Haiti After the Earthquake (16 page)
Read Haiti After the Earthquake Online
Authors: Paul Farmer
I had an early breakfast with Bernard Kouchner, the French Foreign Minister and also a physician and cofounder of Médecins Sans Frontières. We'd met in the 1990s, when he was France's health minister and I was looking for help improving tuberculosis care in Russian prisons. We hadn't always agreed about Haiti, but that morning we did. We talked about health care financing and the need for an insurance system to protect the poor.
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Kouchner also supported integrating NGOs within Haiti's public sector. (As noted, experiences in Haiti and Rwanda had convinced me that this was a necessary step if we were serious about building robust and sovereign health systems with local partners.) I described the disarray at the General Hospital and asked whether France might help rebuild it. Such an effort would require a good deal of capital, partners, and patience, but it was infrastructure projects like this that would help Haiti recover and create jobs.
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Kouchner also supported integrating NGOs within Haiti's public sector. (As noted, experiences in Haiti and Rwanda had convinced me that this was a necessary step if we were serious about building robust and sovereign health systems with local partners.) I described the disarray at the General Hospital and asked whether France might help rebuild it. Such an effort would require a good deal of capital, partners, and patience, but it was infrastructure projects like this that would help Haiti recover and create jobs.
An hour later, Kouchner and I joined dozens of others at a round table. People were jockeying, quite literally, for a seat at that table, and the big players were the big donors: wealthy nations, multilateral development banks, UN agencies, the odd international NGO. At this point, two weeks after the quake, more than $1 billion had been sent for immediate relief. But this conference sought to test the waters about longer-term reconstruction aid: would donors be willing to make significant and long-term pledges to help rebuild Haiti? The United States, Canada, Japan, Spain, Brazil, the European Union, the Inter-American Development Bank, the World Bank, and others were represented by their leadership. In addition to Secretary Clinton and Minister Kouchner, there were a dozen other foreign
ministers, as well as high-level functionaries from Italy and Japan. The cast seemed promising.
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ministers, as well as high-level functionaries from Italy and Japan. The cast seemed promising.
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Stephen Harper, Prime Minister of Canada, opened the meeting with a call for long-term support for reconstruction: “an initial ten-year commitment is essential,” he insisted. This emerged as the conference's encouraging (if vague) “take-home message,” as my medical students would say. A ten-year commitment sounded good, especially if resources pledged on March 31âthe date chosen for the donor's conference in New Yorkâwere used more effectively than they had been in the past. Most present seemed willing to acknowledge, at least behind closed doors, that the aid machinery itself was flawed and that Haiti had been particularly vulnerable to these flaws. Almost none of the billion dollars already spent on rescue and relief went to the public sector. Although this was understandable for acute relief effortsâafter all, government employees and infrastructure had been dealt a rude blow, and it was difficult to move resources through broken conduitsâit was not a good formula for reconstruction. Those present were, after all, representatives of their own countries' public sectors; they must have understood the implications of relying on contractors and NGOs.
The delegates, who had all read stories about poor aid coordination, agreed that the Haitian government needed to lead the charge. Hillary Clinton put it succinctly: “The government of Haiti must and will be in the lead. We cannot any longer in the twenty-first century be making decisions for people and their futures without listening and without giving them the opportunity to be as involved and make as many decisions as possible.”
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The people who we needed to listen to were not in that room, of course. The only Haitians there had flown up on the Canadian jet with me or were members of Canada's large diaspora. Finding a way to include Haitians from all social strata in discussions about Haiti's future was clearly going to be a bone of contention in the coming year.
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The people who we needed to listen to were not in that room, of course. The only Haitians there had flown up on the Canadian jet with me or were members of Canada's large diaspora. Finding a way to include Haitians from all social strata in discussions about Haiti's future was clearly going to be a bone of contention in the coming year.
The participants also seemed to agree that rebuilding would take not only time but also a lot more money, although the numbers were still all over the map. The grim lists were still growingâby late January, estimates of loss of life reached up to a quarter of a millionâ
and few, it turned out, knew how to assess the value of a destroyed capital city. The Haitian government, at least privately, had estimated that at least $3 billion would be required to rebuild Port-au-Prince. That sounded like a lot at the time, but it turned out to be too little to rebuild the city, much less build it back better. And so there was surface consensus on one more point: aid would be most effective if a rigorous needs assessment were conducted before the big donor meeting. This, it seems, was the reason for the meeting about the meeting. Secretary Clinton explained: “We're trying to do this in the correct order. Sometimes people have pledging conferences and pledge money, and they don't have any idea what they're going to do with it. We actually think it's a novel idea to do the needs assessment first and then the planning and then the pledging.”
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and few, it turned out, knew how to assess the value of a destroyed capital city. The Haitian government, at least privately, had estimated that at least $3 billion would be required to rebuild Port-au-Prince. That sounded like a lot at the time, but it turned out to be too little to rebuild the city, much less build it back better. And so there was surface consensus on one more point: aid would be most effective if a rigorous needs assessment were conducted before the big donor meeting. This, it seems, was the reason for the meeting about the meeting. Secretary Clinton explained: “We're trying to do this in the correct order. Sometimes people have pledging conferences and pledge money, and they don't have any idea what they're going to do with it. We actually think it's a novel idea to do the needs assessment first and then the planning and then the pledging.”
