Continued Challenges in Rebuilding Haiti

The NGO sector has been roundly condemned for failing to deliver effective humanitarian aid after the Haitian earthquake. Critically assess the extent to which NGOs are deserving of these criticisms.

The Haitian earthquake in 2010 was considered as “the worst national disaster in the history of the western hemisphere,” with an estimation of between 90,000 and 316,000 people killed and more than 1.5 million displaced (Birrell, 2012; Jones, 2015). Haiti, having the nickname of the Republic of Non-governmental Organisations (NGOs), had nearly 10,000 NGOs operating there even prior to the earthquake (Edmonds, 2013, p. 2). The international response to the earthquake was impressive, estimating that nearly £2bn was donated to charities during primetime and another £6bn was pledged by governments and institutions (Birrell, 2012). However, last September (2014) more than 85,000 Haitians were still living in tents (Dec, 2015), which shows that the reconstruction and development efforts have been slow despite having billions to spend on rebuilding the country. There have been many criticisms of the NGO sector for failing to deliver effective humanitarian aid after the earthquake. This report will argue that although the NGO sector could have done more to deliver effective humanitarian aid, there were many other challenges and limitations which must be taken into account when assessing to what extent they deserve such criticisms. This report will firstly discuss what the Haitian earthquake was and why it was such a disastrous event. Secondly, it will introduce the NGOs, notably the Partners in Health (PIH), the (American) Red Cross and Médecins Sans Frontières (MSF), explain their remits and assess their involvement in providing aid. The report will then discuss what has yet been done and analyse the reasons behind the lack of effectiveness in the provision of humanitarian aid. Lastly, it will assess the challenges and limitations they faced which hindered the delivering of effective aid. On 12 January 2010, a 7.0-magnitude earthquake hit Haiti and killed an estimation of between 90,000 and 316,000 people in just thirty-five seconds (The Nation, 2012, p. 11). This earthquake was very concentrated and destroyed over eighty per cent of Port-au-Prince, the Haitian capital (Beaubien, 2013; Zanotti, 2010, p. 756). The earthquake was particularly disastrous because of the poorly built infrastructure, with an estimation of 300,000 buildings destroyed or damaged (The Nation, 2012, p. 12). It also destroyed all three branches of government buildings and 15 out of 17 ministries (Zanotti, 2010, p. 756). To compare the Haitian earthquake to the earthquake which happened in Chile only a few months after, the 8.5-magnitude earthquake killed less than 1,000 people, and where very few buildings collapsed (Pierre-Louis, 2011, p. 187). Other than the poor infrastructure and overcrowded living conditions, the severity of the earthquake could be further explained by the weak Haitian government in place and the country’s background of poverty and economic difficulty. Even prior to the earthquake, Haiti has been referred to as the poorest country in the Western hemisphere, with having numerous heads of state, coups, military regimes and interventions since 1986 (Edmonds, 2012, p. 2; The Nation, 2010, p. 15). Moreover, the cholera epidemic, an outbreak which originated with United Nations (UN) peacekeepers, erupted in October 2010 and induced more than 600,000 cases of cholera within the first year (Clarke, 2013, p. 15; The Nation, 2010, p. 12; Arroyo,2014, p. 110).

This catastrophic earthquake left the country devastated. With a weak and inefficient government in place, the reconstruction of the country would be slow. However, the generosity of the international community has led to more than US$10bn in donations and an influx of NGOs which was impossible to keep track in numbers (Harvey, 2012, p. 28). These NGOs, along with the UN, provides eighty per cent of Haiti’s basic services (Harvey, 2012, p. 28). Although there are more than 10,000 NGOs operating in Haiti after the earthquake, this report will solely mention three of the major players in providing humanitarian aid after the earthquake, the Red Cross, PIH and MSF. These three NGOs have been operating in Haiti since 1932, 1985 and 1991 respectively, and all have different remits and aims (Inside Disaster, n.d. a). The Red Cross is the largest humanitarian organisation in the world. It aims to “prevent[s] and alleviate[s] human suffering in the face of emergencies by mobilizing the power of volunteers and generosity of donors” (Red Cross, n.d.). In the Haitian earthquake, the Red Cross has benefitted Haitians with hygiene promotion activities; cholera prevention and outbreak response services; housing and neighbourhood recovery; disaster preparedness and risk reduction activities; community health services; improved water and sanitation; and livelihoods assistance (Red Cross, 2015, p. 2). The Red Cross received US$488 million in donations and has reached more than 4.5 million Haitians since the earthquake (Red Cross, 2015, pp. 1-2).

Whilst the Red Cross is the largest humanitarian NGO and is considered to be one of the most important, it had less staff and volunteers than PIH. The PIH had a strong base in Haiti even before the earthquake (Inside Disaster, n.d. a). PIH, or in Creole Zanmi Lasante (ZL), was founded in the 1980s, its main goal initially was to provide free health care to poor Haitians (Zanotti, 2010, p. 762). PIH is the largest nongovernmental health care provider in Haiti and played a leading role in response to the earthquake. PIH/ZL aims to provide access to primary health care; provide free health care and education for the poor; rely on community partnership; address basic social and economic needs; and serve the poor through the public sector (PIH, n.d.; Zanotti, 2010, p. 763). At the end of January, PIH was donated US$40 million, and had 2.8 million patient encounters in 2011 (Give Well, n.d. b; PIH, n.d.). As for the MSF, it aims to “deliver[s] emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare” (MSF, n.d. a). In the event of the Haitian earthquake, MSF was there to aid Haitians in the areas of social violence; healthcare exclusion; endemic and epidemic disease; and natural disasters (MSF, n.d. b). MSF has spent all of its US$138 million donations for Haiti by the end of 2010 and has treated at least 358,000 patients within the first six months of the earthquake (Give Well, n.d. a; MSF, n.d.c).

