Focus on Haiti: The Road to Recovery

On Tuesday, July 27, 2010, Paul Farmer, Partners In Health co-founder and UN Deputy Special Envoy to Haiti, and Loune Viaud, Director of Operations and Strategic Planning of Zanmi Lasante (ZL), the Haitian sister organization of Partners In Health (PIH), testified at a Capitol Hill hearing hosted by the Congressional Black Caucus, "Focus on Haiti: The Road to Recovery - A Six Month Review.”

In his testimony, Paul discussed how foreign governments and NGOs must accompany Haiti’s government throughout the rebuilding process. “This shift will not be a panacea for Haiti but could be coupled with a powerful and complementary focus on another movement of capital, this time from public to private and from wealthy to poor: a focus on job creation and on strengthening the hand of those trying to farm (and reforest) the land and also on young people, especially young women, living in poverty,” he stated in his prepared testimony. “We need a greater sense of urgency. And the most urgent task of all is the creation of jobs that will confer dignity to those in greatest need.”

Read Paul Farmer's full prepared testimony

Throughout her testimony Loune highlighted the strides made in Haiti since January 12, while also stressing the immense challenges still facing her country. Haitians affected by the earthquake desperately need “healthcare, employment, decentralization, protection of children, women, adolescent girls, the elderly and the most vulnerable members of the population.” Loune noted that these challenges cannot be fixed with foreign donations. “Rather than charity, Haiti needs partners… Haiti needs jobs. Jobs will stabilize other parts of the country, empower the communities, and save lives.”

“We need Haitians to lead the reconstruction efforts. We need our partners to take a rights-based approach in the construction of a new Haiti,” said Loune in her testimony. “This means supporting the capacity and the leadership of both the Haitian government and Haitian communities; it means deferring to the experiences of Haitians and guaranteeing our participation in the rebuilding of our country; it means unconditionally respecting all of our human rights—including the right to food, the right to decent housing and sanitation, the right to health, the right to potable water, the right to education and the right to security.”

Read Loune Viaud's full testimony

Congresspersons Barbara Lee and Donald Payne oversaw Tuesday’s hearing. Testimony was also given by Dr. Rajiv Shah, Administrator, U.S. Agency for International Development; Marie St. Fleur, Former Massachusetts State Representative; Camille Chalmers, Director, Plateforme Haitienne de Plaidoyer pour un Developpement Alternatif / Haitian Platform to Advocate for Alternative Development, Haiti; and Ira Kurzban, Chair, Board of Directors, Institute for Justice and Democracy in Haiti.

Read the full text of the Paul and Loune's testimonies below.

Testimony of Paul Farmer
Co-founder of PIH, Chair of the Department of Social Medicine at Harvard Medical School, Chief of the Division of Global Health Equity at Brigham and Women’s Hospital in Boston, and Deputy Special Envoy for Haiti at the United Nations
[Download a PDF of Paul Farmer's prepared testimony - 33 KB]

	Paul Farmer

1. Acute-on-chronic
The six-month anniversary of the earthquake, which many Haitians have taken to calling, simply, “the catastrophe,” will cause soul-searching in some circles, grim determination in others, and bitter recriminations from still other quarters. I will not contribute here to these veins of commentary, although we all know they’re important and inevitable. Instead I will use my time to comment on a few large but soluble problems now before us and to make two distinct and complementary recommendations. Indeed, most of these problems have long faced all those of good will who seek to stand in solidarity with the Haitian people, which is why, as physicians, we know that what happened on January 12^th is aptly described as an “acute-on-chronic” event.

Though by some reports and some “macro” indicators there had been slow improvements in Haiti in the year prior to the quake, the problems we’re struggling with today are longstanding, if much aggravated by the worst natural disaster to befall the world in recent centuries. Whether we look at health, education, potable water, or safe, affordable housing, we can draw similar conclusions: first, great weakness in the public sector makes it exceedingly difficult to deliver basic services at significant scale; second, not enough of the pledged earthquake relief has reached those in greatest need.

