Haiti After the Earthquake (62 page)

24
Jonathan Demme's 2003 documentary
The Agronomist
follows Jean Dominique's and Michèle Montas's struggle to make Radio Haiti-Inter a mouthpiece of the people.

25
Régine Chassagne. “I Let Out a Cry, as if I Had Just Heard that Everybody I Love Had Died.”
Irish Times:
January 17, 2010.

26
For more about their organization,
Kanpe
, see
http://www.kanpe.org/home.html
(accessed April 15, 2011).

27
There were many such stories from the early days after the earthquake. Some aid workers were stuck en route to Haiti; others had trouble leaving. See, for example, Alan McDowell. “Aid Workers Face Logistical Problems.”
National Post
(January 14, 2010). Available:
http://www.nationalpost.com/news/story.html?id=2442757
.

28
The full text of President Obama's speech is available here: http://abcnews.go.com/Politics/State_of_the_Union/state-of-the-union-2010-president-obamaspeech-transcript/story?id=9678572 (accessed April 15, 2011).

29
The full text of the 2003 testimonial is available here: http://foreign. senate.gov /imo/media/doc/FarmerTestimony030715.pdf (accessed April 15, 2011).

30
For evidence on this score, see Tracy Kidder's piece in the
Nation,
“The Trials of Haiti” (October 27, 2003). Available:
http://www.thenation.com/archive/trials-haiti
.

31
Paul Farmer, Joseph P. Kennedy, and Jeffrey Sachs. “U.S. Owes Aristide a Fair Chance to Govern.”
Boston Globe
(June 30, 2001), Sect. A:15; P. Farmer, M. C. Smith Fawzi, and P. Nevil. “Unjust Embargo of Aid for Haiti.”
Lancet
361 (2003): 420–423.

32
Full coverage of the hearing is available here:
http://www.cspan.org/Watch/Media/2010/01/28/HP/A/28965/Senate+Foreign+Relations+Cmte+Hearing+on+Haiti+Relief.aspx
(accessed April 15, 2011).

33
The Foreign Assistance Act was signed into law by President John F. Kennedy in 1961. A product of Cold War politics, its stated goal was to win “hearts and minds” in developing countries declaring intentions to adopt socialist or communist tactics. Cold War mentalities still influence the U.S. foreign aid strategy. For example, Jeff Sachs notes that only one of the five operational goals outlined by the U.S. Agency for International Development (USAID) contributes to long-term development (“promoting transformational development”). The other four (“supporting strategic sites, strengthening fragile states, providing humanitarian relief, and addressing global challenges such as the HIV/AIDS epidemic and climate change”) are important components of foreign policy but do too little to take on poverty and economic development. Sachs tracks the meager $2.8 billion (out of $16 billion total) that went to transformational development. “The entire sum,” he writes, “went to technical cooperation: payments made primarily to U.S. entities—consultants from government agencies or nongovernmental organizations (NGOs)—for assignments in recipient nations. These missions may be useful, but the expenditures are not long-term investments in local clinics, schools, power plants, sanitation, or other infrastructure.” Further, the benefits of the aid that is
disbursed are tempered by high overhead and policies promoting U.S. interests: food aid comes most often in the form of grain shipments—great for subsidized American agribusiness and perhaps less so for local farmers—and almost half the money for food aid goes to transportation costs, instead of food (see Jeffrey Sachs. “The Development Challenge.”
Foreign Affairs
84, no. 2, pp. 78–79). In addition to its Cold War legacies, U.S. foreign aid struggles under the weight of great bureaucratic inefficiencies. Aid disbursement, for example, is splintered into eighteen institutions within the State Department and the U.S. Agency for International Development alone, and an additional twenty or more government institutions also have aid programs. Stewart Patrick of the Center for Global Development has called for a new cabinet-level agency that would centralize foreign assistance for international development under one roof. See Stewart Patrick. “U.S. Aid Reform: Will It Fix What Is Broken?” (September 2006), available:
http://www.cgdev.org/content/publications/detail/10497
(accessed April 15, 2011). All these problems have led a growing number of government officials, development practitioners, and academics to endorse far-reaching reform of the Foreign Assistance Act. The Bush Administration proposed reform legislation in 2006, which has since been shelved. Oxfam America and ActionAid have both proposed more substantial reforms. See also “New Day, New Way” (June 1, 2008), a proposal made by a coalition of development and foreign affairs practitioners and policymakers known as the Modernizing Foreign Assistance Network. The report is available at: http://modernizingforeignassistance.net /documents/newdaynewway.pdf (accessed April 15, 2011).

