Essay on Haiti: Social conscience should be our guide
April 29, 2010
By BALJINDER BATHLA, M.D.
When I chose medicine as my lifelong vocation many years ago, I was unaware whether I did it because of family pressure, because my friends were doing it, or because I simply wanted to do it. What I knew for certain was that medicine could be potentially fulfilling.
It was not until I grew older that I realized how significantly fulfilling the practice of medicine can be. Medicine has changed me over the years more than I could have imagined.
If I had chosen medicine as a career, my wife was called to it. She is one of those rare doctors who sincerely chose medicine to "help people." As soon as we got married, whether I wanted to or not, we were traveling to other countries through local charities: to Thailand after the Tsunami of 2004, to New Orleans after hurricane Katarina, and most recently, to Haiti after the earthquake.
None of these places has left the lasting impression on me that Haiti did. Haiti is a very special place. Each time we went, we returned with heavy hearts, but also hearts filled with joy and inspiration from witnessing the resiliency and determination of its people.
It's a country dealing with circumstances that are beyond unfair, which have only been confounded by not-so-genuine interests of other countries and, recently, the earthquake.
It was astonishing to see the poverty there and even more difficult to comprehend that these living conditions -- even before the earthquake -- could exist so close to us in the Western Hemisphere.
A sentiment I heard many times while in Haiti was "Hopefully once the dust settles, this will make Haiti stronger." It's a great thought, but it's unfortunate that it took a devastating earthquake to give Haiti some attention.
I never knew of Haiti's dire situation and history until I went there for earthquake relief.
Several things changed between my two visits to Haiti, which were about a month apart. Many of the Non-Governmental Organizations have gone back home, possibly due to lack of funding or frustration. Much of the news media that was there have also left. This leaves the Haitians with a sense of being forgotten, unfortunately, a feeling that is not unfamiliar to them.
Furthermore, it's unclear how the Haitian people will face the seemingly insurmountable task of cleaning up and rising again. No federal building or records exist anymore; therefore, no mechanism of recording or collecting taxes is available.
It appears that Haiti can only rely on international humanitarian aid and, more importantly, each individual's efforts.
The challenge for all of us now is to keep Haiti and countries like it within our sights so they will not be forgotten and lost to us. It is imperative that we don't forget; that we keep giving; that we further develop our "social conscience."
To me, developing and nurturing a social conscience entails being aware of the problems that less fortunate societies and communities face on a day-to-day basis.
Working toward greater awareness brought me to the realization that as individuals, we are not independent entities. We do and should rely on others throughout our lives to help us, and conversely, we should always offer our help to others without thoughts of our own benefits and returns.
No place has taught me social awareness like Haiti. Seeing the numbers of volunteers who left their families, comforts of home, and paychecks was not only tremendously inspiring, but humbling as well.
Baljinder Bathla, M.D. works with Continental Anesthesia and is a staff member of the Pain Management Center at Saint Francis Hospital, a Level I Trauma Center in Evanston. He is Board Certified in Pain Management and Physical Medicine and Rehabilitation. The Pain Clinic can be reached at (847)433-3361.
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Thursday, April 29, 2010
Wednesday, April 21, 2010
UN Aid in Haiti
Updated April 20, 2010
U.N.'s Ballooning $732 Million Haiti Peacekeeping Budget Goes Mostly to Its Own Personnel
By George Russell
FOXNews
The United Nations has quietly upped this year's peacekeeping budget for earthquake-shattered Haiti to $732.4 million, with two-thirds of that amount going for the salary, perks and upkeep of its own personnel, not residents of the devastated island.
The United Nations has quietly upped this year's peacekeeping budget for earthquake-shattered Haiti to $732.4 million, with two-thirds of that amount going for the salary, perks and upkeep of its own personnel, not residents of the devastated island.
The world organization plans to spend the money on an expanded force of some 12,675 soldiers and police, plus some 479 international staffers, 669 international contract personnel, and 1,300 local workers, just for the 12 months ending June 30, 2010.
Some $495.8 million goes for salaries, benefits, hazard pay, mandatory R&R allowances and upkeep for the peacekeepers and their international staff support. Only about $33.9 million, or 4.6 percent, of that salary total is going to what the U.N. calls "national staff" attached to the peacekeeping effort.
Presumably, the budget also includes at least part of some $10 million that the U.N. has spent on renting two passenger vessels, the Sea Voyager (known to some U.N. staffers as the "Love Boat") and the Ola Esmeralda, for a minimum of 90 days each, as highly subsidized housing for some of its peacekeepers and humanitarian staff. The tab for the two vessels, which offer catered food, linen service and comfortable staterooms and lounges, is about $112,500 per day.
Under a cost-sharing formula, the U.S. pays a 27 percent share of the entire $732.4 million peacekeeping tab for Haiti during this 12 month period, or about $197.7 million.
The ultimate size of the peacekeeping bill for Haiti this year has been a source of much concern among the three dozen or so of the U.N.'s 192 members who pick up roughly 96 percent of the U.N.'s overall peacekeeping bill.
That concern rose sharply about a month ago, when U.N. Secretary General Ban Ki-moon's office issued an updated peacekeeping estimate that used a $700 million figure strictly as a placeholder for the final Haiti post-quake number.
The new figures take some of the uncertainty out of that estimate, but even so, the U.N. was taking no chances of raising concerns higher with its new tally; rather than take a new vote on the expanded peacekeeper budget, the U.N. Secretariat simply issued its revised tally as an extension of the previous $611 million allotment it had voted for Haiti.
The Haitian peacekeeping budget is relatively unique among U.N. efforts, because there was no civil war or widespread bloodletting to inspire the original peacekeeping force, which arrived in 2004. Instead, the mission has mainly been intended to bolster political order in a society crushed by hurricanes, political turbulence, and grinding misery.
The revised peacekeeping tab is over and above the roughly $15 billion in short- and long-term aid that the international community — led by the U.S. and European Union — pledged to Haiti at an international donor's conference last month.
It is also over and above the $773 million in humanitarian aid raised from donor nations and private citizens in a "flash" appeal in the days after the Jan. 12 earthquake — which is about half the total hoped for by the United Nations Office for the Coordination of Humanitarian Affairs when it raised the appeal.
Moreover, the revised Haiti peacekeeping budget only covers a period that ends in about 10 more weeks — on June 30, 2010 — at which time, Ban's office will have to formulate another peacekeeping estimate for the stricken island, not to mention the remainder of its global peacekeeping effort.
Given the temporary nature of this year's sudden 20 percent boost in Haiti peacekeeping costs, there is some possibility that next year's budget will mark a decrease from the $732.4 million figure.
Since the U.N. installed peacekeepers on the island in 2004, however, the budgeted cost of peacekeeping has roughly doubled, from an original $372.8 million.
George Russell is executive editor of Fox News
U.N.'s Ballooning $732 Million Haiti Peacekeeping Budget Goes Mostly to Its Own Personnel
By George Russell
FOXNews
The United Nations has quietly upped this year's peacekeeping budget for earthquake-shattered Haiti to $732.4 million, with two-thirds of that amount going for the salary, perks and upkeep of its own personnel, not residents of the devastated island.
The United Nations has quietly upped this year's peacekeeping budget for earthquake-shattered Haiti to $732.4 million, with two-thirds of that amount going for the salary, perks and upkeep of its own personnel, not residents of the devastated island.
The world organization plans to spend the money on an expanded force of some 12,675 soldiers and police, plus some 479 international staffers, 669 international contract personnel, and 1,300 local workers, just for the 12 months ending June 30, 2010.
Some $495.8 million goes for salaries, benefits, hazard pay, mandatory R&R allowances and upkeep for the peacekeepers and their international staff support. Only about $33.9 million, or 4.6 percent, of that salary total is going to what the U.N. calls "national staff" attached to the peacekeeping effort.
Presumably, the budget also includes at least part of some $10 million that the U.N. has spent on renting two passenger vessels, the Sea Voyager (known to some U.N. staffers as the "Love Boat") and the Ola Esmeralda, for a minimum of 90 days each, as highly subsidized housing for some of its peacekeepers and humanitarian staff. The tab for the two vessels, which offer catered food, linen service and comfortable staterooms and lounges, is about $112,500 per day.
Under a cost-sharing formula, the U.S. pays a 27 percent share of the entire $732.4 million peacekeeping tab for Haiti during this 12 month period, or about $197.7 million.
