The Aid Business in Haiti

By Ton Vriens

(Translation of an article about Haiti for the Dutch magazine De Groene Amsterdammer, issue March 30, 2010)

Two months of international aid has turned Port-au-Prince into occupied territory. Military helicopters thumping overhead with gunners in the door opening – Apocalypse Now – navy vessels anchored in the bay. An American force of 22,000 troops, now being reduced to 11,000 in addition to a UN-army of 11,000, is mobilized to secure the aid operation. A ba okipasyon! – down with the occupation! – reads the graffiti all over town.

Makeshift camps – big and small – have arisen on every public place, square and park ground – even on sidewalks.  This wrecked city is engulfed in bad odors. Toilets are a rare amenity in the camps. Thousands of inhabitants are lining up for six, seven hours at a few UN distribution places to receive some food packages. Here and there one sees a lone bulldozer at work and some small groups of men are clearing rubble by hand. At this rate, Port-au-Prince will be lost forever. The many foreign dignitaries who came to visit in March must have noticed the futility of the clean-up so far.

But, the markets are full with vegetables and corn and rice, and the food stands on every street are doing brisk business. The bright colored tap-tap  buses blare their horns through the heavy traffic. UN trucks and the many SUV’s of the hundreds of aid organizations are causing traffic jams everywhere. On a busy crossroad a Haitian volunteer in a self-styled uniform directs the traffic. Haitian drivers tip him in passing.

On a soccer field off Delmas 33 twelve  hundred homeless have set up a crowded camp – a combination of donated tents and shacks they made themselves. A few men are playing dominos. Women cook on charcoal fires, exchanging jokes while children run around amid the tents. A glimpse in one of the tents shows that there is hardly a foot of space between the many mattresses. It is quiet on this afternoon. Whoever still has a house goes there in the daytime to do some cleaning. But at night everyone returns to sleep here. It is considered safer. Everyone knows: God’s punishment ain’t over yet.

The neighborhood committee includes a few young men of the local soccer team. They have organized the camp as well as possible. The donated tents have been allocated to the elderly and handicapped. At night there are patrols and who is not from the neighborhood will not have access to the camp. Water filters for drinking water have been installed and a group of volunteers of the university of Florida built two toilets connected to a compost tank. The committee watches over everyone and encourages an attitude of helping each other in these hard times.

Many kill time with bargain-hunting on the markets or waiting for food distribution. Unemployment was high before the quake and there is hardly any work left. The UN Development Program – a UN department – has a budget of $35 million for a cash-for-work program. They have asked for another $45 million to expand the program. The workers make around $4.50 for a six-hour day cleaning rubble. They’re hired for 24 days at the time. Fonkoze, the largest micro-credit bank in Haiti, founded by Americans, handles the payments to the workers.

Dick Dijk, a former manager at a Dutch bank, applied as a volunteer with Fonkoze the day after the earthquake. He and other volunteers work day and night to prepare the envelopes with the cash for each worker. When Dick discovers that the UNDP transferred only half of the money, he is concerned about the workers’ reaction. “These people are waiting for their payment.  Are we going to have riots?” At the very last minute the balance of the money comes in. The UNDP apparently had decided to do the payments themselves without any notification but soon discovered it was too much work.

The UNDP claims to have recruited 70,000 workers for the cash-for-work program so far. But when you do the math, it becomes clear that the total of their obligations to the workers is not even one fifth of their budget. What are they waiting for to expand the program? The bottle-neck – they say – is the lack of rubber gloves and spades for the workers.

The UN or UNDP don’t publish what their overhead is for this or any other program. The lack of transparency of the big streams of international aid money raises a red flag for journalists – or it should.  The Haitian people are also becoming mistrustful of non-government organizations who are part of the aid machine. ‘ONG Volè,’ – ‘NGOs are thieves’ – is the writing on the wall and one notices resentment against the foreigners brewing in the city. It is of course difficult for any organization to show visible results in such a large disaster area. And many Haitians, with or without an Obama T-shirt, seem to expect that the foreigners can solve their problems in no time – if they only want to. What the population is painfully aware of is a lack of food supplies, a scarcity of tents and insufficient medical care. What they see in the streets are hundreds of brand new SUVs with white people in the back ignoring them. The SUVs speed past the stinking camps where life is often chaotic and near unbearable. They will not get out of their air-conditioned cars to ask how things are going and what is needed.  It is the same attitude that makes the NGOs bypass the local organizations such as churches and neighborhood committees. This way, the white man’s fear of an angry mob could become a self-fulfilling prophecy.

