Haiti Is Everybody’s Business

Haiti Is Everybody’s Business

The need to invest in people, develop private-public partnerships, and reduce poverty is what is needed right now in Haiti, participants in a Global Health Council panel told a packed room at the International AIDS Society conference in Vienna June 20.


Participants in the panel, moderated by Jeffrey L. Sturchio, president and CEO of the Global Health Council, were Mirta Roses Periago, director of the Pan American Health Organization; Ambassador Eric Goosby, U.S. Global AIDS Coordinator; Paul Farmer, UN Deputy Special Envoy for Haiti and co-founder and executive vice president of Partners in Health; and Jean William Pape, founding and current director of GHESKIO.

"The U.S. Government is committed to putting Haiti in a central position to determine its future," Goosby said. This means Haiti needs to take the lead in planning and deploying its resources to rebuild its infrastructure, he said. The government also needs to look at building a bridge with civil society and find a way to institutionalize the voice of the people, of civil society. "We need to reposition the motors of decision making," Goosby said.

Farmer, whose NGO, Partners in Health, has worked in Haiti for 28 years, applauded Goosby for the U.S. government's reversal of its "hostile approach" to Haiti for the past 200 years. "The model used in the past has not been the right model," he said. The Haitian government, which had 17 percent of its workforce killed or injured and 27 out of 28 federal buildings destroyed when the quake levelled Port au Prince, must be supported in order to build capacity, he said.

Dr. Roses, as others on the panel, lamented that only 10 percent of the $1.8 billion pledged has made its way to the country. Never has she seen a global response as she saw in the aftermath of the Jan. 12 earthquake when there was "such a loss of life, leaders and infrastructure," she said. "Suddenly, Haiti was everybody's business." And, now, she said, support cannot wane and money must be delivered because the country needs a long-term commitment, she said.

Farmer noted that the number of NGOs, who flooded the country in the aftermath of the quake, presented a serious problem, even though they came with the best of intentions. He said Haiti now has the highest per capita number of NGOs in the world with the exception of India. But there is a lack of coordination and a carrot-and-stick approach is needed to improve their performance. And the stick is money, he said, as NGOs often are driven by funding. "We need to pool resources and only make the funds available when they obey the rules of the road," he said. "Haiti does not want a republic of NGOs," he said, but its own system of governance.

"We think the country needs a chance," said Dr. Pape, who with GHESKIO published the first comprehensive description of AIDS in the developing world in 1983. The organization now covers 52 percent of ARV therapy in the country and 47 percent of all TB cases. GHESKIO this year received the Gates Award for Global Health at the Council's annual conference in June.

In the wake of unprecedented destruction, 7,000 people came to GHESKIO's campus overnight, including prisoners who escaped. GHESKIO's TB hospital had entirely collapsed, there was no electricity, sanitation, communications or water, and it lost 70 percent of its workspace. Yet, the staff continued, despite the fact that 60 percent of their homes were destroyed, 24 percent had lost family members, and their own children were in need. "We have to thank the staff, who realized they had to care for their mission," Pape said.

Pape said Haiti needs to have money coming in to improve its infrastructure. "We see no machines, just people with wheelbarrows moving debris." Dr. Marie Marcelle Deschamps, secretary general of GHESKO, said, "There is no way we can go ahead and rebuild without the coordination of NGOs." With hurricane season on top of Haiti, thousands upon thousands of people are still living in camps." She said her priority is to see children educated instead of whiling away their time in stagnation, and GHESKIO has already started a school within the camps.

Pape said with 1.2 million people living in tents, shelter, nutrition and job opportunities are his priorities. GHESKIO's next step, he said, is to build a model village, not just for housing but to create jobs and schools. Haitians, with on-the-job training, need to and will build their own model village on land the government has given them, he said.

"We need the NGOs and government to work as one, as the public-private sector. The biggest challenge is to do that," Pape said.

Poverty reduction is key to the future of Haiti, one of the oldest republics in Latin America, Farmer said. Hospitals, schools and houses need to be built and Haitian workers need to be paid for their labors. "Here is a chance to put millions of dollars into the hands of laborers, doctors and health workers," he said. "We need to transfer $1.8 billion into Haitian pockets to relieve poverty."

Annmarie Christensen is executive editor of GLOBAL HEALTH and director of publications and new media at the Global Health Council