The ultimate size of the peacekeeping bill for Haiti this year has been a source of much concern among the three dozen or so of the U.N.'s 192 members who pick up roughly 96 percent of the U.N.'s overall peacekeeping bill.
That concern rose sharply about a month ago, when U.N. Secretary General Ban Ki-moon's office issued an updated peacekeeping estimate that used a $700 million figure strictly as a placeholder for the final Haiti post-quake number.
The new figures take some of the uncertainty out of that estimate, but even so, the U.N. was taking no chances of raising concerns higher with its new tally; rather than take a new vote on the expanded peacekeeper budget, the U.N. Secretariat simply issued its revised tally as an extension of the previous $611 million allotment it had voted for Haiti.
The Haitian peacekeeping budget is relatively unique among U.N. efforts, because there was no civil war or widespread bloodletting to inspire the original peacekeeping force, which arrived in 2004. Instead, the mission has mainly been intended to bolster political order in a society crushed by hurricanes, political turbulence, and grinding misery.
The revised peacekeeping tab is over and above the roughly $15 billion in short- and long-term aid that the international community — led by the U.S. and European Union — pledged to Haiti at an international donor's conference last month.
It is also over and above the $773 million in humanitarian aid raised from donor nations and private citizens in a "flash" appeal in the days after the Jan. 12 earthquake — which is about half the total hoped for by the United Nations Office for the Coordination of Humanitarian Affairs when it raised the appeal.
Moreover, the revised Haiti peacekeeping budget only covers a period that ends in about 10 more weeks — on June 30, 2010 — at which time, Ban's office will have to formulate another peacekeeping estimate for the stricken island, not to mention the remainder of its global peacekeeping effort.
Given the temporary nature of this year's sudden 20 percent boost in Haiti peacekeeping costs, there is some possibility that next year's budget will mark a decrease from the $732.4 million figure.
Since the U.N. installed peacekeepers on the island in 2004, however, the budgeted cost of peacekeeping has roughly doubled, from an original $372.8 million.
George Russell is executive editor of Fox News
Monday, April 19, 2010
Haitian-American Doctor in Haiti...a Must Read
Haiti Earthquake Relief, Phase Two — Long-Term Needs and Local Resources
Dominique Bayard, M.D.
A month and a half after January's devastating earthquake in Haiti, the National Organization for the Advancement of Haitians, a U.S.-based nonprofit organization with a division dedicated to improving health care in Haiti, sent in teams of U.S. physicians and other health care professionals, primarily of Haitian descent, as the acute phase of disaster response was ending. As part of this group, I worked in a makeshift hospital in Tabarre, a section of northeast Port-au-Prince.
As a first-generation Haitian-American and an internist, I expected to be prepared for the situation I was walking into. Haiti was a country I knew, I spoke the language, I understood the people, and by this point I had been watching the disaster on television daily for over a month. I knew that with the threat to life no longer minute to minute but week to week, the long-term recovery phase was beginning. According to my relatives in Haiti, the initial shock was passing. Dead victims had been cleared from the streets, families were either reunited or mourning their losses, the roads were somewhat drivable, and food and water were slowly making their way to survivors. Yet when I came face to face with the disaster, I realized that the media hadn't even begun to capture the extent of the devastation. Seeing Haiti through a framed television screen had given me only a snapshot of destroyed buildings, misplaced families, and stories of loss and survival.
When you're on site, there is no television to turn off, no place to avert your gaze, no way to avoid hearing endless conversations about loss and devastation — and fears about worse to come. Nor could I turn off the unrelenting heat, or the airborne dust from the rubble of destroyed buildings, or the smoke rising from burning bodies, wood, and rubber. As I looked around, not a single standing building interrupted my line of sight in any direction. Every street was spilling over with masses of displaced people, many of them young children, stuck in a strange purgatory with no place to stay and no place to go.
I soon saw that the Haitian people were paralyzed by fear. In the middle of the night, while coworkers and I were asleep inside a small home that had survived the earthquake, a minor tremor (measuring 4 on the Richter scale) knocked me out of bed. Immediately, people were screaming in the streets, afraid that "the next big one" was upon them. Neighbors yelled frantically, telling us to get out, that they could hear the building cracking. The next thing I knew, I was sleeping in a tent — the most secure and comfortable option. At that point, my only solace lay in focusing on what I could control — what little I could offer as a physician.
At our makeshift hospital, we were past the heroic stage of rescuing bodies from the rubble and performing emergency lifesaving surgeries. Now the delayed effects of the earthquake, which affected an estimated 1.4 million people, were manifesting themselves. Inconsistent wound care and rehabilitation for trauma victims and amputees resulted in a multitude of patient visits for infections, disabilities, and complications from delayed treatment, such as gangrene and sepsis. The dust and smoke in the air led to respiratory illnesses, including severe asthma, flares of chronic obstructive pulmonary disease, bronchitis, and pneumonia. According to the World Health Organization (WHO), respiratory infections are now the main cause of illness, followed by trauma or injury, diarrhea, and suspected malaria.1 Crowding and poor sanitation in rapidly growing tent settlements were creating or exacerbating medical problems, particularly in children. Mobile clinics from Tabarre provided targeted, large-scale treatment of postoperative infections and therapies for outbreaks of lice and scabies in orphanages. Before the earthquake, diarrheal illness accounted for 17% of deaths in children under the age of 5 years. Now, in addition to the already contaminated water supplies and poor sanitation, the rainy season will increase the risk of acute respiratory infection, diarrhea, and waterborne and vectorborne diseases, including dengue, typhoid, and malaria. In anticipation of this onslaught, the WHO is undertaking large-scale vaccination campaigns and tasking mobile health clinics with identifying outbreaks quickly in order to limit the associated morbidity and mortality.
In addition, the chronic diseases that patients had been ignoring since the earthquake were rearing their ugly heads. Several patients arrived after having interrupted their treatment for tuberculosis or HIV, with no records of their previous regimens. Large numbers of patients — some who had had no regular health care before the earthquake and others whose care had been interrupted — now presented with acute manifestations of their uncontrolled chronic diseases, in the form of hypertensive emergencies, strokes, seizures, and diabetic ketoacidosis. Although many medications were available, donors had provided a supply of drugs that generally were not targeted to chronic health problems. In Tabarre, despite the fact that we limited each patient to only 10 to 15 pills at a time, the medications in highest demand — such as basic antibiotics, asthma inhalers, and hypertension and diabetes medications — became scarce, while boxes of others, such as intravenous amiodarone, remained untouched.
Public health problems affecting women, ranging from sexual violence to a lack of obstetrical care, were also exacerbated by the earthquake. We treated women and girls as young as 12 years of age for newly acquired sexually transmitted infections (STIs). Many women reported being the victims of forced sexual encounters in the tent settlements. Though these reports are unconfirmed, increasing numbers of reports by health care workers of STIs and sexual violence have led to an official WHO investigation and a targeted assessment of women's health care needs.2,3
Ultimately, it became clear to me that the most important resource for the ongoing relief effort is the one most threatened by the earthquake: the local people. Though I had not been back to Haiti in 15 years and was there for only 2 weeks, the local people were what enabled me and my colleagues, both emotionally and logistically, to provide care to more than 800 patients a day. Local volunteers — who constituted about half our staff, though they could easily have been devoting time to their own recovery instead — spent every day, sunrise to sunset, making it possible for us to provide care. They triaged patients, organized the physicians, distributed medications, and rose to any necessary task. Patients were grateful that the Haitian diaspora was returning to help. Despite their own loss and tragedy, they would laugh at my American-accented Creole and tell me how proud they were of me for coming back. Neighbors living in tents in their backyards cooked a full breakfast and dinner for me and several coworkers every day. In exchange for our provision of a 2-week proverbial Band-Aid, the people helped, encouraged, and took care of us. While international volunteers come and go, the local people will remain the backbone of the recovery process, and integrating them into international relief efforts will be vital.
The road to recovery will be long, and with the rainy season beginning, circumstances will get worse before they get better. Six months after the 2005 earthquake in South Asia, a similar pattern of respiratory infections, diarrhea, infectious disease outbreaks, poor sanitation, and insufficient shelter persisted and worsened despite a strong initial relief response.4 In Haiti, the initial response has also been strong, and we have learned from previous disasters what to anticipate in the months and years to come. Clear insight into the changing medical needs, together with the collaboration of the strong-willed Haitian people, will drive an effective effort to rebuild Haiti and, I hope, make it stronger than ever.
