Haiti After the Earthquake (41 page)

Within hours of leaving Saint Ignatius, my brother Jeff and I were headed back to Miami and then I was on to Port-au-Prince. We needed to mark the one-year anniversary of the quake.

I grabbed a copy of the Boston
Globe
in Logan airport, and on the front page was a thoughtful and well-researched article about Partners In Health by Stephen Smith. Caught up in eulogizing Tom White, and in seeing, at his funeral, many of my friends and coworkers for the first time since the earthquake, I was reminded by Smith's piece that, although we were working in a dozen countries, it was Haiti that had consumed us the preceding year. Haiti would be central to our work in the coming years, too. Smith's article captured the struggles we'd been facing (and sometimes avoiding), and also made clear just how generous our supporters had been:

Smith echoed many of the questions we had been wrestling with since the quake—questions of scale and scope, of our strategy in the spontaneous settlements and in cholera treatment centers across the country, and of the future of our work in Haiti when the world's generosity turns its eye to the next disaster natural or unnatural.

That next day, the twelfth of January, we were back in Haiti, some in central Haiti (in the “bucolic village” of Cange—a former refugee camp) and some in Port-au-Prince. The capital city still looked as if it had just been leveled by an earthquake. But many of us remembered how different the cityscape looked the year before.

The city was full of people marking the anniversary with solemn ceremony, quiet prayer, and even protest over everything from the slow pace of reconstruction to the results of the recent presidential primaries, which at one point counted more than thirty candidates. The political class was locked in old struggles for power over an increasingly debilitated state. The popular movement, to a considerable extent excluded from formal participation in the elections, was scattered and leaderless in Haiti. (Its leader remained exiled in South Africa.)
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Unsurprisingly, voter participation hit an all-time low in November, and was followed, also unsurprisingly, by dispute (some
of it violent) over the election results. As cholera spread and as reconstruction faltered, many delegations and gatherings of important personages commented on which two candidates received the most votes in the first round of what were clearly flawed elections—flawed in concept (again, because the elections were not fully inclusive of all political groupings) and in execution (people in the camps had a predictably hard time voting even when they wanted to). As Claire Pierre said to me, sadly, “It's been a long, sad road from 1986, when everyone who is now bickering was in agreement about ending the Duvalier dictatorship and building a democracy.”

Little did Claire know that the Haitian political scene would soon become even more shambolic: on January 16, Jean-Claude Duvalier himself showed up in Haiti, stepping off a French commercial flight. It was unclear why he had returned. But it was unnerving to many, especially to his former victims. There was talk of his facing charges. But for all the bluster—and there wasn't much of it, given how worn down people were and how many Haitians hadn't even been born when Duvalier fell—the Haitian justice system didn't even have the organizational capacity to bring charges against the aging dictator. If, as Marx averred, history repeats itself first as tragedy, second as farce, it was hard to know where Duvalier's return fit in the spectrum.

Farcical electoral disputes had, as usual, consumed the attention and time of the Haitian political class and of the “international community” in Haiti. That meant that less attention was being paid to problems like cholera, which continued its grim march forward in the absence of consensus regarding comprehensive prevention and care. Electoral squabbles also took away energy that should have gone to resettlement and rebuilding. By the one-year anniversary, the numbers in camps had declined, but between eight hundred thousand and a million Haitians remained without safe shelter. Although Parc Jean-Marie Vincent was now full of makeshift restaurants and beauty parlors and cell-phone distributors, it was as teeming and precarious as ever.

The Port-au-Prince–based team, including Drs. Louise Ivers, Anany Prosper, and the Kobels, was still working in the camps. But
conditions were difficult. We did not have, as Stephen Smith had discovered in his research for the
Globe
, any sort of exit plan. Yet we were sick of hearing the words “exit plan” from disaster-relief NGOs and “shelter specialists” and “internally displaced persons experts.” How could we leave when most of the conditions that had first led us to work in the camps persisted a year after the quake? Then again, we had also failed to install proper sanitation in the camps.

