A Physician's Prescription for Foreign Aid in Haiti

When Paul Farmer speaks, people listen. Usually. The founder of Partners in Health, an organization famously depicted in Tracy Kidder's Mountains Beyond Mountains, over the past 30 years, Farmer has acquired more credibility than almost anyone on Haiti. After all, he's built one of the most durable health institutions in the country, which counts some 5,000 employees and -- incredibly -- serves over 10% of Haiti's population.

This week, he testified before Congress on Haiti's foreign aid, offering one of the more well-articulated discussions that I've heard. Speaking before members of the Senate Committee on Foreign Relations, Farmer (who's both a physician and the UN's Deputy Special Envoy to Haiti) delivered three messages that aren't getting as much mainstream coverage as they deserve.

The first is that donors need pressure to actually deliver on their promises. So far, a heady $2 billion has been pledged from around the globe, while this week, a high-profile donor conference in Montreal also claimed headlines. But it's hard not to experience a sense of déjà vu.

As Farmer notes, a similar conference for Haiti actually took place in DC last April -- less than a year ago. At the time, some 30 nations pledged they'd stand by Haiti with $402 million as the country recovered from the devastating hurricanes that hit in 2008.  Yet as of this week, fully 85% of even those promised funds haven't been delivered.

Secondly, the U.S. needs to stop sidelining the Haitian government. Right now, there are more NGOs per capita in Haiti than anywhere else in the hemisphere -- some 10,000 in total. That, says Farmer, is "in part a reflection of need, but also in part a reflection of overreliance on NGOs divorced from the public health and education sectors." (Currently, the Haitian government receives less than a penny of every aid dollar the U.S. sends.)

Farmer tells the story of encountering Haiti's Minister of Communication after the earthquake, who at the time lacked even a phone. A "healthy dose of skepticism regarding the way our aid has been funneled so exclusively to the NGO sector," he says, is important. But while skepticism about the Haitian government's capacity to deliver is warranted, he says, Haiti's government also needs tools.

Finally, Farmer argues that while charity is kind, opportunity is even better. The U.S. and other donors need to focus their efforts on job creation, he says:  "Putting Haitians back to work and offering them the dignity that comes with having a job and its basic protections is exactly what brought our country out of the Great Depression." Why should Haitians be treated any differently?

Photo Credit: bartificial