Sunday, July 18, 2010

Yarnie (1985-2010)



Photo by John Carroll
Southern Haiti
July, 2010


In the late 90's Haitian Hearts brought Yarnie to the United States for heart surgery.

Yarnie was about 13 years old at the time and she had valvular heart disease caused by rheumatic fever.

She survived surgery at OSF in Peoria and became much healthier and stronger. Yarnie returned to her home town in southern Haiti which is called Dame Marie. This little village is the home of the famous Haitian-American author Edwidge Danticat.

Yarnie survived the next 12 years in rural Haiti and had she had a two year old baby.

Yarnie was in Port-au-Prince on the afternoon of the earthquake in January and survived. However, shortly after the earthquake she became ill.

Yarnie was evaluated by Cuban doctors in southern Haiti.

An echocardiogram was performed which indicated she needed heart surgery. However, OSF in Peoria refused her repeat heart surgery because she is a Haitian Hearts patient. And another hospital could not be found in time to transport her to the US.

Yarnie died several weeks ago.

Her child is now an orphan in Haiti, one of the very most difficult countries to grow up in the world.

Maria, my wife, wrote a poem about Yarnie in 2002.

It is printed below.


---------

Chosen For

Little did I know
25 years ago when I said,
"Sure, I'll go to Haiti with you,"
that half an island would claim me.

In my work, I am faced
with the limits of what I can do
in the land of limitless heart patients.
Not patients with great hearts, that don't work quite right.

They all know me, Dr. Blan,
who can whisk them
to the magic land, the heaven
up north where hearts
can be synchronized.

The Haitians wouldn't put it that way.
They would say they no longer feel
th ocean rising in their chest
and maybe they won't drown.

Thousands need help.
Who to choose?

A priest tells me of
a sick girl in Dame Marie.
Yarnie, the best student
in her class and maybe the cousin
of Edwidge Danticat, who wrote
Breath, Eys, Memory.

I'm sure she is lovely and deserving,
and her weak breath concerns,
but five kids on the list are coming back.
Perhaps next time.

The next morning I scale an
eight-foot airport fence
and drop to my knees.
The priest arranged
for a Haitian Pilot Man
to fly me to Yarnie.
If I can take five, what's six?

Why is the pilot tasting the gasoline?
Because it's mostly water?
We lift off while the sun peeps
innocently over mountains.

Heading west, preparing to land,
the guilty sun blinds the cockpit,
and the pilot confirms,
"I cannot see anything."
Whack! Whack! Whack!
We hit the treetops and prepare
to die in Dame Marie's red clay.

But instead we land in mud.
Haitian Pilot Man boasts,
"I use only one half of runway and am only pilot,
in Haiti who will land here,"
and then warns me not
track mud in his plane when I reenter.
Priorities.

A group walks toward us.
Yarnie and others.
A runway examination reveals
tachypnea and a heart rate of 140,
the beautiful girl, a stick figure.

The brave fool pilot says he will
fly lower than the mountains for Yarnie's breath.
What choice do I have?
Yarnie's mother cries for
her daughter who she
will lose to find.

Back in Port-au-Prince,
I must get yarnie a visa.
If she falls asleep,
she stops breathing, a deadly cardiac slumber.
I tell another cardiac kid, Nadia, to shake
Yarnie if she doesn't breathe after 15 seconds.

I am gone three hours.
Will there be a girl for this visa?
Rushing in the door,
Yarnie standing and smiling,
"Sure had a good nap. Made a new friend who
kept shaking me for some reason."



Maria King Carroll
Cri de Coeur, 2002

Saturday, July 17, 2010

Expedite Haitian Visas



Photo by John Carroll
Zanglais, Haiti
July, 2010

BOSTON GLOBE EDITORIAL

Haiti: Expedite visas for family members
July 17, 2010

Two days after a calamitous earthquake erupted in Haiti in January, President Obama rightly called it “one of those moments that call out for America’s leadership.’’ Since then the United States has done many things to help Haitians, delivering food, medical assistance, and temporary shelter to the island. Sad to say, however, the administration has yet to do one thing that could help significantly: allow the 55,000 Haitians who have already been approved for immigrant visas to join family members here in the United States.

Homeland Security Secretary Janet Napolitano is empowered to grant this relief simply by ordering it, with no act of Congress needed. Congressional quotas created the current backlog of approved visa recipients; children and spouses of legal residents have to wait four years, while siblings of US citizens must wait 11 years. These Haitians approved for entry to the US will come here eventually. If they are enabled to come now, and if they are permitted to work here legally, the money they remit to Haiti will serve as an efficient form of foreign aid, greatly accelerating the island’s economic recovery.

In the past, bureaucratic obstacles have been removed, for humanitarian or national-security reasons, so that refugees from Cuba, Indochina, and Kosovo could enter this country. Haitians are no less deserving.

Obama should instruct Napolitano to allow the 55,000 Haitians approved for visas to come to these shores now, and to expedite decisions on the visa applications of 19,000 other Haitians. This would be the most effective way to take the leadership role America should have in helping Haiti cope with the catastrophe of last winter’s earthquake.

Friday, July 16, 2010

Transitional Housing in Haiti



Photo by John Carroll
Haiti, July 2010


Haiti's Homeless: Is 'Transitional' Housing the Solution?
July 16, 2010
By Jessica Desvarieux / Port-au-Prince


On Monday night, July 12, severe winds blew away about 350 tents in a tent city in the Port-au-Prince suburb of Corail-Cesselesse. There were no deaths reported, but six people were injured by flying tent poles and debris. And the hurricane season has yet to hit its stride in Haiti.

The omens are not good for the 1.5 million Haitians still homeless after the Jan. 12 earthquake, mostly living in box-shaped tarpaulin emergency houses, some set up haphazardly, others planned out but still fragile as the ones in Corail-Cesselesse were. One approach to the crisis is to set up what are called transitional shelters: structures composed of plywood walls and steel frames, durable enough to stand up to inclement weather and strong winds but not meant to provide long-term housing. Each unit, which can house a family of five, can last about three years and costs an average of $1,000 to build. That relatively small amount has helped push transitional shelters over more-permanent housing. "It's a practical decision," says Adam Fysh, coordinator for the so-called U.N. shelter cluster group that is overseeing the structures. "You can help 40 families vs. four." There are plans to build 76,000 additional transitional shelters in the next nine months.

However, so far, there are only 5,500 such units in the Port-au-Prince metropolitan area and its immediate environs. Of them, 1,300 are in the capital itself; the rest are located outside the city in areas like Carrefour, where land-ownership objections have been raised by an active mayor and long-standing nongovernmental organizations. The pace of building new shelters has quickened recently: 5,000 of the 5,500 shelters were built in the past two months. But what took so long — six months after the catastrophic temblor — to get the process going?

Timo Luege, the U.N. spokesman for shelter cluster, points to the slow removal of the estimated 20 million–to–25 million cu. yd. (15 million to 19 million cu m) of debris — enough to fill the Louisiana Superdome five times. Also, land-ownership disputes continue to stall construction of the temporary shelters. "You want to get people out of tents and tarps as soon as possible," says Luege. "But we have a big problem when it comes to finding land to create housing solutions."

The land disputes can get heated and can even turn violent. Earlier this month, gunmen allegedly representing landowners threatened staff members of the International Organization for Migration (IOM), an intergovernmental group attempting to relocate residents of Parc Fleurieux. The tents in the community were set up around a flooded soccer field, putting the people in them at risk of not only rising floodwaters but also water- and insect-borne disease. IOM spokesman Leonard Doyle says the region's mayor gave IOM permission to use the land in the Tabarre region of Port-au-Prince to resettle the people from Parc Fleurieux into tents and eventually transitional shelters. "We had assessed them for evacuation, and now we're at a dangerous crossroads," says Doyle. "We have been pressing very hard to get land." However, the gunmen forced them to stop their resettlement plan, and now IOM and the U.N. shelter cluster hope to relocate the Parc Fleurieux residents to another site 10 miles (16 km) north of the capital, in the tent city of Corail-Cesselesse.

There are some organizations, however, that do not believe transitional shelters are the solution — and not just because of the problems in setting the structures up. "Transitional housing winds up to be permanent housing — essentially slums," says David Rivard, head of humanitarian logistics for Airline Ambassadors International, a humanitarian group created by airline employees. "It's really going to be wasting the money." Adds Rivard: "Transitional shelter sets a precedent to build unsafe buildings and unsafe communities."

His organization is working with the United Nations Stabilization Mission in Haiti (MINUSTAH) to build 160 homes in the central region towns of Mirebalais and Pandiassou. The $3 million project includes plans to construct homes that would come with proper sewage and water treatment, drainage and community centers. The average cost per unit is $16,000, but Rivard says the price difference is well worth it in the long term. The project has been able to avoid land-ownership issues because local ministries donated the land. Homes will go to 500 displaced people who fled Port-au-Prince seeking refuge with family members in the provinces. There are an estimated 600,000 other Haitians in the same predicament, so Rivard hopes this will be a starting point for other projects. (See pictures of Haiti's gingerbread houses.)