Dr. Bayard is an editorial fellow at the Journal.
This article (10.1056/NEJMp1003839) was published on April 14, 2010, at NEJM.org
Dominique Bayard, M.D.
A month and a half after January's devastating earthquake in Haiti, the National Organization for the Advancement of Haitians, a U.S.-based nonprofit organization with a division dedicated to improving health care in Haiti, sent in teams of U.S. physicians and other health care professionals, primarily of Haitian descent, as the acute phase of disaster response was ending. As part of this group, I worked in a makeshift hospital in Tabarre, a section of northeast Port-au-Prince.
As a first-generation Haitian-American and an internist, I expected to be prepared for the situation I was walking into. Haiti was a country I knew, I spoke the language, I understood the people, and by this point I had been watching the disaster on television daily for over a month. I knew that with the threat to life no longer minute to minute but week to week, the long-term recovery phase was beginning. According to my relatives in Haiti, the initial shock was passing. Dead victims had been cleared from the streets, families were either reunited or mourning their losses, the roads were somewhat drivable, and food and water were slowly making their way to survivors. Yet when I came face to face with the disaster, I realized that the media hadn't even begun to capture the extent of the devastation. Seeing Haiti through a framed television screen had given me only a snapshot of destroyed buildings, misplaced families, and stories of loss and survival.
When you're on site, there is no television to turn off, no place to avert your gaze, no way to avoid hearing endless conversations about loss and devastation — and fears about worse to come. Nor could I turn off the unrelenting heat, or the airborne dust from the rubble of destroyed buildings, or the smoke rising from burning bodies, wood, and rubber. As I looked around, not a single standing building interrupted my line of sight in any direction. Every street was spilling over with masses of displaced people, many of them young children, stuck in a strange purgatory with no place to stay and no place to go.
I soon saw that the Haitian people were paralyzed by fear. In the middle of the night, while coworkers and I were asleep inside a small home that had survived the earthquake, a minor tremor (measuring 4 on the Richter scale) knocked me out of bed. Immediately, people were screaming in the streets, afraid that "the next big one" was upon them. Neighbors yelled frantically, telling us to get out, that they could hear the building cracking. The next thing I knew, I was sleeping in a tent — the most secure and comfortable option. At that point, my only solace lay in focusing on what I could control — what little I could offer as a physician.
At our makeshift hospital, we were past the heroic stage of rescuing bodies from the rubble and performing emergency lifesaving surgeries. Now the delayed effects of the earthquake, which affected an estimated 1.4 million people, were manifesting themselves. Inconsistent wound care and rehabilitation for trauma victims and amputees resulted in a multitude of patient visits for infections, disabilities, and complications from delayed treatment, such as gangrene and sepsis. The dust and smoke in the air led to respiratory illnesses, including severe asthma, flares of chronic obstructive pulmonary disease, bronchitis, and pneumonia. According to the World Health Organization (WHO), respiratory infections are now the main cause of illness, followed by trauma or injury, diarrhea, and suspected malaria.1 Crowding and poor sanitation in rapidly growing tent settlements were creating or exacerbating medical problems, particularly in children. Mobile clinics from Tabarre provided targeted, large-scale treatment of postoperative infections and therapies for outbreaks of lice and scabies in orphanages. Before the earthquake, diarrheal illness accounted for 17% of deaths in children under the age of 5 years. Now, in addition to the already contaminated water supplies and poor sanitation, the rainy season will increase the risk of acute respiratory infection, diarrhea, and waterborne and vectorborne diseases, including dengue, typhoid, and malaria. In anticipation of this onslaught, the WHO is undertaking large-scale vaccination campaigns and tasking mobile health clinics with identifying outbreaks quickly in order to limit the associated morbidity and mortality.
In addition, the chronic diseases that patients had been ignoring since the earthquake were rearing their ugly heads. Several patients arrived after having interrupted their treatment for tuberculosis or HIV, with no records of their previous regimens. Large numbers of patients — some who had had no regular health care before the earthquake and others whose care had been interrupted — now presented with acute manifestations of their uncontrolled chronic diseases, in the form of hypertensive emergencies, strokes, seizures, and diabetic ketoacidosis. Although many medications were available, donors had provided a supply of drugs that generally were not targeted to chronic health problems. In Tabarre, despite the fact that we limited each patient to only 10 to 15 pills at a time, the medications in highest demand — such as basic antibiotics, asthma inhalers, and hypertension and diabetes medications — became scarce, while boxes of others, such as intravenous amiodarone, remained untouched.
Public health problems affecting women, ranging from sexual violence to a lack of obstetrical care, were also exacerbated by the earthquake. We treated women and girls as young as 12 years of age for newly acquired sexually transmitted infections (STIs). Many women reported being the victims of forced sexual encounters in the tent settlements. Though these reports are unconfirmed, increasing numbers of reports by health care workers of STIs and sexual violence have led to an official WHO investigation and a targeted assessment of women's health care needs.2,3
Ultimately, it became clear to me that the most important resource for the ongoing relief effort is the one most threatened by the earthquake: the local people. Though I had not been back to Haiti in 15 years and was there for only 2 weeks, the local people were what enabled me and my colleagues, both emotionally and logistically, to provide care to more than 800 patients a day. Local volunteers — who constituted about half our staff, though they could easily have been devoting time to their own recovery instead — spent every day, sunrise to sunset, making it possible for us to provide care. They triaged patients, organized the physicians, distributed medications, and rose to any necessary task. Patients were grateful that the Haitian diaspora was returning to help. Despite their own loss and tragedy, they would laugh at my American-accented Creole and tell me how proud they were of me for coming back. Neighbors living in tents in their backyards cooked a full breakfast and dinner for me and several coworkers every day. In exchange for our provision of a 2-week proverbial Band-Aid, the people helped, encouraged, and took care of us. While international volunteers come and go, the local people will remain the backbone of the recovery process, and integrating them into international relief efforts will be vital.
The road to recovery will be long, and with the rainy season beginning, circumstances will get worse before they get better. Six months after the 2005 earthquake in South Asia, a similar pattern of respiratory infections, diarrhea, infectious disease outbreaks, poor sanitation, and insufficient shelter persisted and worsened despite a strong initial relief response.4 In Haiti, the initial response has also been strong, and we have learned from previous disasters what to anticipate in the months and years to come. Clear insight into the changing medical needs, together with the collaboration of the strong-willed Haitian people, will drive an effective effort to rebuild Haiti and, I hope, make it stronger than ever.
Dr. Bayard is an editorial fellow at the Journal.
This article (10.1056/NEJMp1003839) was published on April 14, 2010, at NEJM.org
Spike in Infectious Disease
Health Workers in Haiti Fear Spike in Infectious Disease
Jeff Swicord |
Port-au-Prince
19 April 2010
Port-au-Prince General Hospital is the largest hospital in Haiti. Some of its buildings were damaged during the earthquake, but with the help of international medical organizations it has remained open. On any given day, more than 300 patients arrive looking for care. More than two months after the quake, doctors are seeing less of the crush injuries they saw right after the earthquake. Now, as the rainy season begins, they're concerned about infectious disease.
Dr. Megan Coffee is an infectious disease specialist from California. She has spent the past two months volunteering at Port au Prince General Hospital.
She's concerned about the likely spread of infectious disease in Haiti. She said the medical needs of the population have changed since the January earthquake.
She said doctors rarely see the cuts, crushed limbs, and broken bones that were common early on.
"These tents use to be all orthopedic injuries, all people who had been injured in the earthquake," said Dr. Coffee. "Now some of them are post-op patients, post surgical patients. Some are still patients remaining from the earthquake."
With the rainy season beginning and much of the population in closely confined spaces in tent cities, health workers are on the lookout for infectious and water-borne diseases.
"The problems of typhoid and malaria are going to grow with tent cities, with people who don't have the best sanitation, and, having sitting water which is the cause of both those diseases," Dr. Coffee added.
Tuberculosis, a highly contagious respiratory disease, is another concern. Of the 300 patients who come to the hospital each day, about 4 have tuberculosis.
Stanley is one of them.
"[Stanley] came in with tuberculosis that had filled up his entire left lung, and had also started to fill up his heart," explained Dr. Cofee. "He came in quite ill, basically unable to breath and needed to have a tube put in to drain the fluid."
Dr. Coffee says in Haiti, patients often wait until a condition reaches a crisis stage before seeking treatment. And that makes recovery more difficult.