Although Haitians are rightly tired of having their country labeled “the poorest in the western hemisphere,” it is nonetheless true that the country has poor health indicators, was a few years ago deemed the most water-insecure nation in the Americas, has low levels of literacy, and now, with up to 1.6 million in IDP camps, has enormous, almost overwhelming, housing instability. Into the breach have come a large number of well-intentioned NGOs, which have sought, with some local success, to provide basic health and educational services, and, on an even smaller level, access to potable water and improved housing. I am myself from this sector, since I’ve been a life-long NGO volunteer and work for a U.S. medical school as a teacher and clinician. But I would like to argue here that my own earnest engagement in this arena has taught me that one of the primary tasks of development assistance, including that delivered by NGOs, must be to strengthen Haitian public-sector capacity, especially in the arenas of health, education, water, and housing—which some refer to as basic social and economic rights. Our historical failure to do so is one of the primary reasons that trying to help the public sector now is like trying to transfuse whole blood through a small-gauge needle or, in popular parlance, to drink from a fire hose.

Why the public sector? Before answering, I’m not suggesting here that NGOs and the private sector are not part of the solution; far from it. But there is a pragmatic and humble point to be made here: the profusion of NGOs—and some have estimated that Haiti, a veritable Republic of NGOs, has more of them per capita than any other country in the world—has not led to adequate progress in provision of basic services to all who need them nor to a functioning safety net for the poorest. Case in point: over 85% of primary and secondary education in Haiti is private, and Haiti is, as mentioned, plagued by illiteracy; over 500,000 school-age children were not in school prior to the earthquake.

There are transient ironies, too. Sometimes bursts of attention can improve a terrible situation; some blood does get through the too-small needle. Take water insecurity: by some reports, it has lessened since the earthquake led many groups to focus on bringing clean water to the displaced. One survey in Port-au-Prince suggested that diarrheal diseases had by last month dropped 12% below the pre-earthquake level. But is the massive importation of bottled water readily sustained? Is it the way to improve water security for all?

There is also a more philosophical point behind a plea for attention to the public sector: How can there be public health and public education without a stronger government at the national and local levels?

2. Why?
I have argued that the quake dramatically worsened a bad situation. I could focus on statistics, noting that some 17-20% of federal employees were killed or injured in the quake, or that 27 of 28 federal buildings were destroyed. And I would note that few public personnel were able to perform well within the buildings prior to the earthquake. Some of the best doctors and nurses I know are struggling to perform in the public sector without the tools of our trade—diagnostics and medications, for example, but also anything approaching adequate salaries. In a hearing like this one, it is important to ask why this is so, and I have previously done so before both houses of our Congress. It is not a pretty story, for the decline of Haiti’s already feeble civil service is tightly tied, and has been for a century, to internecine strife but also to U.S. policies. Other powerful countries have played unhelpful roles, too. 

Let me take only the last decade. Beginning in 2000, the U.S. administration sought, often quietly, to block bilateral and multilateral aid to Haiti, having an objection to the policies and views of the administration of Jean-Bertrand Aristide, elected by over 90% of the vote at about the same time a new U.S. president was chosen in a far more contested election. How much influence we had on other players is unclear, but it seems that there was a great deal of it with certain international financial agencies, with France and Canada; our own aid, certainly, went directly to NGOs, and not to the government. Public health and public education faltered, as did other services of special importance to the poor. I noted in a book written in those years that the budget of the Republic of Haiti, nine million strong, wasn’t much different from that of the city of Cambridge, Massachusetts, with 100,000 citizens; neither amounted to a quarter of the budget of the Harvard teaching hospital, a single one, in which I trained and now work.

Without resources, it was difficult for public providers to provide; many left to work in NGOs, which did not have a mandate to serve all citizens, and others left the country altogether. Choking off assistance for development and for the provision of basic services also choked off oxygen to the government, which was the intention all along: to dislodge the Aristide administration.

But the coup, simply denied as such by some in the so-called international community, did not really take. The U.S.-selected caretaker government was unpopular, unrest continued to grow, and Port-au-Prince became the kidnapping capital of the world in spite of a very large U.N. presence. Again, the so-called forces of order, the police, were weak or corrupt—as pale a reflection of what the force should have been as were public health and public education.