We disdained glib talk of exit plans and “sustainability” but still lacked a sound strategy for delivering better services as the crisis caravan moved on to the next humanitarian disaster. The actor Sean Penn, working since the quake in the only camp larger than Parc Jean-Marie Vincent, had better ideas and more commitment to implementing them than did many of the self-described experts. One of our modest ideas—to find educational opportunities for young Haitians in African universities—was already bearing fruit: the first five Haitian students were already enrolled, by January 12, 2011, in the National University of Rwanda. But south-south collaboration of this sort would not solve the problems in the quake zone.

We needed new ideas, as our colleagues said to Stephen Smith. The
Globe
article described the dilemma of seeking to deliver better services in temporary settlements:

I was full of admiration for Anany and the Kobels and for all our colleagues working in these steamy tents day after day, month after month. I though of them often on the anniversary.

The first ceremony I attended that morning took place in an empty lot downtown, where the Haitian version of the IRS had stood before the quake. Any evidence of the big white building that once filled the site was gone: the lot was razed and raked flat. A couple of tents had been erected for the ceremony. It wasn't yet 100 degrees underneath them, but it would be soon. President Clinton, Laura Graham, and others on Clinton's staff were there, as were President Préval and members of his government. A bugler, perhaps one of the surviving members of the military band mentioned by Oscar Arias in his long-ago, upbeat op-ed about the dissolution of the Haitian army, played taps; two women in traditional white Haitian dresses sang a mournful song written for the occasion; several speeches struck a solemn note. Distracted and thinking of all I had seen over the preceding 365 days and wondering what other friends and colleagues were doing to mark the anniversary, I knew I wouldn't remember the speeches. (Tom White's funeral service had been only 24 hours earlier, and it seemed long ago and far away.)

Claire Pierre and I left the formal ceremony early to visit the General Hospital, only a few blocks away. It would be President Clinton's next stop and we'd promised to meet him there. We passed the site of the Ministry of Health; it too had been cleared of debris, belying oftheard claims that no rubble had been removed. The ruins of the palace, on the other hand, looked untouched, and most estimates
concluded that less than 20 percent of the quake debris throughout Port-au-Prince had been cleared.
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The General Hospital was bustling that morning. Dr. Lassègue and Miss Thompson were there, as were a handful of die-hard American volunteers, including a former student from Harvard Medical School who is now an infectious disease doctor, marking a year of service to the hospital and its patients.
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Most of the disaster relief organizations were long gone. The hospital showed no signs of reconstruction, only a new tent—the cholera treatment unit. President Clinton came by to cheer the staff and volunteers, and to pledge support for the planned reconstruction promised by the governments of France and the United States. “It looks a lot better now than the last time I was here,” he said. It was true. Clinton's public comments at the hospital were largely about AIDS and tuberculosis drugs, but he also praised the American Red Cross and Dr. Lassègue for working together to help keep the General Hospital employees at their posts during the tough year since the quake.

I didn't say so then, but knew, as President Clinton did, that only steady and patient accompaniment of the Haitian officials in charge of the hospital would get it rebuilt and improve the quality of the care and training there. Patient accompaniment had never been a strong suit of foreign aid—much less the crisis caravan—but that didn't mean, as Clinton reminded us, that we couldn't change the aid system itself. If billions of dollars had been raised for Haiti by private charities and relief groups, there had to be better ways of getting money into the hands of those working in tough postings like these.

The rest of the day went by in a haze. The indefatigable President Clinton went on to two more commemorative events—at one of them, Prime Minister Bellerive spoke of 316,000 dead—and then to visit a women's economic recovery initiative. But for those of a less formidable constitution, it was time for solitary reflection. Not feeling prayerful, I retreated to Maryse's house to contemplate the year quietly and alone.

The next day, I boomeranged back to Boston after Loune, my brother-in-law, and I made a brief visit to the beautiful school
Maryse and her husband had helped build not far from one of the planned cities that had still not been started. We'd hoped to make it to Mirebalais, but were short on time: our colleagues and supporters in Boston were also gathering to mark the one-year anniversary. We expected a big crowd, including some Haitians who, like Sanley, had received care in Boston. Claire wanted to go too, but she was working full-time as the health lead with the Recovery Commission, and so stayed behind.
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