By Katie Sprinkel
I had the opportunity to spend the past week in the back of a pickup truck in Haiti as part of a group of healthcare providers and development specialists from various sectors to look critically at the aid effort thus far and where we should go from here to rebuild Haiti. Zeke, our tattooed, uniquely interesting and insightful driver and accomplice deserves special mention. He is intimately familiar with the Haitian people and culture and through him we were introduced to Haitian homes and slums, their grievances against each other and the world, their slang and profanity, their food and music and driving habits, their slums and their homes. Over the course of 9 days, we spent time with a wide range of aid organizations and at every level, from IDP camps and small NGO operations to World Bank conference tables and UN trailers, it was easy to talk about everything that has gone wrong. In fact, it was often hard to move away from that topic. At the end of most days, I felt overwhelmed by the complexity and seemingly insolvable nature of Haiti’s problems and the inadequacies and outright failures on the side of international aid efforts. However, in an attempt to distill some coherent conclusions from my experiences, I want to focus on a few positives, two shining stories of success in Haiti. Well, three if you count fried plantains, which are worth their weight in gold in my opinion.
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Digicel
An Irish billionaire named Denis O’Brien owns Digicel, which is Haiti’s main mobile phone service provider and the country’s largest employer and taxpayer (this last part is key). As told by one Haitian source, before Digicel moved into Haiti, mobile phones were expensive and inaccessible to most everyone, for example the phone itself was prohibitavely expensive and on top of that you’d be charged for both making and receiving calls. Digicel changed the market with low price phones and services, and has been the leading example in a business centered approach to redevelopment. They make the extra effort to work with the Haitian government (Denis O’Brien has at times reportedly paid government salaries out of his own pocket to keep the wheels turning) which is no small feat, but surprisingly unique among private corporations and almost unheard of among NGOs. This lack of government involvement is a major factor that undermines the governments ability to become the strong and reliable force it needs to be. One of O’Brien’s more ingenuitive and promising ideas to put a tax on international calls and use that money to finance education seems to have hit a stumbling block in that a large portion of the revenue has disappeared, presumably into someone’s pocket. The Irishman has met this with resolve to find the missing money, consistent with his reputation for intolerance of corruption and an aggressive approach to enforce accountability and produce results. The nod of respect Digicel has received from the Haitian public is also notable. For example, at a recent public demonstration with a significant amount of public property damage, Digicel billboards were left untouched. In the court of public opinion, this stands in direct contrast to Haitian people’s distrust towards notoriously corrupt law enforcement and attitudes ranging from indifference to overt aggression towards foreign aid workers, who they feel have turned development into a money making business with no real benefit to the Haitian people.
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Partners in Health
PIH is the country’s third largest employer, behind Digicel and the government. The main visionary behind this incredible nonprofit is Dr. Paul Farmer, an equally impressive personality to O’Brien and an inexhaustible force in providing healthcare with sustainable models to the world’s toughest populations. We had the chance to walk through their new hospital in Mirebalais, a 320 bed teaching hospital opening its doors this spring. I can honestly say its the coolest hospital I have ever set foot in, and easily the most inspired I’ve felt on a tour of a healthcare facility. Even the layout is designed to uplift the most oppressed subset of the Haitian people, with women’s health set up as a dedicated, one stop shop at the front entrance. PIH empowers and involves Haitians at every level of their model, from their novel use of community health workers in rural settings to their current partnership with the Haitian Ministry of Health, with a ten year plan to completely transition control of the hospital. This is in contrast to many other aid organizations, who seem to justify their lack of Haitian employment with many reasons, among them they can’t afford the risk of unreliable, dishonest, and uneducated locals, also that their donors want direct control of implementation of their funds. Other reflections of the careful forethought and ingenuity that characterizes PIH’s operations include building codes that would pass California’s standards for earthquakes, they will house the country’s 4th CT scanner, they have dedicated teaching space for planned international video conferencing for Haitian doctors in training, and will utilize solar power. Notably, the signs around the facility will all be in Creole, a subtle but important change from the standard French signage in other government and public institutions, yet another way to disengage and oppress the poor and uneducated.
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Fried plantains
With a cold Coke or Prestige, life doesn’t get much better.
Although Digicel as a lucrative cell phone company, and PIH as a grass roots organizations championing healthcare for the poor, couldn’t be farther apart as examples of Haitian development home runs, I think they share important similarities. They are lead by extremely driven and dedicated individuals who use novel approaches and apply strict discipline to make slow and purposeful progress towards sustainable change. They work within the government infrastructure, acknowledging that it is more costly and infinitely more cumbersome to do so. Finally, they invest in education and empowering Haitians (read: employing and paying locals) to take control of their country’s future.
