Haiti After the Earthquake

by Paul Farmer

  2 Anna Zingg et al. “Haiti-Hurricane Season 2008.” International Committee of the Red Cross Report (September 23, 2008).

  3 Jean-Claude Duvalier, for example, often spoke of making Haiti the “Taiwan of the Caribbean” to attract foreign businesses and investment. More often than not, what he attracted were offshore assembly plants which had mixed effects on Haitian employment (many offered impossibly low wages, less than $5 per day in most cases) and long-term growth. See Maguire. Haiti After the Donor Conference.

  4 This estimate of 2009 disbursements was prepared in January 2010 in an internal memorandum of the UN Office of the Special Envoy for Haiti. President Clinton, in his capacity as UN Envoy, frequently appealed to donors to fulfill their commitments. See Helprin, “Bill Clinton Chides Nations over Help to Haiti.”

  5 Madeline Kristoff and Liz Panarelli. Haiti: A Republic of NGOs? U.S. Institute for Peace, Peace Brief (April 26, 2010). Available: http://www.usip.org/publications/haiti-republic-ngos (accessed April 15, 2011).

  6 In 2004, the de facto government published a set of ground rules following the forced departure of President Aristide. The Haitian government put out two reports in 2007, one on political decentralization (the government had little presence outside Port-au-Prince) and another on poverty reduction, and then another report in 2009 that spelled out a rebuilding strategy after the previous year’s hurricanes. The RAND Corporation summarized the Haitian Government’s strategic plans in a report in 2010, which can be found online at www.rand.org/pubs/monographs/2010/RAND_MG1039.pdf (accessed April 15, 2011).

  7 Neil MacFarquhar. “Haiti Frets over Aid and Control of Rebuilding.” New York Times (March 30, 2010). Available: http://www.nytimes.com/2010/03/31/world/americas/31haiti.html?ref=haiti (accessed April 15, 2011).

  8 These pledges for reconstruction aid were separate from the $2 billion or so already promised or disbursed in Haiti for immediate disaster relief.

  9 Jonathan Katz. “US and EU Pledge $9.8 Billion to Rebuild Haiti After Earthquake.” Associated Press (April 1, 2010). Available: http://www.huffingtonpost.com/2010/03/31/us-and-eu-pledge-billions_n_520560.html (accessed April 15, 2011). The story notes that Venezuela’s $2 billion contribution may have included money already sent to Haiti as relief funds.

  10 Quoted in “Over US $5 Billion Pledged for Haiti’s Recovery.” http://www.haiticonference.org/story.html (accessed April 15, 2011).

  11 Pamela Falk. “Haiti Donor Meeting Far Exceeds $4B Goal.” CBC News (March 31, 2010). Available: http://www.cbsnews.com/stories/2010/03/31/world/main6350269.shtml .

  12 One report found that the quake left 40 percent of the civil service injured or dead, along with twenty-eight out of twenty-nine federal buildings down. Haiti—no leadership, no elections. Senate Foreign Relations Committee Report. 111th Congress, 2nd Session (June 10, 2010). Available: http://www.gpoaccess.gov/congress/index.html (accessed April 15, 2011).

  13 This is not meant as an ideological claim; telecommunications is a case in point. The public sector was unable to meet demand for telephones in Haiti—only a few thousand firms and families had landlines. It was not until the cell phone revolution, over the past decade, that privatized phones became valuable, even to the very poor, who use them as banking tools as well as a means of communicating with family and friends. More people had access to cell phones now than had they waited for a publicly controlled company to deliver. Similarly, independent service providers and NGOs might do a better job getting social services to the poor now. But should we compare providing cell phones to providing health care or safe water or education?

  14 Jonathan Katz. “Clinton-Led Commission Starts Up in Haiti.” ABC News (June 17, 2010). Available: http://abcnews.go.com/Business/wireStory?id=10943320&page=1 (accessed April 15, 2011).

  15 See Charity Navigator’s special report on the anniversary of the quake. Available: http://www.charitynavigator.org/index.cfm?bay=content.view&cpid=1186 (accessed April 15, 2011).

  16 At the Skoll Foundation Conference on April 30, 2010, we brainstormed this question as a problem of catalysis, hoping that the entrepreneurs gathered there would seek new technologies and delivery strategies that might fill the gap between goodwill and implementation in Haiti. Catalyzing Collaboration: Our Humanity at Stake. http://www.skollworldforum.com/forum-2010 (accessed April 15, 2011).