"It is really important for people like him to be able to be treated," she added. "Because otherwise, if they were to go home without full treatment, they would be quite infectious to all of their neighbors."
Stanley has been in the hospital for two months. Half that time was spent with tubes in his chest.
Dr. Coffee says there's no way to tell if malaria, typhoid, and tuberculosis are on the upswing since the earthquake. But with the rainy season looming, they could spread quickly.
Jeff Swicord |
Port-au-Prince
19 April 2010
Port-au-Prince General Hospital is the largest hospital in Haiti. Some of its buildings were damaged during the earthquake, but with the help of international medical organizations it has remained open. On any given day, more than 300 patients arrive looking for care. More than two months after the quake, doctors are seeing less of the crush injuries they saw right after the earthquake. Now, as the rainy season begins, they're concerned about infectious disease.
Dr. Megan Coffee is an infectious disease specialist from California. She has spent the past two months volunteering at Port au Prince General Hospital.
She's concerned about the likely spread of infectious disease in Haiti. She said the medical needs of the population have changed since the January earthquake.
She said doctors rarely see the cuts, crushed limbs, and broken bones that were common early on.
"These tents use to be all orthopedic injuries, all people who had been injured in the earthquake," said Dr. Coffee. "Now some of them are post-op patients, post surgical patients. Some are still patients remaining from the earthquake."
With the rainy season beginning and much of the population in closely confined spaces in tent cities, health workers are on the lookout for infectious and water-borne diseases.
"The problems of typhoid and malaria are going to grow with tent cities, with people who don't have the best sanitation, and, having sitting water which is the cause of both those diseases," Dr. Coffee added.
Tuberculosis, a highly contagious respiratory disease, is another concern. Of the 300 patients who come to the hospital each day, about 4 have tuberculosis.
Stanley is one of them.
"[Stanley] came in with tuberculosis that had filled up his entire left lung, and had also started to fill up his heart," explained Dr. Cofee. "He came in quite ill, basically unable to breath and needed to have a tube put in to drain the fluid."
Dr. Coffee says in Haiti, patients often wait until a condition reaches a crisis stage before seeking treatment. And that makes recovery more difficult.
"It is really important for people like him to be able to be treated," she added. "Because otherwise, if they were to go home without full treatment, they would be quite infectious to all of their neighbors."
Stanley has been in the hospital for two months. Half that time was spent with tubes in his chest.
Dr. Coffee says there's no way to tell if malaria, typhoid, and tuberculosis are on the upswing since the earthquake. But with the rainy season looming, they could spread quickly.
Monday, April 12, 2010
Renew Haiti from the Ground Up---Amy Wilentz
Renew Haiti from the ground up
by Amy Wilentz
Monday, April 12th 2010, 4:00 AM
Everyone was talking about reimagining Haiti at the UN donors' conference two weeks ago. Haitian representatives and Haiti's friends, as they are called - including the U.S., France, Brazil, Canada, the UN and the Red Cross, as well as the two global development banks - got together to decide what to contribute and how those funds should be apportioned in the wake of January's catastrophic earthquake. All told, they pledged some $11 billion.
That's a lot of money, which is to be invested in nation building, infrastructure, education, health care, agriculture, etc. But even with that aid package on its way (which it is not yet - for the moment, much of this is only pledged), it's hard to imagine what Haiti, reimagined, will look like.
Haiti before the earthquake was already unimaginable. It was an unprecedented state, the product of the world's only successful slave revolution, invented out of bloody revolt and French ideals and thin air. As two postrevolutionary centuries passed, the country, long shunned by the world economy, sank slowly into a mire of financial and political lethargy and corruption, punctuated by short periods of hope. Its zigzagging history, and its tormented relationship with the United States, ended up - in the first days of 2010 - with Haiti a precarious electoral democracy with a tiny national coffer and deep social and economic fissures that have only been exacerbated by seismic ones.
Yet Haiti, in the runup to geological destruction, was also a place of unimaginable beauty and delicacy, where cornmeal curlicues laid out in the dirt summoned up gods who descended into men's souls, where gorgeous artworks decorated not just the walls of galleries but the doors and sides of shacks, and where you could come around a corner in Port-au-Prince to find a copper-colored rooster standing on the edge of a blue wall in the late afternoon sun.
The real question for Haitians and others who love Haiti goes beyond issues of appropriation and pie-dividing and asks, instead, whether what was special and unimaginable about Port-au-Prince and the country as a whole can be retained while building something new in its place. While donors talk about "building back better," old Haiti hands and skeptics secretly chortle at the phrase. There can be no thought, for example, of building Port-au-Prince back, better or worse. What is gone, a heart-tugging city of surprising beauty and terrible, ruthless privation, cannot and should not be reinvented. Only sentimental foreigners and perhaps its elderly residents can long mourn the city's demise.
Instead Haiti needs a Pretoria or a Brasilia in its stead, a clean, sturdy and perhaps sterile city of civic buildings, with housing and a support system for the government, and another town nearby, perhaps somewhat less neat and clean, to serve the national port. The capital can also provide the nation's connection to the rest of the world. This may be unsentimental, but it's true.
And then everything and everyone needs to be swept back to the countryside - already this movement of internal refugees has begun, and some country towns have nearly doubled in population since the earthquake. The donors in New York last month recognized this, and many proposals brought to the conference emphasized decentralization and aid to the provinces. Seeds, fertilizer, new schools, country clinics, strong, efficient provincial governments, organized local tax collection - these are the new watchwords. Real jobs with pay in the countryside - now that would be an innovation.
For those who hope that the Haiti of the imagination can be retained and reinvented, a new life in the countryside holds out the greatest promise. It was after all in the mountains and fertile valleys of this magnificent piece of land that, at least according to legend, the Haitian slaves conspired to invent Haiti. In the countryside, too, the gods of Africa have never ceased to be worshiped under broad mapou trees and the crashing cascades of waterfalls.
It was this countryside - reimagined as lush, bountiful and verdant - that the great Haitian artists of the 1940s through contemporary times used for many of their most astounding tableaux. Here, also, the coumbite - or cooperative work group - was an everyday organization that, with no help from the outside, constructed houses and farm buildings, and raised roofs, and planted seed. Out of such materials - a revolutionary spirit, the strength of traditional belief, and cooperative endeavor, which are the very life and breath of the countryside - Haiti may rise from the rubble of this latest, and most profound, national disaster.
Instead Haiti needs a Pretoria or a Brasilia
in its stead, a clean, sturdy and perhaps
sterile city of civic buildings, with housing
and a support system for the government, a
nd another town nearby, perhaps
somewhat less neat and clean, to serve the
national port. The capital can also provide
the nation's connection to the rest of the
world. This may be unsentimental, but it's
true.
And then everything and everyone needs to
be swept back to the countryside - already
this movement of internal refugees has
begun, and some country towns have
nearly doubled in population since the
earthquake. The donors in New York last
month recognized this, and many
proposals brought to the conference
emphasized decentralization and aid to the
provinces. Seeds, fertilizer, new schools,
country clinics, strong, efficient provincial
governments, organized local tax collection
- these are the new watchwords. Real jobs
with pay in the countryside - now that
would be an innovation.
For those who hope that the Haiti of the
imagination can be retained and
reinvented, a new life in the countryside
holds out the greatest promise. It was after
all in the mountains and fertile valleys of
this magnificent piece of land that, at least
according to legend, the Haitian slaves
conspired to invent Haiti. In the
countryside, too, the gods of Africa have
never ceased to be worshiped under broad
mapou trees and the crashing cascades of
waterfalls.
It was this countryside - reimagined as
lush, bountiful and verdant - that the great
Haitian artists of the 1940s through
contemporary times used for many of their
most astounding tableaux. Here, also, the
coumbite - or cooperative work group -
was an everyday organization that, with no
help from the outside, constructed houses
and farm buildings, and raised roofs, and
planted seed. Out of such materials - a
revolutionary spirit, the strength of
traditional belief, and cooperative
endeavor, which are the very life and
breath of the countryside - Haiti may rise
from the rubble of this latest, and most
profound, national disaster.
Wilentz is the author of "The Rainy Season:
Haiti Then and Now," which is being
reissued with a new postearthquake
introduction.
Sunday, April 11, 2010
Adoptions in Haiti post-Earthquake
Photo by John Carroll
By DAVID CRARY (AP)
NEW YORK — Logistical challenges and potentially bitter disputes lie ahead as passionate advocates of adoption press for changes that might enable thousands of Haitian children affected by the earthquake to be placed in U.S. homes.
