Almost any and every news item or research article about Haiti begins with the sentence, “Haiti is the poorest country in the western hemisphere…” (Come to think of it, so does this piece). As my flight lands on the mostly undamaged tarmac at Aeroport Toussaint L’Ouverture in Tabarre, Port au Prince (PaP), I wonder what that statement means. And how long have we been saying this? For 20 years, 30 years, or ever since Haiti’s establishment as the first black republic in 1804?

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I am in the country for two weeks representing a public health non-profit organization that has worked on community health and development programs in rural Haiti since the early 1980s. While none of its immediate staff members have been killed or injured, many of Global Health Action’s programs were brought to a halt immediately after the January 12, 2010 earthquake. My mission then is to understand the scale and scope of the devastation from the perspective of its staff and its community members. Over the two weeks I visit programs, partners, and communities in the towns of Leogane, Petit Goave, Darbonne, and Port au Prince.

I clear customs and wait for my co-worker outside the arrivals area. I strike a conversation with a young man, distributing flyers for port-a-potties. “Do not stay inside a building,” he warns me. He adds that there are aftershocks every other day (though I did not experience even one during my two-week sojourn). “I sleep outside my house in a tent,” he says. “Buildings are not to be trusted.” I nod knowingly, regretting my decision to leave the three-person tent behind at home. My inchoate views about voodoo lead me to believe that his advice draws not only from post-traumatic stress but from his complex faith. Not true. As the days progress I  begin to understand his warnings a little more. Post traumatic stress, yes, but it is also the sheer magnitude of the devastation that is leading people to abandon all structures for the open space, with the sky alone as their roof.

I climb into an air-conditioned rental car, and we drive out into the city. We drive past many sights rendered familiar to me in my 23 years in India; vendors hawking mangoes and papaya on the street; half naked infants playing in the mud; dogs lounging about by a garbage dump … a general sense of semi-urban chaos.

And then, almost out of the blue, I spot a building in ruins. We turn a corner and find a street full of rubble, buildings down in every geometrically possible angle. It has already been a few months since the earthquake hit, but the evidence of the 7.0 magnitude earthquake stares you in the face, grips you by the shoulder and demands, no, forces your attention. It threatens you. The tremor may have only lasted 36 seconds, but it is still palpable in the ruins, the rubble, and the tent cities. Tent cities—an unfortunate term, for they aren’t really cities—the tent villages are everywhere in PaP. One of the most exclusive golf clubs, the Petionville Golf Club, now hosts more than 40,000 homeless people. The square outside the presidential palace is now a tent village. Playgrounds, football stadiums, parks, all are sites of camp villages. The ramifications for public health, sanitation, hygiene, and just city planning, are unfathomable.

I soon realize that the young man I met outside the airport is not alone in his belief. Staying outdoors seems to be the popular coping mechanism here, across class lines. Word has gotten around that there is a 5% chance of another earthquake hitting this region in the next 2 years, so why risk building a house just to see it collapse again? I briefly meet with a mayor of a small municipality in the Port au Prince area who believes that there is now a 40% probability of another earthquake of similar or higher severity in the next two years.
Why does the earthquake pick one building and not the other? Why is a palatial bungalow with high walls reduced to nothing but a small shack held together by ropes and wire intact? Haitians ask themselves this and chalk it down to the fury of a vengeful nature that always seems to pick on this tiny scrap of a nation to wreak havoc.

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God wants us to repent, somebody tells me, so we can rebuild a better stronger country. Repent for what, I wonder?

That the international community is reaching out to Haiti is evident in the scores upon scores of aid paraphernalia one sees everywhere; SUVs sporting WFP and UNICEF logos, UNFPA trucks, the Spanish Red Cross, the Haitian Red Cross, the French Red Cross, Feed the Hungry, Feed the Poor, Save the Hungry,  Save the Children. Then there are the smaller charities and mission groups who visit camps setting up clinics, and doing odd construction jobs.

Have people picked up their lives? Of course they have … life does go on. There’s enough evidence of an economy, a local economy; vendors selling food, fruits, vegetable, clothes, soap, and toiletries. There is even a mobile pharmacy. Many a day I spot a man carrying a load of multicolored little trinkets on his shoulders. Jewelry, I think. No, these multi-colored trinkets are pills, of every imaginable size and shape. In some of the better parts of town that witness more traffic from UN employees one can find artists displaying beautiful artwork on the pavement.