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Few disagreed. Perhaps no one did. This sentiment would crystallize into the Post-Disaster Needs Assessment, to be led by the Haitian government in collaboration with the UN, the Inter-American Development Bank, the Economic Commission for Latin America and the Caribbean, the World Bank, and the European Commission. The needs assessment would lay the groundwork for the New York donor conference, with the hope of generating a large pool of dedicated reconstruction funding.
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On the surface there was nothing but consensus, but there was an undercurrent of dissensus. Publicly, some raised doubts about the ability of the Haitian government and its implementation partners to absorb the large influx of capital necessary for reconstructionâa lack of “absorptive capacity.” Privately, there was much talk of corruption and inefficiencies of all sorts.
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Although the purpose of the meeting was to promote reconstruction and growth, Prime Minister Bellerive seemed anxious. The half-dozen of us who'd just come from Haiti knew that the disaster was still unfolding and that the acute needs of the Haitian people were immense. Several times Bellerive steered the discussion back to the immediate needs: the wounded in need of medical care, children without food and clean water, families without even a tarpaulin for shelter. Haitian president René Préval, who had already taken a public shellacking for failing to move more quickly to meet the immediate
needs of the victims, had sent a written memo calling for two hundred thousand family-sized tents and one-and-a-half million food rations.
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Some gathered in Montréal found it odd that Préval would issue a written plea to an international donor body before formally addressing his own country; others criticized him for passivity or incompetence. But the Haitian authorities felt trapped, as did so many of the rest of us, between immediate needs and interventions that might bear fruit in the long term.
needs of the victims, had sent a written memo calling for two hundred thousand family-sized tents and one-and-a-half million food rations.
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Some gathered in Montréal found it odd that Préval would issue a written plea to an international donor body before formally addressing his own country; others criticized him for passivity or incompetence. But the Haitian authorities felt trapped, as did so many of the rest of us, between immediate needs and interventions that might bear fruit in the long term.
The Haitian government was in a tough spot. It was struggling to run the country from a small police station. On the afternoon of January 12, Préval had avoided being crushed in his own home because, moments before, he had carried his infant granddaughter outside for a breath of fresh air. Sitting in Montréal, at a meeting about a meeting, it was impossible not to think about both the grim lists and the burdens of leadership in general. Why, I thought, would people fight for these jobsâpresident, prime minister, secretary of stateâespecially when resources seemed always in short supply? Governing Haiti was a pretty thankless job, and sometimes a lethal one. Préval faced acute disasters on top of chronic problemsâfrom joblessness to dirty water, from homelessness to deforestation, from hunger to crumbling schoolsâthat would have given any head of state nightmares.
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Perhaps the question of reconstruction was best addressed outside of the quake zone, removed a bit from its nightmares. Harper's and Clinton's commitment to a Haitian-led reconstruction effort was reassuring, but which Haitians? Those gathered in Montréal seemed to have the interests of the Haitian people at heart, but they also had only a vague and summary knowledge of the country, its leaders, and its challenges. As noted, few Haitians were present: two highranking government officials and a handful of Haitian-Canadians, some of whom hadn't lived in Haiti in decades. I thought about how difficult it was, in such meetings, to “echo and amplify” the voices of the rural Haitians we'd worked with for almost thirty years: members of women's groups, church groups, peasant cooperatives, and other Haitian organizations too small to be included in any international
meeting, much less a gathering of ministers. How might we bring in their perspectives? Neither those squatting in crowded tent camps nor their families in the countryside had been invited to this meeting or any other outside Haitiâand to precious few within it.
meeting, much less a gathering of ministers. How might we bring in their perspectives? Neither those squatting in crowded tent camps nor their families in the countryside had been invited to this meeting or any other outside Haitiâand to precious few within it.
Although it's easy to make such critiques, the logistical challenges of incorporating the views of Haiti's most vulnerable citizens were sobering. The rural poor don't have passports and visas, much less the money for a plane ticket to Canada. Realizing inclusivity in a class-divided society with a large and far-flung diaspora would be no easy task. After the conference closed, I called Nancy Dorsinville. As an advocate of the poor from a relatively privileged background, she was familiar with people on both ends of the spectrum. For years, she'd helped me understand (and span) these worldsâthey had seemed like separate worlds to meâand now I confessed my anxieties about attending a meeting so far away, geographically and socially, from our colleagues and patients in Haiti.
