Haiti After the Earthquake (9 page)

In Boucan Carré, one obstacle to getting stuff done was the challenge of getting there during the rainy season. We'd been talking about building a bridge there for years, but Partners In Health didn't have the expertise or resources to do so; the Haitian Ministry of Public Works was chronically starved of funds and expertise, too. In my UN role, I learned that the Brazilians had both military engineers and a robust bridge in a warehouse somewhere, and started importuning Mr. Annabi and the Brazilian force commander to help span the river at a place locals called
fonlanfè
—“hell's deep.” Several people had
died trying to ford the river, including two pregnant women the previous year, and we'd recently lost an ambulance there to a flash flood. With this coalition, I thought, we could surely build a proper bridge before the next rainy season. The Ministry of Public Works liked the idea, and so did the Brazilians, and so did Clinton. Denis OʹBrien, an Irish cell phone magnate with deep affection for Haiti, said he'd pay for the labor and the little stretch of land necessary.

The people of Boucan Carré were also thrilled with the idea, as were the doctors and nurses there, including one of our protégés, Dr. Mario Pagenel, who had helped launch our efforts in Boucan Carré. Also pleased were all those who'd been stranded on the wrong side of the river when they needed the care we could offer in other, larger facilities. But getting the bridge up required a lot of paperwork, many meetings and calls, and then more paperwork. (One UN formality required that the Haitian government promise that no one involved in the project be harmed. The Brazilian general, as impatient with paperwork as anyone, scoffed at that stipulation, adding, with sarcasm, “I think we can take care of ourselves with the dangerous Haitians out there.”) I pestered Mr. Annabi by phone and e-mail, begging him to make it happen; I begged the Haitian government, too. Each party (excepting OʹBrien and the inhabitants of Boucan Carré) referred to certain forms that needed to be signed and approved. Just when we were starting to get discouraged about this fetishization of process, the Prime Minister (who also believed in the project) signed the last forms, Annabi gave the go-ahead, and a team of Brazilian engineers, a few Irish and American volunteers, and hundreds of Haitians pulled together to erect the bridge in a matter of days.

This remarkable project, as modest as it might seem to engineers, was a reminder that even patchwork coalitions could complete important, lifesaving work.
²⁴
Ophelia Dahl described the bridge in a speech in the fall of 2009, a few days after it was completed:

Getting that bridge up made me believe that our small UN office—which was about nothing so much as building bridges—could get stuff done and on a larger scale. It was modest as a project but potent as a symbol, as were the glittering solar panels atop the Boucan Carré hospital. I wanted others to see that such projects could be accomplished in rural Haiti.

Less than a month later, I crossed the bridge with one of Clinton's closest friends, Rolando Gonzalez-Bunster (who runs a large Latin American energy company and donated a big generator to the General Hospital right after the quake). We were again part of a large UN convoy and protected by UN security, which amused my Haitian coworkers. They'd welcomed me to Boucan Carré many times, but never with such an entourage. Thinking of patients lost to flash floods, and even of our ambulance, I crossed the river in what most would consider the correct way: safely, a dozen feet above the rushing water. As I held back tears, I told our first-time guests about the two women who'd died in childbirth stranded on the wrong side of the river. I was pretty sure they were unimpressed by the engineering—why the fuss over such a simple bridge?—but the Brazilian general and my coworkers, Haitian and American and Irish, understood why I was so moved.

But it was not to be a simple visit: as ever in Haiti, more drama awaited us. A few hundred meters past the bridge, on the rutted and muddy road to Boucan Carré, our convoy was blocked by an overturned UN truck that had scattered large sacks of food (none of it locally grown). We got out, planning to walk the rest of the way on foot, when some Haitian colleagues came to take us to the hospital. The main attraction for me was the fact that the hospital was by then almost entirely solar powered. Walt Ratterman wasn't there, but the director of his Solar Electric Light Fund explained the system to Clinton's friends and the UN visitors.

The hospital was busy. My Haitian colleagues (and a few students from Harvard Medical School) showed us the facility, which had been built by reclaiming an abandoned building, erected many years ago as part of a failed development project. Right next to the hospital was a bank run by Fonkoze, a Haitian microfinance group offering financial services to poor women. The guests were also shown an ingenious charcoal-briquette maker that used sugar cane waste rather than trees, and the beginnings of a tilapia hatchery we'd started near the bridge.
²⁶
All I had to do was listen, but I couldn't help thinking about the promise of decent implementation and of the proper integration of efforts in health care, small businesses, pro-poor financial
services, cleaner fuels, and better infrastructure. We were hoping that Rolando Gonzalez-Bunster and other guests would invest heavily in similar efforts across Haiti. It was a pretty impressive show and they said as much.