U.N. spokesman Luege isn't so sanguine. "If you put 500 nice houses on some field and there are no jobs, no infrastructure, it's not going to work," he says. Yet Luege defends the decision to stay with the transitional shelters, saying they're cheaper and use less material. In the confused atmosphere of postquake Haiti, few people have commented on the fact that two U.N. agencies — MINUSTAH and the shelter-cluster organization — are pursuing different housing agendas.

In the vast tent city in Corail-Cesselesse, an open field has been cleared out, awaiting the wood frames and steel reinforcements of transitional shelters. During the earthquake, Abekay Robert lost his home and most of his possessions in the Delmas area of the capital. Now he lives with his wife and toddler daughter in a podlike tent. He's been working with the humanitarian organization WorldVision to design a suitable transitional shelter for his community. But he says he doesn't have any intention of making Corail his permanent home. "They told us that this is a temporary shelter. Temporary doesn't mean years," says Abekay Robert. "We don't intend to live here for long." But the next question is, Where will the permanent houses come from?

OSF's New Children's Hospital Blessed

Bishop Jenky and the other "Catholic prelates" in attendance have to be embarrassed with OSF because of OSF's abandonment of the Ethical and Religious Directives for Catholic Health Care written by the United States Conference of Catholic Bishops.

A prominent Catholic Monsignor in Peoria described to me the "corporate malaise" at OSF. And the good Catholic priests in parishes of The Catholic Diocese of Peoria are frequently uninformed about huge moral issues at OSF. One priest explained to me how he didn't want to make Bishop Jenky angry regarding a serious "Catholic problem" at OSF and did not want to even talk to Bishop Jenky about it.

Bishop Jenky and The Catholic Diocese of Peoria are afraid of OSF's power and money and have given in to OSF on very crucial Catholic issues. And the priests and laity of the Diocese--we all follow along with our heads in the sand.

It's all about money, power, and instilling fear in people so they remain quiet.

Too bad.


Below is the Journal Star article regarding the blessing of the new Children's Hospital at OSF today.


OSF's new Children's Hospital blessed

By CATHARINE SCHAIDLE (cschaidle@pjstar.com)
Journal Star

Posted Jul 16, 2010 @ 03:04 PM

“This is the day the Lord has made; let us be glad and rejoice,” U.S. Secretary of Transportation Ray LaHood quoted from Psalm 118: 24 at the dedication ceremony Friday morning of the new Children’s Hospital of Illinois and OSF Saint Francis Medical Center.

Indeed there were hundreds of reasons for rejoicing. Speaker after speaker related various stories, of the long and arduous path to the shining new hospital that was blessed by Bishop Daniel Jenky and a host of other Catholic prelates before a contingent of Peoria dignitaries and well-wishers.

Scriptural verses and symbolisms abound at the brand new building which is being celebrated on the 133rd anniversary of its founders, the Sisters of the Third Order of St. Francis.

Despite his pious opening, LaHood couldn’t let a cheeky observation pass. He was among many who believed it was necessary for the children’s section of the hospital to have its own unit. In those early days, LaHood said, “We fought just to get one sign up.”

Today, the $280 million “sign” is a shining light giving witness to the state-of-the-art facility dedicated to the care of children.

With this project, the Sisters of the Third Order of St. Francis re-affirmed their original mission when they arrived in Peoria on May 22, 1876, and opened a new orphanage and school called “Mount Mary.”

It was while begging on behalf of their wards, that they met the pastor of St. Joseph Church, Rev. Bernard Baak, who asked them to set up a hospital in Peoria.

In October 1876, six nuns led by Sister M. Frances Krasse, set up a make-shift hospital in a rented three-story house on Adams Street. They named it St. Francis Hospital.

And the rest, as they say, is history.

Check out the new hospital for yourself this weekend. Two public open houses are scheduled for 10 a.m. to 4 p.m. Saturday and Sunday.

Money Needed for Haitian Countryside



Photo by John Carroll
Les Cayes, Haiti


Agriculture Short-Changed in Haiti's Post-Quake Recovery
Lack of rural jobs threatens reconstruction effort

Steve Baragona | Washington, DC
16 July 2010


Rural jobs would improve food supplies and prevent crowding in Haiti's capital.

After a powerful earthquake struck Haiti in January, boosting agricultural production was seen as one of the keys to the nation's recovery.

Six months later, the U.N. Food and Agriculture organization (FAO) says only half the funding pledged for agriculture has been delivered.

Experts say short-changing food production is a common problem in many humanitarian crises and, in Haiti, it threatens to undermine the nation's already-troubled recovery.

Rural help wanted

When the earthquake ravaged Haiti's capital, Port-au-Prince, an estimated 600,000 people fled for the countryside.

The flood of people put tremendous strain on their hosts. Experts believe one of the best ways for the rural areas to cope with the new arrivals would be to create jobs boosting food production.

In a country where more than half the population was undernourished before the earthquake, the extra hands could be put to good use.

"But it definitely is not happening like everybody had hoped," says Keith Flanagan with the Inter-American Institute for Cooperation on Agriculture. He and others hoped to see large-scale irrigation, reforestation and other projects that would help farmers grow more food.

But, for the most part, he sees a lot of people being paid to sweep the streets.

"Tomorrow it's going to look just like it did yesterday," he says. "It is better than a handout, but I think there are things that can make a more lasting impact."

Back to Port-au-Prince

Most of the reconstruction activity so far has been focused on Port-au-Prince.

"If all the investment now will be done in the city where there are huge needs to reconstruct all the infrastructure, where there will be a lot of demand in terms of construction work, then you will have again a pull effect from the rural areas back into a city that is not ready to absorb a lot more people than they have today," says Christina Amaral, FAO's emergency operations chief.

Port-au-Prince was overcrowded before the earthquake. The mass exodus from the capital presented an opportunity to relieve the strain. Now, concern is growing that that opportunity is slipping away.

The United Nations requested $60 million in emergency reconstruction aid for agriculture. It's a tiny sliver of the total aid package of $1.6 billion the UN had asked for. But six months later, only about half of the funding for agriculture has come through.

Urban bias

That's no big surprise to Marc Cohen, a policy researcher with the humanitarian aid group, Oxfam.

"If you look across the United Nations humanitarian appeals, pretty consistently agriculture gets short-funded," he says.

Cohen says part of the problem is an urban bias among policy elites in both the donor and affected countries. He adds that donors get much more immediate and visible results from relief like education, medical care and direct food aid.

"If you're feeding people, you can see the direct impact," he says. "Whereas if you send seeds, they have to be planted, they have to cultivated, they have to be harvested before there's an impact."

But the impact does come, says Cohen, noting that more than 100,000 farm families will soon be harvesting crops grown with seeds, fertilizer and tools donated to help them cope with the earthquake's aftermath.

The FAO planned to help 25,000 more families, but ran out of funds.

Long-term plans

In the longer term, the Haitian government has a $700 million plan to create rural jobs while improving food supplies.

Those programs are expected to begin in the coming months. The World Bank and the United States are making major contributions.

But, in the meantime, people are beginning to drift back into Port-au-Prince, amid concerns that the opportunity to rebuild a less crowded capital and boost the rural economy may be fading.

OSF in Peoria Denying Care to their Haitian Patients

See this Forum article I wrote and the Peoria Journal Star printed today.


Forum: OSF failing patients from Haiti with urgent needs.

Posted Jul 15, 2010 @ 11:00 PM
Re. July 5 article: "Children's Hospital tours scheduled":

I am sure the brand new, $290 million OSF Children's Hospital and Emergency Department is beautiful and will be loaded with technology. People from central Illinois deserve this structure, along with competent medical personnel inside to deliver high-quality care.

However, every society around the world deserves the same chance at cutting-edge medicine.

During the last seven years Haitian Hearts patients who have returned to Haiti after heart surgery at OSF have been categorically denied follow-up surgery at OSF. Several weeks ago, a young girl operated on 13 years ago at OSF died in Haiti. She needed repeat heart surgery.

It's difficult to find other medical centers in the U.S. to take OSF's Haitian patients. They believe Haitian patients cared for in Peoria are OSF's medical and ethical responsibility.

Two more Haitian patients operated on at OSF need heart surgery again. They survived the devastating January earthquake and both have been homeless in Port-au-Prince. Last month I examined them. Both will die without heart surgery soon.

Haitian Hearts donated over $1.1 million to Children's Hospital of Illinois earlier this decade to help build this new OSF medical complex. We would pay for both of these patients, as well.

Over 130 years ago, OSF's founding Sisters said they would turn no one away. The current OSF Sisters say the same, but unfortunately Haitian Hearts patients have been excluded from their mission.

The new OSF medical complex needs to show how "beautiful and uplifting" it really could be. OSF could really shine if they would accept back their Haitian patients and give them another chance at life.

John A. Carroll, M.D.

Haitian Hearts Medical Director

West Peoria

Copyright 2010 pjstar.com.
------

I am quite sure OSF is mounting a rebuttal to my opinion written above.

