Haiti pays a price for outside help

Government ministries were flattened in the quake and 35% of civil servants perished Reuters

With aid organisations still playing a major part in rebuilding earthquake-stricken Haiti, swissinfo.ch takes a look at how they are helping and hindering the country.

At a medical clinic in the Goâve region, southwest of the capital Port-au-Prince, it is possible to see Haiti’s imported health system at work. Two hours by car from Grand-Goâve, the Meyer dispensary is a hive of activity.

In the courtyard, a little girl suffering from malnutrition struggles while being put on the weighing scales. In front of the entrance about 30 patients pay close attention to a cholera prevention message delivered by two Terre des Hommes workers.

This is the only medical centre for the 10,000 inhabitants living in surrounding dismal settlements.

The building is still standing but the torn sections of walls bear witness to the violence of the earthquake that hit the island last year on January 12. The centre’s administrator, an employee of the Haitian health ministry, is absent.

Here, as elsewhere, the state has nothing more than a representative function at best. At worst it acts as a parasite on the meagre resources available. The salaries, drugs and nutritional supplements are supplied by Médecins du Monde, an international non-governmental organisation and the backbone of the health system in the area.

Side effects

In Port-au-Prince and in most regions of the country, doctors from Cuba and Médecins Sans Frontiers have replaced the state in providing basic health care.

Absent before the earthquake, the state is even more irrelevant today. The ministries are flattened – 35 per cent of civil servants perished in the quake – and the influx of NGOs has widened the gulf between the humanitarian battalions and a crippled state.

This invasion has not only produced perverse side effects – higher rents and helping to line the pockets of local fat cats – but it has also created unreasonable expectations at the heart of the deprived population. Irresponsible behaviour by certain humanitarian players has not helped matters.

In the Goâve region, Médecins du Monde and other organisations in place for the long term have watched the arrival of American NGOs with alarm. The newcomers “distributed the money they had collected directly to the population, also paying bribes along the way to local officials”, complains François Zamparini, general coordinator of Médecins du Monde Switzerland in Haiti. 

By distributing free food en masse, the NGOs also managed to sabotage years of patient work supporting agricultural supply chains.

Inept emergency aid

Outside the city of Grand-Gôave lies an empty camp of blue tents under the “Samaritan’s Purse” banner, an evangelical NGO. “A phantom camp just like several others in the region,” Zamparini says. “People came here during the day to benefit from the food aid and then went back to their homes in the evening.”

For a population on its knees, the NGOs represent, after God, the only possible salvation. Sometimes the two come hand-in-hand with aid backed by the proselytism practised by some North American Protestant NGOs.

To ensure their re-election, politicians know how to work within this new system. The mayor of Petit-Goâve organised a demonstration a few months ago against an American NGO which was behind schedule on repairing a road.

Love and forgiveness

In neighbouring Grand-Goâve, mayor Salam Joseph has an annual budget of SFr75,000 ($77,640) for a population of 125,000. “Without international support, we are powerless,” he said.

Incapable of providing even an approximate assessment of the needs of the residents in his district, the mayor looks to the UN’s Office for the Coordination of Humanitarian Affairs. John Bosco, who is responsible on the ground, does not waste words.

“Regarding provisional shelters, I have neither reports of progress so far nor future plans to communicate. The shelters are built according to the resources of the NGOs and not the needs of the population,” he declares at the weekly meeting between the humanitarian actors and the local authorities.

The mayor of Grand-Goâve needs a detailed assessment however. He wants to show the population what has been accomplished under his authority. For 2011 he has already chosen two tools to respond to the plight of his voters: “Love and forgiveness”.

Lessen the shock

Zamparini says the abdication of responsibility by the state across all domains, coupled with the humanitarian takeover, has had “dramatic consequences for Haitian civil society”. “The NGOs lessen the wave of shock and deprive the population of the capacity to revolt.”

And the fault is partly due to those who now have taken the place of the failed state.

“That is where the pitfalls and ambiguity lie in humanitarian action,” Zamparini argues. His organisation is fighting for free health care and for the Haitian government to take charge again of the health system in the medium term.

Access to free health care, as decreed after the earthquake, has never been as good in Haiti, according to Zamparini. But questions remain over what it will have brought when the period of large scale action ends, leaving the state and civil society more demobilised than ever.

Haiti in figures

Corruption: Haiti is one of the world’s poorest countries and its history has been marked by a series of natural disasters. Politically the last 50 years have seen coups and dictators. The NGO Transparency International places Haiti in 12th place globally in the list of most corrupt countries.

Poverty: The country is ranked 146th in the UN’s Human development index. 78% of the population live in poverty, 54.9% in extreme poverty, according to the UN Development Programme. Life expectancy at birth before the earthquake was 59.6 years.

Agriculture: In 1970, Haiti produced 90% of the food it needed. Today it imports 55%. From 1993 to 2003 malnutrition doubled, according to Unicef, affecting two-fifths of the population. Just 2% of the banking system’s credit funds the agricultural sector and rural development. Less than 1.5% of the surface of the country is covered in forest because of massive deforestation caused by using charcoal for cooking.

Switzerland- Haiti

In 1804 Haiti separated from France and proclaimed its independence. Switzerland recognised Haiti immediately.

In 1935, after Haiti had been occupied by American troops, Switzerland opened an honorary consulate, which was changed to a consulate in 1959 before becoming, in 2006, a general consulate and finally an embassy the following year.

Switzerland represented Haiti’s interests in several states during the Second World War and in Cuba from 1964 to 1967.  

Trade volumes between the two countries remain modest. The French language is a link which fosters a variety of contacts in religious, scientific and cultural domains. Both countries are members of the International Organisation of La Francophonie. 

Swiss development activity is mainly carried out by private charities. But Switzerland is also present in the provision of humanitarian aid as Haiti is the poorest country on the American continent. In 2007, 130 Swiss were resident in Haiti.

Haiti opened a consulate in Switzerland in 1934 (there was an earlier consulate in the 19th century). Diplomatic relations between the two countries are handled by the Haitian embassy in Paris.

At the end of 2008 451 Haitians were resident in Switzerland.

(Adapted from French by Clare O’Dea)