Paul Farmer’s “Haiti: After the Earthquake”
By James Maskalyk,
On Jan. 12, 2010, a group of second-year nursing students in Port-au-Prince, Haiti, felt their world come apart. Dust drifted between the seams of a cracked ceiling that broke and fell on them in heavy cement chunks. Nearly the entire class was killed, along with their teachers and hundreds of thousands of others as buildings across Port-Au-Prince crashed down on those inside. Survivors staggered into the street, bleeding and broken. They couldn’t tell where they stood; everything familiar had fallen.
Phones around the world started ringing. One call went to Paul Farmer, a lifelong advocate for the Haitian people and co-founder of one of the world’s most notable NGOs, Partners in Health.Farmer is a Harvard anthropologist, doctor and, at the time of the quake, the United Nations’ deputy special envoy to Haiti.
Soon Farmer was on a plane filled with doctors heading to Port-au-Prince. There are few more fragile cities on earth than this one, and the earth had shaken just as the first rays of hope were creeping in. After centuries of foreign manipulation, Haiti had managed two peaceful elections and had the high-wattage attention of Bill Clinton as U.N. special envoy for the country.
But now Haiti’s future would be forever divided into “before” and “after.” Farmer’s new book, “Haiti,” captures his own year in the country and the perspectives of other doctors and humanitarians who have contributed essays to this collection. His intention was to prepare the book in time for the anniversary of the quake. Though he never says so outright, Farmer knows that the world’s attention is fickle. Lest it turn somewhere new before firm foundations are poured, he wants our eyes where his heart has been for 30 years.
Unfortunately, the book suffers for being thrown together so quickly. At times, we are introduced to a parade of people we never really get to know, and they disappear before we get to fully understand their lessons. But still, the importance of this volume cannot be overstated. What emerges clearly is that Haiti’s disaster is not merely geologic. The shaking earth only added to the woes of a long-stricken country abused by foreign-backed dictators, economic embargoes and historic French demands to be paid for its slaves freed at independence 200 years ago. “Haiti” underscores the desperate need for a lasting solution for a people who live hand-to-mouth on an island that once grew enough sugar for nearly the entire world.
Farmer’s book raises a question: Now that Haiti has the world’s attention and is the beneficiary of one of the largest philanthropic outpourings in history, can this republic of NGOs use its collective knowledge to build the country back to a better place? Though hopeful, Farmer recognizes that massive work lies ahead. Progress depends on a coordinated effort to end Haiti’s culture of dependency. He believes that Haiti’s situation has many parallels to another country where he has spent considerable time: Rwanda. What’s needed, he says, is to put promised money into projects that create lasting jobs for Haitians, building safe and efficient communities, improving public health care and education, and encouraging transparent governance.
Timothy T. Schwartz, an anthropologist who has worked off and on in Haiti for 20 years, illustrates the challenge in one of the book’s best essays. He was in Leogane, epicenter of the quake, 10 days after it struck. Eight medical groups and 28 aid organizations were already in the small town of less than a square mile, turning it into an ill-equipped “massive hospital.” Leogane wasn’t set up to care for many of the most severely injured, and Schwartz was asked to get a baby in critical condition back to Port-au-Prince for an x-ray — a tough assignment on his motorcycle. Since other patients needed transportation, too, Schwartz decided to hire taxis. When he tried to find an organization to help pay the drivers, he was frustrated again and again by soldiers just doing their job, surgeons rushing to other tasks and aid officials who couldn’t access the millions already raised. After much searching, the money was scrounged up, but before the baby could get transported, German paramedics agreed to take the child by helicopter to Port-au-Prince and then on to Miami. “Yah,” a paramedic told Schwartz, “it will die soon if we don’t.” Not until days later did the U.N. office for Coordination of Humanitarian Affairs arrive and call a meeting to discuss urgent priorities. One of the coordinators explained the steps: “First, we need taxis to run between the different hospitals. . . .”
James Maskalyk is an emergency physician and author of “Six Months in Sudan: A Young Doctor in a War-Torn Village. ”