What Haiti needs most

Aid worker who survived quake says focus should be on health, farming and education

February 11, 2010|By Richard L. Santos

In Haiti, Focus on the Basics

I recently returned to my family in Silver Spring after spending 55 hours trapped in the rubble of the collapsed Hotel Montana in Port-au-Prince, Haiti. The intense emotions I felt while waiting for help, and those I experienced as I heard that two colleagues did not make it, still pale in comparison to what I felt when I was on the way to the U.S. Embassy after being pulled from the hotel rubble. The scale of destruction was truly heartbreaking.

Relief is essential. But it is only the beginning. What are the priorities once it is time to move from relief to recovery and rebuilding? This will be the discussion when the international community meets in March at a pivotal Haiti donor conference.

Based on our organization's work in Haiti, and my 20 years of working in the international development field, I suggest that the international community, public and private, focus on three areas.

•Health care. This is the first priority because it is foundational to all else. According to the World Health Organization, life expectancy at birth is 60 years in Haiti. This compares to 77 years in the U.S. Healthy life expectancy - the average number of years that one can expect to live in "full health" - is only 43 years. Even before the quake, health care was poor. Neglected tropical diseases and other preventable illnesses inflict terrible suffering, and primary health care is insufficient, especially among children. Neglected tropical diseases and a lack of primary health care incapacitate large numbers of Haiti's working-age population, restricting their ability to earn a living and contribute to society.

While the U.S. Agency for International Development and private groups have made great strides in the battle against neglected tropical diseases, it's not nearly enough. A basic health care system, accessible to all Haitians, is necessary. Development groups have experience setting up basic health care systems in South Sudan, the Democratic Republic of Congo and other difficult environments. The same can and must be done in Haiti. Only when Haitians obtain a basic level of health care will they be able to build a stable economy and society.

•Agricultural development. Haiti was self-sufficient in rice for 200 years. For many reasons, including U.S.-initiated changes in Haitian trade policy, this reversed in the 1990s. Haiti became a net rice importer. When rice-related jobs disappeared, thousands of Haitians moved to Port-au-Prince and other cities. Many of these are the unemployed people who lived in the poorly constructed shantytowns flattened by the quake.

The earthquake is forcing many Haitians back to the countryside. It is essential that the international community help find ways to develop sustainable agriculture. As with those successful projects implemented after Indonesia's tsunami, the key is a workable plan to move agricultural production up the value chain. This means the transfer of processing, marketing and other skills that enable local people to build and develop comprehensive food-related industries.

•Education. According to UNICEF, 62 percent of Haitians can read and write. Haiti will not develop any kind of sustainable economy, nor a truly participatory political system and accountable government, until it raises that number.

This has become that much more difficult with the destruction of many of Haiti's schools. The international community, with a significant commitment from the Obama administration, must dedicate whatever it takes to rebuild and upgrade Haiti's school system. To help staff these new schools, the federal government could mobilize the many Haitians living in the U.S. who are searching for ways to become directly engaged in the country's development. An expanded Peace Corps is first step. Another is a "Haitians Teaching Haitians" program. Participants would not only impart "the basics." They would also share how they built businesses, made sure their children received a good education and became engaged in their local communities, including the political system.

The international community's response to date gives one hope that, this time, things will turn out differently in Haiti. If the nation is to truly experience a rebirth, those who seek to help must focus on the basic building blocks of a sustainable society. This time, let's really help the people of Haiti help themselves.

Richard L. Santos is president and CEO of IMA World Health, a nonprofit organization based in New Windsor providing health care services and supplies to vulnerable and marginalized people. His e-mail is ricksantos@imaworldhealth.org.

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