My impression of Haiti, from a mission trip Mrs. Gagg and I took there a few years ago, is one of disaster at the best of times. I cannot conceive of what kind of a Dantesque scene it must be now after the earthquake. But learning more about the history of this beleaguered island has given me a better understanding of who’s to blame - and it’s not the devil!

On our trip, our team treated a young child, victim of an exploding kerosene stove, who had had nothing more than home made poultice as treatment, and had hideously infected wounds. Even at the clinic we were running, in the church compound with all our supplies, we had to debride/clean the wounds using codeine containing cough medicine as the only “anesthetic” available.

What is happening now must be the same challenging need for supplies and infrastructure - but a million times worse.

I imagine for the vast majority it will be a case of muddling by, with no access to the normal sorts of things you need in disaster relief like transfusions, IV fluids, splints, sutures, dressings, antibiotics or even pain medicines. Rather patients and providers left to their own devices - in a country, which has only 2 doctors per 10 thousand head of population.

The mission trip that we went on was with a team primarily from the local hospital ER, and was to Cite Soliel. The name had me hopeful of some, albeit third world, tropical paradise.

Wrong. Cite Soliel is deemed “the worst slum in the western hemisphere”, where people live in “houses” made of sticks with plastic sheeting or flour sacks. Effectively a garbage dump between stinking, putrid drainage ditches.

Which is of course a set up for the next stage in such disaster scenario - cholera and dysentery from contaminated water.

Infrastructure

Like so much of public health, it is not the teams of heroic surgeons and emergency technicians flying in that is going to save the most lives. It is infrastructure - and this is something we found sadly lacking in a country where the impression is of politicians out for their own interests, not that of their people.

Obviously if the Haitians had quakeproof buildings in the first place would have been desirable. But then it’s a case of being able to get the injured to help, or help to the injured. A case of organization, transport, communications, and the right machinery - all of which is lacking in Haiti.

There is talk of the death toll being 200 thousand. In California, by contrast, in 1989 there was also a Richter scale level 7 quake, but only 63 people died.

Corruption and crime are other factors liable to impact ability to help people. The clinic we worked in, in one of the churches of the Haitian Outreach Ministries in Cite Soliel, was surrounded by glass topped walls and accessible only through huge iron gates - and we were herded back and forth in the safety of the back of a pickup, rather than allowed to make our own way in this somewhat lawless nation.

Lawlessness is just one of the litany of horrors and healthcare challenges. Marauding gangs with machetes looting relief and medical supplies - aggravated by prisoners released by the collapse of the jail: Concerns about aid money for quake victims being diverted: The desperate poverty, lack of food and abject squalor making people susceptible to infections - infections such as TB and HIV which are already rife in this would tropical paradise (read Mountains Beyond Mountains by Tracy Kidder).

At the time of writing there are still horrific pictures of limbs projecting from rubble or people having to have limbs amputated to get them out of the debris. Casual mention of burning 2000 bodies. Talk of a third of the population of 6 million needing medical attention.

All this in a country where, even when everything was running optimally, the only access many of the residents of Cite Soliel had was the witch doctor across the road from the church/clinic where we worked.

Who’s to Blame?

After making our pathetically small contribution on the mission trip we did (I found it really made me question the long term benefit of a bunch of volunteers dropping in, throwing a month or twos worth of donated medicines at the seething, dispossessed masses, then flying out again to their comfortable suburban lives) my principal emotion was anger at the Haitians themselves and their government. “What the hell’s wrong with them? Why can’t they get it together?”

In a wonderful British publication, ‘The Week’, modestly characterized, as “all you need to know about everything that matters”, they had a brief history of the “nightmare republic” that is “already undone by dictators, debt and foreign oppression”.

Of Haiti, they note, not only is it situated in the wrong place, between two fault lines and in the path of hurricanes - so that there have been 15 natural disasters, including hurricanes, storms, floods, mud slides and earthquakes since 2001, but it has suffered persistent meddling by other countries that want to capitalize or don’t like the politics.

Or have I got it wrong. Is it really, as Pat Robertson would have us believe, due to making a pact with the devil?

France ruled and prospered from Haiti from 1697, with 30,000 Europeans and 500,000 slaves. Then, after the slaves rose up and asserted independence (which is when they are meant to have made their pact with the devil I guess), Haiti was forced to pay a crippling compensation, to the tune of 80% of its national budget. In 2004 it was estimated Haiti had paid France in excess of $21 billion.

Then the US steps in, overturns Haiti’s ban on foreign ownership of land, took control of the finances, put in “Papa Doc Duvalier” who modeled himself on a voodoo god and instituted a reign of terror with the help of his thuggish militia, the Tontons Macoutes.

His son, “Baby Doc” was equally unpopular and finally was driven out by riots in 1985 - and was helped escape to exile in the south of France by the US.

Then when catholic priest Aristide was swept into office with massive popular support, he was “forced from power by the Bush administration after it questioned his 90% majority in the 2000 election”.

Even in Aristide’s era, and during that of present regimen of Lavalas, “Haiti was dogged by its old curses of corruption, endemic infighting and powerful gangs” together with being “dominated by cronies and family members seeking to get rich - politics being one of the few routs to wealth in Haiti” notes ‘The Week.’

It doesn’t all seem to be geographic location judging by the contrast with Haiti’s neighbor, and other half of the island, the Dominican Republic. This has a better record on hunger, disease and infant mortality; it has an economy seven times larger, and is the Caribbean’s most popular tourist destination, whereas tourists fear to travel to Haiti.

It may be that Haiti is like Afghanistan and the War Lord/intimidation/corrupt way of life is so ingrained that it would take generations of supervision/colonization and fair handed justice to turn it into a “democratic” nation, that would meet with the approval of the US  - where the corruption is maybe just more discreet in the form of corporate or lobbyist influence fueled by money? (We’ve just been watching ‘Food Inc’!). 

Is the corruption and misrule of Haiti born of desperation? Would the return of Aristide, currently in exile in south Africa, but “ready to leave today, tomorrow, at any time to join the people of Haiti to share in their suffering, help rebuild the country” be the answer?

To his supporters “Aristide is a leftist leader never given a chance by the US, and he remains the only politician with a mandate to guide Haiti’s recovery” says ‘The Week’.

Meanwhile, massive amounts of money and volunteers will help Haiti over the immediate mess but I have no doubt it will take  more than that for sustained change from the grinding poverty and mismanagement we saw.

Pat Robertson in a previouse incarnation

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