Haiti After the Earthquake (59 page)

At 5:02 P.M. on January 12, 2010, I was at my desk in the Office of the Special Envoy in New York, preparing for a meeting with philanthropists and private sector investors the next day. My colleagues
Nancy Dorsinville, John Harding, and Ricardo Sanchez were on assignment in Port-au-Prince. As I worked on a briefing note, I received a “red earthquake alert” by an e-mail message, part of a natural disaster alert system to which I'd been subscribed since the tsunami. A 7.0 earthquake had occurred in Port-au-Prince. I immediately e-mailed and texted Nancy, John, and Ricardo: “Are you okay?” Nothing. Within minutes, my New York colleagues were in my office. We were in a state of shock. Was Paul Farmer in Haiti? No. He had just left a week before. Had anyone heard from Nancy, John, and Ricardo? No news.

Each hour brought worse news. We sat in the UN's Situation Center, listening to live updates by satellite phone from the top UN officer, Brazilian Commander Carlos Alberto dos Santos Cruz. Cruz's voice was controlled but shaken as he recounted what he saw: The UN compound, holding approximately two hundred staff members, had collapsed. Both the head of the mission, Hédi Annabi, and his deputy, Luiz Carlos Da Costa, had been in a meeting with a Chinese delegation on the sixth floor of the UN compound when the earthquake struck. That meant that our colleagues—their chiefs of staff, administrative assistants, and special assistants—were also in the meeting with the Chinese. As we were absorbing this update, we learned that another UN building had collapsed. So too had the National Palace and the Hotel Montana.

The next day, President Clinton addressed the United Nations General Assembly. He conveyed determination to support the Haitians as they recovered from the worst natural disaster in the region's history, and he set out the foundations of his “building back better” approach. As he stood there, with Paul Farmer at his side, in front of 192 delegations and countless media and UN staff, we had a momentary sense that we could pull through this, that Haiti would get back on its feet.

President Clinton continued to use the term “building back better,” and it took on a more profound meaning. The phrase was about not rebuilding to pre-earthquake standards but using the disaster as an opportunity to define and support a sustainable vision for Haiti. Haitians must be in charge of their own destiny. International
organizations and not-for-profits must coordinate their efforts and strengthen Haiti's government and local institutions instead of implementing programs that have unintended negative consequences (such as food aid leading to the destruction of the Haitian agriculture sector).
^g

At the time of this writing, we can point to a few initiatives led by the Office of the Special Envoy and aimed at laying the foundation for Haiti's long-term recovery.

On March 31, 2010, the government of Haiti, the United Nations, and the U.S. government cohosted the International Donors' Conference Towards a New Future for Haiti in New York. This conference culminated in $6.2 billion in pledges for 2010–2011. The Office of the Special Envoy (OSE), together with the government of Haiti and the United Nations Development Programme, supported the conference by launching online, real-time tracking of donor pledges. These efforts made the conference one of the most transparent of its kind, and built upon advances made by the Office of the Special Envoy in tracking the April 2009 Washington, D.C., conference pledges to Haiti.
^h

The tracking of international assistance was part of the Office of the Special Envoy's original, pre-earthquake mandate. President Clinton was determined to ensure that the funding for Haiti's recovery would be transparent and that donors would be held accountable for the pledges they had made. Before the earthquake, the Office of the Special Envoy was the only entity tracking overall aid to Haiti, and the only one with credible information on the April 2009 Washington donor conference pledges. Between December 2009 and January 2010, due in large part to the work of the Special
Envoy, Washington conference disbursements increased from 12 to 30 percent.

Any thoughtful analysis of the work of the not-for-profit community in Haiti before the earthquake will reveal that although intentions were usually good, the results of the work often did little to make lasting change in Haiti or, in many cases, to even help Haitians. This lack of long-lasting effect has many explanations. The work of not-for-profits was uncoordinated and did little to reinforce the priorities of the Haitian government. International NGOs expended great effort determining ways to address problems they saw, but often they did not include Haitians in meaningful ways as they developed those plans.

International NGOs are accountable to their international donors—not to the disenfranchised communities they are trying to serve. They often deliver goods and services but less often pay local salaries. As a result, NGOs have created a culture of dependency rather than self-sufficiency. Many years of effort by NGOs has served to only weaken the already weak government, which did not, even before the earthquake, have the resources to pay its employees. As a result, public health and education officials are paid intermittently, hospitals lack basic medicines and supplies, and schools are 90 percent privately owned and unregulated.

Some NGOs have sought to break this pattern. After weeks of quiet advocacy from President Clinton and Paul Farmer, Gail McGovern, CEO of the American Red Cross, committed $3.8 million to strengthen the Hôpital Université d'État l'Haïti (HUEH). In addition, the Red Cross provided a $500,000 grant for hospital equipment and an additional $2 million was approved for support to the hospital. Paul Farmer helped the government of Haiti meet the conditions set by the American Red Cross so that they could discharge their responsibilities to their donors and stakeholders. This was the first time the American Red Cross has provided direct budget support to a government. Imagine if we could replicate this model in the education sector or throughout the social sectors.

A little more than two hundred years ago, Haiti produced threequarters of the world's sugar. Yet despite this wealth in natural resources, the island nation is now the poorest in the Western hemisphere. This is largely due to its history, fraught with donor governments undermining its capacity to thrive. Promises were broken, debt was imposed, dictatorships were supported, and natural resources were depleted.

