 140 and 50, respectively.11 Ban Ki-moon was similarly optimistic: “As we move from emergency aid to long-term reconstruction, what we envision is a wholesale national renewal, a sweeping exercise in nation-building on a scale and scope not seen in generations.... Today, we have mobilized to give Haiti and its people what they need most: hope for a new future. We have made a good start; we need now to deliver.”
Delivery would indeed become the chief challenge if the capital really showed up in Haiti. Below the surface consensus, rifts began to appear regarding who would be in charge of the reconstruction dollars. The international financial institutions were vying for control, as were a few major donor nations and the UN. But the cast of characters raised the same question I’d had in Montréal: What about the Haitians? And which Haitians? It was an election year, and all involved feared that political turmoil would delay reconstruction.
These tensions, though hidden away, were fierce, and led to another proposal: a new approval body was needed to coordinate the coming surge in reconstruction funds. The Interim Haiti Recovery Commission (IHRC) would be co-chaired by Bill Clinton and Jean-Max Bellerive and made up of Haitian officials and representatives of donors that had pledged at least $100 million of reconstruction assistance or debt relief (the United States, Canada, France, Venezuela, the EU, Japan, the World Bank, the Inter-American Development Bank, and a few others). During its eighteen-month mandate, the commission would act as a clearinghouse for Haiti’s recovery with the goal of increasing the efficiency and impact of allocations. It would also provide an infrastructure of transparency to reassure donors that funds were not languishing in corrupt or inept bureaucracies and to hold donors accountable to their pledges. Finally, the commission would find new ways of tracking, in real time, the implementation of projects.
The commission’s evolution—from the doubts about Haiti’s “absorptive capacity” (and veiled references to corruption) that surfaced in Montréal to the process of choosing who would be members among those gathered in New York—was fascinating to watch. The elephant in the room was that few donors trusted the Haitian government to disburse their money. But the government was by necessity a protagonist in Haiti’s rebuilding effort, and almost three months after the quake, it was still sorely in need of funds just to keep its civil servants at their posts (mostly large tents or temporary buildings).12
To move relief funds quickly, donors had relied heavily on NGOs and contractors. For reconstruction to proceed in keeping with the action plan, the Haitian government needed to have an active role in vetting projects, inspecting progress, ensuring that laborers got their lot, and resolving land-title disputes. The public sector had not proven capable of performing these regulatory functions even before the quake, and now many donors deemed it even less able to do so. A history of outsourcing development projects to NGOs and contractors made trying to help the public sector now like trying to transfuse whole blood through a small-gauge needle, or in popular parlance, to drink from a fire hose. But leaving reconstruction solely in the hands of private contractors and other implementers (including large international NGOs) was a sure way to continue the same dysfunctional cycle.13 The IHRC was meant to break through this impasse by providing a platform for collaboration and coordination, enhancing trust and inspiring what was termed donor confidence. However, as one could have guessed, the IHRC would be forced to live out its short life—eighteen months seemed short to me—in very adverse circumstances.
After many debates about governance, local control, transparency, and other issues, the commission did at last come into being by presidential decree and later parliamentary approval. The weeks ticked by during this long labor, which took us into May, and like any infant, the commission needed care and feeding. It needed funding. It had been clear in New York that some donors thought they should have more control over the flow of pledged resources. Bilateral agencies seemed unsure why they should abandon business as usual and go through a commission. Meanwhile, many Haitians were sure that the blan—foreign firms and contractors—would get all the money.