Our discussions hatched the idea for a project called Voices of the Voiceless. We would interview mothers,
ti machann
(market women), farmers, fishermen, factory workers, the unemployed, and others often excluded from such discussions; we would ask them about reconstruction, about what they considered the greatest priorities and most urgent needs. This was no original idea. Many development projects claimed “community participation” and engagement with “civil society.” But in Haiti and other parts of Latin America, these buzzwords usually refer to institutions run by the relatively privileged and based in capital cities: NGOs, funded human rights groups, and mainstream political associations to name a few. The urban poor, the displaced, and the
moun andeyò
âthe “people outside” (outside Port-au-Prince)âhad little to do with such institutions. Nancy agreed that to plumb their opinions we would need help, especially if we wanted to pull something together before the big donor conference. Who would be able to span such diverse worlds?
ti machann
(market women), farmers, fishermen, factory workers, the unemployed, and others often excluded from such discussions; we would ask them about reconstruction, about what they considered the greatest priorities and most urgent needs. This was no original idea. Many development projects claimed “community participation” and engagement with “civil society.” But in Haiti and other parts of Latin America, these buzzwords usually refer to institutions run by the relatively privileged and based in capital cities: NGOs, funded human rights groups, and mainstream political associations to name a few. The urban poor, the displaced, and the
moun andeyò
âthe “people outside” (outside Port-au-Prince)âhad little to do with such institutions. Nancy agreed that to plumb their opinions we would need help, especially if we wanted to pull something together before the big donor conference. Who would be able to span such diverse worlds?
Michèle Montas, a journalist and defender of the rights of the poor, sprang to mind. She and her husband Jean Dominique ran Radio Haiti-Inter for three decades, pushing an ambitious (and thus
dangerous) social and political agenda that called for genuine democratic participation in Haiti's government. Michèle and Jean had trained young journalists to interview peasants, coffee farmers, youth groups, the urban poor, and others effectively barred from the public sphere. Radio Haiti-Inter was the first radio show to broadcast in Creole, the lingua franca, in addition to French. Michèle and Jean played a big part in the fight against the Duvalier dictatorships and against the repressive coup-backed régimes of the late eighties. Back then, I listened to their show every day. Jean Dominique's deep voice is still a vivid memory, speaking, for example, of
“Haiti, la belle prisonnière de l'armée”
(“Haiti, the beautiful prisoner of the army”). He was assassinated in 2000 in downtown Port-au-Prince.
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dangerous) social and political agenda that called for genuine democratic participation in Haiti's government. Michèle and Jean had trained young journalists to interview peasants, coffee farmers, youth groups, the urban poor, and others effectively barred from the public sphere. Radio Haiti-Inter was the first radio show to broadcast in Creole, the lingua franca, in addition to French. Michèle and Jean played a big part in the fight against the Duvalier dictatorships and against the repressive coup-backed régimes of the late eighties. Back then, I listened to their show every day. Jean Dominique's deep voice is still a vivid memory, speaking, for example, of
“Haiti, la belle prisonnière de l'armée”
(“Haiti, the beautiful prisoner of the army”). He was assassinated in 2000 in downtown Port-au-Prince.
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After Jean's death, Michèle became Ban Ki-moon's spokesperson at the UN and helped launch the Office of the Special Envoy. She still worked with the UN but had returned to Haiti after the quake. When Nancy and I floated our idea, she agreed not only to lead the effort but to present the project's findings at the donor conference in March. Under her direction, Voices of the Voiceless took root, funded by friends and coworkers. (We tried to obtain funding from the UN but encountered red tape and protocol; we decided it would be quicker to do it ourselves.)
I carried down dozens of tape recorders, and before long a small team of Haitian interviewers fanned out across the country to survey the opinions of the rural poor about reconstruction. It would have been easy for an effort like this to be sidelined and never completed. But Michèle and others involved wouldn't let this happen. They would have something to present by the time the larger donor group gathered in New York and the real pledge making began. The donor's conference suddenly seemed right around the corner.
That same night, Régine Chassagne and Win Butler, the husbandwife force behind the band Arcade Fire, met me for dinner. Régine's parents fled Haiti in the 1970s, and she'd been born and raised in Montréal. She wrote a stirring piece for the
Irish Times
called “I let out a cry” about what the quake meant to the diaspora. I quote it at length:
Irish Times
called “I let out a cry” about what the quake meant to the diaspora. I quote it at length:
Somewhere in my heart, it's the end of the world. These days, nothing is funny. I am mourning people I know. People I don't know. People who are still trapped under rubble and won't be rescued in time. I can't help it. Everybody I talk to says the same thing: time has stopped. Simultaneously, time is at work. Sneakily passing through the cracks, taking the lives of survivors away, one by one. Diaspora overloads the satellites. Calling families, friends of families, family friends. Did you know about George et Mireille? Have you heard about Alix, Michaelle etc, etc? But I know that my personal anguish is small compared to the overwhelming reality of what is going on down there. When it happened I was at home in Montréal, safe and cosy, surfing the internet, half randomly, like millions of westerners. Breaking news: 7.0 earthquake hits Haiti near Port-au-Prince. Such emotion came over me. My breath stopped. My heart sank and went straight into panic mode. I knew right away that the whole city is in no way built to resist this kind of assault and that this meant that thousands were under rubble. I saw it straight away. I ran downstairs and turned on the television. It was true. Tears came rushing right to my eyes and I let out a cry, as if I had just heard that everybody I love had died. The reality, unfortunately, is much worse.
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