Since the earthquake, donor disbursements to Haiti have been consistent and debt forgiveness has been forthcoming. The donor community is committed to supporting Haiti. But will it be willing to invest directly in the government? Or will it continue to channel the majority of its funding through the not-for-profit community? Without a solid commitment to budget support—and without the capability to control the monies flowing in and the capacity to strengthen its own public institutions—Haiti will never fully recover.

This is why, in all its advocacy with donors, multilateral institutions, nongovernmental organizations, and foundation partners, the Office of the Special Envoy has promoted investment in budget support for the government of Haiti. This advocacy effort, and President Clinton's personal engagement with donors, has as of December 2010 helped mobilize US $226.7 million in new commitments to budget support following the earthquake, in addition to $122.4 million in existing commitments.
ⁱ
Although this figure represents a small percentage of the total contributions to Haiti from the pledges made at the New York conference ($5.6 billion for 2010–2011), it is an important step in the right direction.

As this book goes to press, I am struck by how heartbreaking the last few months have been for those of us who care about Haiti. Recovery has been slow, rubble still fills the streets of Port-au-Prince, and hundreds of thousands of people still live in camps. The spread of cholera has exacerbated an already dire situation.

Yet, pockets of hope exist. The government of Finland, for example, announced a 700,000 euro contribution to teacher salaries. This contribution is significant because it represents a shift in priorities; rarely do donors provide budget support in the form of salaries.

What will Haiti look like in ten years if we truly commit to “building back better”? Although we are humbled by the question and realistic about what can be achieved, our vision for “building back better” includes a robust public sector (especially in health and education), investment in job creation, food security, safe housing for all Haitians, and a truly participatory recovery process, where Haitians from all walks of life are consulted in a meaningful way. This vision for Haiti, although it is one we believe in and strive for, is far from reality today. A week before Christmas 2010, our team met with Paul Farmer for dinner. While we discussed the cholera epidemic and the disputed first round of presidential elections, some of us found it difficult to remain optimistic about the possibility of “building back better” in Haiti. Paul was quick to remind us of Haiti's history of struggle, the fighting spirit of Haitians, and the need for perspective in our analysis. “You must not think of where Haiti will be in two years but where it will be in one hundred years, and how what we do today will help Haiti in the long run,” he said.

Whether displayed in the streets of Port-au-Prince or in the camps, the resilience of the Haitian people is resounding. Haitians are survivors. The twenty-seven-year-old Haitian whom President Clinton met on his first visit as Special Envoy is now selling his briquettes to the UN, which is using them to warm meals for school children. The plastics and metals that cannot be used in briquette production are sold to recycling companies at market value. And the consumers of the briquettes pay 78 percent of the price of a comparable
amount of charcoal.
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Meanwhile, since meeting President Clinton, fish farm owner Valentin Abe was among those voted the hundred most influential people in the world for 2010 by
Time
magazine.

Although these compelling stories of “building back better” have received significant media attention, we cannot forget the hundreds of thousands of other Haitians who quietly face their predicament with determination and fortitude.

The truth is that “building back better” is not easy. The process takes time and involves setbacks and frustration. Impatience is growing. Earthquake survivors are still living in tents while cholera has gripped the nation, killing tens of thousands. But a natural disaster is not a moment; it's a tragedy that unfolds over many months. It took seven years for Japan to rebuild after the 1995 Kobe earthquake. In the United States, those still displaced by Hurricane Katrina provide a stark reminder of how even the richest nations take years to recover from a natural disaster. The extent of the damage caused by the recent 9.0 earthquake and tsunami in Japan is still unclear. Yet in Haiti, in less than thirty minutes, an estimated 222,570 people died and an additional 300,572 were injured. This natural disaster may be the worst in recent history. The challenges ahead seem daunting, but we cannot escape one truth: The survivors of the quake deserve to have their country rebuilt as they dream it to be, not as it once was.

1
R. Yates. “Universal health care and the removal of user fees.”
Lancet
373 (2009): 2078–2081.

2
Such anxieties were warranted: there were at least fifty-two aftershocks of magnitude 4.5 or greater in the two weeks after the quake. See Mike Melia, Jonathan Katz, and Michelle Faul.
As Haiti Mourns, Quake Survivor Found in Rubble.
Associated Press: January 24, 2010. Available: http://savannahnow.com /latestnews/2010-01-24/haiti-mourns-quake-survivor-found-rubble (accessed April 15, 2011).

3
See Rudy Roberts. “Responding in a Crisis: The Role of National and International Health Workers—Lessons from Haiti.” Merlin: London (August 2010).

4
Mobile Army surgical hospital (MASH) units are field-ready medical tents containing emergency medical equipment, oxygen, electrical generators, and other supplies; they are deployed by the military during disasters and other medical emergencies. Many of us hoped that MASH units might be leveraged to strengthen health systems in disaster zones, leaving behind more robust surgical capacity.

5
For more details about the USNS
Comfort,
see
http://www.navy.mil/search/display.asp?story_id=50653
(accessed April 15, 2011).

6
In her chapter, “Humanitarian Aid, Impartiality, and Dirty Boots,” Louise Ivers considers the role of the U.S. military in the immediate earthquake response in more detail. For coverage in the media, see “Haiti Earthquake: Confusion at Airport Hampers Aid Effort.”
Telegraph:
January 18, 2010. Available:
http://www.telegraph.co.uk/news/worldnews/centralamericaandthecaribbean/haiti/7016051/Haiti-earthquake-confusion-at-airport-hampers-aid-effort.html
(accessed April 15, 2011).