OSF's usual modus operandi is to recruit a well known Peoria person to write an article stating why I am all wrong. Who would want this job to defend OSF's neglect of Haitian kids who are dying as a result of OSF's neglect?

Someone will run with the ball for OSF and I will post their article when it appears.

The host families for these Haitian kids in the Peoria area are very afraid of OSF...and for good reason. Much of the Peoria community is afraid of OSF...even big donors to OSF would like to see Mr. Steffen replaced, but their own medical problems make them think twice about going public.

In the meantime, I need to find medical centers to accept Jenny and Henri. They don't have the same time or resources as does OSF.

Haiti Needs to be Green Again



Photo by John Carroll
Les Cayes, Haiti
June, 2010


A Tree Grows in Haiti

Six months after a devastating earthquake, the nation is still struggling to regain its footing. Why the best recovery efforts may hinge on something green.

by Jeneen Interlandi
Newsweek
July 16, 2010

Surrounded as it is by an amphitheater of treeless mountains, the city of Gonaïves has long been defenseless against the onslaught of hurricanes that pound Haiti every summer. Unencumbered by trunks or roots or shrubs, the water sloshes freely downward, gathering into apocalyptic mudslides that destroy homes, crops, and livelihoods. In 2004 a single storm claimed 2,000 lives from this one city.

Like the rest of Haiti, Gonaïves is bracing for another punishing hurricane season, even as earthquake-recovery efforts falter and the city struggles to absorb thousands of refugees from Port-au-Prince, 100 miles to the south.

Amid a host of competing priorities, the seemingly least urgent task may prove to be the most significant: planting as many trees as possible. “Almost all of the country’s problems—natural disasters, food shortages, poverty—can be traced back to rampant deforestation,” says Ethan Budiansky, the Caribbean-programs officer at Trees for the Future, a nonprofit group that is planting thousands of trees in the mountains around Gonaïves. “So if we want to fix the country, we have to start there.”

While there are no panaceas in Haiti, successful reforestation might come close. By absorbing water and holding soil in place, trees can minimize the impact of natural disasters and repair nutrient-poor agricultural lands. An aggressive reforestation campaign would also bring much-needed jobs to the region and, if done correctly, could solve the energy conundrum that led Haitians to cull their forests in the first place. “Planting trees is not just some quaint side project,” says U.N. Development Group chair Helen Clark. “It’s the key to rebuilding the country.”

Haitian deforestation has many culprits—from French colonizers’ coffee and sugar plantations to the swaggering timber industry of the 19th and 20th centuries—but most experts agree that the biggest modern contributors are the food and fuel needs of Haitians themselves.

As population grew from 3 million in 1940 to 9 million in 2000 rural Haitians were forced to clear ever-larger swaths of mountainside for subsistence crops. The trees themselves doubled as a source of fuel and cash for families who not only used the wood to cook with but also sold it as charcoal in energy-starved Port-au-Prince. (Charcoal is made by burning wood and other carbon-rich substances in an oxygen-proof furnace.) In time, the charcoal trade grew to account for 20 percent of the rural economy and 80 percent of the country’s energy supply. Before long, 98 percent of the country’s forests had been chopped down, and Haitians were burning 30 million trees’ worth of charcoal annually. Soil eroded, crop yields shrank, and floods became more severe. Eventually, everyone who could abandoned the countryside for the capital city.

That’s saying a lot. Six months after the earthquake, collapsed buildings still addle the landscape; millions of Haitians continue to live in makeshift tent cities. And with February elections still waiting to be held, the country’s government has all but dissolved. Meanwhile, torrential rains have begun to lash Haiti daily. According to forecasts by Columbia University’s International Research Institute for Climate and Society, the country faces a 55 percent chance of above-average rainfall this season, and a slightly higher-than-average chance of being hit by a tropical storm. And thanks to the January earthquake that disturbed massive amounts of rock and soil, landslides are almost certain to be worse.

And as Port-au-Prince grew populous, economic development took a decidedly urban bent. Haitian entrepreneurs in-vested millions of dollars in hotels and restaurants, and the international community focused on promoting tourism and attracting manufacturers from the U.S. and Brazil.

In 2009 former president Bill Clinton, the U.S. special envoy to Haiti, secured Haitian-based textile companies duty-free access to U.S. markets, and persuaded Royal Caribbean Cruise Lines to invest $55 million in an expansion project on Haiti’s northern coast. Those efforts brought some welcome attention and investment dollars to the beleaguered country, but did little for the 6.5 million rural Haitians who earn their living off the land. And as the agricultural sector continued to wither, farmers turned increasingly to the charcoal markets.

In 2008 the economic toll of such environmental degradation became apparent. That year’s hurricane season—the worst to hit Haiti in decades—cost the country tens of millions of dollars in export crops and infrastructure. And the economic consequences of deforestation stretch well beyond those losses. Without trees to protect the soil, rains have washed it down into rivers and streams at a rate of 36 million tons per year. Sediment buildup has polluted drinking water and choked the life out of once bountiful fisheries. And without soil to absorb the rain, water tables have dwindled precipitously, adding a string of droughts to the country’s woes.

These days, “decentralization”—refocusing economic-development efforts from dense urban centers like Port-au-Prince to rural outposts like the mountains around Gonaïves—has become a buzzword among relief workers and legislators. They say that if the recent rash of natural disasters has taught them anything, it’s that in Haiti there can be no economic growth without environmental restoration. “The land is so degraded that just one storm or quake can undo a decade’s worth of progress,” says Budiansky. “And with people pouring into the countryside now, it’s only going to get worse.” Since the earthquake, more than 600,000 Haitians have fled Port-au-Prince searching for food, shelter, and work among their rural kin. With no other recourse, they will soon be forced to convert the remaining 330 square miles of forests into subsistence farms and charcoal for sale.

Budiansky and his colleagues say that a good agroforestry plan—planting the right trees in the right places and teaching Haitians to harvest them properly—can reverse this cycle of destruction. The trained workforce needed to manage these new, sustainable forests would mean thousands of new living-wage jobs, most of them in the countryside. Growing more fruit trees will also provide a steady source of income: Whole Foods has started selling Haitian mangoes in its stores. If harvested sustainably, fast-growing species that can be planted at a high density will generate enough charcoal to meet the energy demands of rural populations.

For cities like Port-au-Prince, experts are looking to the jatropha tree, which has been hailed as a promising biofuel and could one day spawn an energy economy that doesn’t destroy the forests. Other trees, like the moringa, have leaves that are tasty, packed with protein, and hardy enough to flourish even on the barren mountains of Gonaïves. “They call it the miracle tree,” says Budiansky. Haiti could use a few miracles to take root.

Wednesday, July 14, 2010

Champs de Mars Tent City Going Nowhere Quickly



Photo by John Carroll
Champ de Mars
May, 2010

In May I walked through the Champ de Mars tent city in Port-au-Prince.

It is situated directly in front of the crumbled National Palace.

I wound through the maze of Champ de Mars. Thousands of people were living in this inhuman place. Graffiti in the area say "Down with Preval".

I felt a little uneasy because this was new territory for me and for Haiti.

It was sad seeing Neg Marron with drying laundry hanging on his shackled leg and even more sad to see good Haitian people living like this.

Also, Carlos who is mentioned in the article below, told me of his problems in detail.



Miami Herald, July 12, 2010

In Haiti's tent cities, a return to normalcy is unimaginable

By FRED GRIMM


PORT-AU-PRINCE -- The concept of temporary, amid Haiti's teeming refugee camps, has morphed into a dismal variation of forever.

A deluge of earthquake victims, shocked and terrified, spilled out of the city's ruins after the disaster and found refuge in parks, school yards, soccer pitches, garden patches, almost any private or public space they could find in their tumbled down city.

Their flimsy tents, fabricated from bed sheets, tattered plastic, sticks and strings, reinforced the assumption that these impromptu settlements, 1,300 of them, would surely vanish before the summer rains could wash them away.

Six months later, the dispossessed remain, in transition to nowhere, with nowhere to go. With a million or so (no one really knows) still occupying what had been the city's open spaces, a return to normalcy has become unimaginable.

In the Champs de Mars, a once-compelling 42-acre network of parks and plazas with shaded lawns, a bandshell and amphitheater by the National Palace, the sprawl of bed sheet tents erected just after the Jan. 12 earthquake has evolved into a dense shanty settlement of crude but markedly more substantial dwellings. Thousands of quake survivors have fabricated little one-room shacks fashioned from lumber and corrugated metal salvaged from wrecked buildings with roofs of gray plastic tarps imprinted with ``From the American people.'' Lately, shanty dwellers have begun adding cement and rock footings around the base of their no-longer-so-temporary homes. And doors with locks.

Nelson Pierre, a one-time physics teacher, built his cottage-tent hybrid near the stylized statute of Haitian revolutionary hero Toussaint L'ouverture, with a glass window and a gable of wooden slats for ventilation. A poster featuring the periodic tables of chemical elements, recalling his life before the earthquake, share the wall with pictures of Jesus and fashion models. His home defies the notion of temporary.

