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February 09, 2011

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Haiti: Challenges On the Path Ahead

Address by CRS President Ken Hackett to the Baltimore Council on Foreign Affairs.

Let me begin by saying that I am not going to give you an uplifting talk about the great work CRS is doing in Haiti. That's not to say that we are not doing great work, some of it quite uplifting and inspirational. But clearly that is not the story of Haiti a year after the earthquake. This is a tough one.

I have seen and participated in major emergencies around the world throughout my entire professional life. I can tell you that what happened with this earthquake is like no other disaster I have ever experienced. The immensity of destruction; the many, many needs of the people on so many levels; the absence of a strong government; the extent of the displacement; and the difficulties of coordination among those who were — and still are - responding — these are but a few of the factors that made it so complex from day one.

Over the last year, it got even more complex: with an outbreak of cholera - first time that bacteria has been in Haiti in 50 years; with Hurricane Tomas dumping huge amounts of rain on the hundreds of thousands still living in tents; with the government, which is supposed to be in charge of coordinating the hundreds of millions of dollars of aid flowing into Haiti, basically coming to a standstill. Though just in the last few days there has been some hopeful political movement. But with Jean Claude Duvalier returning after 25 years of exile and Jean Bertrand Aristide also in the wings, political stability is not the mode of the day in Haiti. Add to all that the fact that before the earthquake Haiti was one of the poorest countries in the world, the poorest in our hemisphere, and you begin to get an idea of the challenges groups like Catholic Relief Services face.

So when we talk about finding a path ahead in Haiti, getting it right, we are not talking about spending a few years cleaning the place up and leaving behind a prosperous, developed country with everyone nicely housed and fully employed and well-fed and healthy. That is not going to happen. Haiti was a poor country before the earthquake and it will still be a poor country after the earthquake relief work is finished.

That said, there is a real opportunity here not just to help Haiti recover from this devastation, but to take some meaningful steps that will begin the journey out of poverty. That's where you will find a real solution to the destruction of an earthquake. Look at Chile. Not long after Haiti's earthquake, it was hit by earthquake of similar power. Yet destruction and loss of life was minimal. Very little international help was requested or needed. Why? Because as an economically developed country, Chile had built structures that could withstand an earthquake. Its government had developed and enforced building codes as well as systems and processes to respond. That's what has to be worked toward in Haiti.

Why is there an opportunity to take steps in that direction now? For one thing, there was, as you know, an unprecedented outpouring of generosity after the earthquake. Private American charities raised over $1.4 billion. At CRS we raised some $160 million in private support alone. That's a lot of money. Then add to that government money, and there are several billion dollars available for Haiti.

That kind of money is obviously important, but even more important is the opportunity to re-think how assistance is used to help Haiti.

There is a big risk here. All who care about this country - that means humanitarian organizations and donor nations as well as the Haitian people and government - must come together in ways like we have never done before. Otherwise at the end of the day all we at CRS and other such groups may be able to say is that many good acts of charity were done and some buildings were reconstructed. Yet Haiti may well remain as broken a society as it was before the earthquake with even more Haitians living in soul-grinding poverty.

Why do I say that? Over the last three decades when faced with problems in Haiti, our solution has too often been to do it, fix it, and run it. There are thousands of fragmented, individual initiatives and hundreds of humanitarian groups, religious organizations, individual parishes, and even individuals, active in Haiti. And the earthquake brought even more in.

Such fragmentation of effort has led to an improvement in the lives of many individuals, but it has also promoted a mentality among Haitians of passivity, a reliance on foreign solutions and resources. At the same time, it has undermined the responsibility of the Haitian nation as a whole - both its government and its other civil institutions. That's what has to change if the path ahead to prosperity is to change. It's a tall order.

I think we should spend a few minutes contemplating the complexities of responding to this earthquake. Every disaster has its share of second-guessing and Haiti is no exception. The criticism of the relief effort that continues to this day began in the first hours after the earthquake. We weren't doing enough. We weren't fast enough. People were dying needlessly.

The fact is, given a destroyed port and barely functioning airport and roads clogged with rubble - not to mention the immensity of the destruction, deaths and injuries — the relief effort was quite amazing.

As our Country Representative put it at the time, it was as if the apocalypse had happened in one of the poorest, most undeveloped countries in the world. Yet within days, hundreds of thousands of people were getting food, a lot of it from CRS as we already had stock in Haiti and across the border in the Dominican Republic for our ongoing programs. Though there were complaints about bottlenecks at the airport, a huge amount of supplies got in very quickly. The U.S. military did a remarkable job dealing with logistics and security, including getting the port and airport up and running well before anyone thought possible.

The problem was not the emergency response; the problem was the scale of the disaster. You organize a feeding program for 10,000 people in a couple of days, you're doing a great job. But when a million people have just lost their homes, it looks like a drop in the bucket.

