Haiti in 2013
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| From http://en.wikipedia.org/wiki/File:Haiti_map.png |
We returned from Haiti on June 24, 2013 from a dental aid mission, and I thought I would pass on my thoughts and experiences on the trip. What I ended up with was more a summary of the social climate in Haiti and its causes. Our time in Haiti was one of wonder, surprise and dismay.
The question a visitor from a wealthy developed nation first asks is how can a nation so rich in natural resources and with such an industrious and creative population be so poor? I hope the following yields some perspective on this but I don’t pretend to have a definitive answer.
The same question comes to mind when one considers North and South Korea, where members of the same culture and roughly the same geographical location live in vastly different worlds. One is one of the richest and most successful democracies in the world while the other cannot feed it populace and the people live under a tyrant.
In Haiti we experienced a mind bending spectacle. There is still visible destruction from the earthquake everywhere, tent cities along almost every road we traveled on, many seem to live in the streets. There are items of every imaginable description for sale along most of the roads. People seem animated and industrious. There is an intensity everywhere you go, and the most aggressive of the street vendors and the beggars are still friendly. We were warned of pervasive violent crime, but in our limited time mixing with the people on the street we only experienced friendly, if sometimes persistent and assertive interactions.
Driving is like nowhere else I have ever been, (not even Boston), and more difficult than anywhere else in Mexico and Central America I have visited. Car swerve into each other competing for tiny unoccupied spaces, stop or veer only fractions of an inch before a collision. This game of chicken is played with skill worthy of an Olympic event. Drivers seem to avoid out and out collisions in fractions of a second by a subtle and complex car horn language which involves the frequency and intensity of honking their horns. The communication is bidirectional and can involve several cars simultaneously. Drivers are aggressive and depend on the highly developed skills of all drivers to avoid pileups. Motorcycles routinely challenge Mack Trucks.
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| A central Port Au Prince street and traffic scene (Photo by Faria Shinn) |
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| Three Riders on a Motorcycle Pass New Construction |
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| Housing in Port Au Prince. Note unrepaired structures that collapsed in the earthquake three years ago. (Photo by Faria Shinn) |
The roads are full of deep holes and rubble. Although most cars are dirty and damaged, some are kept remarkably clean and shiny. There is an abundance of small trucks and vans converted to buses which are painted elaborately. These are called Taptaps. Colorful murals can cover every surface. Many trucks have had platforms welded onto them and routinely carry 15 or so people with their makeshift extensions.
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| One of Thousands of TapTaps |
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| Most TapTaps Are Seen Fully Occupied |
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| A large and colorful Taptap. Most are converted small pickup trucks, but there are buses as well. All vehicles in Haiti are transported there by boat. (photo by Faria Shinn) |
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| Our dental aid team. From left to right: Jeff Bernhardt, Jacob Bernhardt, Brigette Bernhardt, Jaeyoon "Julie" Jeong, Devin Bernhardt, Simiade "Simi" Fabiyi, Dr. Nannette Benedict, Faria Shinn, Dr. Sherwin Shinn |
The church runs a school and takes care of some orphans. The pastor of the church estimates that about 30% of the children in Haiti get a primary school education at some level. UNESCO estimates that 30% finish sixth grade, and 20% complete high school. This is a significant improvements over a decade ago. The best schools in the country are the Catholic schools, but the cost beyond the means of most Haitians. We spent a couple of hours visiting the classrooms and the children looked to be getting a comprehensive education, were remarkably well behaved and the average class size was about 20 students. The older students were in classes of under 15 students. The classrooms all had chalkboards. There was no air conditioning and the temperature was in the high 80s or low 90s with high humidity.
All teachers of primary and secondary schools must complete a four year course of study for teachers. There are state schools to train teachers that are free, but only the highest scorers on a national exam are admitted. There are private schools for teachers, but graduates from the private schools can only teach in a private school. There is no equivalent of a master’s program which degree is required for university instructors. Teachers at that level generally have generally studied at US or Canadian universities.