Narrow passageways wind through the Champs de Mars' spontaneous ghetto, a place that has developed its own commerce, politics and vice along with shanties. At the wider places along these haphazard paths, cooks toil over charcoal fires, laundry dries on clothes lines, vendors hawk their wares. In one little opening, on a piece of plywood barely six feet long, Guilaine Pierre sold zucchini, carrots, corn meal, beans, eggplants, peppers, plantains, cooking oil, dried fish, flour, salami and Madam Gougousse brown rice.

Other vendors claimed the better locations along the street curbs, selling sundries and rice, flour and corn meal that had first come into camp as relief supplies from international humanitarian organizations. Fredes Batus, 46, sought me out to complain that the self-appointed boss of his plaza, controlled distribution of relief supplies, a means to build himself a political power base. ``He's stealing 70 percent of it,'' Batus said, bitterly. On a park wall, graffiti summed up the seething mood of Haiti's dispossessed in absurdist terms: ``Welcome back JC Duvalier'' for the long-exiled, famously brutal dictator, Jean-Claude Baby Doc Duvalier.

Carlos Jean Charles, 29, in a T-shirt emblazoned with an American flag and the face of country singer George Strait, spoke darkly of other commerce that has taken hold. Charles, who sleeps with his wife and three children in a seven-foot-long corrugated metal and scrap wood hovel barely wide enough to hold a single twin-bed mattress, said some families were so desperate that they offered up their children, some as young as 10, as prostitutes. Charles talked about criminal gangs vying for control of their shanty town. He grabbed a 16-year-old kid, Michel Mirat, who had run afoul of a gang known as the Reds, and pulled back his shirt and pants to reveal three not-quite-healed bullet wounds.

In another opening amid the maze of shacks, a cluster of small boys, no more than 12, sat in a circle smoking marijuana. Five young orphans were building their own little shanty out of boards and sticks.

Around a turn, neighbors lined up to fill plastic buckets with water from a large undulating orange bladder, imprinted with Action Contre la Faim. Fresh water, latrines, medical needs -- the stuff needed to fend off an epidemic -- come from non-government organizations. And they also illustrate the great dilemma facing post-earthquake Port-au-Prince. The NGOs, acting in the stead of a weak government, fend off disease and starvation in these squalid camps. But even the most rudimentary services, in a stricken place like Port-au-Prince, have the perverse effect of sustaining the new, spontaneous slums that are stifling the city's recovery.

The Haitian government has been talking for months about relocating the people of Champs de Mars in planned relocation camps outside of town. No one I talked to inside the camp professed any faith that an overwhelmed and irresolute bureaucracy could accomplish such a logistical feat.

``We could be here next year, the year after that, the year after that,'' said Jourdain Ernso, 18. ``We wouldn't like this camp to be permanent. This should be a public place but we have no place else to go.''

Twelve miles north of Port-au-Prince, on a treeless, sun-bleached gravel plain called Corail Cesselesse, some 1,300 families were moved off a Port-au-Prince golf course in April and into an official, sanctioned relocation camp. Each family has been assigned a white semi-cylindrical tunnel tent, arranged in long orderly rows, reminiscent of Quonset huts on a 1940s military base. NGOs have built showers and latrines, provided potable water, medical services. Save The Children has erected a large tent to house a school this fall. But Camp Manager Richard Poole of the American Refugee Committee said food supplies have been limited by a government worried about nurturing a dependency culture.

The camp is isolated, with very few vendors. One of the few, Meloude Charles, 30, had led a mule out of the mountains with a load of charcoal to sell in the camp. And there's little prospect in this area for employment other than earn $4.50 a day the NGOs pay men who dig drainage ditches around the camp. Nothing grows in this gravel field, much less a garden. ``People are hungry,'' said the frustrated Poole.

With hunger comes conspiracy theories. Rumors fly through the camp that the NGOs, in league with the government, have stolen food money. Such talk, so far, has spawned four food riots. ``The people were very, very angry,'' Poole said. ``It was very scary.''

Over the next few months, supposedly, these 5,000 refugees will be moved out of tents and into plywood huts. Not permanent housing, mind you. Just a higher grade of temporary. But temporary has become as meaningless a concept in Corail Cesselesse as in the Champs de Mars.

Over the last three months, unauthorized squatter camps have sprouted on land around Corail Cesselesse and on the slopes of Goat Mountain, looming in the background. Estimates indicate that as many as 40,000 people have pitched tents or built shanties to be near the services provided by the NGOs in the official camp.

Squatters, Poole said ruefully, are even selling plots of land out there for $250 each. No matter that they're selling someone else's private property. ``More and more are showing up out there every week,'' he said. ``We're going to be dwarfed by squatter camp.''

Corail Cesselesse looks to be the small orderly center (residents of the official camp wanted Booth to build a razor wire fence to keep out the unruly masses) surrounded by a unplanned anarchic slum.

``I've seen this happen after the earthquakes in Lima and Mexico City,'' Poole said.

In Corail Cesselesse, the notion of temporary has evolved into a permanent squatter city.

Back in Port Au Prince, a kind of perpetual weariness afflicts Brother Milo Frederique, priest and lower school principal of what, before the earthquake, had been considered the finest boys school in Haiti. Lately, Frederique contends with finding the money to rebuild ruined school buildings, scheduling classes for 1,500 kids in 16 tents, dealing with a financial crisis caused by so many parents who can no longer pay tuition.

And all those squatters -- his other problem. Some 6,000 refugees now live in the mahogany grove on the 15-acre Institution Saint Louis de Gonzague campus.

``Because the government knows that education is important . . .'' Frederique hopes that the refugees will be moved away, into more appropriate housing. He said that they'll probably be gone by August, before the next school term. Or September. His voice trailed off. ``Maybe by October,'' he said, wistfully, with more hope than conviction.

The homeless colony at Saint Louis de Gonzague again illustrates the peculiar conundrum of the effort to bring Haiti back. Back to what? Haiti's poor were in such utterly desperate shape before the earthquake that ``temporary'' makeshift housing and refugee camps, however unpalatable to outsiders, can actually represent an upgrade in their standard of living.

Lifranc Herold, the secretary general of a self-governing committee elected by the Saint Louis evacuees, said that the NGOs provide the colony clean water, medicine, food rations -- something out of reach for most of them before the disaster. Then Doctors Without Borders provided them with expensive family-sized tents, pitched in the shade of tall mahoganies. Herold said that many of the people had been renting shoddy little rooms before the earthquake. Besides, rents have since gone up. ``Some of these people are living better now than before,'' he said.

Even if they had some place to go back to, why would they? he asked.

Of course, most of the St. Louis interlopers could be persuaded with money or food or real jobs to move out of the city into relocation camps. Except most of these camps are only proposals, vague plans, foundering somewhere within Haiti's inscrutable bureaucracy.

Haiti's dispossessed, meanwhile, know that escape from their temporary ghettos will be a long time coming.

Sean Penn Hits it on the Head



Photo by John Carroll
Les Cayes, Haiti
July, 2010

(CBS, July 12, 2010)

Sean Penn Unrelenting with Haiti Relief Efforts
Six Months Post-Quake, Actor Still Works To Make a Difference


Six months after Haiti's earthquake, the numbers are still staggering.

Between 220000 and 330,000 died. Another 300,000 were injured. And about 1.5 million people are still are homeless as we head into hurricane season.

Before the quake, actor Sean Penn had never been to Haiti.

But he's been there almost full-time since January, building a relief organization that's helping tens of thousands survive.


Penn joined "The Early Show" exclusively from Port-Au-Prince, Haiti, Monday to share with viewers just what he's experienced in the last half year there.


Penn says the biggest issue he's seen when it comes to the relief efforts is the lack of coordination between international agencies and the Haitian government.


"So, what happens is that floods and floods of money come in when people see immediate trauma and the drama that goes along with that. And then there are agencies, big agencies that have a lot of time, sorting out the ways to best spend the money and have detailed capacity to do it," said Penn. "So, what happens is that you get six months down the line and those things that would be preventive have not been put in place for any legitimate measure."


Penn rushed to Haiti after the massive natural disaster that struck the small country, to help with immediate relief. He stayed to finish what he started.


As the days wore on for Haiti, relief began to trickle down to a stop. As the government moved on, so did the media, along with the throngs of people who had Haiti in the spotlight.


"So many questions and criticisms could have been answered," explained Penn. "People could understand what's going on here; they could understand the heart and courage of the Haitian people and the necessity for the coordination efforts that are still not happening, in anything close to an effective way. I think that the media has played an enormous part in the failures that are still going on today and the recovering here and relief operations."


Penn has been applauded by many, including those who may not agree with his politics. He's been described as a "Do-er, not a talker," by the Lieutenant General of the U.S. Southern Command, who also commended Penn's ability to break down the bureaucracy of the U.N., as well as take the leadership role Penn has shown in a tough situation.


Though there's no obligation for Penn to be making such in effort for Haiti's relief, he says there is inner turmoil that drives him day-to-day to continue his work in that country.