The obstacles are daunting, starting with a need to register Haiti's dislocated children. If done right, this would enable authorities to distinguish between children who might be good candidates for adoption and those with surviving relatives willing to care for them.
There also will be efforts to overhaul Haiti's troubled child protection system, update its adoption laws and boost support for family reunification programs in Haiti.
But even before those goals are pursued, there are sharp divisions over how vigorously and quickly to seek an expansion of adoptions.
A prominent leader of the campaign to bring more orphans to American homes is Sen. Mary Landrieu, D-La., who believes some of the major aid organizations active in Haiti — including UNICEF — are not sufficiently supportive of international adoption.
"Either UNICEF is going to change or have a very difficult time getting support from the U.S. Congress," Landrieu said in a telephone interview.
Landrieu and a few other members of Congress visited Haiti last week, meeting with top Haitian officials to discuss the plight of the devastated nation's orphans.
Since the Jan. 12 earthquake, about 1,000 Haitian children have been brought to U.S. families who had filed adoption applications before the quake. That pool of children in Haiti is dwindling, and adoption advocates — including many religiously affiliated agencies — are now ratcheting up their efforts to get a new, larger stream of adoptions in the works.
"There is great support in the United States to begin to open up opportunities for adoption as soon as possible," Landrieu said. "There are thousands of children who don't have parents or even extended families to be reunified with."
UNICEF says a time may come when large-scale foreign adoptions would be appropriate — notably for older children and those with disabilities. But the U.N. agency and like-minded groups are asking for patience, saying the next priorities should be to register vulnerable children and try to improve conditions for them and their families in Haiti.
"It's complicated," said Susan Bissell, UNICEF's chief of child protection. "We've got to get a registration system in place. Once we have that, we want families for children — and that includes adoption. We are not against intercountry adoption, but we are against exploitation."
Bissell said she was frustrated by the hostility toward UNICEF that is commonly expressed by leading supporters of international adoption in the United States.
"I find myself saddened by it, but it's not going to take the wind out of our sails," she said.
The chief operating officer for Save the Children, which is deeply engaged in helping Haitian orphans, said the tensions and disputes were likely to revolve around timing — with some groups seeking to resume large-scale adoptions much more quickly than other groups.
"It's hard to know how big the problem is without taking the time to go through this registration process, and I know for many it's an excruciating process," Carolyn Miles said.
"There are no records," she added. "To be sure that a child is an orphan, that will be difficult — going back to their villages, trying to find people who know their families."
The challenge of verifying children's statuses was illustrated in the weeks after the quake, when members of an Idaho church group were arrested for trying to take children they falsely claimed were parentless out of Haiti without government approval. The group's leader remains in custody, facing a possible trial for kidnapping.
The church members have said they only wished to rescue desperate children from suffering.
An estimated 40 percent of Haiti's pre-quake population was under 14, including about 50,000 living in orphanages and more than 200,000 others not living with their parents. It's been commonplace for poor parents to abandon their children, and some are taken in by wealthier families who use them as household labor.
Hundreds of thousands of Haitian children lack birth certificates or other identification, which could complicate adoption efforts. The Organization of American States is proposing a plan to provide all Haitian minors with ID cards, but estimates this wouldn't be completed until 2013.
Landrieu hopes significant headway on registration can be made much faster than that — but says the many groups working on the task need to coordinate better.
Looking ahead, she hopes for a sizable number of new foreign adoptions by the end of this year — compared with just a handful at present now that the backlog of pre-quake applications has been largely dealt with.
In recent years, about 300 Haitian children annually were adopted by Americans. Landrieu believes that number could rise to several thousand a year in the future.
"Children belong in families, not in orphanages or in some amorphous kibbutz," she said. "Americans take this call very seriously."
Landrieu and other members of her delegation to Haiti came away convinced that government officials there would support expansion of adoption as long as steps were taken to guard against trafficking and ensure that children weren't being sent away from parents who wanted them.
Indeed, Haitian authorities say they are now accepting new adoption applications, though it isn't clear how long these might take to process.
The head of Haiti's child welfare agency, Jeanne Bernard Pierre, has conveyed some skepticism about efforts to speed up adoptions, saying Americans have taken advantage of the disaster to flout Haitian adoption laws.
"Since the earthquake, the U.S. Embassy has said, 'If you see a kid you like, here's the paper, you can take them with you,'" Pierre told The Associated Press.
Michele Bond, one of the U.S. State Department's senior officials dealing with international adoption, firmly disagreed, saying the post-quake transfers of Haitian children to the United States were rigorously monitored.
Bond also expressed hope that Haiti would proceed with revisions to its adoption laws, which critics say are outdated. The laws place tight age limits on adoptive parents and prohibit adoptions by parents who have biological children — with exceptions granted only through presidential dispensation.
Chareyl Moyes of Wasatch International Adoptions in Ogden, Utah, has helped bring more than 30 Haitian children to adoptive families in her region since the quake.
Moyes, the adoptive mother of a 6-year-old Haitian boy, supports efforts to reunify divided families in Haiti and to improve the lot of disadvantaged children there. But even with those steps, she believes international adoption would remain the best option for many of them.
"The last thing we want to do is take a child, and then have a parent come forward and say, 'I'm looking for my child' after it's placed in the U.S. — but there are thousands of orphans for whom that would not happen," she said.
She shares Landrieu's concern that spending another year or two in an orphanage — while registration and assistance programs unfold — could be damaging to some children who have been traumatized and might fare better with adoptive families.
Dr. Jane Aronson, a New York City pediatrician and expert on international adoption, plans to travel to Haiti on April 19 to help establish long-term assistance programs for orphans.
"I really want everyone to be aware: While you're working hard for adoption, you need to be working hard for the welfare of children — for more services in-country, better care-taking and education, helping parents get jobs."
She sounded impatient with the ideological disputes over adoption.
"All the accusations have to stop," she said. "You must come to the table together, and you must believe there's a solution together."
Associated Press writer Jonathan Katz in Port-au-Prince, Haiti, contributed to this report.
Copyright © 2010 The Associated Press. All rights reserved.
Wednesday, April 07, 2010
Bob Braun on Haiti
Photo by John Carroll
Haitians offer to share food, water and stories with American journalists after earthquake
By Bob Braun/Star-Ledger Columnist
January 19, 2010, 9:45PM
PORT-AU-PRINCE, Haiti — Nothing new — a group of men atop a collapsed building using whatever tools they have to try to find entombed family members.
But something odd happens when two Americans — les blancs, literally "whites," but a general term here for foreigners — arrive. One of the men gets angry.
Matt Rainey/The Star-LedgerPeople scavenge for Rebar in Petionville in this photo taken on Jan. 16.
"You come here to watch, but that is all you do," shouts the man. "You do not help. You do not bring water. You just watch."
He leaves the pile of rubble. Another man Delva Presendiem, pauses in his hot, exhausting and, ultimately, futile work.
"Do not worry about him," says Presendiem. "Please stay."
The incident was odd because, in six days here, his was the only angry face turned to me and my colleague Matt Rainey. During our brief stay, Haitians — in the worst moments of their lives — were kind, welcoming, and helpful. They opened their homes, offered to share what little food and water they had, and willingly told their stories.
Remember this if you read, hear, or even see accounts of violence or looting. We were all over this city — from Petionville on the mountain to the ghetto of Belair and the shanty town of Cite Soliel — and we did not witness one act of looting or violence.
Undoubtedly, some did occur, but all we saw were orderly, patient queues for water, for food at supermarkets, for medical care.
Haiti is not a violent country. The Canadian Foundation for the Americas put its murder rate in 2007 at 11 per 100,000 population — compared to 23.9 in Newark and 26.7 in the Dominican Republic, the nation that shares the island of Hispaniola with Haiti.
"Haiti stands out in comparison to the rest of the region for low levels of violence," the foundation reported. Most violence is committed by "official actors" — the police and army among them — and 90 percent of all murders in the entire country occur in three neighborhoods in the capital city, it noted.
--------------------------------------------------------------------------------
Veteran Star-Ledger columnist Bob Braun and Pulitzer Prize-winning photographer Matt Rainey are in Haiti covering the aftermath of the disaster
--------------------------------------------------------------------------------
John Carroll, a physician from Peoria who works here, told me another reason on my first trip here in 2004 in the aftermath of the coup that brought down former President Bertrand Aristide. I was staying with him in a motel in Delmas, and he suggested we go out for beer and pizza. It was after dark, and I hesitated.
