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Andre Picard's Second Opinion

To rescue Haiti we must look at past mistakes

Andre Picard | Columnist profile | E-mail — PUBLIC HEALTH REPORTER
From Thursday's Globe and Mail

The media coverage of the Haitian disaster can, at times, be overwhelming. The scars on the land, like the scars on the faces of the children, are painfully raw.

There is seemingly no end to the misery.

But, amidst the aftershocks, the healing – of individuals and a nation – must begin. And an integral part of that process must be learning the lessons that such a disaster offers.

The world – and Canada in particular – has responded generously, and we should be proud of our response. But, in addition to writing cheques and heartfelt expressions of solidarity, we should be asking ourselves tough questions about our past (in)action and future plans.

Before the magnitude 7 earthquake hit, on Jan. 12 at 4:53 p.m., Haiti was already a man-made disaster – a kleptocracy burdened by abysmal poverty, high child mortality, homelessness, inadequate basic infrastructure like water and sewage, malnutrition, infectious disease, violence, corruption and so on.

The island nation was a living laboratory demonstrating the damage wrought by inequality and neglect of public health. The earthquake merely exacerbated these horrors and exposed them to a heretofore willfully blind world.

Haiti, located within spitting distance of the richest nation on Earth, was forsaken. It has been for generations.

Why did it take the shift of tectonic plates for us to start caring – at least temporarily? It is a harsh question that merits reflection. Merely replacing indifference with guilt is not a solution.

The aftermath of the Haitian earthquake has, if nothing else, served to brutally underscore what is essential for good health – clean water, food, a solid roof over one's head, a social network (family, friends, community), some economic power (read: money), and basic health services like vaccination.

While the quake itself has been deadly, there is concern that diseases that spread in insalubrious conditions, like cholera and dysentery, and threats that thrive where there is instability and desperation, like rape and HIV-AIDS, could leave even more Haitians wounded and dead in the weeks to come.

Battlefield medicine – scenes of orthopedic surgeons amputating limbs with rusty hacksaws while using vodka as anesthetic like we saw in the early days after the quake – makes for dramatic TV news stories, but it is a triviality.

Public health grunt work such as distributing food and water, reuniting families (both specialties of the Red Cross), preventing outbreaks of measles, cholera and the like with sanitation and vaccination (a forte of Médecins Sans Frontières) and setting up temporary shelter is crucial for mitigating the impact of disasters. But these temporary solutions must evolve into permanent ones.

Looking at past failings should help guide future actions.

Watching the news, one is left with the impression that Haiti is a uniformly poor country. But for those who wish to see, the earthquake has laid bare the gross inequalities that persist in this former colony.

The disparities – financial, educational, racial and geographic – have, in many ways, set the stage for the post-earthquake chaos we are seeing now.

At the highest point in the capital Port-au-Prince is the wealthy neighbourhood of Piétonville. While the earth moved there too, the enclave was largely unscathed, with the exception of the Montana Hotel, a pied-à-terre for foreigners that has received an inordinate amount of media attention.

The houses of Piétonville, well-built, did not crumble. Residents of the enclave have generators for electricity, water for drinking and all the food they need. The stores have re-opened selling luxury goods. Armed security guards keep looters at bay.

The elite of Piétonville were not spared by Mother Nature: They were protected by wealth and, perversely, they stand to grow wealthier still from the reconstruction. Their employees are still paid the minimum wage of $3 a day or less.

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