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| The Classroom Complex at the Catholic Compound We Worked In. Note the Water Tank. Most of the populace of Port Au Prince Does Not Have Available Potable Water. |
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| A Classroom at the Catholic Compound. We provided Dental Hygiene Instruction to the Students and Distributed Toothbrushes. The folks in the back who don't look like young students or Haitian teachers from the right, are Jacob Bernhardt, Dr. Nannette Benedict's son, and Brigette Bernhardt, Dr. Benedict's daughter. They have traveled on several aid missions to Guatemala before working in Haiti. On the left is Jaeyoon "Julie" Jeong, who is described below. |
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| A Billboard Promoting the Current President of Haiti |
In Haiti, as in many Central and South American countries the Catholic Church has sided itself with the poor and downtrodden, and has suffered for it. The Catholic Church has frequently been at odds with the government. The wealthy in Haiti have a firm hold on the country and according to pastors of Haitian churches inside and outside of Haiti we spoke with corruption is so rampant that very little monetary aid gets to its target. They also reported that even with the increasing freedom of the press, and allowance of free speech true threats to the position of the wealthy still are met with violence and even death. The president of the country himself has stated that he would prefer aid workers to financial or material aid as only the direct delivery of the aid will insure it reaches its intended target. The Tonton Macoute (more about that below) is long dismantled, and death squads no longer roam the country with government sanction, but some former members are still are prominent politically or economically.
Haiti suffered inconceivable destruction from the January 12, 2010 earthquake throughout the city of Port au Prince and outskirts. The destruction of the center of Port Au Prince, the capital city and largest city in Haiti, drove people outward, and pushed the middle and upper classes deeper into the mountains. Concentrated areas of street commerce also pushed outwards. There has been an explosion of new construction and in some ways the earthquake has revitalized parts of Haiti, but at a horrendous cost. The death toll is in dispute for a host of reasons but it is no lower than 46,000 and has been reported credibly to be as high as 220,000. The Haitian government reported a figure of 315,000 but this has been largely discounted.
At least three million people were affected by the earthquake, and six months after the quake over three quarters of a million people were living in unsafe housing or temporary shelter. There is semi-permanent housing under construction in several outskirts of Haiti but we saw thousands still living in tent cities off some of the main roads.
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| One of many tent cities we passed driving through Port Au Prince |
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| Another tent city on the outskirts of Port Au Prince. This, like most of the other tent cities had no visible source of water. |
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| More children are educated now than ever before but only 20% finish the equivalent of high school. These are secondary students in the Catholic school. |
Half of Haiti’s national budget is foreign aid. Most of it seems to never reach its intended recipients. In the US and other countries much of the money designated as foreign aid is transferred between different government agencies. For instance, three hundred million dollars was transferred from the State Department budget to the armed forces budget to pay for armed forces stationed in Haiti to stop the looting and prevent roaming bands of armed men from terrorizing the city. About one half billion dollars was paid to a private company which contracted out construction projects.
Shortly after the earthquake occurred, US Ambassador Kenneth Merten sent a cable titled "THE GOLD RUSH IS ON" as part of his situation report to Washington. This was reported in Wikileaks, and by The Nation magazine. (Ansel Herz and Kim Ives, "Wikileaks Haiti: The Post-Quake 'Gold Rush' for Reconstruction Contracts," The Nation, June 15, 2011. Online at: http://www.thenation.com/article/161469/)ikileaks-haiti-post-quake-gold-rush-reconstruction-contracts). One of sadly many instances of rampant aid abuse is quoted from HaitiAction.net:
“Capitalizing on the disaster, Lewis Lucke, a high ranking USAID relief coordinator, met twice in his USAID capacity with the Haitian Prime Minister immediately after the quake. He then quit the agency and was hired for $30,000 a month by a Florida corporation Ashbritt and a prosperous Haitian partner to lobby for disaster contracts. Locke said "it became clear to us that if it was handled correctly the earthquake represented as much an opportunity as it did a calamity…"(Ansel Herz and Kim Ives, "Wikileaks Haiti: The Post-Quake 'Gold Rush' for Reconstruction Contracts," The Nation, June 15, 2011. Online at: http://www.thenation.com/article/161469/wikileaks-haiti-post-quake-gold-rush-reconstruction-contracts) Ashbritt and its Haitian partner were soon granted a $10 million no bid contract. (Jimmy Wyss and Jacqueline Charles, "A year later, Haiti's recovery gridlocked," Miami Herald, January 8, 2011. Online at: http://www.miamiherald.com/2011/01/08/v-fullstory/2007280/a-year-later-haitis-recovery-gridlocked.html )
Lucke said he was instrumental in securing another $10 million contract from the World Bank and another smaller one from CHF International before their relationship ended up in court when Lucke sued Ashbritt and his Haitian partner for nearly $500,000 in bonuses for the contracts he helped them land.” (Ben Fox, "Ex-US official sues contractor in Haiti for fees," Associated Press, December 31, 2010, reprinted in Business Week available online at: http://www.businessweek.com/ap/financialnews/D9KF42PO2.htm).
