Haiti: After the Earthquake

Just finished reading "Haiti, After the Earthquake" by Paul Farmer.  It was missing some of the anger and intensity of some of his previous, more academic writing.  That may be due to the fact that he now works in a more official UN role, as some critics have said.  Or maybe it's just because this sort of writing and remembering requires more solemnity, or maybe he was just more sad and exhausted than angry.  I get that.

Either way, it was definitely a powerful book and, even over a year and a half later, I was surprised at my emotional reaction to some of Farmer's firsthand accounts as well as my gut reaction to many of the essays from different relief workers, Haitians, and others connected to the earthquake.  At some points in the book, I was astounded at how perfect the words were; how it felt like they were written just for me, or how they reflected exactly what I felt and thought.  It reminded me of how powerfully connected those in the "Haiti Club" are. 

A few things that stood out:
  • "Acute on chronic." Farmer uses this medical term in reference to an acute event (the earthquake) intensifying present chronic problems that Haiti had through its tumultuous history.  He again highlighted how many of those chronic problems were partially the fault of foreign governments (usually ours) imposing unfair and often immoral trade policies, military occupations, meddling in coups, etc. One quote from Bill Clinton saying he officially apologized for and regretted some of his agricultural policies favoring American farmers that, in turn, flooded Haitian markets with cheap subsidized rice and contributed to the rice riots, struck me.  Even a former president admits that the U.S. has hurt Haiti in more ways than it has helped in the past.

  • Farmer made a lot of appeals for more direct support to the government of Haiti.  This is always a touchy subject, and rightfully so, considering our (i.e. US government, World Bank, IMF etc) unfortunate history of supporting corrupt governments who didn't exactly use aid money as hoped.  However, I think Farmer is right in many of his assertions; the country can't be dependent on foreign NGOs forever.  And nobody in Haiti wants it that way.  To recognize the government's sovereignty and the importance of assisting it to do its job (i.e. support it in achieving larger infrastructural changes that NGOs cannot complete) is to respect the Haitian people and invest in their future independence.
    • What struck me most was that, 9 months after the earthquake, the Haitian government had received only 0.3% of the aid that had reached Haiti.  This isn't exactly sustainable, and Farmer also highlights the struggles NGOs have had in coordinating their efforts.  Donating 99.7% of earthquake relief money to independent foreign NGOs that aren't talking to each other isn't the best way to make larger, centralized change.

  • Farmer used recent successes in Rwanda as examples for "building back better." He covered everything from Rwanda's resettlement of refugees (pertinent to Haiti), their trials for those involved in the genocide (pertinent to Haiti's trial of Baby Doc Duvalier, former dictator, upon his return to the country this last spring), and government oversite of foreign NGOs and requirements that they comply with priorities set by the Rwandan people.  It was nice for me to have this reference of what is possible when tragedy strikes a country. 

  • Lastly, Farmer highlighted again, as he does in many of his writings, the constant battle, as healthcare practitioners, between treating the patient in front of you as best you can with every resource you have and the possibility that those resources may be taken from more widespread efforts such as prevention and more "sustainable" programs.  This is something I struggle with often, and some of my recent reading has highlighted major ideological differences on this within the development community. Farmer's organization has received criticism for going above and beyond to treat one patient when they could have used the same money to launch prevention programs that stop illnesses in the first place.  There is no right answer, but I invoke my favorite quote "Tout Moun Se Moun," (every person is a person) to remind me that each person deserves a chance.  I'm sure this battle will be waged inside my heart for years. 

To remind us to continue to engage in pragmatic solidarity with the Haitian people, a favorite quote:
 "The scars left by the earthquake are lasting; may the effects of the solidarity it provoked be permanent as well."

And, as if Paul Farmer can read my mind: "Some, spared against long odds, can still taste January 12 as the unfamiliar flavor of relief or gratitude.  Most still taste the bitter dregs of sorrow."