"This," he said, tapping on my bare arm. "Your white skin and your American citizenship. It protects you." A group of Haitians with us agreed.
Violence directed at, or in the presence of, Americans would only bring more suffering to Haiti, Carroll said. The U.S. Army occupied Haiti and ran it from 1915-1934 and, according to a U.S. Foreign Policy Association, the occupation was a "failure" because it brought on the subsequent dictatorship of Francois "Papa Doc" Duvalier.
But there are other reasons. "Haitian people suffer in patience," says Jean Jacob Paul, a Presbyterian pastor who helped us when we first arrived here. "They share everything, including their misery."
Matt Rainey/The Star-LedgerHaitians in Port-au-Prince cover their faces from the smell of bodies in this photo taken Jan. 15.Of course, violence and theft occurs, and they may have occurred here since the earthquake, but we did not see it. On two occasions, we were surrounded by crowds and, to nervous les blancs, the scenes may have looked like incipient riots.
In the sprawling tent city outside the destroyed National Palace, we made rounds with doctors and nurses from Cuba. Homeless Haitians, mostly women, surrounded us, pressing their sick and injured children into our faces, begging for help. I explained we were not doctors, and they backed off and patiently waited for aid.
What would American mothers frantic about their injured or sick children do?
At the Second Baptist Church on Sunday, the pastor introduced us and told more than 100 congregants that we were interested in hearing stories about the disaster. Virtually everyone pressed in on us, handing us their identity cards to make spelling their lyrical but (for me) oddly spelled Creole names easier to write down.
I repeated pas besoin — no need — but it was useless. They wanted to help.
Americans remember 9/11 as a day of unprecedented fear and suffering. Although the disaster here was natural, not man-made, 1/12 affected far more Haitians. At least tens of thousands of people are dead and the nature and magnitude of the carnage has stripped away an important part of their culture.
Deaths are attended with considerable ceremony and large, extended family gatherings. Or were until last Tuesday. Pictures are taken of the deceased — dressed in expensive finery. On my last trip here, I watched helplessly as a 16-month-old baby girl died, apparently of meningitis. Carroll, the Illinois physician, could not save her.
"Now," he said, "her mother will spend a year’s income to bury her. She will wear a dress far prettier than anything she would have worn had she lived."
But, here now, the best that can be done is to wrap the dead in sheets and put them at the curb to wait, often alone, for the wandering garbage trucks to collect them to be dumped in a mass grave. That’s the best — the worst is the unattended corpses dumped on the street or lying half-buried in the rubble of a collapsed building.
Violence? Looting? Maybe some has occurred. Maybe more will. These are people steeped in wretched poverty before the earthquake — and now most have lost someone, they loved but cannot properly mourn. They have nothing to eat and nothing to drink, and they are surrounded by gawking, well-fed, well-watered les blancs, who probably soon will leave and forget Haiti until the next disaster.
What would happen here?
Perspective from Haiti
Yale Daily News
--------------------------------------------------------------------------------
Published: Wednesday, April 7, 2010
Price: Perspective from Haiti
By Brian Price
Guest Columnist
On Jan. 12, a devastating earthquake measuring 7.0 on the Richter scale struck Haiti, leaving over 200,000 people dead and over 1 million people homeless throughout the country. Almost immediately, the world’s more prosperous countries and many of Haiti’s neighbors, prosperous or not, responded with pledges of material assistance. Over spring break I had the opportunity to observe and participate in the efforts of Haitians and donors to cope and recover from the quake. I traveled to Port Au Prince, Haiti, where I worked with a local NGO, Hospice St. Joseph, in the hard hit community of Christ Roi.
Although I had been told prior to the trip to prepare for the “sight and scent” of death, the destruction, the dire conditions, and for the despair and anguish felt by so many people, I only came close to fully appreciating the scope of the tragedy upon arriving. There’s no running water, electricity or sanitation in Port Au Prince. Streets are lined with thousands of little shacks and sticks covered with tarps, rubble and debris are still everywhere, businesses are still shut down and vast tent cities with tens of thousands of people each have been formed. After witnessing all of this, I couldn’t help but wonder: Where is all the money that has been donated to the relief effort?
My primary task while working with Hospice St. Joseph was to contact and meet with the agencies directing the relief effort (UNICEF, World Food Program, World Health Organization among others) in order to assess what was being done in Christ Roi and throughout the affected area, determine which organizations we should coordinate with, and most importantly, to procure much needed medical supplies, food, water and shelter for St. Joseph’s child and maternal clinic and children’s nutrition program.
Sadly, the latter effort was a frustrating, albeit illuminating, failure. After two weeks of one-on-one meetings, cluster meetings, phone calls, e-mails and being transferred from one person to the next day after day, I received no supplies for my organization to distribute. No food, no water, no medicine, no tents, nothing. My experience was not an isolated incident. The director of Hospice St. Joseph was unaware of a single local NGO or community organization that had received any assistance from the agencies in charge of coordinating the relief effort. He personally had gone directly to the United Nations’ compound, where these lead agencies were located, and just like me, made no progress in receiving supplies for those people we were striving to serve.
Right now UNICEF, WFP, WHO and other large international organizations are directing the relief effort in Haiti. Much of the money and resources coming into Haiti are channeled through these organizations and “intended” to be distributed to (usually large international) organizations operating in Haiti. What seems apparent from my experience in Haiti is that those coordinating the relief response are detached from the situation. You can’t fully understand what Haitians are going through by sitting in an air conditioned office or hotel. You can’t experience life on the streets by driving through them instead of walking on them. And you really can’t help people if you don’t meet with them, talk with them, listen to them.
That is perhaps the greatest obstacle in Haiti right now. Those people who know and understand the country, the people and their needs, are not sufficiently involved in the decision-making process. Local organizations that have been operating in Haiti for years and are run by Haitians have been swept aside by large international agencies and NGOs that just arrived in the country and are coordinated mainly by Americans and Europeans. As a result, the relief effort has been poorly managed. Hundreds of thousands of Haitians have yet to receive any assistance.
How do I know this? I toured Port Au Prince, traveled to the provinces and went to Leogane, near the epicenter of the earthquake. I walked the streets of the devastated capital, I lived and worked in one of the worst affected areas, I lifted rubble side by side with people who had lost their homes, and I climbed over rubble to meet with people struggling to survive.
I spoke with hundreds of people while I was in Haiti. I was fortunate enough to come across someone who spoke English and Creole and was willing to assist me as my translator. I heard anger, frustration, sadness, faith, hope, uncertainty and determination in their voices. Many are thankful to be alive, others are questioning God for why the earthquake occurred, others are blaming the government for corruption and the problems of the relief response and many are blaming the UN for ignoring and neglecting them. On more than one occasion, I was told this was reminiscent of “master and slave” all over again.
There was one question I would ask that consistently produced a unanimous response, however. In each place I went, I asked Haitians if they had received any assistance at all after the earthquake; any food, water, a tent, anything. The answer was always no. Over the course of two weeks not a single person I met and spoke with had received any assistance at all.
Although many Haitians have been neglected by the relief effort, there are of course hundreds of thousands of people who have received assistance. Several camps have been set up that are receiving services, and many people have received food, water and medical care. However, when nearly 2 million people were affected by the earthquake, more than two months have elapsed and billions of dollars have been raised, providing assistance to such a small proportion is unacceptable. If the responses I received are any indication, the majority of Haitians have yet to receive assistance, especially in the areas outside of Port Au Prince and in areas that are less accessible. Most aid seems to be concentrated in the areas closest to the airport, where the international organizations, both public and private, have set up operations.
What should the focus of the relief effort be? What does Haiti need right now? Haitians desperately want someone to take charge, to work through the bureaucracy and corruption, and to lay out a plan and vision for the future of Haiti. Removal of the rubble from the streets and communities is needed. Food, water, medicine and shelter, especially with the approaching rainy season, are vital. Jobs are needed to help rebuild the country and produce income. Schools and businesses must be reopened. Infrastructure must be built outside of Port Au Prince so that people will have opportunities if they move to the rural areas. Haitians want to help shape the future of their country and be a part of it, not become idle bystanders.
