After Gou-Dou-Gou-Dou: Building Haiti back better

By Peter Costantini

May in Haiti is the last month of the rainy season before the hurricanes begin to spin up out of the Atlantic. It’s a month when armadas of bloodthirsty mosquitoes patrol the enveloping humidity that thickens in the afternoon into slate-gray clouds and driving downpours. It is not a good month to be living in a tent. But about a million and a half Haitians still are, after losing their homes and often their family members in the January 12 earthquake.

I spent the month of May in Haiti as a volunteer and journalist. I saw some encouraging efforts at the grassroots level, where a strong community spirit has survived. I witnessed inspiring generosity, cooperation and inventiveness on the part of many Haitians in the face of unimaginable destruction.

But after the initial outpouring of emergency assistance, many international initiatives by the United Nations, the United States, and large non-governmental organizations seemed to become fragmented and disjointed as they tried to transition towards reconstruction. As for the Haitian government, perhaps a quarter of its employees were killed or injured, and its equivalent of the White House, Capitol, Supreme Court, and most federal departments were leveled. Much of it remained barely functional and disconnected from the needs of its citizens.

Now, over half a year after Gou-Dou-Gou-Dou (a nickname derived from the sound it made), why are so many people are still displaced and living in makeshift, unsafe camps?

The huge scale of the event itself may explain some of the slowness of the recovery. The death toll –estimated by the government at 220 thousand to 300 thousand in a county of 10 million – is equivalent to that of a major war.

The location of the epicenter just west of Port-au-Prince on the coastal plain meant that the full force struck the most heavily populated area. The nation’s capital, where the public and private sectors were excessively concentrated, was decimated. Total damages amounted to nearly $8 billion, about 20 percent more than Haiti’s yearly gross domestic product.

Everywhere, the prevalent poor quality of construction and the marginalization of poor people into unstable areas contributed heavily to the disaster. Fifty years of kleptocratic dictatorships, usually supported by our government, relieved occasionally by weak democratic governments, usually undermined by our government, left virtually no building regulations or urban planning.

Since long before the quake, decades of high-level looting of the economy had left roughly three-quarters of Haitians living on two or less dollars a day, with half of those earning under one dollar. As a result, 58 percent are undernourished and life expectancy is roughly 52 years. Adult literacy is 56 percent.

Some 75 percent of the people still live and work in rural areas, but agriculture accounts for only 28 percent of Haiti’s economic output. Seeking a livelihood, many rural residents have migrated to bidonvilles, the slums that skirt Port-au-Prince, where jobs, drinkable water and basic services are rare.

To respond to such a devastating geological and social blitzkrieg, a sustained Marshall Plan-like effort is clearly required of the world. And much of the initial response was generous. At a March conference in New York, international donors pledged $5.3 billion for the first year and a half, and more than $9 billion over five years. So far, though, only about 10 percent of the promised funds have actually been disbursed. In the U.S., enabling legislation for most of the aid is stalled in the Senate.

In Haiti, however, competing visions of how the aid will be used have intensified a long-running debate over what development should mean.

The initial United Nations plan envisions primarily the same model that had long been imposed on Haiti by international financial institutions and had failed before: industrial agriculture for export and offshore assembly manufacturing competing on the basis of low wages.

Many progressive Haitians and popular organizations say Haiti shouldn’t be re-built in the sense of restoring the previous dysfunctional government and economy – instead, they say, it needs to be built up from the grassroots for the first time to meet the needs of all its people and encourage more just and durable development.

Haiti’s large and sophisticated peasant and community organizations are also advancing alternative visions. Some advocate “agro-ecology”, which prioritizes sustainable small farming building on the organic farming that many Haitians have always practiced out of necessity.

For the 1.6 million people stuck in temporary camps, immediate prospects are dismal. Less than 2 percent of them have been moved into supposedly safer transitional camps with better drainage and stronger tents. The absence of clean water, sanitation and lighting leave women and children particularly vulnerable to crime, exploitation and disease.