We employed “fixers” who arranged a variety of “favors” for a price. One of our group leaders was allowed to meet us before we entered immigration and customs, and ushered through entry customs without any inspections for $100 US. At least in this case most of the money went to middle class airport and government employees.
Haitian currency is arcane. The price of items are usually displayed in Haitian Dollars. Haitian Dollars do not exist as actual currency. The two actual currencies one finds circulating are American Dollars and Haitian Gourdas. The American Dollar is fixed at five Haitian Dollars per American Dollar and the Gourda is currently at 44 Gourdas per Dollars, but floats. People seem to be able to do these conversions easily in their heads and most stores and many vendors trade in both.
Our team included of two dentists, two third year dental students, and a recent college graduate who is planning on attending dental school. Three of us were there for other support functions ranging from equipment repair to teaching good dental hygiene. By nationality we had one person from Nigeria, one from Uganda, one from Korea, and the six from the US.
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| Our Aid Team and the Local Priests Who Hosted Us |
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| One of the two dentists on the team operating on a patient. Dr. Sherwin Shinn (center) and his wife Faria Shinn (right, who is originally from Uganda). They have done extensive aid work in Africa and the Americas with the organization Dr. Shinn founded, For World Wide Smiles (www.forworldwidesmiles.org). On the left is Simiade Fabiyi, a third year dental student attending the University of California at San Francisco Dental School. She hails from Nigeria. |
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| Dr. Nannette Benedict (left) operates on a patient with assistance from Devin Bernhardt, her son, a third year dental student at the University of California San Francisco Dental School. Jaeyoon "Julie" Jeong is on the right. Julie graduated from The State University of New York at Buffalo and is applying to dental schools. She is from South Korea and an adventurous, competent and meticulous individual. She googled Dr. Shinn's organization one day, and next thing was on a plane to Haiti. |
As is to be expected with setting up for the first time in any new facility there were unexpected problems and difficulties. The church complex runs off a generator except for a few hours of municipal electricity in the afternoon. The first day that the full complement of the team worked both integrated dental units failed. Both units overheated and shut down repeatedly so the first day was partly lost. Problems with the generator, building circuitry, and one of the drill stations followed. In spite of this over 100 patients were seen in the five days, some with multiple issues.
Why is Haiti so poor and in need of this help in the first place? A few historical anecdotes that give a feel for Haiti’s difficult and tumultuous history might help with perspective. These represent a few years in Haiti’s 500 plus year history of colonization since the displacement of the island’s native population.
Following a masterfully executed but vicious slave rebellion against brutal French slave owners, Haitian history is a tragic series of attempts at domination by external forces and ruthless dictatorships; interspersed with attempts at reform. The United States’ history with Haiti is one of uniform hostility and antagonism at best to domination and invasion at worst until very recent times. From the time of Thomas Jefferson to the American Civil war, Haiti’s example of slave revolt was considered an intolerable threat.
In more recent times, United States antipathy toward Cuba led to unconditional support of one of the most brutal and long serving dictators in Haiti’s history, “Papa Doc” Duvalier, (4/14/07 – 4/21/71, who ruled from 10/21/56 to his death on 4/21/71). Duvalier ruled with an iron hand and terrified the populous into submission with the Tonton Macoute death squads, murdering an estimated 30,000 Haitians. Countless people were kidnapped and tortured to death, with their families never knowing what happened to them.