"In our case, we came down with the idea of spending two weeks and trying to help out, said Penn. "There's something that takes over and it's really an obligation because you see the strength of the people who have never experienced comfort, and the gifts that that can give to people like myself and to our country and culture. You see the enormous gaps."


Penn now finds himself among hundreds of people sharing the same belief that every little bit can make a difference. He feels the situation is only temporary, and that "it is fixable."


For Penn and his team, the work is far from over. He hopes that, by making a continuous effort, others will join in the fight to piece Haiti back together.


Penn said, "It remains to be seen whether or not the American people, the world community, are going to join together and maintain the kind of commitment that the United States military showed here and to do this completely rather than to do a cosmetic emergency response and then let a country that's been suffering for so long suffer that much longer."

Les Cayes, Haiti

Go to this website for slide show.

Tuesday, July 13, 2010

Haiti Reconstruction...We can only Hope



Photo by John Carroll
Cathedral, Port-au-Prince

Posted on Tue, Jul. 13, 2010

Haiti launches into reconstruction
BY JACQUELINE CHARLES, LESLEY CLARK AND TRENTON DANIEL

jcharles@MiamiHerald.com

With dozens of black-and-white government dump trucks, bulldozers and other heavy equipment parked on the lawn of a crumbled presidential palace, Haitian President René Préval on Monday declared that the country's reconstruction has begun.

``While we're continuing to help people in the camps, we officially want to launch the reconstruction phase to allow these people to get out from underneath the tents,'' Préval said, adding that 100 of the CNE vehicles are being dispatched to neighborhoods to help in demolition and rubble removal. ``It will not be easy and it requires a lot of resources. Before we reconstruct, we must clean up.''

Préval marked the six-month anniversary of the catastrophic quake with a morning ceremony recognizing some two dozen Haitian and foreigners including Miami fire rescue volunteer Karls Noel Paul who helped in the early days.

Over at the U.N. Stabilization Mission, staffers marked the day with tears and the unveiling of a mural by eight Haitian artists that commemorated the 102 staff members killed.

In South Florida, there was good news. Federal officials announced at the Miami field office of the U.S. Citizenship and Immigration Services that they plan to extend the deadline for undocumented Haitian nationals living in the United States to apply for Temporary Protected Status. They also said they are reviewing the possibility of extending the benefit, which defers deportation, to those who arrived shortly after Jan. 12.

But immigration advocates remained concerned over how to legally get more Haitians out of the country.

``It's something that would be a tremendous shot in the arm to the recovery of Haiti,'' immigration advocate Steve Forester said.

Alejandro Mayorkas, director of U.S. Citizenship and Immigration Services, said his office also is examining -- along with the state department -- whether to expedite visas for Haitians whose petitions for relatives in Haiti have been approved.

In Washington, President Barack Obama, meeting with Dominican Republic President Leonel Fernandez, thanked that nation for coming to Haiti's rescue, while Cheryl Mills, chief or staff to Secretary of State Hillary Clinton, provided a progress report. It includes providing food to the estimated 1.5 million left homeless by the quake and improvements in healthcare.

``There is still an enormous amount that needs to be done,'' Mills said.

Housing and removing rubble remain Haiti's two biggest challenges, Préval said during the ceremony that was attended by former President Bill Clinton, who co-chairs the Interim Haiti Reconstruction Commission.

With enough rubble -- 20 million cubic meters -- to fill five super domes, Haiti has struggled to move to reconstruction. Préval said his government was considering a 90-day plan that would expedite the removal, yet still only take care of 10 percent of the debris.

But he also pointed out some quiet progress. In the hilltop neighborhood of Fort National, the government has been seeking to move people back into their homes, sending in heavy equipment to demolish and employing residents in cash-for-work programs. U.N. humanitarian chief John Holmes later toured the site.

Critics have slammed Préval and his government for not moving fast enough in a country that even in pre-quake days struggled to provide basic services to its 9.6 million citizens.

The international community, too, has come under fire for not providing the aid it promised when dozens of countries in March at a conference in New York pledged $5.3 billion in reconstruction assistance. Clinton said he intends to make sure they provide a schedule of reimbursement.

``When we come out of this, we want Haiti to have a strong middle class and we want poor people to own their property and believe they can work themselves into the middle class,'' Clinton said.

During the ceremony, Préval handed out a spread sheet to show the origin of $35 million in aid the government has received. The amounts ranged from people who sent 43 cents to $1, to countries that sent $1 million to $5 million.

Monday's ceremony aimed to symbolize both the tentative end of one chapter and the beginning of another while recognizing scores of Haitians and foreigners who aided Haiti in the days immediately after the disaster.

In all, some 24 people were given medals -- marked 12 January 2010 -- including Cendra Guillaume, a mother and excavator operator for the government's road-building outfit, Centre National des Equipments. Hollywood bad boy-now-Haiti camp manager Sean Penn was also honored.

Charles reported from Port-au-Prince, Clark from Washington, D.C., and Daniel from Miami. El Nuevo Herald staff writer Alfonso Chardy also contributed from Miami.





--------------------------------------------------------------------------------

Responsibility to Haiti



Photo by John Carroll
Les Cayes, Haiti
July, 2010

Read Michael Diebert's article in the Guardian regarding the responsibility of the international community to Haiti.

Cost of Chaos Measured in Lives



Photo by John Carroll
May, 2010
Pediatric Tent, General Hospital
Port-au-Prince

In May I walked through the General Hospital complex in downtown Port-au-Prince. It is a huge complex (a square city block) with many medical buildings surrounding a courtyard with a pretty blue and white church in the courtyard. A morgue sits in the back corner.

I had been to the General Hospital many times in the last three decades and it looked just as bad as ever.

I had worked in the Pediatric department in the past evaluating children with heart murmurs to determine if they were candidates for heart surgery in the United States.

The ancient Pediatric building (which had been built by the American Red Cross decades ago) had significant damage and a large crack running through the front wall. The building obviously was not safe to have patients inside. So the pediatric patients had been moved outside into large tents on the road in front of the building.

The tents were filled with babies in tiny cribs. IV's dripped fluid into their veins and some babies had oxygen via nasal prongs or oxygen masks.

The tents were very orderly but extremely hot inside. I wondered about all of the "insensible" fluid loss the babies were having in the sweltering tent heat.

In one of the tents a Haitian pediatrician sat at a desk in the corner recording a history on a new admission. Fans were running at full bore but circulating warm humid air.

In these tents, mothers sat attentively at bedside with their sick little ones. And when water was needed, the mother or other family member went outside to a giant blue cushion that looked like a huge water bottle. It was filled with water. I think the UN had donated this cushion and filled it with water. There was also an intricate appearing spigot system near the blue cushion that provided access to the water.

Just a few feet down the street which coursed through the General Hospital medical complex was a field filled with debris. A smashed red van sat on the edge of the field. This area had a nursing school and dozens of young nurses were killed in the horrible 47 seconds on January 12. It made me sad to look at this vacant spot and think of the beautiful young Haitian women that died instantly as they were pursuing their nursing degree that horrible afternoon.

The General Hospital Emergency Department was still functioning in its original pre earthquake location and was somewhat busy, but still not as busy as it should have been in a city with three million people without basic services.

I saw many foreign nurses who seemed to be "running the show" in the Emergency Department. I did not see Haitian doctors or nurses working inside the Emergency Department, but I may have missed them too. And as Jonathan Katz's article below clearly states, it would be nice if the General Hospital doctors and other hospital personnel were paid their fair salaries.

But this is not a new story either. Haitian resident physicians that do the majority of the work at the General Hospital over the years, have frequently not been paid their salaries by the State of Haiti. And Haitian doctors have gone on strike multiple times in the previous decades because they have not been paid. And patients have died. And several years ago their bodies were piled on the sidewalk in front of the General Hospital as a form of protest by the doctors and hospital employees.

Can you imagine American doctors in the same situation? Would we continue working?

And when doctors who don't get paid for months go on strike and the hospital shuts down, who is at fault? The doctors or the State?

Today is July 13, 2010. And Haiti is in big trouble.

I am working in a clinic in southern Haiti and people are very sick here. The medical system is sick and so is Haiti's infrastructure.

Name a problem and it is here.

I examined a 14 year old girl today who is an inpatient at the clinic. Her father is dead and her mother is home in a town down the coast with her seven siblings. She has no family or friends at her bedside. And she is 14 years old. She needs someone and she needs a system to look after her.

See Jonathan Katz's article below. He writes that the "cost of chaos is measured in lives". This is true. But so much of the chaos doesn't need to be. Hospitals and medical clinics need to have the basic technology and hospital personnel need to be paid fairly.



Haiti Struggles With Ongoing Hospital Woes
Overall, Haitian Medical Care Better After Quake

JONATHAN M. KATZ, Associated Press Writer
Posted: 4:45 pm PDT July 10, 2010
Updated: 12:32 am PDT July 12, 2010

Haiti Hospitals Show Recovery Challenges

PORT-AU-PRINCE, Haiti -- It was a simple problem with a novel solution.