Last week the International Donors Conference Towards a New Future for Haiti was held in New York. Billions of dollars in assistance were pledged by the international community to Haiti over the next several years. Ensuring that those pledges become actual commitments is vital for Haiti’s reconstruction. Furthermore, economic assistance is only part of Haiti’s recovery and reconstruction. Responsible and responsive leadership is needed in Haiti. Ensuring that each and every Haitian receives the necessary resources to survive must be the goal of the international community in Haiti. How do you work towards accomplishing this goal? How do you ensure that aid is effective? Start by listening to the people.
Brian Price is a senior in Trumbull College.
--------------------------------------------------------------------------------
Published: Wednesday, April 7, 2010
Price: Perspective from Haiti
By Brian Price
Guest Columnist
On Jan. 12, a devastating earthquake measuring 7.0 on the Richter scale struck Haiti, leaving over 200,000 people dead and over 1 million people homeless throughout the country. Almost immediately, the world’s more prosperous countries and many of Haiti’s neighbors, prosperous or not, responded with pledges of material assistance. Over spring break I had the opportunity to observe and participate in the efforts of Haitians and donors to cope and recover from the quake. I traveled to Port Au Prince, Haiti, where I worked with a local NGO, Hospice St. Joseph, in the hard hit community of Christ Roi.
Although I had been told prior to the trip to prepare for the “sight and scent” of death, the destruction, the dire conditions, and for the despair and anguish felt by so many people, I only came close to fully appreciating the scope of the tragedy upon arriving. There’s no running water, electricity or sanitation in Port Au Prince. Streets are lined with thousands of little shacks and sticks covered with tarps, rubble and debris are still everywhere, businesses are still shut down and vast tent cities with tens of thousands of people each have been formed. After witnessing all of this, I couldn’t help but wonder: Where is all the money that has been donated to the relief effort?
My primary task while working with Hospice St. Joseph was to contact and meet with the agencies directing the relief effort (UNICEF, World Food Program, World Health Organization among others) in order to assess what was being done in Christ Roi and throughout the affected area, determine which organizations we should coordinate with, and most importantly, to procure much needed medical supplies, food, water and shelter for St. Joseph’s child and maternal clinic and children’s nutrition program.
Sadly, the latter effort was a frustrating, albeit illuminating, failure. After two weeks of one-on-one meetings, cluster meetings, phone calls, e-mails and being transferred from one person to the next day after day, I received no supplies for my organization to distribute. No food, no water, no medicine, no tents, nothing. My experience was not an isolated incident. The director of Hospice St. Joseph was unaware of a single local NGO or community organization that had received any assistance from the agencies in charge of coordinating the relief effort. He personally had gone directly to the United Nations’ compound, where these lead agencies were located, and just like me, made no progress in receiving supplies for those people we were striving to serve.
Right now UNICEF, WFP, WHO and other large international organizations are directing the relief effort in Haiti. Much of the money and resources coming into Haiti are channeled through these organizations and “intended” to be distributed to (usually large international) organizations operating in Haiti. What seems apparent from my experience in Haiti is that those coordinating the relief response are detached from the situation. You can’t fully understand what Haitians are going through by sitting in an air conditioned office or hotel. You can’t experience life on the streets by driving through them instead of walking on them. And you really can’t help people if you don’t meet with them, talk with them, listen to them.
That is perhaps the greatest obstacle in Haiti right now. Those people who know and understand the country, the people and their needs, are not sufficiently involved in the decision-making process. Local organizations that have been operating in Haiti for years and are run by Haitians have been swept aside by large international agencies and NGOs that just arrived in the country and are coordinated mainly by Americans and Europeans. As a result, the relief effort has been poorly managed. Hundreds of thousands of Haitians have yet to receive any assistance.
How do I know this? I toured Port Au Prince, traveled to the provinces and went to Leogane, near the epicenter of the earthquake. I walked the streets of the devastated capital, I lived and worked in one of the worst affected areas, I lifted rubble side by side with people who had lost their homes, and I climbed over rubble to meet with people struggling to survive.
I spoke with hundreds of people while I was in Haiti. I was fortunate enough to come across someone who spoke English and Creole and was willing to assist me as my translator. I heard anger, frustration, sadness, faith, hope, uncertainty and determination in their voices. Many are thankful to be alive, others are questioning God for why the earthquake occurred, others are blaming the government for corruption and the problems of the relief response and many are blaming the UN for ignoring and neglecting them. On more than one occasion, I was told this was reminiscent of “master and slave” all over again.
There was one question I would ask that consistently produced a unanimous response, however. In each place I went, I asked Haitians if they had received any assistance at all after the earthquake; any food, water, a tent, anything. The answer was always no. Over the course of two weeks not a single person I met and spoke with had received any assistance at all.
Although many Haitians have been neglected by the relief effort, there are of course hundreds of thousands of people who have received assistance. Several camps have been set up that are receiving services, and many people have received food, water and medical care. However, when nearly 2 million people were affected by the earthquake, more than two months have elapsed and billions of dollars have been raised, providing assistance to such a small proportion is unacceptable. If the responses I received are any indication, the majority of Haitians have yet to receive assistance, especially in the areas outside of Port Au Prince and in areas that are less accessible. Most aid seems to be concentrated in the areas closest to the airport, where the international organizations, both public and private, have set up operations.
What should the focus of the relief effort be? What does Haiti need right now? Haitians desperately want someone to take charge, to work through the bureaucracy and corruption, and to lay out a plan and vision for the future of Haiti. Removal of the rubble from the streets and communities is needed. Food, water, medicine and shelter, especially with the approaching rainy season, are vital. Jobs are needed to help rebuild the country and produce income. Schools and businesses must be reopened. Infrastructure must be built outside of Port Au Prince so that people will have opportunities if they move to the rural areas. Haitians want to help shape the future of their country and be a part of it, not become idle bystanders.
Last week the International Donors Conference Towards a New Future for Haiti was held in New York. Billions of dollars in assistance were pledged by the international community to Haiti over the next several years. Ensuring that those pledges become actual commitments is vital for Haiti’s reconstruction. Furthermore, economic assistance is only part of Haiti’s recovery and reconstruction. Responsible and responsive leadership is needed in Haiti. Ensuring that each and every Haitian receives the necessary resources to survive must be the goal of the international community in Haiti. How do you work towards accomplishing this goal? How do you ensure that aid is effective? Start by listening to the people.
Brian Price is a senior in Trumbull College.
Haiti's Most Wanted
Photo by John Carroll
Many of Haiti's most-wanted on the loose after earthquake
by Manuel Roig-Franzia
Wednesday, April 7, 2010; 1:59 PM
PORT-AU-PRINCE, HAITI -- Early one morning this month, in the buzz saw that is downtown Port-au-Prince, three men approached a police checkpoint, firing automatic weapons. When the shooting finally stopped, a seven-year veteran of the Haitian National Police force lay dead, his body riddled with bullets.
Police say the killers were dispatched by a gang leader named Ti Wilson, a menacing underworld force believed to control a kidnapping and robbery empire, who has taken to calling himself "Obama," presumably as a symbol of power. What was particularly unnerving about this killing is that Wilson would be behind bars now, if not for the Jan. 12 earthquake that shattered Port-au-Prince.
On that afternoon, while tens of thousands of Haitians were being crushed to death, Wilson and more than 4,500 other inmates slipped out of a wing of the National Penitentiary known as the "Titanic." Since then, Haitian and international police say, the most notorious of the escapees have begun terrorizing neighborhoods, stolen aid supplies and fought ever more pitched battles among themselves that threaten the stability of a fragile society still far from recovering from one of the worst disasters in recent memory.
As the gangs have gained confidence, their turf wars have suddenly spiked, filling the same city morgue that swelled with quake victims with gunshot victims: at least 50 in the past few weeks. After escaping, for instance, Wilson knocked off his main rival, a gangster known as Billy, who had taken over the imprisoned gang leader's kidnapping trade in the Fort Touron neighborhood, police say.
Gangs have charged into settlement camps slashing machetes to swipe food and water delivered by aid groups, stolen money from sidewalk vendors and gunned down passersby to steal as little as a few hundred Haitian gourdes, the nation's currency, police say. Officials say the spike in violence is particularly demoralizing because Haiti had made great strides to bring the gang problem under control prior to the earthquake.
In a series of heavily militarized offensives that peaked three years ago, U.N. police fought gunbattles block by block in neighborhoods controlled by gangs, such as the Cité Soleil slum, Boston and Martissant. The campaign crippled most of the major gangs and led to the arrest of the country's most notorious gang leaders, all of whom were sent to the National Penitentiary. Police say the kidnapping and homicide rates plummeted, but now those same gang leaders are being blamed for a resurgence of crime.