President Nixon’s ambassador to Haiti, an ardent supporter of Duvalier as a bulwark against communism, was given an honorary membership in the Tonton Macoute. In 1963 one of Duvalier’s chief henchman and former head of the Tonton Macoute turned against him. Duvalier was convinced the turncoat was a “shape shifter” and was hiding disguised as a black dog. All black dogs were ordered to be shot on sight.
| François "Papa Doc" Duvalier | |
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| 40th President of Haiti | |
| In office 22 October 1957 – 21 April 1971 |
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| Preceded by | Antonio Thrasybule Kébreau (Chairman of the Military Council) |
| Succeeded by | Jean-Claude Duvalier |
Duvalier held several elections. In one he announced winning by 1,320,748 votes with not a single person voting against him. In another, a 1964 referendum to change the constitution to appoint him president for life, the ballots were printed premarked “yes.” Anyone caught trying to vote "no" was arrested for mutilating state property.
Papa Doc’s legacy, facilitated by the acquiescence if not outright support of Haiti’s neighbors and the developed nations, was Haiti’s slide into unprecedented poverty and inequity. The educated, the intellectuals, professionals and any who could afford to leave, fled Haiti. This drove the nation deeper into an accelerating downward economic, social and infrastructural spiral. While by no means the sole cause of Haiti being the poorest nation in the hemisphere, it was yet another essential component of a perfect storm of internal and external calamity battering a nation otherwise rich with natural resources and human potential.
Today the country is still firmly in the grip of the very small group of the very rich and any actions which threaten their wealth or power will be stymied. A crude estimate is that there are 200 multimillionaires who live in the outskirts of Port Au Prince. They have powerful allies outside the country. They also have the support of many foreign opportunists who exploit the generosity of those who contribute to the immediate need to rebuild and help those ravaged by the earthquake. We outside the country can contribute the most to real change by relieving the pressures of simple survival, especially for those who are in the best position to work for real change in the social order.
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| The home of a wealthy Haitian. This house is well protected with high fences and armed guards |
Health Care – Half the children in Haiti are vaccinated, 40% or less of the population has any access to health care, what hospitals exist are understaffed and equipped poorly, and 90% of the country’s children have waterborne diseases or intestinal parasites. 2.2% of the population has HIV/AIDS,
30,000 people contract malaria every year, and the rate of tuberculosis is ten times that of any other country in Latin America. Diseases that occur at unacceptably high rates, but for which the exact rates are unknown are Hepatitis A and E, typhoid fever, dengue fever, and leptospirosis.
The availability of dental care is even less than that of medical care. We saw many people who would be considered middle class by Haitian standards that had never been to a dentist.
Education - An overview of the education status of the country was given already.
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| Haiti's best hope, an educated populace |
Water – 75% of Haitians do not have running water. Fresh water is frequently contaminated, and standing fresh water is likely to harbor the leptospirosis organism. Cholera has been transmitted by contaminated water. In some places people will spend 30% of their days looking for water.
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| This is not a tire lying on the ground, but the opening to a public water well. We were warned before traveling to Haiti not only to not drink from such sources, but to not even touch any standing fresh water. A severe form of Leptospirosis is endemic to Haiti, and can be contracted from standing fresh water. The spirochete is thought to be able to penetrate intact skin. |
Fuel – The most common fuel used in Haiti is charcoal and the use of wood, and now charcoal has led to 98% of the original forests of Haiti being cut down. In 1925 60% of the forests remained. A large amount of LPG is imported, but the cost of a gas stove rules out its use for most of the people of Haiti. A charcoal burner costs about the same as a bag of charcoal, but a gas stove costs over $500 US, an amount the average Haitian lives on for a year. An inexpensive gas stove could transform the countryside of Haiti by stopping or even reversing the deforestation. At least 75% of Haitians do not have electricity at all, and somewhere over 90% of Haitians do not have electricity for more than a few hours a day. The municipal electricity supplied to the church facility we worked at was on for a few hours a day, and a diesel generator supplemented by solar cells and lead acid battery storage supplied the rest of their needs.
Sugar plantations were established in Haiti in the 1600’s. The sun shines in Haiti almost every day of the year with equatorial intensity. Haiti should be a net energy exporter.
Employment – the unemployment rate in Haiti is estimated to be greater than 66%. There is not more that needs to be said about this.
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| The United Nations, Coca Cola and Jesus have an authoritative presence in Haiti |
-Jeff Bernhardt
7/9/2013