There are beauty parlors in tent cities, barber shops, even small scale farming outside a campsite that we visit in the town of Petit Goave. However, these kinds of economic activities cannot mask the more than 70% unemployment rate that plagued the country even before the earthquake.

The government instituted a cash-for-work program within a few weeks after the earthquake. The idea is that instead of free food distribution, people are signed up for a program that attempts to employ them gainfully in exchange for food. Driving around  Port au Prince I see groups of Haitians sporting cheerful blue or yellow T-shirts, with a broom in their hands, some sweeping, but most just standing around. Sometimes I note a group of five or six people cleaning the same few square inches of the side walk. I wonder why, until I am told that they are participating in the program; a program that has great potential in extraordinary contexts such as in Haiti, but has the unfortunate effect of making a mockery of Haitian labor. There are a few who are gainfully employed in rubble and debris removal, albeit without any proper safety equipment—no masks, no gloves, no earth moving equipment, and no systematic attempt to transport debris.

There may be debilitating unemployment, pitiful infrastructure, a weak government, but there is also faith. What keeps the nation together, its people plodding along in the drudgery of everyday life is their devoutness and their faith. Stories abound about how people started singing together and praying together on the streets, within hours of the quake. The first Sunday after the quake, church services went ahead as usual, outside the church, on the streets, by the street corner.  While most Haitians are Catholic, many practice voodoo, a syncretic religion that draws from Catholicism and African animist traditions, and a small minority practices Protestantism.

As I write this, I am reminded of the mobile clinic that I visited up in the mountains, outside the town of Petit Goave.

It is early in the morning, the doctors and nurses are about to begin seeing patients, of which there are almost 100. The head nurse walks out to the visiting room to call out the name of the first patient. She does call out for Celeste, but only after leading the entire group of assembled villagers in a two-minute prayer song—Jesus puissante or Jesus, the powerful. It is already sweltering inside the clinic. Most people are standing, many holding infants, and some still nursing wounds from the earthquake. But those two minutes are, for me, surreal.

This happens again, before the start of a group discussion that I am about to lead with some community health workers.

What has the earthquake wrought in Haiti? Over 200,000 have died, over 300,000 injured, and 1.2 million homeless. For a country of only 9 million, those are huge numbers. The entire government machinery has been undermined by the earthquake. Haiti has lost many hundreds of doctors and nurses and other health workers. Many thousands live in tents, with no hygiene or sanitation. My fear is that, despite the enormous amounts of money and sympathy pouring into the country, some things in the country are doomed to remain the same.

Despite the number of international organizations and aid groups and mission teams, there is little evidence of coordination of efforts. A disaster such as an earthquake is, given the exigencies of international aid, an opportunity for aid organizations. Precarious economic times the world over mean that aid groups are in a hurry to prove quick impacts and outcomes from their relief operations. That means that a post-disaster context such as in Haiti is divvied up between members of the aid industry. Even before the earthquake, Haiti has been home to more than 10,000 NGOs, the highest per capita next to India. So, aid is nothing new to Haiti. In fact the economy is supported by international aid. The earthquake may have only exacerbated the already extant inefficiencies and inefficacy of international aid.

My fear is also that the governmental mechanism continues to remain ineffective and inefficient. The office of the president operates out a tent in the UN compound. What chance does efficiency have in the face of battered state machinery? International donors have, however, pledged close to 10 billion dollars for long term rebuilding and rehabilitation over the next three years and beyond.

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In the years to come, people will look back to January 12, 2010 as a watershed moment in Haiti’s history. The earthquake has devastated a country and its people. Haiti has lost some of the most productive members of its society. How will a nation where the majority live on less than $2 a day survive? But importantly, how will it rebuild and thrive?

My two weeks are up. I am being dropped off at the airport. We take the Delmas highway that runs through the eponymous suburb to the south and east of Port au Prince. Traffic is bumper to bumper. Cars, UN trucks, the ubiquitous tap-taps or share taxis, and SUVs. I see the same graffiti that I’ve seen before on other walls—an anthropomorphic Haiti, with eyes, and tears rolling down its face.

My hope is that when I pass by the same wall on my next visit, the eyes are no longer awash with tears but brimming with a quiet confidence and pride in a nation’s resurgence.

The above account reflects the personal opinions of the author and not those of Global Health Action.

Girija lives in Atlanta and works in the area of International Development

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