Book report time! Anyone? Ok, I’ll go first. I’m reading a new book by Paul Farmer, UN Deputy Special Envoy for Haiti and Chair of the Department of Global Health and Social Medicine at Harvard Medical School. In 1987, Dr. Farmer, along with several colleagues, founded Partners in Health, an organization dedicated to serving the health care needs of the poorest of the poor. He has worked tirelessly as an advocate for health services as a basic human right and has actively promoted and provided health care in Haiti for decades. His latest book, “Haiti after the Earthquake” gives a superb account of the situation in pre-quake Haiti, the cataclysmic event itself, and the aftermath. Most valuably, Dr. Farmer gives a forthright assessment of what went right and what has failed in the international attempt to help Haiti “build back better.”
Admittedly, this is not a light read. Having said that, however, it is very readable. As brilliant an academic as he is, and as complicated as the problems are, Farmer’s presentation is accessible. Moreover, it is important. When Haiti was struck by the 2010 earthquake, the public response for emergency and restoration funding was tremendous. $10 billion dollars were pledged! How that money has been spent, how it has been useful, and how it has been wasted is invaluable information when it comes to understanding disaster relief, if for no other reason than helping us to decide where and how to contribute next time the coffers are rolled out.
One of the biggest points that Farmer makes, or at least the one that resonates most with me, is the importance of working with – and within – the established system, in this case, the government of Haiti. Say what you will about corruption, feebleness, inefficiency, and/or historical ineffectiveness, in Haiti or anywhere. A national government is the only entity with a mandate to serve all of the people. Within the system of government, systemic problems, such as poor water supply, insufficient energy and transportation, inequitable education opportunities, and inadequate public health services can be addressed and ultimately resolved. NGOs of course, OF COURSE, have their place, but coordination of their efforts through the framework of government must be part of the equation.
In Haiti, relief and reconstruction have been slow in part because the framework of government there was already in a weak state before the quake. It had shown itself to be ill-equipped to handle matters on a good day, let alone in a time of catastrophe. Nevertheless, Farmer maintains that in order to “build back better,” it will be necessary to build and strengthen the government concurrently with other broken items on the list. Not by building the government and its systems for the Haitians, but by empowering her citizens and enabling them to participate in the process. One of the more innovative ideas in the reconstruction effort has been to go out into the villages of the hinterlands and ask the people what their priorities are for their country. Can you believe it? That was a novel concept – no one had bothered to ask them before!
I could go on and on. “Haiti after the Earthquake” is thoughtful, challenging, and ultimately hopeful. It is unpretentious, not claiming to have all of the answers, but making it possible believe that there are answers to be found. It may not be the last word on disaster and recovery, but it is an excellent first place to start.