Some efforts to reverse this ruinous policy of squeezing the public sector, which was often and correctly denounced by Congresswomen Lee and Waters and many other members of the CBC, have been palpable over the past year, although progress has been slow. And then came the earthquake, which further decreased the capacity of the public sector to provide meaningful services, leaving once again a growing number of NGOs and other non-state providers to fill the breach. Allow me to give two more data points: on January 27th, it was noted in the Washington Post that less than 1% of all U.S. quake aid was going to the Haitian government. (Almost as much went, even, to the Dominican government.) My colleagues at the U.N. are tracking these numbers, and also pledges made and disbursed, and here’s one of the latest: of $1.8 billion for earthquake relief sent to Haiti, less than 2.9% has so far gone to the government.

I argued here in 2003, in testimony to the Senate Committee on Foreign Relations, that it is difficult, without real and sustained commitments to strengthening the public sector—including its regulatory and coordinating capacity, so that the quality of the services offered by NGOs and others will not be all over the map—to monitor funds and to use them efficiently. This remains true today. Thus are the Haitian people still tasting the bitter dregs of the cup we prepared for them as we weakened, or failed to strengthen, the public sector over the past decades.

During these years, unfair international trade policies cut Haitian farmers off at the knees, accelerating the complex and vicious cycle of urban migration and deforestation that set the stage for the food insecurity that was to follow, for the extreme vulnerability to heavy rains and storms, and for the massive overcrowding and shoddy construction revealed to all late in the afternoon of January 12^th.

3. What is to be done?
This is where we are at the six-month mark, as hurricane season approaches. Less than five percent of the rubble has been cleared. People are going to camps for shelter and for other services that all of us humans need to get by. Gender-based violence worsens the “structural violence” to which the poor, in general, are subjected. The good news is that the enormous generosity and solidarity of the world after the earthquake was and is real: it’s estimated that more than half of all American households contributed to earthquake relief. Speaking as a volunteer for PIH, I can proudly announce that we have, along with the Ministry of Health, already broken ground on a huge new teaching hospital in central Haiti. We know from experience, as my colleague Loune Viaud will report, that it’s possible to get a great deal done in rural Haiti, and these services and jobs will also pull people out of the city and contribute to the decentralization so desperately needed.

But there needs to be a shift, especially in how we plan and deliver basic health, education, and other safety-net services: a commitment to move at least some of the assistance (including private money) into public hands, which has not been at all the favored approach to assistance to Haiti. This is increasingly recognized as the right thing to do, as Paul Weisenfeld, Haiti Task Team Coordinator for USAID, who reported the falling rates of water-borne diseases noted above, observed recently: “I think it’s key to us that if we’re going to have sustainability we are going to have to work through Haitian institutions, which requires strengthening them. Obviously [they’ve] been weakened tremendously by this earthquake, so at the same time that we implement reconstruction programs, we need to strengthen government institutions so that we can work through them.”[1] We have also just worked with the American Red Cross to support performance-based financing of medical and nursing staff in Haiti’s largest public hospital. These efforts will not be easy, but they are necessary.

This shift will not be a panacea for Haiti but could be coupled with a powerful and complementary focus on another movement of capital, this time from public to private and from wealthy to poor: a focus on job creation and on strengthening the hand of those trying to farm (and reforest) the land and also on young people, especially young women, living in poverty. We need a greater sense of urgency. And the most urgent task of all is the creation of jobs that will confer dignity to those in greatest need. As FDR said early in the Depression, “The Nation asks for action and action now. Our greatest primary task is to put people to work.”[2]

As it was during the Great Depression, there are innumerable public-works jobs imaginable, from reforestation and rubble removal to preparing for back-to-school (la rentrée), which must put kids back in schools, safe schools, with the books and uniforms they need and a nutritious lunch during the day. As for health, Haitians need a real health system. This will require a massive investment in new clinics and hospitals, staff to run them, and health insurance at a time when only 300,000 families have it. These are indivisible tasks, as FDR noted at the outset of the Depression: “Public health . . . is a responsibility of the state as [is] the duty to promote general welfare. The state educates is children. Why not keep them well?”[3]