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I am driving with a group of Spanish doctors to Petit-Goâve, a town about 35 miles from the capital that was at the epicenter of the earthquake. The Spaniards from Seville are a group of specialists who took two weeks off to come and help out here. I hope to persuade one or two to visit one of my projects where medical help is still scarce.

On the grounds of the damaged Notre Dame hospital in Petit-Goâve, a number of tents, the size of a large container, have been set up by various NGOs, including the Canadian Red Cross and GED (German Emergency Doctors). Patients are waiting on benches at the entrance of each tent. The Spanish doctors are welcomed by Dennis Filips, a Canadian surgeon who has been here for over a month. He just worked through the night trying to remove a police bullet. The patient died. Dr. Filips is carrying a little girl on his arm. “She is two years old, with the body and development of a one year old. Came in undernourished. Doesn’t have a name; parents are unknown – may have died.”

Filips shows us his patients in his ward. Every case is different, but the majority are suffering from ailments that are not directly related to the disaster. It is more a matter of “delayed maintenance.”

Enrique Hidalgo Rivas, the Spanish trauma surgeon, takes over from Filips who is going to take a nap. A patient with a swollen leg is rolled into the surgery room. I ask him why he waited two months to see a doctor. His teeth are chattering and he makes a circular move with his arm. The man heard that the foreign doctors are quick to amputate. He is in tears and begs to be spared from an amputation: “I have a family to take care of.” The surgeon only drains the infection and the man mumbles mèsi, mèsi.  But the next patient, who has already been amputated three times, has to lose another part of his leg. “Amputated without any after care,” Enrique mutters through his mask. “In a Spanish hospital this would not have been necessary.”

Foreign NGOs staff the Notre Dame hospital and at a meeting of the Haitian and foreign administrators with the local administrators a sensitive issue is on the table. The NGOs are complaining that the local workers don’t show up for work. Dr. Paul Lesly, the Haitian director-general, explains that the national ministry of health is behind with paying the hospital. And the hospital has no income since the NGOs are providing free medical care and free medication. Not all of the NGO people are willing to discuss the matter. But the representative of the Canadian Red Cross proposes that the NGOs will pay the salaries from last January on. “But only 50%.  Because otherwise the employees are going to think we will pay their salaries forever.”

After the meeting an American paramedic explains to me that the local staff used to have a handsome income from selling the hospital’s medical supplies under the table. And many have started freelancing for foreign NGOs elsewhere who pay more for a day than they made in a month in the hospital. Dr. Lesly comes outside and I ask him if he believes the ministry of health is deliberately withholding the payments to the hospital or they just don’t have it. The director-general shrugs. “I work here for twenty years and sometimes I have not been paid for an entire year or longer.” He leaves in his Toyota 4-Runner. I hear later that Dr. Lesly is rarely present in the hospital.

Later that night I check on the little girl in the ward. She sits all alone on the bed. She refuses to eat. When I lift her up she holds on to me like a little monkey. She starts crying without making a sound when I put her down on the bed. I can’t find a nurse – they have left for the day. The patients and their relatives are all asleep.

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I’m on my way to Verrettes in the Artibonite valley. The road leads through the capital. The bus passes a group of American students who are removing by hand rubble from a collapsed building. The students are sweating profusely and the effort looks somewhat futile in this wasteland. A group of Haitians are watching them and, perhaps, making fun of them. No one is inclined to help the kids. It’s perhaps a telling scene, demonstrating the increased divergence in the expectations of foreigners towards Haitians and vice versa. The foreign do-gooders may think: “I’m working my butt off for you and you’re not even willing to help. Hey fellows, this is your country – your mess!” The Haitian bystanders may think: “Of the money you paid for your ticket, we could live a year. Or: if you are that rich, why don’t you give me something?”

