It was a slow Friday at work just before Yale’s generous week-long Thanksgiving holiday. I idly went on Facebook to see what my peeps were up to for the weekend. Someone had posted a link asking people to sign a petition protesting the general humanitarian aid community—everyone from the American Red Cross and Oxfam to the American Jewish Joint Distribution Committee—and their failure to prevent an outbreak of cholera in Haiti. They included the Haitian government, somewhat tangentially, in their critique.
“The international community and Haitian government failed to sufficiently invest in clean water and sanitation after the quake,” the Disaster Accountability Project post begins. “Now, living conditions are so deplorable and infrastructure so poor, the situation is ripe for a cholera epidemic.” They note that the World Health Organization has reported that, in general, “typical at-risk areas [for cholera] include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met.” Culpability is then allocated by DAP with an interesting correlation: “As many as 1.5 million people in Haiti are living in camps like these [that WHO describes] that were set up by relief and aid organizations and the Haitian government.” In this post I will not bother to directly address the gap in logic and the flaw in causation-drawing represented by this argument. It wouldn’t even qualify as an “easy” question on the LSAT (which, yes, I did take).
DAP concludes its post by saying that the reason for this massive failure of aid organizations to properly prepare for a cholera outbreak was not because of an omission of policy, or because of ineffective or non-existent strategies, or because not enough public health experts were on hand to raise red flags. No. The reason for the cholera outbreak’s magnitude is that “the headquarters of these major relief/aid organizations raised billions of dollars” and “chose to spend less than half” on “the Haitian people.” Instead, their money is “just sitting in US and foreign banks.” DAP then asks the question they can’t help but ask: “Why are conditions so poor, after all that has been donated, that cholera is still such a threat?”
My first reaction to this post was to laugh. Let me clarify that I don’t know that much about Haiti; I’m more or less an Africanist and never did any research or scholarly work on Haiti. I do know, however, that problems like infrastructure and clean water are hardly new in Haiti. The line “living conditions are so deplorable and infrastructure so poor, the situation is ripe for a cholera epidemic” gave me a particularly incredulous chuckle. I’m also willing to bet that the vast majority of the organizations on DAP’s hit list have been working on these things for years. What I find most amusing about the anger of these donors is that since cash is the only relationship they have to these organizations and their work, the misuse of their cash automatically becomes the primary suspect of the cholera outbreak. There is no mention of devastating international trade policies promulgated by the US and backed up by the WTO that killed national rice production and resulted in mass starvation, for example. Or the resultant inability of the Haitian government to manage things like poverty, provision of clean water, and sanitation infrastructure. It’s as though all of these problems were brought about solely as a result of this earthquake, over a decade later; there is no background, no context. For individual donors, Haiti was perfectly fine, perfectly functional, perfectly supplied with clean water, and perfectly bereft of IDP camps and peri-urban slums before the earthquake. Because prior to the earthquake, Haiti was not on their radar.
It baffles me that individual donors expect their donations to work miracles. Particularly when their sole criteria for success is the amount of money spent, as though humanitarian assistance projects were akin to political campaigns. And as though money were so easily misdirected for NGOs that their reputation is not at stake. There is nothing in the DAP post or the letter that follows that assesses any of the accused organizations in terms of what their public health strategy was or how they could have done things differently. For all I know, from reading it, aid agencies did everything they could have and should have done in the circumstances. In the broader context of Haiti’s recent history, I wouldn’t be surprised if this were indeed the case.
In the petition letter that follows the post, the do-gooding donors emphasize their anger at the beginning and end, in capital letters, with the same statement: “We Donated and We’re Angry.” Their other opening statement is almost totally true: “Earthquake survivors in Haiti should not be dying from cholera.” Personally, I would amend it to say “Haitians, whether they are earthquake survivors or not, as well as anyone else, anywhere in the world, should not be dying from cholera.” This ties into the problem of niche aid, which prioritizes diseases like HIV/AIDS and leaves no funding for things like diarrhea, measles, or (surprise!) cholera. But perhaps acknowledging that no one in this day and age should die from cholera is too complicated, and too much responsibility. And perhaps it is too likely to involve solutions that are dependent on things other than money or individual donors’ ability to donate it. And then where would our do-gooders be?
“The international community and Haitian government failed to sufficiently invest in clean water and sanitation after the quake.” How about before the quake? (Also note the equation of humanitarian aid agencies with “the international community,” whatever that is.) Again, there is no context.
They ask at the end of their petition letter, “We’d like to know why conditions are so poor that cholera is such a threat, despite all that has been donated, 10 months after the earthquake.”
This question is sadly shallow. Haiti’s problems began long before the earthquake. The situation is not comparable to Katrina (a connection DAP tries to make), which took place in a country that had the resources and infrastructure to deploy help but failed to do so. The cholera outbreak in Haiti, I think, is the result of a crippled economy (made so by international corporate influence on trade policy) and a weak public health system being driven to its breaking point by a natural disaster it could not handle. No aid organization, no matter how well-equipped or well-funded, could guard against that.
The conditions in Haiti “were so poor” that cholera was a threat before the earthquake. Ten months is hardly time to fix decades of damaging trade policy and Machiavellian military shenanigans, even if that were the task of aid organizations (which it obviously is not). This donor outrage, which appears to be generated mostly from the US, fails to recognize how the politics of the US government itself has resulted in the weakening of the ability of aid groups to work together with the Haitian government to avoid such catastrophes— in “normal” circumstances, let alone in the face of an earthquake.