Job creation and improved health and educational services, with greater investment in the public sector: this should be a big part of the mantra. I do not mean to suggest that this transfer of capital, resources, etc., is easy. We know it’s not, because we’re in direct contact with the representatives of large multilateral and bilateral agencies, which have to follow laborious processes in order to disburse funds. But let us ask, in the face of urgent need, if we are well served by the fetishization of process now retarding the flow of capital into the hands of families in greatest need. The International Commission for the Reconstruction of Haiti, which is now being born, needs to be swift and nimble; the rules of the road for development assistance need to be rewritten, not to favor contractors and middlemen and trauma vultures, but to favor the victims of the quake. Right now there are shovel-ready projects, which could create tens of thousands of jobs and perhaps more. There are plenty of people living in poverty, including the market women who have never had access to capital or financial services and who have been working against an undertow of unfair trade policies, who are as entrepreneurial as anyone else in the world. Projects of all sorts can be greenlighted, but will move sluggishly if the funds seep into the ICRH too slowly and if projects cannot be moved forward because of strangling strictures on how the money is to be used.

People in this country know it’s possible to move forward with a sense of urgency. During the Depression, job creation and improved services from health care to education to rural electrification were the focus of many efforts. FDR, then the governor of New York, called for “workfare” and welfare through the Temporary Emergency Relief Administration (TERA). This call was made on August 28, 1931, and it was up and running by winter:

The crisis had finally imposed some discipline of responsibility even on the Republican legislators, who with uncharacteristic docility did what the governor asked. (The New York Voters would overwhelmingly approve the bond issue in November 1932.) Faithful to romantic notions of rural life, Roosevelt had TERA subsidize the resettlement of as many unemployed as possible on marginal farmland, with tools and instruction on how to cultivate it. In six years TERA assisted five million people, 40 percent of the population of New York State, at a cost of $1,555,000. At the end of the period, 70 percent of these were no longer reliant on government assistance.[4]

Later these lessons were taken to scale in many programs, including the Civil Works Administration, which created millions of jobs and moved billions into the public sector through public works and into the hands of the previously unemployed.

Certainly Haiti’s need is no less great than that faced by the States during the Depression. Let us hope it can build a more just tax base, even though its IRS, like its Ministries of Health and Education, has been destroyed. In the meantime, the world has responded generously and now it is incumbent upon us to move these resources into the hands of the Haitian people, especially those directly affected, in these two complementary ways. Again, this is not a choice between public and private sectors, any more than this is a choice between strengthening local agriculture and rebuilding infrastructure, but rather a plea to focus resource distribution on the poor and displaced by providing basic services and through job creation. There is no evidence whatsoever that this is an impossible mission.

[1] Remarks by Paul Weisenfeld, USAID Haiti Task Team coordinator, at a media roundtable on July 19, 2010. Available at: http://www.usaid.gov/press/speeches/2010/sp100719_1.html.

[2] Roosevelt, Franklin D. First Inaugural Address. March 4, 1933.

[3] Black, Conrad. Franklin Delano Roosevelt: Champion of Freedom. New York: PublicAffairs, 2003. Page 194.

[4] Black, pages 216-217.

Testimony of Loune Viaud
Director of Operations and Strategic Planning for Zanmi Lasante
[Download PDF of Loune Viaud's testimony - 42 KB]

Chairwoman Lee, esteemed members of the Congressional Black Caucus, thank you for inviting me to testify here today. My name is Loune Viaud, and I am Director of Operations and Strategic Planning for Zanmi Lasante, an organization devoted to providing a preferential option for the poor in rural Haiti. Zanmi Lasante is the partner organization of Partners In Health, an organization which also advocates for and provides a preferential option for the poor around the world. On behalf of Zanmi Lasante and Partners In Health, I want to thank the members of the Congressional Black Caucus for arranging this hearing, and for ensuring that the voices of Haitians are heard.  Today I will address the current situation and needs of the Haitian people, the needs of vulnerable children, the status of the healthcare system, and the need for decentralization and job creation.

