Haiti: After the Earthquake, by Paul Farmer

At the beginning of his new book, Paul Farmer writes regarding the purpose of his book. His organization Partners in Health has now been in Haiti for twenty-five years. Also, PiH has been very supportive of our plans to build a medical clinic in the Central Plateau Region, the area Paul Farmer and PiH have focused their work over the years. We have been grateful for PiH’s counsel and input, as they have begun plans to build a larger hospital not too far from where our community clinic is planned to be situated:

This quarter-century has been, for us, one of satisfying growth in spite of disappointments and the dashing of many of the hopes awakened by the fall of the Duvalier dictatorship in 1986. If this book has a central metaphor, it’s one taken from clinical medicine: the earthquake can be understood as an “acute-on-chronic” event. It was devastating because a history of adverse social conditions and extreme ecological fragility primed Port-au-Prince for massive loss of life and destruction when the ground began shaking on January 12. For this reason, the account is not linear but rather follows clinical logic: it explores the acute-on-chronic disaster that occurred on January 12 and its origins in Haiti’s troubled history.

A sound account of the quake must go deep into Haiti’s history to illuminate what caused the chronic disabilities, engendered over five centuries by transnational social and economic forces with deep roots in the colonial enterprise. Haiti was born of resistance to this enterprise, and therein lies both the strength and disability of the new polity-the reactive and reticulated pattern of growth registered in the nineteenth century and in the past one, when Haiti became anchored more formally in the “American hemisphere” through a nineteen-year military occupation by its oldest neighbor. When the U.S. Marines withdrew in 1934, they left a superficial calm and a social class that relied heavily on the army as the arbiter of political transitions.

Historians often claim that their discipline reveals the significance of current social processes, and they are right: the decades preceding the quake set the stage not only for what occurred during the acute event but also for the challenge of reconstruction. Following a brief review of Haitian history-which is necessarily, a review of the history of the New World-we return to the challenge of reconstruction after the temblor of 2010. In the years before it, we saw that Haiti had become a veritable “Republic of NGOs,” home to a proliferation of goodwill that did little or nothing to strengthen the public sector. Thus did clinics sprout up without much aid to the health system; thus did schools arise by the hundreds even as the Ministry of Education faltered; thus did water projects appear even as water security (like food security) was enfeebled.

This was the situation pre-quake, as described in this book. Efforts to rebuild after the quake needed to draw on the sudden attention of the world and the generous promises and pledges to craft a new way of doing business that did not further weaken the Haitian government. It’s hard to imagine public health without a public sector, and the same could be said for public education and public works. And so this book recounts efforts to stand up a “recovery commission” to address the dysfunctional system of humanitarian aid that, good attentions aside, has become another obstacle to Haiti’s recovery and sovereignty.

It’s the argument of this book that rebuilding capacity-public or private-in Haiti requires sound analysis of what, exactly, has gone so wrong in the previous four decades…. We’ve also sought to focus on the shortcomings of the quake response, rather than the victories.

In academic circles, few rewards are given for this sort of candor, … But knowing that a quarter of a million voices were silenced on a single night and that more recent problems (such as cholera) are part of the same tragedy encourages us to offer these personal and place-specific narratives.

… they constitute our collective effort to recount and account: to recount what happened before it slips from our memories and to account for what placed Haiti, a country we all love, at such extreme risk well before January 12, 2010.

This book, with all its limitations, is offered as a humble tribute to those who perished that day, to those who live on with their injuries, visible and invisible, and to those who continue to stand with the Haitian people. Among them are the tens of thousands who responded to the suffering caused or worsened by the earthquake, including those who supported, quietly from afar, the imperfect efforts described in these pages.

Haiti: After the Earthquake, pp. 3-5.

After reading in Kapic’s book (see previous blogpost), that over the last five decades 2.3 trillion dollars in foreign aid have been spent worldwide, with little to show for it, … I am all the more humbled to consider just how “in over our heads” we are to be so audacious as to believe that we might do something meaningful in a place like Haiti; yet, genuine humility is a necessary prerequisite for meaningful ministry nonetheless, so I guess being overwhelmed is better than not being so... o come quickly Lord Jesus! One final insight- if you hope to attempt to do meaningful work in places like Haiti, as so many at Grace Chapel do, then the following is a must read for you: When Helping Hurts. The book is required reading for all our teams that travel with us to Haiti.