The Dutch foundation that I represent has worked since 2007 in Verrettes with a women’s group. I have visited them dozens of times. I know their families and attended births and funerals of family members. Of the original group of sixty-nine, thirty-five members are active and coming to work. They make hand-felted sleeves for iPhones and MacBooks from organic wool (the McSock) and the Krik-Krak Creole dolls. Sales in the U.S. are improving as the products have become more accomplished. Last summer, the women became a legal, worker-owned co-operative. In short, there is a lot to be proud of.

But at this meeting, the women are in a bad mood. Since the earthquake they have not worked – they were busy with relatives from the capital who came over to live with them. We received a rush order to make one thousand dolls from a foundation that wants to hand out these dolls to Haitian children in hospitals. The client has offered $8.50 for each doll – not a bad price – but the ladies are demanding $ 27. I show them a little toy bear I bought at the airport for six dollars. Everyone wants to have the cute bear. But it does not change their point of view. “You foreigners say you want to help us. So why don’t you pay us the twenty-seven thousand dollar we are asking?” When the time has come to say goodbye, they embrace me heartily. I should not take it personally – and, of course, they will think some more about the order. But I’m leaving them with a strong sense of defeat and hopelessness.

Back in Port-au-Prince I meet Ajay Badhwar,  board member of Pure Water for the World, an American organization that manufactures and installs water filtration systems in schools. Badhwar, a manager at Dow Chemical, one of the corporate sponsors of Pure Water, is visiting Haiti with a small delegation of interested Americans.

How does Pure Water for the World procure financing and orders? Providing drinking water is probably one of the most competitive areas in the world of NGOs. Pure Water distinguishes itself by working with local organizations. Also, the majority of the staff in Haiti is Haitian. As a relatively small NGO, they receive orders from larger NGOs who often have government funding. Badhwar believes that this system works well. The larger NGO supervises their work but he concedes that they could provide more extensive financial reporting. Badhwar doesn’t say it with so many words but here speaks the belief in a free market mechanism, even for NGOs.  He abhors the thought of having to coordinate the aid with the Haitian government. “This will not work. They (i.e. the Haitian government) have already taken steps to tax incoming aid. It opens the door for more corruption. And they don’t have the expertise.”

Similar objections are being voiced at a recent conference at the UN in New York  – one of many that were laying the ground for the international donor conference on March 31^st. Representatives from NGOs as well as from the diaspora are adamant that they – not the Haitian government – should be in control of the reconstruction. Already before the catastrophe Haiti attracted more foreign NGOs than any other development country – an estimated ten thousand – and they operate without any form of registration or supervision. Shouldn’t the work of NGOs be coordinated by the country’s democratic government? Who will guard the custodians if the NGO’s are their own masters, free to do as they see fit?

Not only the aid given by NGOs but most of the official development aid as well circumvents the Haitian government and Haitian institutions. According to a February overview by USAID, the largest governmental aid channel, it disbursed $688 million since the earthquake. Of this, $285 million went to the US Department of Defense – in other words, the money was transferred from the right pocket to the left. The other $403 million was distributed among thirty large NGOs and UN departments. How these organizations spend the money and who are the beneficiaries isn’t publicized. Not one dime for the Haitian government.

President Obama has asked Congress for an extra appropriation for Haiti of $2.8 billion. But most of this is to compensate US governmental institutions for the costs of the emergency aid. USAID, consistently, pays about 70% of its funds to American contractors.  Companies that don’t want to spend a lot of time on on-the-job training of locals, avoid as much as possible local governments and institutions and don’t leave anything sustainable behind once they have completed a project.

The lack of transparency and inefficiency of the aid machine makes Haitians wonder about America’s generosity. The persistent rumor that a large oil reserve was found offshore adds to the mistrust. Some wonder whether aid is a pretext for occupying the country and exploiting it again. But the often-heard suspicion that the U.S. involvement is driven by commercial interests does not make sense. The country is just too small and lacks resources.