Doctors, nurses and technicians at Haiti's most important hospital had not been paid since before the earthquake - causing strikes and staffing shortages, and turning the facility into a dangerously inefficient, rat-infested mess. So in March, the American Red Cross volunteered to donate a small part of the $468 million it raised for quake relief toward supporting their salaries.

But the $3.8 million promised to the hospital is only now being delivered after four months of negotiations and red tape. While billions were spent on short-term projects, including medical assistance, doctors' strikes continued and neglected patients at the capital's main medical facility were left to suffer and die.

The breakdown at State University Hospital is a prime example of the difficulty in grinding out a successful recovery. Six months after the magnitude-7 quake leveled much of the city and turned the hospital's courtyard into a grisly open-air morgue, promises to help Haiti become more self-sufficient have produced often frustrating results.

"The intent is there. The money is there. It's just that these are complicated issues," said Louise Ivers of Boston-based Partners in Health, which acted as an intermediary between the Red Cross and the hospital.

Sources involved with the project say the problem came down to clashing styles, needs and timetables. Haitian hospital administrators were trying to please government officials and satisfy angry employees while maintaining control of their institution.

The Red Cross, meanwhile, was trying something new: Disaster relief funds rarely go to fix up local institutions, especially ones run by the government. Doing so required heavy auditing and learning a new set of rules for operating.

The organization is proud of the project. Nan Buzard, the American Red Cross' senior director for international response and programs, said the infusion of money is an essential stopgap measure for Haiti's medical system.

"We really think this is one of the best things we can do," she said, adding that she understands doctors' frustrations given how long it had been since they were paid.
Former U.S. President Bill Clinton, who is helping oversee reconstruction, said in a Saturday interview that his staff worked hard to see the agreement through - in large part because it might encourage other donors to support existing but foundering Haitian institutions.

"It took a while for it to get together, but we were working very intently on this," Clinton told The Associated Press by phone. "This is a little bit of a departure from what the Red Cross or other NGOs have done in the past. When you're trying to change all these cultures, it's really something."

But at the hospital, frustrations are running high. Unpaid staff have little incentive to work - passion for helping those in need can only take them so far. Cleanliness, thoroughness and efficiency fall by the wayside.

For a hospital in rundown Port-au-Prince, where public sanitation is nonexistent, that means horror show conditions. The operating rooms are not sterile, and doctors say vermin sometimes run through during surgery. With much of the building damaged from the quake, patients endure long waits for overworked doctors in hot, flimsy tents that offer little protection from the elements.

"We are back to running this hospital as before the quake," said its executive director, Dr. Alix Lassegue. That does not mean, he quickly added, that there is an acceptable standard of care.

Until the Health Ministry prepares and presents a master plan for improving conditions to the interim reconstruction commission led by Clinton and Prime Minister Jean-Max Bellerive, that is unlikely to change, Lassegue said.

Yet it is one of the ironies of Haiti's reconstruction that medical care on the whole is better in the impoverished country now than before the quake, thanks to a flood of volunteer doctors, nurses and equipment.

But the promised leap from emergency aid to long-term viability for the medical system has not happened. Aid groups, once massed at the hospital in central Port-au-Prince, have left. The last group abandoned rooms of equipment and a filled-out white board.

Reginald Cadet, a 26-year-old first year medical resident, said that until paychecks show up regularly, he and his colleagues will be forced to continue intermittent strikes. He started working at the facility in May and has not once received his $150-a-month salary.

Still, he does not want to work anywhere else. "I'm a doctor. I always had a dream to be here," Cadet said.

The cost of the chaos is measured in lives.

Recently a 28-year-old woman was brought in with vague symptoms including fatigue, recalled Dr. Megan Coffee, an infectious disease specialist volunteering from San Francisco. The doctor ordered tests, which lab technicians took three days to produce.

The woman, whose name was not disclosed for confidentiality reasons, had failing kidneys. Emergency dialysis would save her life. Without it, she would die.
But there were too many patients who needed dialysis and not enough equipment or doctors.

The woman's body began to fail. Realizing help would not come, the family took her home. They called within hours to say she had died.

If support like that of the Red Cross would come, such tragedies could be avoided, Coffee said: The hospital has the expertise, and her Haitian nurses have the dedication.

"They just need to know that their job will support them," Coffee said.

Copyright 2010 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Monday, July 12, 2010

Same Old Haitian Song


Read this sad article.

Today in the medical clinic in southern Haiti, I saw terrible inhumane medical disasters that should never have happened.

Terrible skin abscesses, terrible infected scabies, terribly malnourished babies swollen with edema because they lack protein, and asthma attacks that required emergent care. And the two young asthmatic women had come from long distances across the mountains. I do not see how one of them stayed alive to reach us.

This is all very embarrassing and horrible. Humans should not live like this. Haitians are not really living right now. They are just making it through the day if they are lucky.

Haitians Press Forward Somehow

 

Photo by John Carroll
July, 2010
La Plaine, Haiti
Posted by Picasa

Saturday, July 10, 2010

Clinging to the Edge in Haiti



Photo by John Carroll
Cite Soleil, Haiti
June, 2010


July 10, 2010

In Haiti, the Displaced Are Left Clinging to the Edge
By DEBORAH SONTAG
New York Times

PORT-AU-PRINCE, Haiti — Hundreds of displaced families live perilously in a single file of flimsy shanties planted along the median strip of a heavily congested coastal road here called the Route des Rails.

Vehicles rumble by day and night, blaring horns, kicking up dust and belching exhaust. Residents try to protect themselves by positioning tires as bumpers in front of their shacks but cars still hit, injure and sometimes kill them. Rarely does anybody stop to offer help, and Judith Guillaume, 23, often wonders why.

“Don’t they have a heart, or a suggestion?” asked Ms. Guillaume, who covers her children’s noses with her floral skirt when the diesel fumes get especially strong.

Six months after the earthquake that brought aid and attention here from around the world, the median-strip camp blends into the often numbing wretchedness of the post-disaster landscape. Only 28,000 of the 1.5 million Haitians displaced by the earthquake have moved into new homes, and the Port-au-Prince area remains a tableau of life in the ruins.

The tableau does contain a spectrum of circumstances: precarious, neglected encampments; planned tent cities with latrines, showers and clinics; debris-strewn neighborhoods where residents have returned to both intact and condemnable houses; and, here and there, gleaming new shelters or bulldozed territory for a city of the future.

But the government of Haiti has been slow to make the difficult decisions needed to move from a state of emergency into a period of recovery. Weak before the disaster and further weakened by it, the government has been overwhelmed by the logistical complexities of issues like debris removal and the identification of safe relocation sites.

In some cases, the government has also been politically skittish about, say, creating new slums or encouraging people to return to undamaged homes when the ground beneath them could move again.

In others, it has taken charge but gotten bogged down. Since early May, President René Préval has personally focused, in granular detail, on returning about 11,600 Haitians camped in front of the National Palace to the Fort National neighborhood. But while Fort National is now a beehive of cleanup activity, no transitional shelters have been erected there yet.

In contrast, the Adventist Development and Relief Agency, working directly with a hands-on mayor in the Carrefour municipality in metropolitan Port-au-Prince, has already moved more than 500 families from its large tent city into simple pine houses whose concrete foundations incorporate recycled debris.

“Even though I lost my mom in the earthquake, I feel so content, so comfortable and so lucky to have this place,” Ketly Louis, 33, said, welcoming visitors into her new home on the site of the old home that collapsed on her mother.

International organizations here, while empathetic because of the difficulty of issues like land ownership, criticize the government for creating obstacles of its own. Significant delays in clearing supplies through customs, for instance, slow recovery efforts even as they earn the government substantial fees for storage.

And with hurricane season under way and many tents and tarpaulins needing replacement or reinforcement, some humanitarian groups complain about what they see as the government’s failure to articulate a clear resettlement strategy.

“Everywhere I go, people ask me, ‘When will we get out of this camp?’ ” said Julie Schindall, a spokeswoman in Haiti for the international aid group Oxfam. “And I have no answer. There needs to be communication on how all this camp business is going to be resolved.”

Haitian and United Nations officials urge patience in the aftermath of what they call the largest urban disaster in modern history. They point to accomplishments in providing emergency food, water and shelter and averting starvation, exodus and violence.

“What hasn’t happened is worth noting,” said Nigel Fisher, deputy special representative of the United Nations secretary general in Haiti. “We haven’t had a major outbreak of disease. We haven’t had a major breakdown in security.”

Also, they note, the Haitian government, while juggling the sometimes conflicting pressures from international donors, is handicapped by the destruction or damage of most of its ministries and the large numbers of civil servants killed. “I defy any country on earth to be fully functional at this stage after such a disaster,” said Imogen Wall, spokeswoman for the United Nations Office for the Coordination of Humanitarian Affairs.

In Aceh, Indonesia, after the tsunami of 2004, which left the national government intact, it took more than two years to get the displaced population out of tents, Ms. Wall said.