Ominously, when a July 12 wind and rain storm well below hurricane strength struck the transitional resettlement camp at Corail, it destroyed the tents of nearly a quarter of the 7,000 residents. If a hurricane hits Port-au-Prince this season, which lasts until November, it could cause many more deaths and injuries.

Those of us who want to support Haiti need to hold donors accountable for disbursing all the aid they pledged. Beyond that, we should follow the money to make sure that it quickly develops safe homes and communities for those in desperate situations and that it empowers Haitian citizens and organizations to democratically build Haiti back better for all.
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Peter Costantini writes for Inter Press Service (www.ipsnews.net) and blogs on Huffington Post at (www.huffingtonpost.com/crossover-dreams).

Note: Appropriate Infrastructure Development Group and Architecture for Humanity need experienced masons, concrete workers and building contractors to do training in Haiti. Contact jpetercostantini@comcast.net.

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Haiti: Amputations with no anesthetic

By Ann Ballard
In 2004 I began traveling to Haiti, briefly as a Peace Corps volunteer and later with Healing Hands for Haiti International. HHHI is dedicated to providing rehabilitation training, treatment, education and equipment to the physically disabled in Haiti.
During the January 12 earthquake, HHHI lost all seven buildings on their property. Among thousands of Haitians lost were three residents on campus, including Annia St. Louis, the wife of a staff member, a proud medical school graduate and an even prouder mother of two children, a 4 year old and a seven-month old baby.
The organization reeled with shock and quickly took action. High level meetings were held and a group was sent to treat emergencies, including Emergency Room doctors, family practice doctors, orthopedic and trauma surgeons, nurses and a rehabilitation doctor. Bandages, needles, syringes, surgical kits, IV fluids and as much medication as they could fit into their bags were loaded for travel.
The reality was daunting. On day two, a trauma surgeon and orthopedist left in the morning on helicopter for Leogane, a hard-hit small town south of Port-au-Prince. They heard that one of the surgeons was doing amputations without anesthetic. The other surgeons and a trauma nurse went to the Sacre Coeur hospital. After a long hard day, they ran out of pins, screws and sterile gowns.
A homeless, parentless 13-year-old boy’s tibia fracture was treated and a plan set to treat his crushed femur. The next morning he was out on the lawn waiting with the other patients for the sun to come up and the doctors to return. In these circumstances the doctors work tirelessly and will do a good job for him. It’s what they are trained to do. The worry is: After the medical care, what will happen to him then?
That evening HHHI transported a girl to a French clinic and set her down in the street under an awning. Because she was frightened, they drove back to the chapel and brought her grandfather to stay with her.
A French team was using a private plastic surgery center as a makeshift trauma unit with their triage on the street and sidewalks. The cooperation was amazing, everyone sharing what they had, helping when they could, and working to ease suffering.
Noel, an HHHI driver, spoke to the founder of HHHI about the quake. The driver’s two daughters, age 18 and 8, were at the market when it hit. He ran to the area to find it demolished. Frantically, he crawled over the rubble calling his daughters’ names until finally he heard, “Papa, papa, help me!” He got as close as he could and spent the next three days and nights comforting them, urging them to feel around for food and water. They were rescued on the fourth day, both seriously injured, but alive. The anguish in his eyes as he described sleeping next to his daughters was indescribable.
Prosthetic organizations and charities worldwide have warned of the huge task facing Haiti as it struggles to rehabilitate hundreds of thousands of amputees. Doctors say they are already struggling to cope with the sheer numbers of people needing amputations after being trapped in the rubble.
Some surgeons estimate that as many as 200,000 Haitians will end up losing one or more limbs – in a country where the few rehabilitation facilities that existed before the earthquake have largely been destroyed.
In Haiti, where an estimated 800,000 people were already living with disabilities before the disaster struck, meeting the needs of the amputees will require years of international commitment.

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