  17 See Walter Rodney’s forceful argument that colonialism led to the underdevelopment of Africa. Walter Rodney. How Europe Underdeveloped Africa (Dar-Es-Salaam, Tanzania: London and Tanzanian Publishing House, 1973). Available: http://www.blackherbals.com/walter_rodney.pdf (accessed April 15, 2011). On so-called dependency theory see the work of Hans Singer (“The Distribution of Gains between Investing and Borrowing Countries,” American Economic Review 40, no. 2, 1950) and Raúl Prebisch. (The Economic Development of Latin American and Its Principal Problems. [New York: United Nations, 1950].) Dependency theory emerged in the post-War era to counter reigning modernization theory, which held that all countries progressed along a series of stages of economic development. In contrast to this progressivist vision of development, dependency theorists posited that the poverty of countries at the periphery was intimately linked to the wealth of countries at the core. According to this narrative, the rich get richer because the poor get poorer.

  18 Paul Collier has argued the combination of high population growth and unemployment in Haiti has created a large and volatile group of unemployed young people—a “youth tsunami,” in his words. “Haiti has exceptionally rapid population growth,” he writes, “which adds to an already acute pressure on land. This youth tsunami is accelerating the process of environmental degradation and adding to the potentially explosive pool of underemployed youth.” See Paul Collier. “Haiti: From Natural Catastrophe to Economic Recovery.” United Nations (January 2009). Available: http://www.scribd.com/doc/26835870/Paul-Collier-on-Haiti (accessed April 15, 2011). Secretary Clinton referred to this concept in her speech at the 2009 donors’ conference: “Haiti has the highest unemployment rate in our hemisphere. Seventy percent of its people do not have jobs. It also has one of the region’s highest growth rates. Together, these trends have created what Paul Collier has called a youth tsunami. Nearly one million young people are expected to come into the job market in the next five years.” Available: http://www.haitiinnovation.org/en/2009/04/14/secretary-clintons-remarks-haiti-donors-conference (accessed April 15, 2011).

  19 Jonathan Katz. “Does Camp Corail Explain How Haiti Relief Can Be Done Right?” Center for Economic and Policy Research (April 26, 2010). Available: http://www.cepr.net/index.php/relief-and-reconstruction-watch/does-camp-coraildemonstrate-how-haiti-relief-can-be-done-right/ (accessed April 15, 2011).

  20 Jonathan Katz. “Haiti Recovery Paralyzed 6 Months after Deadly Quake.” Associated Press (July 11, 2010). Available: http://www.msnbc.msn.com/id/38184951/ns/world_news-americas/ (accessed April 15, 2011).

  21 Jonathan Katz and Marko Alvarez. “Haiti: Summer Storm Floods ‘Safe’ Refugee Camp.” Associated Press (July 13, 2010). Available: http://seattletimes.nwsource.com /html/nationworld/2012347420_apcbhaitihomelesscamp.html (accessed April 15, 2011).

  22 For more information on Zanmi Beni, see “Update: A New Home at Zanmi Beni.” Available: http://www.pih.org/news/entry/update-a-new-home-at-zanmibeni/ (accessed April 15, 2011).

  23 Remarks by Paul Weisenfeld, USAID Haiti Task Team coordinator, at a media roundtable on July 19, 2010. Available: http://www.usaid.gov/press/speeches/2010/sp100719_1.html (accessed April 15, 2011).

  24 Ibid.

  25 Franklin D. Roosevelt, First Inaugural Address. March 4, 1933.

  26 See Martin Luther King, Jr. All Labor Has Dignity (Boston: Beacon Press, 1963).

  27 Conrad Black. Franklin Delano Roosevelt: Champion of Freedom (New York: PublicAffairs, 2003), p. 194.

  28 The crisis had finally imposed some discipline of responsibility even on the Republican legislators, who with uncharacteristic docility did what the governor asked. (T
he New York voters would overwhelmingly approve the bond issue in November 1932.) Faithful to his own romantic notions of rural life, Roosevelt had TERA subsidize the resettlement of as many unemployed as possible on marginal farmland, with tools and instruction on how to cultivate it. In six years TERA assisted five million people, 40 percent of the population of New York State, at a cost of $1,555,000. At the end of the period, 70 percent of these were no longer reliant on government assistance. See Black. Franklin Delano Roosevelt, pp. 216–217.

  29 Robert Maguire has written eloquently of the need for similar programs in Haiti. See, for example, Haiti Held Hostage: International Responses to the Quest for Nationhood, 1986–1996. Occasional Paper #23. (Providence, RI: Thomas J. Watson Jr. Institute for International Studies, Brown University: 1996). See also his more recent Haiti after the Donors’ Conference: A Way Forward. This article calls for a national civic service corps that would generate shovel-ready projects, akin to President Roosevelt’s Works Progress Administration and its subsidiary Civilian Conservation Corps. Not only would such an initiative grease the wheels of economic growth, he contends, but it could also combat the cycles of deforestation and erosion that—along with dumping subsidized American produce in Haitian markets—fuel rural poverty and urban crowding.

