Beyond Relief: How the World Failed Haiti

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As the relief effort has dragged on for well over a year, virtually every actor involved has blamed the others: U.S. aid officials pitted against Washington bureaucrats, U.N. agencies against private aid groups. Some veteran insiders blame a new breed of technocrats who, with little to no experience in development, have descended on Port-au-Prince armed with bold theories and PowerPoint presentations, as if the entire country were a case study from Harvard Business School. Others say the goals were too lofty, the plans unrealistic; maybe Haiti, the poorest country in the Western Hemisphere, was simply too damaged to be fixed. Or perhaps the very idea of fixing Haiti at all is a flawed concept, revealing not only the limits of Western humanitarianism but the folly of believing that any country and its problems are ours to set right.

Amid all the finger-pointing, however, nearly everyone taking part in the relief effort is quick to place at least some of the blame on the Haitians themselves. "Corruption is the reason those reconstruction funds haven't broken loose," says one U.S. business consultant, who describes most Haitian politicians as "pathological narcissists" with little interest in helping their own country. Such accusations have been made by outsiders for as long as outsiders have tried to help Haiti — which itself may be the biggest problem. "Haitian people have always found a way to get rid of those who've tried to control them," says Raoul Peck, Haiti's former minister of culture. "It's very easy to point at the Haitians for being corrupt or weak. What's much harder is looking at what's wrong with those who say they are just trying to help."

Last fall, a line of graffiti began to appear on walls throughout Port-au-Prince: BON RETOUR J.C. DUVALIER ("Welcome back, J.C. Duvalier"). It was a reference to Haiti's last dictator, Jean-Claude "Baby Doc" Duvalier, who, prior to being deposed in 1986, presided over a kleptocratic police state of such paranoid dimensions that writer Graham Greene dubbed Haiti the "Nightmare Republic." Today, in a testament to their current-day nightmare, some traumatized Haitians have begun to yearn for the days of Duvalier in the same way that some Iraqis, in the wake of the U.S. invasion, came to idealize life under Saddam Hussein. "It's selective memory," explains my translator, a cynical former businessman named John. "At least with Duvalier, we had lights."

It is a broiling November day, and John and I are driving through the wreckage of what used to be Port-au-Prince. Two-thirds the size of Manhattan, Haiti's capital is still buried under some 8 million cubic meters of rubble — enough, according to one expert, to build a road from Port-au-Prince across the ocean to Los Angeles and back again. Enormous piles of this debris, some sprouting odd pieces of metal or computer parts, now comprise much of what used to be small neighborhoods. Choking clouds of exhaust hover above the roads, which are clogged with idling cars as well as people, dogs, cows, donkeys, the odd pig. Some 1,000 camps, or "informal settlements," have sprung up in seemingly every available space in the city: vacant lots, basketball courts, soccer fields, road medians, the large, gated plaza in front of the prime minister's office, even the Champs de Mars park, across from the National Palace, home now to some 10,000 people.

Filth — whether it's human waste or the giant heaps of rotted mango peels, empty water bottles and other refuse that line the roads and ditches and canals — is as much a part of life in post-earthquake Haiti as frustration and despair. "There are things in this country you just can't believe," one exhausted aid worker tells me. "I'm at this river the other day, and here's what I see: three men washing some Land Rovers in the water, two pigs having sex, a group of children gutting some pigs and cleaning their intestines right next to the pigs having sex, and a few women washing clothes and bathing — all in the same tiny part of the river. And next to all of that was a hand-washing poster put up by some NGO to teach people good hygiene."

Haiti's dysfunction, while undeniably exacerbated by the quake, goes back generations. The first independent black republic in the world, it has been hobbled for most of the past century by a series of repressive dictatorships and military regimes, and so dependent on Western aid groups that since the late 1990s, it has been known throughout the development world as "the Republic of NGOs." The earthquake didn't so much destroy Haitian society as it exposed how deeply broken that society already was. In 35 seconds, the quake leveled government ministries and the National Palace, killed an estimated 20 percent of the country's civil servants, and severely damaged 50 of the nation's hospitals. Schools collapsed on their students; churches collapsed on their clergy; and houses built into the hillsides crumbled like sand, sliding to the bottom of the ravines. From his home overlooking Port-au-Prince, Charles Henri Baker, a Haitian manufacturing titan, recalled seeing the dust rising from the city, and with it the cries of "3 million people calling to Jesus."

