An anecdotal account of Haiti's medical situation created by structural violence and negligence. Go to Peoria's Medical Mafia and PMM Daily to see Peoria's role. Also see Live From Haiti and Haitian Hearts.
Saturday, August 14, 2010
Rebuilding Haiti
Rebuilding Haiti Requires New State-Building Strategy
(Rand Corp. report – Friday, August 13)
Haiti's future prosperity and peace depend on its ability to build a more resilient state, one capable of providing public services like education and health care as well as responding effectively to natural disasters, according to a new study from the RAND Corporation.
Even before a 7.0 magnitude earthquake battered the Caribbean country in January, its state institutions were riddled with weaknesses in human resources, organization, procedures and policies. Now, with the international community having pledged nearly $10 billion in aid, priorities need to be set and state building should be at the forefront of earthquake recovery efforts, according to RAND researchers.
“Many studies have identified Haiti's most-pressing problems, but what haven't been focused on are the state institutions themselves: how to make them stronger and more resilient,” said James Dobbins, a co-author of the study and a senior fellow at the RAND Corporation, a nonprofit research organization. “Haiti will remain vulnerable to natural disasters, political turbulence, and civil unrest until it develops effective institutions.”
The RAND study finds that most plans and proposals for rebuilding Haiti are too broad in scope, too ambitious in their objective, and fail to set priorities or lay out a sequence for introducing changes. The study identifies the main challenges to a better government and proposes a realistic set of actions. Specifically, it recommends the Haitian state and international donors focus on public administration, justice, security, economic policy, infrastructure, education and health care.
In preparing the report, RAND researchers spoke to representatives of the Haitian government, international organizations, key donor agencies, people in the Haitian private sector, foreign investors and nonprofit organizations that work in Haiti. Dobbins, director of RAND's International Security and Defense Policy Center, previously served as the Clinton administration's special envoy to Haiti.
Haiti is the poorest country in the Western Hemisphere, with a per-capita income less than a quarter of the average for Latin America and the Caribbean. The country has no coherent public education or health care system, its judicial system is a shambles and the state has created a hostile environment for business, according to researchers.
Nevertheless, the situation is not hopeless. Following a change of government in 2004, Haiti enjoyed five consecutive years of economic growth and made tentative progress toward better governance. With the right institutions and incentives, the country can not only recover from the earthquake that killed more than 300,000 people, but embark on a period of improved public security, social well-being and sustained economic growth, according to the study.
“State-building may not have the same appeal to international donors as erecting new buildings, but it's got to be done if Haiti is to successfully rebuild itself,” said Keith Crane, a study co-author and a senior economist at RAND. “International donors have poured billions into Haiti, but they have not focused on creating sustainable institutions to provide a payoff from those investments. For example, roads have been constructed, but until recently donors failed to ensure that the Haitian state would maintain those roads. Donors have invested in new power plants, but some power plants have ceased operations because not enough money was charged and collected to pay for fuel.”
Identifying the state's core functions — with a focus on those that promote security, stability, and economic growth — should be the first step of any state-building strategy, researchers say. Next, Haiti needs to establish what actions are top priority, and create a set of deadlines and responsibilities.
Laurel Miller, co-author of the study and a senior policy analyst with RAND, identifies judicial and corrections reform as critical. She recommends that the Haitian government and the United Nations continue to maintain an international military and police force in Haiti for at least the next five years, while reforms to judicial and penal systems are put in place.
The study also recommends:
· International donors should work with the Haitian government to create a modern civil service replete with job descriptions, pre-determined qualifications for positions and a competitive process for recruitment, hiring and promotion.
· To make reconstruction possible, the Haitian government and the donor community should make rubble removal the most important priority. The Haitian government should make immediate arrangements for depositing rubble; the international community should provide funds and equipment as quickly as possible.
· To accelerate economic growth, the Haitian government should quickly eliminate unnecessary procedures involved in registering businesses and property, and reduce the cost and length of time needed for those actions.
· The Haitian state should focus on monitoring and regulating the delivery of education and health services, not providing those services itself.
· Major donors — including the United States — should submit all project and program concepts to the Interim Haiti Recovery Commission for coordination, to achieve more coherence among the various reconstruction and reform programs.
The study, “Building a More Resilient Haitian State,” can be found at www.rand.org.
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