The real motivation is perhaps more straightforward. Notwithstanding America’s heavy involvement over the last century, Haiti is now often classified as a ‘failed state.’ And Haiti’s underdevelopment, not the earthquake itself, caused one of the largest humanitarian disasters in history. No American administration can sit back when Haiti’s misery becomes worldwide front-page news.  So it seems only logical that America take the lead in getting Haiti to rise from the rubble. Even before the catastrophe, under the Bush administration, Haiti was too close and the Haitian diaspora too numerous to be ignored by Washington. The PR campaign by the Clintons in the last year is more a continuation of U.S. policies towards Haiti than a radical departure.

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Even with all the international conferences on how to rebuild Haiti and all the pledged aid, conditions in Port-au-Prince are still getting worse. There is still a shortage of tents. Thousands of people still have no access to food and clean water. The clean-up of the city has not even started. Human rights organizations report an increasing number of rapes in the camps. An estimated  fifty-thousand people live in camps on dangerous slopes that could collapse in the rainy season.

The only good news so far is an odd duo that may come to the rescue of Haiti: President Bill Clinton, UN special envoy after the previous hurricane disaster, and his sidekick Paul Farmer – the legendary doctor who built a grassroots medical care system in part of Haiti. Farmer writes caustic left-wing articles about America’s imperialist tendencies in Haiti. Clinton spent much of his time as special envoy having lunch with businessmen who are considering setting up sweatshops in Haiti. But the two men, as different as they are ideologically, seem to have found each other in their love for Haiti. And Clinton, who is widely seen as the new development czar of Haiti, seems to have learned from Farmer’s consistent message:  development  aid has to be integrated in the society, not just dropped there.  It should provide schooling and generate jobs and it should work towards becoming superfluous.

On March 25, Clinton and Farmer are meeting in New York with the managers of the one hundred largest NGOs in Haiti. How large? One participant – with a $50 million budget and 800 employees in Haiti – calls himself a small potato. Farmer moderates the meeting and is indefatigable in pointing out how they should see their mission: collaborating with civil society – the local institutions, registering and coordinating with the Haitian government,  being transparent and accountable for their income and expenses. Few may live up to these standards but no one in this room disagrees. Then, after long prompting by Farmer, an elegant lady takes the microphone from him. “Since the eighties the foreign aid machine is following a business model of operating. We have been hijacked by a bunch of slick for-profit consultants. When are we going to provide real development aid by working at Haiti’s grassroots level?”

Bill Clinton, ever the salesman, refers to “the fantastic people of Haiti’s government.” He urges these NGO managers to consider giving them 10% of their budget. It raises the suspicion that he already knows that the international community is going to bypass once again the Haitian government and that they will not allow the government to take the lead of the reconstruction.

And that would be bad news.  The graffiti on the walls of Port-au-Prince doesn’t bode well for president René Préval and his administration. The population will not longer tolerate much longer its weak leadership and failure to provide basic services. More than a million people homeless, exhausted and miserable. And the rainy season is here.

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An international donor conference at the UN in New York on March 31^st will decide Haiti’s future. The costs of the reconstruction have been estimated at around $11.5 billion dollar. As a comparison: the U.S. set aside a development budget for Iraq and Afghanistan of over $100 billion.

The World Bank, where the U.S. has a dominant voice, is going to control the international contributions to Haiti. The question remains how much influence the Haitian government will be allowed to have on the reconstruction. President Préval and Prime Minister Bellerive have asked for $350 million for short-term government expenses, including the payrolls of government employees. But several U.S. Senators are wary of funding the Haitian government directly.

In recent years the U.S has spent considerable money on Haiti (for example $287 million official aid in 2009) but 70% goes to American contractors like, for example, Chemonix, a consultants firm. Less than 10% has been channeled through the Haitian government.

The European Union has committed about $1.6 billion (1.2 billion Euros) to humanitarian aid, policing and development.

Private donations and government aid in the last three months, before the UN conference on Haiti, was $2.2 billion. But most of it has not yet been spent. NGOs raised $644 million. The American Red Cross received $200 million. The average salary, including benefits, of the top 14 managers of the American Red Cross is $400,000, according to its tax return for the year 2008.

Ton Vriens is a Dutch documentary filmmaker and journalist who, through his foundation Turtle Tree, is working with women in Haiti to develop a business co-operative, with the goal of achieving economic and social independence for the members of the self-governed group.

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