This week was the five year anniversary of the earthquake which left Port au Prince and much of Haiti devastated. It was a magnitude 7 event, caused by a strike-slip fault rupturing 8 miles beneath the surface and releasing waves of seismic energy – we talk about it now and then in some of my classes. Describing the technical aspects from a seismology viewpoint doesn’t much get at the heart of what happened after that, though. Estimates of the casualties range from 160,000 to 300,000 killed, with one third of Haiti’s population of 9 million directly affected, and $8 billion in damages. Recovery over the last few years has been slow, with one physician working in Haiti diagnosing the problems caused by the earthquake as “acute-on-chronic.” The severity of the damage – physically, socially, and economically – was greatly exacerbated by already existing chronic problems in the country.
“Acute-on-chronic”: one of the acute symptoms would be the number of buildings that collapsed due to the quake – some 250,000 homes. The amount of destruction is an expression of the chronic problems of rapid urbanization, unsafe construction, and lack of building codes meant to resist seismic hazard. The issue can be traced further; high rates of urbanization followed the collapse of the agricultural industry in Haiti after American subsidies of US rice farms flooded the market with cheap rice – something that Bill Clinton apologized publicly for in the months after the quake. Tetanus cases from injuries in the quake were widespread largely because of failure to vaccinate. The health system was overwhelmed by the disaster, then by the cholera epidemic which followed. Haiti hadn’t had a case of cholera in over a hundred years; it was spread from foreign aid workers.
Haiti leads the Western Hemisphere in ratings of poverty, health, and water security, and any attempt to address those problems needs to look at the history that contributed to them, from the coups and turmoil of the 1980s and 1990s to the exorbitant reparations required by France after Haiti’s revolution cost the French much of their slave trade. In the aftermath of the earthquake, donations and aid poured in, but this week op-eds have abounded on where that money has gone and why more progress hasn’t been made. Of $1.5 billion from USAID, only 1 cent out of every dollar went directly to Haitian organizations; money instead went to international contractors who cost 5 times more than local workers. Providing funds directly to Haitian organizations or government agencies is apparently a sticking point for foreign donors, who have resisted contributing to a UN proposed trust fund that would be controlled by the Ministries of Health and Environment. Complicated problems can require clever ways to address them – I remember reading about aid workers in the immediate aftermath using Google Earth to track what areas needed help because the blue UN tents were visible in satellite imagery. But it seems that having people on the ground who know what they need and what will work, instead of foreign contractors, is a key point. The Health Ministry is one of the few that does receive direct funding, and has apparently made large amounts of progress in HIV treatments and child vaccinations.
If you have a moment or the means to donate, some of the groups doing the best work in Haiti are Partners in Health and Zanmi Lasante, the local Haitian extension of PIH; they run 12 hospitals and clinics in Haiti, and were some of the first medical professionals on the scene after the earthquake. ZL is the largest nongovernment health care provider in Haiti, with a staff of 5,400 Haitians serving 1.3 million. Currently, there is a quiz on the PIH site about maternal health; for everyone who takes the quiz, 50 cents will be donated: http://act.pih.org/page/s/quiz?source=tout&subsource=tout_country
I also recommend water.org; they help provide clean water and sanitation proposals, working with local organizations from proposals put forth by the communities themselves: http://water.org/country/haiti/
To Repair the World, Paul Farmer