The situation in Haiti is quietly, exhaustedly unstable. People I talk to in camps complain of flooding when it rains, and children get fevers and diarrhea for lack of clean water. Port-au-Prince has never had universal potable water, but now that over a million people are homeless and unemployed, many cannot afford to buy clean water. Many buy small sachets sold in the street, which based on my own experience drinking these morsels in the heat of the day, would be hard-pressed to provide adequate hydration. When children fall ill it can be hard to find functioning medical centers to treat them at all, and it is increasingly hard to find free medical care as international organizations that had offered emergency relief begin to pull out. In a displaced persons camp in Canapé Vert, Francois Elveca said that the emergency hospital that had been in place left a couple of months ago. When I asked where she goes she shrugged and said “it’s very hard.”
Stefano Zannini, head of the Belgian section of Doctors Without Borders in Haiti, presented a useful analysis in an interview yesterday. “The money and the investments promised for the health sector have not come through. So we find ourselves today with a health sector in Port-au-Prince better than before, which is a bit of a paradox, perhaps, but it is enormously based on international organizations, which more and more are beginning to pull out or to reduce their activities. So little by little we are returning to the system of before the earthquake, but weakened by the earthquake. And this is extremely serious. If the funds do not come through and the actions promised are not fulfilled, we risk finding ourselves in a few months in another catastrophic situation. This is a serious worry for us and for the Haitian population.”
He said that what Haiti needs is universal free health care. But the route to that end is not clear. And the short-term emergency medical aid is proving a double-edged sword. People had access after the earthquake—free care was available to the point of putting private hospitals out of business, such as the Centre Hospitalier du Sacre’-Coeur, formerly Haiti’s most advanced medical center, which went bankrupt in March. Now, as Zannini emphasized, many NGOs are leaving, with nothing sustainable in their place.
Many international NGOs I meet with recognize the need to build local capacity, but most say it cannot be their immediate priority in the face of pressing humanitarian needs, or say that they do not have the capacity to train Haitians. Many do have some programs, such as Handicap International, which is training some local physio-therapists, and MSF which has trained over thirty nurses to administer anesthesia (a huge issue in rural areas of the country). But it is clearly not enough. The Haitian diaspora is also an incredible resource, but many Haitians abroad I have spoken with have struggled to find funding to come back to Haiti for as long as they want.
Haiti is not a hot button issue anymore. Wyclef brought the word “Haiti” back into headlines, but serious stories about the ongoing issues have fallen out of the mainstream news. People have been writing of donor fatigue hindering funding for flood victims in Pakistan after the mobilization of donors for Haiti this year. But incredible amounts of those funds have yet to come through. Haiti Libre, a local news site highlighted the “inability” of the UN to force its funders to fulfill its promises. Most of the funding is coming through bilateral or private channels, while unifying bodies such as the UN and the Interim Haiti Recovery Commission are struggling to function.
Very few people I meet still believe in the chance to “build back better”, a philosophy highlighted in the early months of the reconstruction. People talk of politics infiltrating “everything”, and murmur that the powers that be don’t want the situation to change.
Alix Dessources Cayot, a Haitian art historian recently asked me how I found the mood among the population. “Do you see that we are a resigned people?” He asked. “I’d say Haitians are resigned.”