The Current Situation and Haitian Priorities
On one visit to Port-au-Prince—even without venturing far from the airport—one will see that little progress has been made to date. I am going to talk about priorities—in any case, what we see as priorities on the ground. I see healthcare, employment, decentralization, protection of children, women, adolescent girls, the elderly and the most vulnerable members of the population. What happened to us the afternoon of January 12 changed everything. The way we live, the way we see the world and the future.

What happened to us is beyond words. So many people died. There are so many new people with disabilities, orphans, unaccompanied and displaced children, elders and women left vulnerable and at a loss. So much despair.

Despite this despair, we also feel grateful for the solidarity around the world. Immediately after the earthquake, a great number of people wanted to help, and many came to Haiti to do so. But now, six months later, we still need solidarity, and we need those who want to help to work in cooperation and partnership with and for the Haitian people. Rather than charity, Haiti needs partners. Haiti needs jobs. In particular, I see decentralization in the form of job creation outside of Port-au-Prince. Jobs will stabilize other parts of the  country, empower the communities, and save lives.

We need Haitians to lead the reconstruction efforts. We need our partners to take a rights-based approach in the construction of a new Haiti. This means supporting the capacity and the leadership of both the Haitian government and Haitian communities; it means deferring to the experiences of Haitians and guaranteeing our participation in the rebuilding of our country; it means unconditionally respecting all of our human rights—including the right to food, the right to decent housing and sanitation, the right to health, the right to potable water, the right to education and the right to security. 

	Loune Viaud with one of the children currently living at Zanmi Beni.

Zanmi Beni and Protection of Vulnerable Children
We at Zanmi Lasante (ZL) are doing our best to protect the rights of some of the very most vulnerable members of our population: orphaned and abandoned children, many of whom are mentally and physically disabled. Child wellbeing has long been one of Zanmi Lasante’s central concerns, as children are often the most vulnerable to sickness and deprivation of rights in the communities we serve. Following the earthquake, there was a desperate need for refuge and support for children affected by the quake.

In partnership with the Ministry of Social Affairs and Operation Blessing International, among other organizations, ZL is working to fill this gaping void. We opened Zanmi Beni, a home just outside of Port-au-Prince for abandoned and disabled children. Zanmi Beni, which means “blessed friends” in Haitian Creole, now provides shelter, education and love for over 48 children. We need more places like Zanmi Beni or at minimum, more children’s shelters. In challenging times and impoverished settings, children are often the most at risk, in part because they are not as able to advocate for themselves. 

Countrywide, the protection of children continues to be a priority as we work to improve the humanitarian situation in Haiti. Children were particularly affected by the earthquake: in the six months following the quake, of the almost 147,000 patient encounters logged at the clinics set up in the four settlement camps in Port-au-Prince, 40 percent were patients under age 20. Half of those patients were under five years old. Thousands more children were injured, traumatized, displaced, and orphaned by the earthquake. Children in Haiti, particularly homeless, disabled, and orphaned children, still desperately need shelter, care, and protection. We must make sure that their fundamental rights are protected, and that the government of Haiti is empowered to fulfill these rights.

The Health Sector
Together, the international community and people of Haiti must also work hard to ensure that the right to healthcare is being fulfilled for all. Strengthening of the healthcare system is essential to the restoration of Haiti.

On July 3, in partnership with local government, the Haitian Ministry of Health, Harvard, Duke, and Dartmouth Medical schools, and a variety of private and public organizations, Zanmi Lasante broke ground to begin building an innovative referral and teaching hospital. Mirebalais, where the hospital is being built, is about 35 miles north of Port-au-Prince, and is known as the “gateway” to the Central Plateau Department. The hospital perfectly embodies our commitment to Haiti in that it integrates research, teaching, and service, and is the result of a broad coalition of public, private, and government organizations, in both the U.S. and Haiti. 

Prior to the quake, our plan was to build a 108-bed teaching hospital offering comprehensive, community-based primary and prenatal care as well as treatment for TB, HIV, malaria, and malnutrition. However, the destruction of 80 percent of Haiti’s healthcare infrastructure on January 12 made the need for a hospital in Mirebalais more urgent than ever. Thousands of people have traveled to, and are still journeying into, the rural Central and Artibonite Departments from Port-au-Prince seeking desperately needed healthcare. Additionally, the earthquake badly damaged the country’s only teaching hospital, and destroyed most of its educational facilities. The state medical and nursing schools were particularly hard hit, and the Port-au-Prince nursing school, where an entire class of nursing students died, was completely demolished. After the earthquake, at the request of Haiti’s Ministry of Health, we expanded our vision for the hospital.

