Haiti—Forgotten Already?

Lee Jacobs, MD

Fall 2010 - Volume 14 Number 3


When Haiti suffered one of the worst natural disasters ever to occur in the Western hemisphere, people from all over the world responded with donations of time and money. The first response was excellent—although at times overwhelming the fragile infrastructure—it was substantial and well intended.

In the past The Permanente Journal (TPJ) has chronicled the experiences of health professionals responding to disasters, including the Katrina flooding1 and the Bande Aceh tsunami.2 Here, TPJ shares the stories of those who responded to the earthquake in Haiti and of those who support them; more stories will appear in the Winter 2011 issue.

As important as these stories are, they are only the first chapter in the story yet to be told of Haiti's recovery: The story of a country almost completely destroyed and the story of a people caring for each other and coping with their present difficult situation. The story yet to be written will be of the massive rebuilding and relocation that must be supported by people and finances from around the world.

During my recent trip to Haiti with a health care team, I had several community leaders describe how immediately after the earthquake, groups from several countries and agencies provided food, living supplies and health needs. After the initial response, care from outside Haiti has markedly decreased and now there are only a precious few volunteer short-term teams, most faith-based, assisting the Haitians. Haitian leaders wonder: Have Americans forgotten their plight already?

There is excellent ongoing support by several large agencies, but the challenge is just too great to meet the basic living needs of the Haitians. The destruction in Haiti is more widespread and devastating than imaginable. Having been part of a medical relief team in Bande Aceh, I have seen destruction and the plight of displaced people. Although the challenges in Haiti are quite different, it is my opinion that the long-term relief needs in Haiti will actually be greater than Bande Aceh.

Living conditions for most Haitians were bad before the earthquake, now the conditions are unspeakable. Thousands of Haitians are living in tents creating clusters that look like refugee camps. Fortunately, large-scale disease outbreaks have been avoided because international agencies have provided clean water and scores of port-a-potties. Tent life is awful. Several Haitians I know who are living in tents tell me of the difficulties of their present living conditions, especially during the heavy rains of May when water would flow through the floors of their tents. One friend of mine lives in a tent with 15 family members. People are hungry. Initially, rice and beans were delivered, now only rice is being made available. Without jobs, many walk aimlessly around these camps. Finally, there are no regular communications from the Haitian government. Nobody knows what to expect.

I'm certain talented people at the United Nations, World Health Organization and US Agency for International Development are making plans to help the Haitian people. InterAction, a coalition of aid organizations, planned to divide their available funds for immediate relief and for long-term rebuilding.3 It can only be assumed that holding funds in reserve must reflect the belief that no further major inflow of relief funds is expected. If that is in fact the case, then the overall funds available will be tremendously inadequate. The funds donated for Haiti relief in the first 4 months was $1.3 billion, which is significantly less than the donations in the first 4 months to either 9/11 ($2.3 billion) or Katrina ($3.4 billion).4

Several major needs over the next decade will include: orphan care, medical and dental care, optical support, microenterprise development, and, of course, light and heavy construction. People and money will be badly needed for years to come.

So What Can Be Done?

First, the extent of this ongoing disaster and the immediate needs of the Haitian people must return to the awareness of the world, especially those of us in North America. Champions are needed to advocate for the Haitian people, beginning with President Obama and then others who can influence Americans, such as celebrities.

Second, major funding far in excess to what has already been donated is needed. Giving must be considered an ongoing need and not an isolated fundraising event. I remember the time when the tragedy of the African AIDS epidemic eventually made such an impact on the world that we started to see regular fundraisers, documentaries, and other ongoing reminders of the needs of the African continent. The living conditions of the Haitian people need to be raised to a similar level of awareness.

Finally, we must make certain that some of our erroneous assumptions do not blunt relief responses. The history of corruption in the Haitian government doesn't change the need. Past living conditions do not make current conditions any more tolerable: the majority of Haitians are living in great uncertainty and in much poorer living conditions.

The Haitians are a wonderful people, a highly literate people, a caring people. Now they are a people in need. How would you answer the question asked by the Haitian leaders? Have we already forgotten them?

1.    Assisting hurricane evacuees in Houston and Louisiana. Perm J 2006 Fall;10(3):59-61.
2.    Beekley S, editor. Permanente and the tsunami relief efforts—one year later—the volunteers' stories: a journal. Perm J 2005;9(4):72-82.
3.    Moore MT. Haiti relief less than Katrina, 9/11 [monograph on the Internet]. McLean, VA: USA Today; 2010 May 13 [cited 2010 Jul 28]. Available from: www.usatoday.com/news/sharing/2010-05-13-haiti-donations_N.htm.
4.    Parker S. Comparing contributions [graph on the Internet]. McLean, VA: USA Today; 2010 May 13 [cited 2010 Jul 28]. Available from: www.usatoday.com/news/sharing/2010-05-13-haiti-donations_N.htm.


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