There's another factor here that cannot be ignored - we like our aid for people suffering from disasters to look a certain way. Here's one example - within a few weeks of the earthquake, it became clear that there was food in Port-au-Prince markets. In such a situation, the right thing to do is to help people buy that food, not give them free food that might disrupt those markets. You want the markets to function as that's a much more efficient way of getting people fed. But try to get the media to cover a cash-for-work program - people getting paid to, say, remove rubble so they can buy food with the money. That does not fit into the media's idea of charity — indeed many peoples' ideas of charity — nearly as much as a food handout. The cameras show up for those, especially if the bags of food have USA printed on them.

I'll give you another example. Right after the earthquake, all sorts of doctors and medical personnel rushed to Haiti. They were needed. At CRS, we worked to get a makeshift hospital going at St. Francois de Sales, an important Catholic hospital that served the poor in downtown Port au Prince. We had been working there for the last five years on our HIV/AIDS anti-retroviral programs. It had been devastated by the earthquake. At first we staffed our effort - before we even had tents we were working outside — with a variety of doctors from all over the world. Then one of our partners at the University of Maryland's Institute of Human Virology began to send rotating teams of doctors and nurses, and then it expanded to include teams from the world renowned Shock-Trauma unit at Maryland. Of course many many more medical teams were arriving in Haiti in those days and weeks after the earthquake, including the US Navy's hospital ship, the Comfort, which sailed from Baltimore.

The story of the Comfort is a good illustration of one of the problems with many peoples' ideas about such medical aid. I think in the minds of a lot of Americans that ship was going to be like the cavalry arriving in those old western movies, saving the day in the nick of time. But very soon, its 400 beds were full — again, due to the scope of the disaster. And then, as the Navy doctors took care of broken bones and other problems that came with the quake, they found their beds filling with chronic patients, most with health problems that pre-dated the earthquake. The question became how to extricate the Comfort from Haiti without tossing patients overboard, a delicate dance.

Of course the medical response got huge coverage in the media. It's great stuff — doctors coming in and giving free, top-of-the-line service to the people of this poor country. Who could have a problem with that? Well, one group could - Haitian doctors. So maybe Haiti did not have the best health system in the world, but it did have a health system. And its doctors were losing their patients - their paying customers - to these free services. So the unintended result of this popular act of charity could be to leave behind a destroyed Haitian health system. Not a good thing. What was going to happen when those first world doctors went home? Which inevitably they would.

I want to mention one other aspect of the response that got a great deal of publicity - the rescue teams that pulled people out of the wreckage of buildings. In no way do I want to disparage the work done by these heroic men and woman, but I would like to put their efforts in perspective. I believe the statistics show that they saved 132 people. Now, those 132 lives are sacred and all are grateful they were saved, but compare that to the 230,000, maybe 300,000, that were lost. In fact, compare it to the thousands who were saved by getting antibiotics to stem the infections of their wounds - or died because they could not get such treatment. With flights to Haiti in the days after the earthquake limited by the damaged airport, should we have brought in more antibiotics instead of rescue teams? It's a legitimate question.

But clearly the work of these rescue teams got a tremendous amount of TV time in the days after the earthquake, out of proportion to their actual impact on the casualties. Why was that? Obviously it's a very dramatic story watching them work to save a life, much more dramatic than giving someone medicine or an IV drip in clinic. But there is another reason this work had such appeal - it fits into our conception of the delivery of aid following a disaster: We in the developed world have the smarts - medical, technological, whatever — and we swoop down from the heavens and rescue the poor, uneducated, helpless victims. The rescue teams were the perfect image of that.

And frankly that's exactly the narrative we have to get away from if we want Haiti to progress. It's a popular narrative. It's very effective, I have to admit, for raising money. And certainly after a disaster people need to be fed, they need to get medical attention, they need to be rescued if trapped in buildings. But once that's happened, we have to go further. And in Haiti, over the decades, we have not succeeded in doing that.

One reason that we at CRS feel a particular responsibility for Haiti is because it is a Catholic country. The church is an important institution in every city and town and village. We work with church partners in many of our projects. And one reason America was so generous with its outpouring of aid for Haiti is because it is so close, just off our shores. Our histories are intertwined.

From a Catholic perspective, this proximity has resulted in many parishes in the United States adopting parishes in Haiti, sending money and other contributions. Such generosity is admirable and should be praised. But the problem is that rarely do these adopted parishes grow up and walk on their own. They remain adopted children. It is a relationship, formed with the best of intentions, which breeds dependence. Once the money is spent, probably on good and needed programs, too often the Haitian church simply goes back to its American adoptive parent and asks for more.

Such an approach leads to haphazard charity. A parish that has a particularly charismatic priest who has formed good relationships with Americans might get a great deal of money, while one with a priest equally dedicated to his parishioners but who does not have appeal or connections to Americans gets none.

This, by the way, is analogous to the popular adopt-a-child programs that many international charities run. Again, the generosity that these programs generate is to be praised.