The new hospital will be 180,000 square feet and have 320 beds, in addition to state-of-the-art infection control, wall-mounted oxygen and medical gases, improved diagnostics (digital x-ray and ultrasound), and increased space around the beds to accommodate teaching rounds for medical and nursing students. The hospital will include the technological and logistical capacity to support educational exchanges, distance learning and remote collaborations. It is our hope that it will serve as a model for Haiti’s national healthcare system, a place where Haitian doctors and nurses can be trained and empowered to take care of the  country’s people. In this way, it is our greatest hope that the Mirebalais hospital will strengthen healthcare throughout Haiti and help solve Haiti’s healthcare human resource crisis.

We are employing local people to build the hospital that will serve them and their communities. This hospital will be our flagship, equivalent in capacity to all of our current facilities in Haiti. Perhaps more importantly, the Mirebalais hospital is a symbol: a symbol of our commitment to public partnerships and infrastructure, healthcare as a human right, and the people of Haiti. It is our commitment to “building back better,” hand-in-hand with the government and people of Haiti.

Simultaneously, we are working to restore the devastated General Hospital in Port-au-Prince—l’Hôpital de l’Université d’Etat d’Haiti (HUEH), the largest medical institution in the country. The General Hospital was nearly destroyed by the earthquake, and in the days that followed, surviving staff members and volunteers—over 370 in total—worked to treat thousands of badly injured patients. Over the course of days and weeks, electricity and running water were restored. In addition, along with numerous partners, ZL was there and helped staff 12 operating rooms, where staff members and volunteers performed surgeries 24 hours a day.   

More than six months after the earthquake, there is still much to be done, and ZL’s focus is changing from the immediate to long-term strengthening and care. The hospital staff has resumed responsibility for most clinical services, and so we have shifted to increased training, capacity, and professionalization of the nursing staff. We have also worked to establish a Friends of HUEH Foundation to build partnerships and financial support for rebuilding and strengthening the hospital.

As with the Mirebalais Hospital, we are committed to cross-sector partnerships and long-term planning. We have found that the best way to ensure that access to these services is both universal and sustainable is by partnering with Haitian public institutions that are ultimately responsible for ensuring that Haitians have the right to health, water, food, and education.  These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating—crucial infrastructure and services—are ultimately owned by the Haitian people.  Our partnerships have been successful because our goal is to support our government in doing its job – to fulfill all Haitians’ right to health.

Job Creation and Decentralization - Aquaculture Project
In addition to focusing on protection of children and on Haiti’s health sector, a main priority in improving the humanitarian situation in Haiti is the creation and decentralization of jobs. This is essential if Haiti is to stabilize and prosper, and to ensure that the human rights of Haiti’s people are fulfilled.

Haiti, like many countries, has historically seen in-country migration from its rural regions to Port-au-Prince, its capital city. Many moved to the city in search of employment opportunities. However, the January earthquake devastated Port-au-Prince, and set in motion a reversal of this trend. In the past six months, hundreds of thousands of people have moved to the Central Plateau and Lower Artibonite, areas where Zanmi Lasante has worked for over twenty years. Initially, most of these migrants were in need of immediate medical care—2,961 earthquake victims were treated at ZL health clinics in the first month after the quake. While many migrants continue to need healthcare, many moved in search of employment, stability, and survival. Decentralization of employment opportunities has become essential.

ZL and Partners In Health, in partnership with the UN Office of the Special Envoy to Haiti and the mayor of Boucan Carre, a region in the Central Plateau of Haiti, are working on a tilapia-raising aquaculture project. This project will bring jobs to hundreds in the region. It is again our hope that this project will also open up the region for development and investment on a larger scale.