  30 Jonathan Katz. “Associated Press Impact: Haiti Still Waiting for Pledged U.S. Aid,” Associated Press (September 28, 2010). Available: http://www.newsvine.com/_news/2010/09/28/5195300-ap-impact-haiti-still-waiting-for-pledged-us-aid (accessed April 15, 2011).

  31 See Nicolai Ouroesoff, “A Plan to Spur Growth Away from Haiti’s Capital.” New York Times (March 30, 2010). Available: http://www.nytimes.com/2010/03/31/arts/design/31planning.html?pagewanted=2&ref=haiti (accessed April 15, 2011).

  32 Those interested in this topic should read Sidney Mintz’s Sweetness and Power: The Place of Sugar in Modern History (New York: Viking Penguin, 1985). The book provides an excellent account, although completed before the era of biofuels. Mintz’s ethnographic work on Haiti, which spans three decades, is also always instructive to read, as are his books on the rest of the Caribbean.

  33 For more on the Butaro hospital, see: http://act.pih.org /page/s/watch-butaro (accessed April 15, 2011).

  34 Denis Lai Hang Hui. “Politics of Sichuan Earthquake,” Journal of Contingencies and Crisis Management 17, No. 2 (June 2009).

  35 Jonathan Watts. “Sichuan Earthquake: Tragedy Brings New Mood of Unity.” The Guardian (June 20, 2008): http://www.guardian.co.uk/world/2008/jun/10/chinaearthquake.china (accessed April 15, 2011).

  36 “Katrina, Five Years Later,” New York Times (September 1, 2010): http://www.nytimes.com/2010/09/02/opinion/02thu1.html (accessed April 15, 2011).

  37 The best example is Amy Wilentz’ The Rainy Season, which spoofs her journalist colleagues’ prejudices about Haiti. Most journalists with deep knowledge of the place have also mocked the Haiti set piece. A case in point set of platitudes comes from an American journalist in 1991: “It’s hard to sell Haiti as a tourist paradise when popular perceptions of the place make a visit fall into the category of ‘Holidays from Hell.’ Dire poverty, AIDS, child slavery, zombies, voodoo animal sacrifices and political violence are just some of the negative images facing tour operators. A U.S. government travel warning ‘strongly advises’ Americans to avoid Haiti.” (San Francisco Sunday Punch, March 31, 1991). Also see Robert Lawless. Haiti’s Bad Press (Rochester, VT: Schenkman Books, 1992). The same sort of template-driven reporting has been critiqued after the quake. Dr. Evan Lyon sent us a wry (and perhaps rueful) article titled “How to Write About Haiti” by an irritated, Haiti-based journalist that captures some of the tropes found in popular press articles after the earthquake. The following passage is representative: “You are struck by the ‘resilience’ of the Haitian people. They will survive no matter how poor they are. They are stoic, they rarely complain, and so they are admirable. The best poor person is one who suffers quietly. A two-sentence quote about their misery fitting neatly into your story is all that’s needed. On your last visit you became enchanted with Haiti. You are in love with its colorful culture and feel compelled to return. You care so much about these hard-working people. You are here to help them. You are their voice. They cannot speak for themselves.” See Ansel Hertz. “How to Write about Haiti.” Huffington Post (July 23, 2010). Available: http://www.huffingtonpost.com/crossover-dreams/a-guide-for-american-jour_b_656689.html (accessed April 15, 2011). As noted throughout this book, the Haitians, however resilient, did not in fact suffer in silence.

  38 “Plans and Benchmarks for Haiti,” New York Times (August 29, 2010). Available: http://www.nytimes.com/2010/08/30/opinion/30mon2.html (accessed April 15, 2011).

  39 Estimates of the amount of debris have ranged between 10 and 20 million cubic meters. Katz. “AP Impact: Haiti Still Waiting for Pledged U.S. Aid.”

  40 The Associated Press reported that of 1,583 U.S. contracts for Haiti relief efforts made by December, only 20 went to Haitian companies (worth $4.3 million out of $267 million). Most went to beltway contractors, including one quarter disbursed through a no-bid process that didn’t include Haitian participants. See Martha Mendoza. “Would-Be Haitian Contractors Miss Out on Aid.” Associated Press (December 12, 2010). Available: http://news.yahoo.com/s/ap/20101212/ap_on_re_us/cb_haiti_outsourcing_aid_1.