34
The history of Haitian debt runs deep: after independence, the French claimed a debt of 150 million francs for property—including slaves—lost during the Haitian Revolution (see p. 127 and n. 14). In 2008, the government of Haiti owed almost $2 billion in foreign debt, half of which was canceled after a donor conference in June 2009. G9 countries announced the cancellation of the remaining half in February 2010, as part of the earthquake relief effort. See “G7 Nations Pledge Debt Relief for Quake-Hit Haiti.”
BBC
(February 7, 2010). Available:
http://news.bbc.co.uk/2/hi/8502567.stm
(accessed April 15, 2011).

35
Increasing evidence points toward the value of cash transfers, especially those targeted at women, at strengthening families and spurring grassroots development. See, for example, Joseph Hanlon, David Hulme, and Armando Barrientos.
Just Give Money to the Poor: The Development Revolution from the Global South
(West Hartford: Kumarian Press, 2010).

36
Transcript available:
http://www.haitispecialenvoy.org/press/transcripts/testimony-of-dr-paul-farmer-to-the-us-senate-committee-on-foreign-relations/
(accessed April 15, 2011).

37
The full text of the 2003 testimonial is available here: http://foreign.senate.gov /imo/media/doc/FarmerTestimony030715.pdf (accessed April 15, 2011).

38
For more on Partners In Health's efforts to manufacture vitamin-enriched peanut butter as a ready-to-use therapeutic food, see Andrew Rice's long exposé “The Peanut Solution” in the
New York Times Magazine
(September 2, 2010). Available:
http://www.nytimes.com/2010/09/05/magazine/05plumpy-t.html?pagewanted=all
(accessed April 15, 2011). As the article notes, producing such vitamin-enriched
peanut butter led to legal threats from a company that claimed exclusive rights to the product. But can you patent peanut butter?

39
Yesica Fisch and Martha Mendoza. “Haiti Government Gets 1 Penny of U.S. Quake Aid Dollar.” Associated Press (January 27, 2010). Available:
http://www.usatoday.com/news/world/2010-01-27-Haiti-aid_N.htm
(accessed April 15, 2011).

40
Our colleagues at the Office of the Special Envoy have been militant about tracking these numbers. The most recent report on relief and reconstruction financing is available here: http://s3.amazonaws.com /haiti_production/assets/22/1._Overall_financing_key_facts_FINAL_6_original.pdf(accessed April 15, 2011).

41
Jonathan Katz, “Billions for Haiti, A Criticism for Every Dollar,” Associated Press (March 5, 2010). Sources compiled from USAID and the United Nations. Available:
http://www.informationclearinghouse.info/haitiaid.jpg
(accessed April 15, 2011).

42
See Farmer.
The Uses of Haiti.

43
Although I've probably spilled too much ink about the Peligré Dam in
AIDS and Accusation
and elsewhere, it has appeared again in headlines: the Inter-American Development Bank is considering a $40 million rehabilitation program. The dam currently operates at half capacity because of residual silt buildup; this has contributed to the country's 30 percent drop in electricity production in the past decade. The bank hopes to amend this shortage by getting the 54-megawatt dam back on its feet. See Jennifer Wells. “A Dam for the People, and a People Damned.”
The Star
(August 2010). Available:
http://www.thestar.com/article/894096---peligre-dam-project-brought-floods-and-darkness
(accessed April 15, 2011).

44
Stephen Smith and James F. Smith. “Rising to Meet an Infinite Need.”
Boston Globe
(January 24, 2010). Available:
http://www.boston.com/news/world/latinamerica/articles/2010/01/24/boston_based_nonprofit_has_been_thrust_into_leadership_role_in_haiti/
(accessed April 15, 2011).

45
With the help of the logistics wizards in Boston, Thierry was able to escort his cousins to their new home, and he soon returned to Cange. He is still planning a career in surgery and hopes to begin his training, in Canada or the United States, by the summer of 2011.