In addition to the decentralization that is essential to Haiti’s recovery, the aquaculture project will help to fulfill other fundamental rights for people in the region. Currently, the region, two hours from Port-au-Prince, does not have access to fresh fish, a highly nutritious source of local food. The fish that is available is dried and is prohibitively expensive for most of the rural population. This project will both increase the amount of fish available, and at the same time decrease the cost to the rural population. In addition to providing food security, which is incredibly important, the aquaculture project will provide food sovereignty for a large segment of the population, enabling them to control food production for themselves and their community. In my humble opinion, we need more projects like this in the countryside of Haiti, especially where there are large rivers, which, instead of swelling during the rainy season and killing people in the region, they could be used  to feed the communities.

I cannot emphasize enough the importance of food security and food sovereignty. Particularly for a marginalized and under-resourced population, food security and sovereignty will be transformative. Any industry, development, investment, and employment that this project brings to the area could similarly transform hundreds of thousands of lives. It is long-term development projects and meaningful investments like this that we would like to focus on, in addition to dealing with more immediate needs.

Conclusion and Recommendations for Moving Forward
On all fronts, there is so much to be done.

I want to take this opportunity to express our gratitude to each and every one of you, venerable members of the Congressional Black Caucus, for all you have done for Haiti. Your work does not go unnoticed, and we are deeply appreciative. However, I am afraid that we still need you to do more.

Both the service and advocacy work will be long-term. Continued discussions and advocacy will be needed for bilateral and multilateral donors to encourage actual disbursement of the nearly US$10 billion committed at the 2010 Donor Conference at the United Nations in March. Working with the Robert F. Kennedy Center for Justice & Human Rights, the NYU Center for Human Rights and Global Justice, and the Institute for Justice and Democracy in Haiti, we proposed a rights-based framework for transparency and accountability to, international donors, implementers, and NGOs.   Along with the UN Office of the Special Envoy and other partners, we will continue to advocate for better implementation of foreign aid-funded projects and to channel more aid through the Haitian government in order to strengthen their systems and their ability to fulfill their citizens’ human rights.

We in Haiti appreciate the U.S. government’s commitment to partnering with our government and our fellow Haitians as we rebuild. We hope that this commitment will come with the tools needed to facilitate our participation. Central to our meaningful participation are transparency mechanisms that will help Haitians across the country track U.S. government funds at the local level and be able to provide feedback on projects as they’re being planned and implemented, and most importantly in the event that they do not have the desired outcome.

An immediate priority is the passage of the Supplemental War Funding Bill (H.R. 4899), which contains $2.9 billion in aid to be released for Haiti’s reconstruction. We need your help to protect the 425,000 or so families that are living in the internally displaced persons camps. These camps are crowded, ramshackle, unsanitary, and insecure - women and young girls are gang raped every night. The best possible solution is to build permanent housing to, among other things, decrease the gender-based violence, as well as create jobs and services. As the supplemental bill languishes, people are dying, and reconstruction is struggling. We need you to help us keep up the pressure to pass this bill.

We also need you to keep the attention on Haiti. Though the people of Haiti have long suffered at the hands of cruel dictators, brutally destructive international policies, and natural disasters; in the past, this suffering has often been ignored. However, immediately following the earthquake, the world’s attention turned to Haiti. Our work has been assisted by the massive outpouring of support and solidarity from people around the world and from the contributions of donor countries. However, we need to maintain this focus. Two weeks ago, on July 12, we marked six months since the earthquake. Unfortunately, this was met with only passing attention by the U.S. media and populace. However, for those of us in Haiti, we are confronted by the effects of the earthquake everywhere, every moment of every day. We are surrounded by evidence that there is so much more we can do to restore Haiti, and to fulfill the human rights of all in Haiti. Despite many challenges, there is much hope… I want to believe that with this administration, this Congress, those great friends of Haiti, there is hope and possibility for Haiti, if the right choices are made and the right actions are taken.

I don’t expect miracles. I expect there will be many challenges ahead both political (i.e. the elections) and by natural disaster (hurricane season and the risk of more earthquakes).  But I also expect your help, solidarity and partnership for the right choices and the right actions to be taken in favor of Haiti, venerable members of the CBC.

Mèsi anpil. Wout la long men avèk anpil men epi bòn volonte, chay la pa dwe lou…

Thank you very much.