The overturned truck was still obstructing the road on the way back. As we walked around it, the head of UN security (guarding me, ostensibly) asked anxiously if we could find a doctor. “I'm a doctor,” I replied with a mix of amusement and irritation: he was surrounded by medics, as Louise Ivers and David Walton were there, too. (My colleagues smirked a bit each time I was addressed as “sir” or “ambassador.”) The UN employees pointed to a woman in labor on the side of the road, carried there by family members on a homemade stretcher; they were trying to reach the hospital in Boucan Carré on foot. Louise and I examined her as discreetly as we could: She was in arrested labor and needed immediate attention in a hospital where, if necessary, she could have a Cesarean section. She needed modern obstetrics.

We asked the head of UN security to take her not to Boucan Carré, but back over the bridge to the nearest Partners In Health affiliate—the hospital we'd just built for the Ministry of Health for $700,000. Thanks to the bridge, it was now only twenty-five minutes away. Off they went, with Dr. Walton in tow. We assured Rolando, whose birthday we celebrated over lunch in Mirebalais, that the baby would be born safely, attended by a nurse-midwife and an obstetrician. And two hours later, Walton joined us in Mirebalais with the good news: a healthy baby boy had been born into good care.
²⁷
I gave silent thanks not only to the Haitian doctors and nurses but to Mr. Annabi and the engineers who built the bridge. Due to the partnership, the woman had been transported over deep hell to the safety of a proper hospital—and thus to a fate far different from that reserved for the two women and their unborn babies the previous year.

As 2009 drew to a close, there was a sense of progress elsewhere in Haiti, too. Some encouraging macro-economic indicators suggested a boost in agricultural productivity and the beginning of a recovery
from the storms of 2008. Of course, there was brisk debate about priorities and an endless stream of criticism, but some endeavors seemed to be moving forward (though not on the scale of a Marshall Plan). Roads and bridges were in poor condition well before the hurricanes cut central Haiti off from the western coast the previous year, and several such infrastructure projects—deemed top development priorities by the government—had been launched.

Many of us also wanted to focus on complementary public works, with reforestation and watershed protection at the top of the list. Our UN team included two specialists in disaster risk reduction, one Swiss and one Cuban; in the second week of January, they set about planning a conference on implementation. Our standing joke was that the field of disaster risk reduction was “eminently technical” but that old-fashioned elbow grease was necessary for implementation. To this end, I begged them to spend more time in Haiti than in Geneva or New York.

Private investment in Haiti was not to be overlooked. It was for this reason that we'd taken Rolando and others to visit places such as Boucan Carré. But as physicians, we knew little about manufacturing, energy, or large-scale agriculture. To fill this gap, the Clinton Foundation seconded Greg Milne, an energetic and talented young lawyer, to the Office of the Special Envoy. Greg set to work with local businesses and institutions such as the Inter-American Development Bank to attract new investments and to “incubate” labor-intensive and environment-friendly enterprises. Denis OʹBrien (who, in addition to helping us with the bridge, had also invested in schools throughout rural Haiti) brought scores of Irish investors to Haiti and allowed us to announce a new award for young women entrepreneurs. These awards were to be given out with the help of the Ministry of Women's Affairs—not just in Port-au-Prince but in each of Haiti's ten administrative departments. A hastily planned investors' conference in Port-au-Prince, headlined by Clinton, Préval, and Pierre-Louis, attracted people from across Latin America, the United States, and even Asia.
²⁸
During the last months of 2009, it was difficult to find a hotel room in the capital. The biggest hotel, the Montana, was fully booked weeks in advance.

We weren't the only ones to sense progress. An article by a journalist knowledgeable about Haiti appeared in the Miami
Herald
on December 8:

Some didn't think this added up to much. The lack of any social safety net in health, education, and sanitation was clearly holding Haiti back. But it did seem possible, just then, to hope for progress. The city of Port-au-Prince was calm, and I let the UN know (diplomatically of course) that it was not necessary to provide me with so much security; I would be in Haiti often (including for the upcoming holidays with my family), and the bodyguards and motorcades seemed a waste of resources.