Mr. Fisher said: “In terms of speed, it’s never fast enough. But this matches what has happened around the world in comparable situations.”

Perilous Settlements

That is little comfort to the residents of the median strip on the Route des Rails.

Since the earthquake, displaced people apparently with no alternatives have planted tenuous roots in the most unsettling places — atop a municipal dump, inside a graveyard, on the bank of a soccer field flooded with contaminated water.

But the median-strip encampment demonstrates acutely both how miserable many settlements are and how they have become hidden in plain sight. Every day, thousands of drivers pass by the threadbare shanties on this coastal thoroughfare.

Only a quarter of the more than 1,200 post-earthquake camps are managed externally by aid organizations; the rest fend for themselves. In the Route des Rails encampment, that means relying on Luma Ludger, the camp leader, who keeps meticulous records in a handwritten ledger — and prays.

“God takes care of us,” Mr. Ludger said. He pointed across the highway. “And we also have those latrines.”

In March, Islamic Aid, a French organization, set up the latrines, which require users to dash through traffic, especially trying for the many camp residents who have diarrhea. The Red Cross also came by and handed out hygiene kits.

“They told us it was very dangerous to be here, and asked what they could do for us,” Mr. Ludger said. “I told them we need land. They said, ‘Wow, we cannot help with that’ and gave us toothpaste.”

Gerta Mojene, a mother of four, asked a reporter how to find a safer place to live. Asked where she might want to go, Ms. Mojene lowered her reddened eyes and said, “Wherever you send me.”

Mr. Ludger said that the mayor had spoken of evicting the median-strip squatters for their safety but had not proposed a substitute location. “Life here is a game of chance, you know,” he said.

A couple dozen residents have been seriously injured by vehicles; they wear casts and slings. At least three have been killed, among them, relatives said, the father of a baby born on the median strip on the evening after the earthquake.

The baby’s name is Katastrof Natirèl — Natural Disaster.

A Presidential Priority

By early spring, when many tent cities appeared to be getting entrenched, President Préval decided to make the large one on the Champ de Mars his personal priority. He wanted to demonstrate the logic of the government’s plan to return displaced people to their original neighborhoods, in this case Fort National. He wanted to show progress and be associated with results.

But Mr. Préval created instead a showcase for the difficulties involved in finding a quick alternative to the camps. Fort National, a densely layered hilltop area badly hit by the quake, proved an especially difficult place to clean up and repopulate first.

The president’s motivation for focusing on the Champ de Mars camp was at least partly political. The raggedy tent city, with its piles of garbage, puddles of standing water, swarms of mosquitoes, packs of thieves and an increasingly restive population, sits in the front yard of the smashed National Palace.

At the camp itself, where residents strip and bathe in the open, squatting over small plastic tubs, many remain unaware that they have become the president’s pet project. “Nobody tells us anything,” said Micheline Félix, 30. “It seems like they’re just waiting for us to wash away with the first big rain.”

But since May, right next door, Mr. Préval has presided over regular, often lengthy meetings of the Champ de Mars-Fort National working group; they begin at 7 a.m. and finish “when the president rises,” said Shaun Scales of the International Organization for Migration.

According to Leslie Voltaire, Haiti’s special envoy to the United Nations, the operating theory was that those with intact homes would be provided some kind of incentive to move back; those with reparable homes would get materials and assistance to fix them; and those with destroyed homes would be given transitional shelters in Fort National or moved to a planned settlement outside Port-au-Prince.

It soon became apparent, however, that Fort National was in very bad shape. In an engineering survey, some 55 percent of its structures received a red tag, meaning they were unsafe and destined for demolition. That is much higher than the average of 24 percent red tags elsewhere.

At the same time, only 18 percent of the homes in Fort National were tagged green, or immediately reinhabitable — compared with 47 percent in other areas surveyed.

Further, rubble removal, a $500 million problem facing the recovery effort, has proved especially difficult in Fort National. International experts say it would take three to five years to remove all the debris from Haiti if 1,000 or more trucks worked daily; fewer than 300 trucks are hauling rubble now. But those trucks cannot penetrate much of Fort National, which has only one main road and lots of steep alleys. In some places, even wheelbarrows cannot be used. Rubble has to be carried out pail by pail, which at least provides jobs.

Tortue Larose, 27, who earns $5 a day cleaning up Fort National, stood at the partly cleared summit of the neighborhood recently, pointing at a speck of green plastic in the dirt: “See that green?” he said. “That’s where my house was. That’s where I was born. That’s where I intend to die.”

Where to dump the rubble that fills Mr. Larose’s buckets presents another problem. There is no debris plan for Fort National just as there is no master plan for rubble removal, said Eric Overvest, the United Nations Development Program’s country director. Normally, he said, a rubble plan is developed within a month of a major disaster. Port-au-Prince, the capital, did not have a pre-earthquake land use plan, complicating matters.

Still, in almost six months the government has identified only one rubble site, the municipal dump called Truitier. More sites are needed — as are decisions on whether rubble will be recycled and how.

Additionally, debris contains personal effects, and sometimes bodies; it also has a potential monetary value if it is to be reused. “It’s not just the rubble, it’s the question of rubble ownership,” Mr. Scales said. Most in Fort National are renters but the rubble technically belongs to the property owners. And sorting out who owns what land, and getting their permission to excavate has proved difficult, Mr. Scales said.

“It isn’t a case of going straight onto land with an excavator,” he said.

For those few whose homes in Fort National are intact, the government has to determine what kind of relocation package to offer. Will they subsidize tenants or landlords? Will they help pay back rent or negotiate some forgiveness? What help will be given those whose homes are reparable and how can repairs be aligned with a building code that has yet to be released? If a one-room transitional shelter is erected where a multifamily dwelling stood, who gets it?

Each issue has generated protracted debate. One international disaster expert, who requested anonymity because he did not want to offend Haitian officials, offered what he called “a microexample” of why bigger questions take a long time to resolve. It involved a flier instructing people on how to secure their tents during the hurricane season.

The government emergency management agency first asked that the phrase “hurricane-proof” be deleted, he said, worried about guaranteeing protection, and then that any reference to strong winds be removed. Finally, only rain could be mentioned and even then the flier did not get approved before hurricane season began.

“It’s as if they imagined themselves to be in a brick and mortar world of real liability,” the disaster expert said. “I think it’s more than lack of capacity by the government. They’re looking at the political landscape, weighing each word like David Axelrod with a focus group.”

Still, many hope that the Champ de Mars process at least lays the groundwork for a speedier resolution of similar problems elsewhere.

And some residents of Fort National, tired of waiting for the government to act, have already moved back, even into dwellings that have been condemned or would be unsafe in a storm.

Negriel Dumas built a roughhewn shack for his family on the barren hilltop. “It’s better to be here with the smell of the dead bodies than to be down at that camp where it stinks of pee,” he said.

Aggressive Advocates

In late April, Rachelle Derosmy’s family of four moved into one of the first transitional shelters to be completed in the Port-au-Prince area. It is a simple pine house, painted grey, with two windows, a concrete foundation and an inclined metal roof fastened with hurricane straps.

“Rain used to fall like a monsoon into our tent,” Ms. Derosmy, 24, said, standing in her 150-square-foot home, which is still bare. “We feel so much better now, more secure. We hope in the future to have beds, too.”

Ms. Derosmy’s new home is in Carrefour, where most of the 1,300 transitional shelters in metropolitan Port-au-Prince have been built. That is partly because Carrefour’s mayor has taken an active role in resolving land issues and partly because the Adventist Development and Relief Agency, long based there, has aggressively negotiated with local officials and landlords. It also settled more quickly than some other aid groups on a shelter design.

Transitional shelters are simple wood or steel-frame structures that offer more space, privacy and protection than tents or tarps. They are meant to last three to five years, tiding over a displaced population while permanent homes are repaired or built. But some disaster experts are ambivalent about them, as is the Haitian president, according to a senior government official. President Préval worries that transitional shelters might never be replaced, the official said, adding, “He thinks he will be attacked for creating new bidonvilles,” or slums.

International experts estimate that Haiti will need 125,000 transitional shelters; so far, just over 5,500 shelters have been completed, mostly in the countryside where land issues are simpler.

In Carrefour, the Adventist agency has set up a well-oiled production workshop, where imported wood is cut and assembled into kits then constructed and painted on site by local workers. Anton De Vries, a South African engineer who runs the shelter operation, which is co-sponsored by the United States Agency for International Development, said he was determined to provide a home for every family in the Adventist-run tent city.

Tall and cheery, Mr. De Vries recently bumped into a local landlord, Henry Frantz St. Surin, on a construction site and displayed some of the hale-and-hearty diplomatic skill that has served him well here. “Thank you for your contribution,” he said in a booming voice. “You are one of the few people who allow others to use their land. I’m sure God will bless you.”

Mr. De Vries also crossed paths with one of his new shelter recipients. “Yoo-hoo!” Ms. Louis cried out to him. She ushered him inside, showing off her décor, a mélange of cloth flowers and stuffed animals, and explained why she preferred her new house to her old one: “If another earthquake happens, this one is not going to kill me.”