  41 When we gathered to lay the cornerstone of the new hospital, Ann read a letter I’d sent her in March of 1989: “When we last spoke, you were teetering between business and art. If business won out, would you please help me to build a hospital for the poor in Haiti? If you stayed with art, would you please send us a painting to cheer up our patients?” We are grateful she became an architect.

  42 For information on the Mirebalais hospital, including recent updates about construction and videos onsite, see http://www.pih.org/six-months/subject/mirebalais-teaching-hospital (accessed April 15, 2011).

  Chapter 7

  1 P. Lawrence et al. “The Water Poverty Index.”

  2 Cholera thrives in the poor sanitation and water conditions of refugee camps. After the genocide in Rwanda, millions of refugees, including most surviving génocidaires, streamed across the Congolese border and took shelter in the region around Goma. Before long, they were housed and fed by the humanitarian machine that now follows conflict as surely as day follows night. Cholera exploded in those camps, drawing ever greater numbers of humanitarian groups to the region. For more on this episode, see Linda Polman. The Crisis Caravan, chapter 1.

  3 Acute Watery Diarrhea and Cholera: Haiti Pre-decision Brief for Public Health Action. CDC (2010). Available: http://www.bt.cdc.gov/disasters/earthquakes/haiti/waterydiarrhea_pre-decision_brief.asp (accessed April 15, 2011).

  4 Farmer et al. “Unjust Embargo of Aid for Haiti.”

  5 For an extended discussion of the effect of the aid embargo on Haiti, see the 2008 report by the Center for Human Rights and Global Justice and the Global Justice Clinic at New York University’s School of Law, Partners In Health, Zanmi Lasante, and the Robert F. Kennedy Center for Justice and Human Rights. Wòch nan Soley: The Denial of the Right to Water in Haiti. Available: www.pih.org/page/-/reports/Haiti_Report_FINAL.pdf (accessed April 15, 2011).

  6 Farmer. AIDS and Accusation.

  7 Karen McCarthy Brown. “Systematic Remembering, Systematic Forgetting: Ogou in Haiti.” In Africa’s Ogun: Old World and New. Sandra Barnes, ed. (Bloomington: Indiana University Press, 1989), p. 67. This topic is more fully explored in Alfred Métraux’s classic study, Haitian Voodoo. Métraux traces the lineage of modern Haitian sorcery accusations to the same source: “Man is never cruel and unjust with impunity: the anxiety which grows in the minds of those who abuse power often takes the form of imaginary terrors and demented obsessions. The master maltreated his slave, but feared his hatred. He treated him like a beast of burden but dreaded the occult powers which he imputed to him. And the greater the subjugation of the Black, the more he inspired fear; that ubiquitous fear which shows i
n the records of the period and which solidified in that obsession with poison, which throughout the eighteenth century, was the cause of so many atrocities. Perhaps certain slaves did revenge themselves on their tyrants in this way—such a thing is possible and even probable—but the fear which reigned in the plantations had its source in deeper recesses of the soul: it was the witchcraft of remote and mysterious Africa which troubled the sleep of people in ‘the big house.’” Alfred Métraux. Haitian Voodoo. Hugo Charteris, trans. (New York: Schocken, 1972), p. 15.

  8 E. Mintz and R. Guerrant. “A Lion in Our Village—the Unconscionable Tragedy of Cholera in Africa.” New England Journal of Medicine 360 (2009): 1060–1063.

  9 Randal Archibold. “Cholera Moves into Beleaguered Haitian Capital.” New York Times (November 9, 2010). Available: http://www.nytimes.com/2010/11/10/world/americas/10haiti.html (accessed April 15, 2011).

  10 Pan American Health Organization. “Health Cluster Bulletin: Cholera Outbreak in Haiti—#15.” (January 21, 2011). Available: http://new.paho.org/blogs/haiti/?p=1739 (accessed April 15, 2011).

  11 Jonathan Katz. “Cholera Confirmed for Resident of Haiti’s Capital.” Associated Press (November 9, 2010). Available: http://www.physorg.com/news/2010-11-cholera-resident-haiti-capital.html (accessed April 15, 2011).

  12 Ibid.

  13 My visit there eleven months earlier, with Luis-Alberto Moreno, the president of the Inter-American Development Bank, and our families, was designed to showcase our efforts with the Haitian public health sector in Lascahobas and, thus, to signal the potential for a similar partnership in Mirebalais, the closest town. None of us would ever have imagined that the two words, Nepal and Mirebalais, would come to have such significance less than a year later—although we should have. As noted twenty years ago, there is, in a global economy, no reason to believe that our pathogens will not be shared as freely as our products, our profits, and our losses. See P. Farmer. “The Exotic and the Mundane: Human Immunodeficiency Virus in Haiti.” Human Nature 1, 4 (1990): 415–446.