One Year Later

I was talking to a reporter friend from a local paper last night who had been with me one year ago when I came to Haiti to help respond to the earthquake that killed nearly 250,000 people and left over 1 million people displaced. He asked me if things had improved since he was here last January. It’s the obvious question to ask as we approach the one year mark of the quake — and it’s one I ask myself every time I leave my home in Sacramento and arrive in Haiti (I’m now on my eighth trip) — but it still gave me pause. It is such a difficult question to fully answer.

Luckily I lost my phone signal soon after he asked the question so I had more time to think about it. What I decided to eventually tell him is if you look at the recovery effort at a macro level you’re going to get discouraged and assume the effort has failed. But if you spend some time in Haiti and squint your eyes a bit, you’ll see some amazing progress that has been made and you might meet a large number of people whose lives have actually improved.

On the surface, things look to be as bad as they were in the days immediately following the earthquake. Very little of the rubble that suffocates the city has been removed and the only homes that have been rebuilt are those owned by the very wealthy. The tent camps are ever present and have not gotten smaller. In fact, the first things you notice as you drive away from the airport are the huge tent cities that seem to grow every time you see them. The tents and tarps that the people are living under are completely exposed and there is no privacy to speak of. Bathing, cooking, and washing are done out in the open. Often times families of up to eight people share the same tent and have to rotate sleeping hours because there is not enough space on the bed or floor to allow everyone to sleep at the same time.

To add to the dire living conditions, there is a constant threat of post-election rioting. The riots are not only violent but they also end up blocking the city’s streets and cutting off essential services like water distribution and sewage removal.

And of course, now there is cholera. Roughly 12,000 people per week have contracted cholera since it broke out in late October and over 3,000 have died. There is not enough IV fluid or oral rehydration solution in the country to treat everyone properly. To make a complicated situation worse, there is a great deal of misunderstanding amongst the local population regarding how it is spread. Locals often do everything they can to keep the cholera treatment centers out of their towns because they fear these centers will bring the deadly disease into their communities. Reports of violence against NGO workers and UN troops have been on the rise and in the rural areas there have been lynching’s of people who are rumored to have brought the sickness. One aid worker I talked to encountered a barricade in the road comprised of dead bodies warning the international community to keep out.

In a disaster of this magnitude it is easy to look at these large glaring problems and say that nothing has been done and that money raised has been wasted. In an ideal recovery situation, nobody would be still living under a tent and everyone would be back in their homes. But it is unrealistic to think that such a feat could be accomplished within a year. Over a million people back inside newly rebuilt homes within a year? No one can realistically say that should have happened by now. More people died in Haiti after January 12^th than all the natural disasters that have occurred in the U.S. combined. It’s hard to even fathom the scale and scope of the destruction. Ninety-nine percent of all government buildings were destroyed and many of the government workers inside them were killed. How do you rebuild a country in these circumstances? What does success look like in this situation?

I would argue that on a micro level there has been a tremendous amount of success. Vital health services are available to segments of the population that lacked them before. The lives of many have changed for the better during the past year and should be taken into account when judging the overall results of the recovery effort.

Before the earthquake, the only organization providing services for the handicapped and amputees in Haiti was a small organization called Healing Hands for Haiti. There are now at least eight other organizations throughout the country that are providing these services, and Healing Hands has dramatically increased its ability to serve patients. In the past year, the Healing Hands team has fit over 900 patients with new prosthetics or orthotics and performed nearly 5,000 rehabilitation sessions for these patients. That’s more than any similar company in the U.S. would ever do in one year.

A year ago Hospital Bernard Mews in Port au Prince was a standard private hospital that could provide a limited number of surgeries and procedures for their paying patients. As a result of the support they’ve received over the past year from Project Medishare, they are now a state of the art facility with multiple sterile surgical theaters and an infant and pediatric intensive care unit. And the hospital can now provide all of its services free of charge. Thousands of people have now been served by this hospital that previously would not have been able to walk through the gates.

And Direct Relief International’s own $750,000 community grant program alone has given over 1,000 students the opportunity to go to school and receive lunch for free, provided care for 500 orphans (many of whom have special needs), trained community health workers to work in an area where there previously wasn’t any access to health care, rebuilt a library, and set up a community arts center for 150 children who were affected by the earthquake. We’ve set up seed banks for 4,000 farmers in the North, offered pre-natal care and safe deliveries to pregnant mothers in Jacmel, brought psychosocial support to the residents of Thomassin, and supplied funding for a hospital in Leogane to rebuild their surgical suite. We’ve been able to do this by tapping into the local talent and expertise of Haitian people who are working to rebuild their country. And Direct Relief is just one of the over 12,000 NGOs working in Haiti. And all of them are also doing amazing things.

And perhaps most importantly, it seems that people are beginning to invest in Haiti and provide the desperately needed jobs so that people can begin to fend for themselves. We rent a warehouse space inside a local factory run by two Haitian businessmen and since we arrived here last year, three private companies — a lumber company, a plastics company, and company making fiberglass domes —have moved in and are now employing hundreds of people. And the owner has told me he has investment plans from other companies for the rest of the 30 acres he owns.

It’s easy to come here and say that things have not improved in Haiti and that the aid is not working. But had aid groups not responded in the immediate aftermath of the quake a much greater number of people would have died. Fewer would now have access to healthcare, schooling, and water. Of course more needs to be done and done better. But I think the people who have been fitted for new limbs at Healing Hands, the patients who have received life-saving surgical procedures at Hospital Bernard Mews, and the kids who are now getting to go to school would say that at least some things have improved.