These examples reflect we as groups concerned about Haiti face, the tightrope we have to walk, as we move forward in Haiti - how do we praise and encourage the generosity that so many have shown to Haiti, both throughout the years and in the wake of the earthquake, while fighting this fragmentation? We must steer money in new directions so its use will be coordinated and have longer lasting benefits.

That's what we have to do if we are going to find the right path ahead.

But how do you do it? One possible model is the way we're going about reconstructing of transitional houses.

You may have heard the statistic that prior to the earthquake between 60 to 70% of the people living in Port-au-Prince were either renters or squatters. There is really not much available land either.

The government set aside a tract of land 15 miles outside the city, but no sooner had people been moved from the tent camps in downtown Port-au-Prince and moved to housing they were given in this desolate area, they returned to the tent camps. First of all there wasn't any work in the new location, nor were there schools, markets or opportunities to farm. Since they didn't have to do much to get the new house, why not play both sides. The new location and the old tent camp.

Some of us are trying a different approach to the transitional housing. At CRS, we have committed to build 8,000 transitional homes. We have also committed to engage Haitian families to the maximum degree feasible in the construction of what will be a transitional and possibly permanent home. Street by street and, in many more cases, alley by alley we have attempted to mobilize neighborhoods to decided whose property should be rebuilt, when should it be rebuilt and by whom should it be rebuilt.

We established a construction yard on one part of town near the airport. There we employ 65 individuals who wanted to learn to be a carpenter or who already had some carpentry skill; 20 women and 45 men. They complete trusses and cut the plywood panels to standardized sizes.

The individual whose house is to be constructed, with help from others in the neighborhood, must clear the site of all debris, level it, crush the concrete into a sakrete like material that can be used to make cement flooring. Then once the site is ready using their own labor and that of their neighbors, with guidance from the CRS carpenters, they will haul the trusses and wooden materials to their site, and construct the home. The construction can be done in one day.

The result is a pride in ownership, a fusion of neighbors who become communities, an opportunity to learn a trade, and the possibility to make some money from the rubble with the crushing of the concrete and the sale of the iron bars as scrap steel.

That's what we are going to try to do in everything we do in Haiti. In most places where CRS works around the world, we are not that operational. That means we don't actually do that much of the work on the ground ourselves, instead working with local partners who know and often live in the communities we are helping. We support these partners, some more than others, but it is important that they share responsibility. On the ground, they are usually better than we are. They know the community, its needs. And when the program comes to an end, we've left behind people with useful experience that benefits the community.

In Haiti, we do work through local partners to the maximum extent possible. We must attempt to resist the temptation to "just do it". Far too many aid groups and charities have done business this way in Haiti. Lifting the burden off the backs of Haitian and Haitian institutions does not generate empowerment, it does not increase ability and capacity, and it breeds dependence. That's what we have the opportunity to stop in Haiti.

Will such programs stand on their own, run entirely by Haitians, right away? No. We and other partners will be working with them for years to come. But the goal of that help will be to get such institutions to take steps toward standing on their own.

It's the vision we see throughout our work in Haiti. The money going into Haiti must flow in a coordinated way. All of our Haitian partners must be helped to become stronger.

I'm no Pollyanna about this. This is a tough mountain to climb. I was just back in Port-au-Prince for the commemoration of the one year anniversary of the earthquake. So much of it is still clogged with rubble. The traffic is terrible; it takes an hour to get anywhere. The needs are still so immense that just meeting them on a day-to-day basis could occupy us 24-7 without ever even thinking about building for the future.

But that's what we have to do if we are going to get this right. CRS has been in Haiti for 55 years and we are proud of that. We've been with Haitians through thick and thin. We were with them through the earthquake and we are going to be with them in this recovery and for years to come.

In the anniversary commemorations I attended I heard people from our staff - both Haitians and those from abroad - talking about the minutes, hours and days after the earthquake. It was harrowing, moving stuff. It became clear there and at a Mass in front of the still-destroyed cathedral that this country has yet to go through mourning for its dead. It's almost as if they were in shock after the earthquake; there was so much to do just to stay alive that grief became a luxury they could not afford. You could feel it coming out now. That was profoundly moving.

But much of the anniversary coverage in this country was a renewal of much of the criticism of groups like ours, along the lines of, "They got all this money, they haven't all of spent it, and Haiti's still a mess. How irresponsible." The opposite is actually the case. It would have been very easy to rush in after the earthquake and churn through tens of millions of dollars handing out food and soap and water and tarpaulins and shelters and such and then get out. But that's what would have been irresponsible.

We're going to be in Haiti for a long time. We will have no problem spending all the money we raised, and more. There's a lot of work to do. Frankly, it would be easier and faster if we just did it ourselves, but that wouldn't develop the people and institutions that Haiti needs.

So my dream, if we get this right, if we find the right path ahead, is that in the future, CRS will still be in Haiti, but we won't be as operational. We will be playing a smaller role, supporting Haitians who are doing the work, through their Church, through their government.

And hopefully 55 years from now, we won't be there at all. Because they won't need us.