During the first few days after the quake, not a single Haitian official — not the president, the prime minister or any cabinet member — emerged to make a public statement. "Their excuse was they were in shock," says Raymond Joseph, Haiti's former ambassador to the United States. "OK, you're in shock, I understand. But act like leaders. Summon the people, tell them something of comfort — do something. No one did."

Over the next few weeks, the amount of aid pledged to Haiti began to outpace the nation's ability to absorb it. Just a few days after the quake, Doctors Without Borders shut down its appeal for Haiti relief funds, informing donors that it simply couldn't spend any more. But most aid groups continued to fundraise for Haiti long after their emergency-relief capacities were maxed out. The American Red Cross has raised $479 million for Haiti, for example, yet it had "spent or signed agreements to spend" only $245 million by the one-year anniversary of the tragedy. The rest remains in an interest-bearing account, awaiting the commencement of "building back better."

Aid workers in Haiti concede that their efforts remain as focused on relief as on reconstruction. "We are ramping up recovery — building more stable housing, a medical infrastructure, that kind of thing — but we're still out there digging ditches, sandbagging hillsides, replacing tarps and tents," says Julie Sell, the Red Cross spokeswoman for Port-au-Prince. "The relief phase, to be honest, is still ongoing. We all wish we were further along than we are."

Sell, like most other aid officials, is trying to put a rational spin on a situation that is both irrational and, by the looks of things, completely unmanageable. On top of the earthquake, aid workers in Haiti are contending with a cholera crisis, a disease of poverty spread through poor sanitation and contaminated drinking water. These are all things that NGOs like the Red Cross have expertise in fighting, but larger structural issues often trump their best intentions. Because international NGOs get most of their money from large government agencies, they are beholden to the broader policy imperatives of their funders. "The big problem is that most NGOs are only really accountable to their donors, when we should really be accountable to the people we're trying to serve," says Dr. Louise Ivers, senior health and policy adviser for Partners in Health, a Boston-based NGO that has worked in Haiti for 25 years. Some organizations, she notes, "exist only to write grant proposals that respond to specific donor requests. If your mandate is just to follow the money, then the money determines what happens."

The money that poured into Haiti after the earthquake was focused almost solely on relief efforts in and around Port-au-Prince. As a result, dozens of health-oriented NGOs in Haiti focused their work in the capital, all but ignoring the countryside. So last October, when reports of people dropping dead of cholera in the rural Artibonite Valley 90 miles from the capital began to emerge, many in the aid community were blindsided. Even as the epidemic made its way to Port-au-Prince, some relief organizations still didn't respond. "It was as if, somehow, those 400 or 500 deaths in the Artibonite weren't registering," says Ivers, who had an office in St. Marc, where the outbreak started. "If you haven't really seen it with your own eyes, it's hard to believe how quickly cholera can become a major catastrophe." Within a month, cholera had become a national epidemic.

One morning, during the height of the epidemic, I attend a meeting organized by the U.N. to coordinate efforts to contain the cholera outbreak. About 60 relief workers from groups like Oxfam, the World Health Organization, UNICEF, the American Red Cross and Save the Children crowd the small room at the offices of Haiti's ministry of water and sanitation, sitting on tables or on the floor. There is a representative from USAID and another from the Centers for Disease Control. There are also a few U.N. peacekeepers and a U.S. Army captain in Oakleys. There are only a handful of Haitians in the room, half of whom are translators.

The meeting, which is held in French, begins with a PowerPoint presentation on the scope of the cholera epidemic, conducted by a frazzled aid official named Pierre-Yves Rochât. Word has come down from the Haitian health ministry that there are only 800 cholera cases in Port-au-Prince, a number everyone in the room knows is a lie. "They're dropping like flies," a CDC official whispers. At one hospital on the outskirts of town, there were 1,200 cases in a single day.

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