Mr. De Vries said his biggest frustration had been bartering with customs authorities. “We work in very close partnership with the Haitian government,” he said with a tight smile. He said that he did not understand why the government did not fast-track emergency supplies and housing materials through its port. He has managed to free 21 shipping containers, enough to complete just over 500 shelters. But another 21 containers have been “held hostage” by the customs agency for more than three weeks now — at a storage fee of almost $16,000 so far.

The port problem has pushed Mr. De Vries to buy local wood. Concerned about deforestation, he did not want to. But he is determined to keep building.

Talk Versus Action

For two months after the quake, Haiti’s architects and planners worked in Pétionville to prepare the post-disaster needs assessment and action plan required to obtain international financial support for the reconstruction of Haiti.

Their dreams were grand. They envisioned Haiti 2030 as a self-reliant, democratically stable, decentralized and reforested land with decent housing and education for all, a national highway network, a hearty fruit and tuber industry, animal husbandry, industrial zones and tourism.

“The government is doing good things in thinking to the future,” said Mario C. Flores, director of disaster response field operations for Habitat for Humanity. “I only wish that all those aspirational plans would become operational.”

At a conference in New York on March 31, donors promised Haiti $5.3 billion over the next 18 months. Two weeks later, although questions about giving up control to foreigners arose, the Parliament approved the creation of an interim reconstruction commission to be led by former President Bill Clinton, the United Nations special envoy to Haiti, and Jean-Max Bellerive, Haiti’s prime minister. It took another couple of months to pick its 26 Haitian and international members, and the search for an executive director is still under way.

The reconstruction commission met for the first and only time so far in mid-June.

After that meeting, a Haitian journalist asked why there had been so much talk and so little progress. Mr. Bellerive mentioned road-building and other projects in the countryside and said, “There is a lot being done actually but some of it may not be visible if you confine yourself to the Port-au-Prince area,” where the bulk of the destruction occurred.

Earlier in the spring, Mr. Bellerive and Mr. Voltaire, who is an architect and urban planner, had visited Mr. Clinton at his home in Chappaqua, N.Y. At one point, Mr. Clinton kept getting distracted by incoming e-mail messages. According to Mr. Voltaire, Mr. Clinton said, “If I receive one more suggestion for the ideal house for Haiti, I will explode.” And Mr. Bellerive said, “You, too?”

After that, the government hired a London firm to solicit and sift through proposals for “the best, safest and most sustainable housing designs of the future. “In October, several dozen model homes will be built and displayed at a housing expo in Oranger, Haiti. People will be selected to live in the prototypes and to evaluate them, Mr. Voltaire said.

Eventually, permanent housing will be built, he said, at one of a few sites that the government is seizing through eminent domain and hoping to turn into new population centers.

One of those sites is Corail-Cesselesse, about 10 miles north of Port-au-Prince, where the first planned tent city was installed in April on a chalky gravel plane. Hastily created for displaced people who seemed most at risk from flooding or landslides in another camp, it is now home to about 5,000 who live in an orderly grid of white tents far from their bustling urban neighborhood.

Some aid groups criticize the location. “That site does not represent clear strategic thinking on the part of the government,” said Ms. Schindall of Oxfam. “It’s like the Sudan. There’s not a tree in sight. And people feel marooned. They are having major issues finding income-generating activities and soon they are going to have trouble feeding themselves. It’s inevitable.”

But several residents interviewed seemed willing to tolerate the camp’s remoteness because living there puts them in line for the transitional shelters that are supposed to be erected there, and then for the permanent houses that may follow.

Jean Mérite Pierre, a mason, asked visitors to accompany him to the barren land.

“Look at all this space,” he said, sweeping his arms over an empty lot. “All those people who died lived in houses that collapsed like dominoes. So even if we are uprooted, life could be better here. We were renters, almost all of us. Here, maybe we can own a house someday. That’s what they say. You have to believe them.”

Frustration in Haiti



Photo by John Carroll
Cite Soleil, Haiti

BBC News, 8 July 2010

Aid agencies 'stretched to limit' in Haiti


Aid agencies have warned that their ability to keep delivering basic services in earthquake-stricken Haiti is being stretched to the limit.

The Red Cross said aid agencies were still providing most of the clean water and toilet facilities six months after the devastating earthquake.

Prime Minister Rene Preval has said his government does not have enough money to run and re-build the country.

The quake killed up to 230,000 people and left one million homeless.

The 7.0-magnitude earthquake struck the area around the capital, flattening homes and buildings in a wide area.

Most of those who lost their homes are now living in temporary encampments.

"We are all stretched to our capacity and simply containing a critical situation, rather than solving it," said Alastair Burnett, an operations manager with the British Red Cross.

Reconstruction has been slow because of the scale of the disaster and a shortfall in humanitarian funding for Haiti.

"From this moment on sanitation must be integrated into wider plans to rebuild Haiti and long-term solutions must be found," Mr Burnett said in a report released on Thursday by the International Federation of Red Cross and Red Crescent Societies.

Charity Medicins Sans Frontieres (MSF) warned that frustration was growing among Haitians with the "dire reality" of their living conditions.

"There is a staggering gap between the enthusiasm and promises for aiding the victims of the earthquake in the early weeks, and the dire reality on the ground after half a year," said MSF's head of mission in Haiti.

One bright spot, however, was that provision of medical services to the majority of Haitians was better than before the earthquake, MSF said.

Thursday, July 08, 2010

Haiti's Debris



The photo was sent to us by the Haitian man in the photo. This is his home after the earthquake.


July 7, 2010
Haiti’s Eternal Weight
By REGINALD DESROCHES, OZLEM ERGUN and JULIE SWANN
Atlanta

It has been six months since the earthquake in Haiti left more than 300,000 people dead and destroyed 280,000 homes and businesses. Haiti still faces a long road to recovery, but one of the biggest things literally standing in its way is earthquake debris.

The quake left an astonishing amount of debris, including concrete and rebar from collapsed buildings, destroyed belongings and human remains. Twenty million to 25 million cubic yards of debris fill the streets, yards, sidewalks and canals of Port-au-Prince — enough to fill five Louisiana Superdomes.

According to our research and conversations with aid groups in Haiti, less than 5 percent of this has been removed since January, and even less has been properly disposed of. A draft of the United States Army Corps of Engineers’ debris management plan says it would take a dump truck with a 20-cubic-yard bed 1,000 days to clear the debris, if it carried 1,000 loads a day — or about three years. But the current rate of removal is much lower. Based on our calculations, partially from the United States Agency for International Development’s reports on debris removal programs, we estimate that it could take 20 years or more.

Today, debris is one of the most significant issues keeping Haitians from rebuilding Port-au-Prince and resuming normal lives. Much of the stuff has been left in place or simply moved to the center or the sides of roads. Some streets with especially large piles of refuse are impassable. As a result, it can take hours to travel just a few miles. Meanwhile, schools, hospitals, businesses and homes remain blocked.

The debris is also an environmental and health hazard. The daily downpours of the rainy season leach toxic chemicals and carcinogens into the storm water system — and ultimately into the drinking water. Debris has been dumped into the sea, turning the blue water brown.

Initial cleanup efforts were promising. Immediately after the earthquake, the Haitian government’s road construction operation began clearing debris. Within a week, the United States Army Corps of Engineers deployed teams to identify sites for sorting and processing debris and drafted a debris management plan, while the Navy hired Haitian and foreign contractors to open major roads with heavy machinery.

But since then, efforts have lagged. At present, there is no significant, coordinated financing by international aid groups for debris removal using machinery, though some estimates predict the next year and a half of debris management could cost around $300 million. Instead, almost all of the operations in Port-au-Prince are in the form of cash-for-work programs like the ones sponsored by Usaid and the European Union, which have Haitians, at best, breaking concrete and loading trucks by hand and, at worst, just moving bricks from one side of a road to the other. Many workers lack masks or gloves. While this inefficient process may put money into the hands of Haitians, it only further slows rebuilding.

Instead, the United Nations, the World Bank and agencies like Usaid, in conjunction with the Haitian government, should create a task force focused on debris removal to coordinate the cleanup efforts of the hodgepodge of aid groups in the country. The task force should identify critical facilities, like hospitals and schools, and the roads that approach them, to clear first. It should lay down environmental regulations for debris disposal and landfill management, and regulate the use of cash-for-work programs. There’s no reason these can’t continue, but more of the money should be allocated to bringing in heavy equipment and expertise. This kind of task force would serve as a model for future disasters.

Debris isn’t sexy. Images of blocked-off streets don’t inspire people to help in the way pictures of hungry or needy people do. However, if Haiti is going to recover, it needs more than food aid and health clinics; it needs functioning, accessible infrastructure.

Reginald DesRoches is a professor of civil and environmental engineering at the Georgia Institute of Technology, where Ozlem Ergun and Julie Swann are associate professors of industrial and systems engineering and co-directors of the Center for Health and Humanitarian Logistics.