46
To see and hear Shelove, see the wonderful short video, “Walking the Walk,” by Rebecca Rollins (translated by Caroline Hilaire). Available: http://vimeo.com (/13281822 accessed April 15, 2011).

47
The blind and otherwise handicapped had never fared much better. Graham Greene's Haiti novel,
The Comedians
, evokes the terror of the Duvalier years but also the link between disability and poverty. When a well-meaning American man visits the post office, he is swarmed by beggars with severe disabilities: “Two onearmed men and three one-legged men hemmed him round. Two were trying to sell him dirty old envelopes containing out of date Haitian postage stamps: the others were more frankly begging. A man without legs at all had installed himself between his knees and removed his shoe-laces preparatory to cleaning his shoes. Others seeing a crowd collected were fighting to join in. A young fellow, with a hole where his nose should have been, lowered his head and tried to ram his way
through towards the attraction. A man with no hands raised his pink polished stumps over the heads of the crowd to exhibit his infirmity to the foreigner. It was a typical scene in the Post Office” (New York: Penguin, 1965), p. 155.

48
Rollins. “Walking the Walk.”

49
David Brown. “Surgeon Seeks to Prevent ‘Unnecessary Amputations' in Haiti's Earthquake Zone.”
Washington Post
(January 21, 2010). Amputation has a fraught history during humanitarian aid efforts. The notorious international response to the amputated victims of Sierra Leone's civil war, for example, triggered unintended, and perhaps perverse, consequences. Some have suggested that the surge of foreign money sent to Sierra Leone after photos of amputated children and women circulated in the western media only encouraged rebels to continue chopping off limbs as a political tactic. See, for example, Linda Polman.
The Crisis Caravan: What's Wrong with Humanitarian Aid?
(New York: Macmillan Books, 2010), pp. 66–69.

50
For more on the graduation of the Global Health Delivery fellows, see “Global Health Delivery Fellows Honored for Accomplishments and Leadership.” Partners in Health Online (March 30, 2010). Available:
http://www.pih.org/haiti/news-entry/global-health-delivery-fellows-honored-for-accompishments-and-leadersh/
(accessed April 15, 2011). One of the graduates had the following to say about the practice of social medicine in the rural reaches of his homeland: “My first day at Zanmi Lasante, I was greeted by Dr. Maxi and Dr. Léandre, and to be honest, I thought they were nuts. They spoke to me about everything except medicine—such as transport costs, income-generating activities, construction of houses, compensation for community health workers. In fact I stayed lost. I wasn't even sure they were doctors. But I needed to learn, I needed time to live this reality . . . Later in my first year, I was annoyed, I did not think doctors should do home visits. I remember one of our faculty asked me to go find a TB patient, who had left without finishing his therapy . . . the attending insisted that any doctor taking care of a patient has a responsibility if the patient leaves the hospital. After returning to the hospital with the patient from the village of Kay Epin, I began to think differently about the doctor-patient relationship; about how my talking with and spending time with the patient changed his outcome. We decided to stay in a rural place, not to return to the city, or to do a residency—but to become “Dokte Mon”—a mountain doctor. You must understand, that we were among the best students in our classes in medical school, each of us was expected to do a residency. Generally, those who are called “mountain doctors” are surrounded by rumors of incompetence . . . but for us, choosing this path is our core engagement to join this determined team, Haitian and foreign, who in a noble mission, serve the Haitian poor. It is not easy to be devoted to this mission, there are sacrifices in these rural places, far from the lucrative and prestigious jobs in the capital that garner a private clinic or a car. But you all have accompanied us to a much greater goal, to see the medicine in a community way, medicine in service to all those who require it.”

51
J. Helprin. “Bill Clinton Chides Nations over Help to Haiti.” Associated Press (September 9, 2009). Available:
http://www.newsvine.com/_news/2009/09/09/3243861-bill-clinton-chides-nations-over-help-for-haiti
(accessed April 15, 2011).

52
“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).

53
Roberts. “Responding in a Crisis.”

54
A report by Merlin underscores this conclusion: “The overall emergency response could have benefited from wider participation in the effort to build capacity of the Ministry [of Health] and to support systems development and coordination, but most international agencies opted to focus on providing direct emergency care in the initial phase.” Roberts. “Responding in a Crisis,” p. 6.