These three major NGOs have received considerable amount of donations for the Haitian earthquake, yet much still needs to be done to recover and reconstruct the country. Even five years after the earthquake, the NGO sector is roundly condemned for failing to provide effective humanitarian aid. There are currently at least 85,000 people still living in 123 camps fearing the risk of eviction (Dec, 2015). One of the major reasons behind the ineffectiveness of the provision of humanitarian aid is that much of the money did not directly reach Haiti, “[M]uch of it went on salaries, accommodation and transport for the NGO workers themselves” (Harvey, 2012, p. 29). This wastes a large amount of resources, considering that there are local workers, such as nurses, unemployed in their camps because of the destruction of their workplace (Edmonds, 2013, p. 7). However, even if the money has reached Haiti, they are usually temporary or not what the population actually needs. They are simply ‘Band- Aid’ solutions put on until the next disaster (The Nation, 2012, p. 14; Edmonds, 2013, p. 8). In Addition, many NGOs simply see these disasters as fundraising opportunities and would raise money whether they can deliver it or not. NGOs are constantly in competition with one another over both financial and human resources. A shared goal, such as the eradication of cholera, becomes more difficult due to their competitive fundraising system (Edmonds, 2012, p. 7). Notable NGOs, for example the Red Cross, received US$255 million in donations, yet only half of it made it to Haiti. The Red Cross only had fifteen staff working there when the earthquake hit. Compared to PIH, which received less than US$40 million, had five thousand staffs there, of which mostly were Haitians. The lack of involvement with the locals and the Haitian government was also a significant issue. “Most donors…are reluctant to [let funds flow through the Government of Haiti], for fear of decreased implementation efficiency and effectiveness” (The Nation, 2012, p. 15). They also believe that channelling funds through NGOs helps fight corruption and foster accountability (Zanotti, 2010, 758). However, it is important to work with the government, as NGOs are not the long-term solutions (Harvey, 2012, p. 30). Haitians would only become more dependent on NGOs than before when the organisations decide to leave (Edmonds, 2012, p. 8). “[T]he recovery effort has been so poorly managed as to leave the country even worse than before” (The Nation, 2012, p. 12). However, the NGO sector should not fully be blamed by its ineffectiveness to provide humanitarian aid. There were many challenges and limitations which hindered these organisations’ efforts. First, the scale of the earthquake. A 7.0- magnitude earthquake is considered to be quite major in the Richter magnitude scale. Although these earthquakes could happen once a year, the situation was aggravated because of the populous city of Port-au-Prince and lack of urban planning or building regulations. This links in to the second challenge, the poor and limited infrastructure of Haiti. This earthquake was so severe that it left behind more than twenty-five million cubic yards of fallen buildings (Interlandi, 2010). Third, the number of homeless and displaced persons. Considering that approximately 300,000 buildings were destroyed or damaged because of the earthquake, it had left many homeless. With more than 1.5 million displaced, many Haitians had no choice but to live in ‘T-shelters’, which are transitional or temporary shelters and housing, that deteriorates quickly(The Nation, 2012, p. 14). Fourth, it was also medically challenging, as many Haitians were suffering from diseases even prior to the earthquake. Although more than seventy per cent of available health care was provided by NGOs, 72 per cent of the population did not have any access to health care at all (Zanotti, 2010, p. 758). Moreover, with the introduction of cholera, it severely heightened the situation and challenged NGOs’ ability to provide effective aid. Fifth, the communication between NGOs, locals and governments. The influx of ‘amateur’ aid workers and ad hoc NGOs meant that many of them cannot efficiently communicate with the locals. Many of which could not speak Creole or French, making it more challenging. Other than language barrier, local Haitians were rarely able to have an input in their needs, insights and feedback. In many NGO meetings or committees, there were not any Haitians represented at all (The Nation, 2012, pp. 11-12). Lastly, the coordination of efforts by NGOs. Although NGOs are loosely coordinated by the UN, they all have their own remits and projects. It is difficult to communicate with and coordinate such a large number of NGOs with little oversight.

Albeit the provision of humanitarian aid can be considered slow and ineffective, Philippe Verstraeten, the head of UN Office for the Coordination of Humanitarian Affairs in Haiti, believes otherwise. “If you compare it to either Ground Zero in New York or the Asian tsunami two years on, then progress in Haiti hasn’t been that slow. We’ve cleared half the rubble, we’ve reduced the number of people in camps from 1.5 million to around half a million, and we’ve provided shelter for 125,000 families, which is significant progress” (cited in Harvey, 2012, p. 30). There were undoubtedly many challenges and limitations which has hindered the NGO sector in its effectiveness in providing humanitarian aid, such as the scale of the earthquake; the poor and limited infrastructure of Haiti; the number of homeless and displaced persons; medical challenges; the communication between NGOs, locals and governments; and the coordination of efforts by NGOs (Inside Disaster, n.d. b). However, the NGO sector ought not to be roundly condemned and criticized for failing to deliver effective humanitarian aid, as the Haitian earthquake was quite an extreme situation and that behind it all laid good intentions.

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Written by: Tsz Ching Kwok
Written at: University of Portsmouth
Written for: Dr. Patricia Shamai
Date written: March 2015

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