"It's like we've turned back the clock," Mario Andresol, Haiti's national police chief, said in an interview under the large, yellow-and-white striped, open-sided tent that now serves as his office. "I get frustrated. We spent four years getting them, and now they are on the run."
* * *
The prison break essentially unleashed Haiti's former most-wanted list -- all at once. Saint Victor, a bearlike 300-pound-plus former policeman arrested for drug trafficking, fled. Another escapee, Ti Wil, is suspected of killing the French consul in the northern city of Cap-Haitien several years ago. ("Ti," which thymes with "wee," is a common Haitian nickname that means "little.")The escapees also included Ti Blan, a charismatic gang leader from Cité Soleil, who was so brazen before his arrest that he frequently escorted foreign reporters on tours of his neighborhood. A person identifying himself as Blan called into a radio program recently, urging police not to arrest him because he had become a devout Christian while in prison.
Joseph DuPont, second-in-command of the Haitian National Police's downtown Port-au-Prince division, chuckled at Blan's plea. "Even in Haiti, being a Christian doesn't put you above the law," DuPont said.
The circumstances of the mass prison break remain clouded in controversy. Some exterior walls were damaged by the quake, but Andresol said that interior walls held firm. He is certain that some of the guards panicked and fled, many leaving behind their weapons, which the prisoners took. A small U.N. contingent, stationed outside the prison, also fled, Andresol said.
Even so, he said, there is almost no way prisoners could have escaped without help from authorities. One week after the quake, the warden, Olmaille Bien-Aimé, disappeared and hasn't been seen since, Andresol said.
"This situation makes the escape very suspicious," said Andresol, a muscly 49-year-old former Haitian army officer who trained at the School of the Americas in Georgia.
After the quake, Andresol created a special undercover team to hunt down the escapees, some of whom are suspected of scattering to small villages far from the capital. Most of those captured so far have been minor criminals. The big killers remain on the loose, and they are well armed -- police say they're often out-gunned by gang members wielding assault rifles.
There are indications that some former rivals are joining forces, creating new mega-gangs, Andresol said, and there are concerns that political parties might be using gangs to spread unease prior to hoped-for elections this winter.
* * *
Newly captured suspects are jammed into a 20-foot-by-10-foot impromptu cell outside a downtown police office. Inmates stand with their arms dangling out the bars and paw at people passing on the sidewalk. One recent afternoon, two Haitian National Police officers chugged bottle of Prestige, a beloved local beer, while standing guard.
Earlier that day, a funeral was held at the Ebenezer Church of God in Port-au-Prince for Theophile Delva, a deacon and father of nine. Delva was shot once in the leg and twice in the chest by thugs intent on robbing him as he was leaving a religious radio station in the Martissant neighborhood where he worked.
"His death is a result of the earthquake," pastor Lochard Remy told the mourners, expressing a sentiment felt by many here.
The same week that Delva was killed, police suspect Ti Wilson dispatched shooters from his 50-member assassin squad to kill more three police officers.
DuPont's men consider Wilson one of their biggest targets. But they don't even have a photograph him -- countless records were destroyed in a fire, presumably set by inmates, during the prison escape at the National Penitentiary.
DuPont's officers have chased Wilson from one neighborhood in the city to another, each time coming up empty. He is believed to sleep in a different hideout every night, DuPont said.
Just then, as DuPont spoke, the radio crackled. A scratchy but loud voice came through the speaker. The officer on the other line had news to deliver: He wanted to talk "about Obama."
Special correspondent Claude Doge contributed to this report.
© 2010 The Washington Post Company
Saturday, April 03, 2010
Promises for Haiti
April 3, 2010
Editorial--New York Times
Promises for and from Haiti
This week’s donors conference for Haiti at the United Nations was strikingly hopeful, in good part because of what participants pledged not to do.
The promises of action were important: Nearly 60 nations and organizations said they would give $5.3 billion in the next two years, and almost $10 billion in the next decade, to help Haiti rebuild from the Jan. 12 earthquake. The United States committed $1.15 billion, in addition to the $900 million it has already spent.
Along with that generosity, major donor countries promised not to repeat the old failed strategy of poorly coordinated projects that wither through waste and neglect. Nongovernmental agencies, which — often for sound reasons — are used to bypassing the Haitian government, pledged to channel their efforts through a redevelopment plan proposed by Haiti and jointly administered by Haitian officials and the largest donors.
Haiti’s president, René Préval, and prime minister, Jean-Max Bellerive, acknowledged the need for their notoriously ineffective and corrupt government to do things very differently. They promised to work with the international community to create, and then abide by, new structures to track the billions being given.
The promises are accompanied by an ambitious plan to build new roads, ports, bridges and desperately needed housing outside the shattered capital of Port-au-Prince. It also calls for building the necessities of a functioning society: systems of justice, policing, education.
There are still a lot of buts. Pledges need to turn into donations. While billions of dollars are needed for the future, the government needs hundreds of millions now to meet its payroll and other expenses in the coming year. We, too, are leery of handing cash directly to Haiti’s government, but the call for budget support has the persuasive endorsement of Dominique Strauss-Kahn, the managing director of the International Monetary Fund.
Many excellent-sounding ideas have not yet been fleshed out. One is the plan to create an interim reconstruction committee led by Mr. Bellerive and former President Bill Clinton, a United Nations envoy to Haiti, that would evolve into a Haitian-led Haitian Development Authority — how will that work? How will the diaspora be able to contribute, beyond sending cash? And, perhaps most important, when and how will the system for following the money and the projects be put in place?
The plans are complicated, too, by the deeply inadequate relief effort. More than a million earthquake survivors are homeless. They want to see a new Haiti someday, but right now they need safe shelter, food and water. And they know that the same leaders who are hatching ambitious plans now were also overwhelmed and distressingly absent in the quake’s horrific aftermath.
Haiti is awash in promises. Haitians need to see results. If dismal history repeats itself, this week would be the high point of optimism, followed by a long slide into disillusionment and failure. That must not happen again.
Editorial--New York Times
Promises for and from Haiti
This week’s donors conference for Haiti at the United Nations was strikingly hopeful, in good part because of what participants pledged not to do.
The promises of action were important: Nearly 60 nations and organizations said they would give $5.3 billion in the next two years, and almost $10 billion in the next decade, to help Haiti rebuild from the Jan. 12 earthquake. The United States committed $1.15 billion, in addition to the $900 million it has already spent.
Along with that generosity, major donor countries promised not to repeat the old failed strategy of poorly coordinated projects that wither through waste and neglect. Nongovernmental agencies, which — often for sound reasons — are used to bypassing the Haitian government, pledged to channel their efforts through a redevelopment plan proposed by Haiti and jointly administered by Haitian officials and the largest donors.
Haiti’s president, René Préval, and prime minister, Jean-Max Bellerive, acknowledged the need for their notoriously ineffective and corrupt government to do things very differently. They promised to work with the international community to create, and then abide by, new structures to track the billions being given.
The promises are accompanied by an ambitious plan to build new roads, ports, bridges and desperately needed housing outside the shattered capital of Port-au-Prince. It also calls for building the necessities of a functioning society: systems of justice, policing, education.
There are still a lot of buts. Pledges need to turn into donations. While billions of dollars are needed for the future, the government needs hundreds of millions now to meet its payroll and other expenses in the coming year. We, too, are leery of handing cash directly to Haiti’s government, but the call for budget support has the persuasive endorsement of Dominique Strauss-Kahn, the managing director of the International Monetary Fund.
Many excellent-sounding ideas have not yet been fleshed out. One is the plan to create an interim reconstruction committee led by Mr. Bellerive and former President Bill Clinton, a United Nations envoy to Haiti, that would evolve into a Haitian-led Haitian Development Authority — how will that work? How will the diaspora be able to contribute, beyond sending cash? And, perhaps most important, when and how will the system for following the money and the projects be put in place?
The plans are complicated, too, by the deeply inadequate relief effort. More than a million earthquake survivors are homeless. They want to see a new Haiti someday, but right now they need safe shelter, food and water. And they know that the same leaders who are hatching ambitious plans now were also overwhelmed and distressingly absent in the quake’s horrific aftermath.
Haiti is awash in promises. Haitians need to see results. If dismal history repeats itself, this week would be the high point of optimism, followed by a long slide into disillusionment and failure. That must not happen again.