Over the past ten years, despite massive funding from international agencies in relief efforts, there has been an increase in the number of families who remain dependent on foreign aid. The fundamental reason for this increase is that the Haitian government and non-governmental organizations (NGOs) have failed to effectively reduce poverty among the most vulnerable by failing to promote self-sustainability. Furthermore, the Haitian government and NGOs underestimate the immensity of the poverty that plagues Haiti. And they each lack the will to significantly address it.
People think of poverty in different ways. Many believe poverty is the inability to buy and sell. Some believe it is the lack of quality education and health care and still others believe it is about the lack of respect and having no influence over their own lives. Although these are all valid observations, through my experience over the past thirteen years working with multinational nonprofits, private organizations, and government agencies, I have come to understand that the harm poverty causes extends far beyond that of monetary deprivation or a reduction in food supply and productivity. The impact that poverty has is more pervasive and deadly, by far. In fact, poverty is more parlous than even cancer. Cancers can be treated with early diagnosis, and many can be cured. Poverty acts like an opportunistic infection attacking the most vulnerable and weak. The more vulnerable a person is, the more aggressive it becomes. It is a silent killer, such as hypertension or diabetes, killing slowly without discrimination of age, gender, or race.
As a medical doctor with extensive experience in Global Health, both in the field and academia, I have witnessed many failures and successes. While placed in various settings I have been privileged to collaborate with and work alongside numerous talented people who have extensive experience within faceted areas of global health. I learned much from them, but it is from this unique combination of experiences, I believe, serves me well today. Indeed, it is this reservoir of information that I credit for having shaped a subject-area of expertise that affords me a keen ability to elaborate here. And so, I offer these following observations in hopes of supporting the development of a superior plan to combat global health challenges and identify emerging issues that millions of people currently suffer and will continue to suffer in developing countries.
For the past thirteen years, I have dealt with two very simple, yet specific kinds of poverty: income and non-income poverty.
Income poverty (IP): This expression of poverty occurs when a household takes in less than one dollar per day. This means that people do not have enough money for food or medicine, nor for adequate shelter or clothing. The IP phenomenon is due to the fact that people do not have access to money or other assets. Since many such people do not own land, they are unable to harvest their own nutritious sources of produce to eat. Therefore, IP can result in stunted growth and early death. It is here that we can begin to see poverty acting as an opportunistic infection, that takes advantage of impoverished people’s vulnerabilities.
Non-income poverty (NIP): This type of poverty happens when people may have a little money but their quality of life is diminished. They do not have access to affordable social determinants of health, i.e., affordable health care, education, drinking water, food security, good nutrition, adequate shelter and a stable environment. They do not feel safe in their own homes, either because they cannot trust the authorities or because they belong to a particular group of people. As such, oppressive phenomenon’s like these may result in a feeling of social isolation, inadequacy or a psychologically prompted belief that they are unsafe in their own skin.
For over a decade, this is what I have witnessed and what I have been dealing with. For me, it seems very simple. I say this because I’m not an economist. My competence is only in global health and community development. Yet, it seems very odd that, despite all the experts who are well educated and have years of experience, never bring sustainable solutions to these problems. And this begs the question as to whether or not many, if not most, “experts” really see what is happening? Why is it still so terribly difficult to eradicate poverty and build a prosperous world for our children? Why is it common-place still that every child in the world cannot have the same opportunities? Why are the gaps of inequality so large between one country to another, or one citizen and another? From what I have witnessed, I believe that the only honest answer to these questions boils down to this: A LACK OF SINCERE WILL AND STEADFAST COMMITMENT.
I did not reach this conclusion through the work I did, or years I spent laboring at prestigious universities, but from my deep faith and rich experience which has helped me to understand a better way to respond to the global challenges being faced today. I remember when I was asked by a journalist in Canada, “What makes your organization different than others?” My reply was very simple: “I am Haitian. I grew up in this reality.” It helps me understand our situation far better than those who have not been among Haitians long enough to completely understand the Haitian culture, its socio-economic context, or the circumstances that impact the ways in which we live and die. I have seen numerous experts come to Haiti, especially after the earthquake, to “solve” the problems of the Haitian people. They always believe they have the answer, and they reject Haitian opinions or decisions. And in this case, the current levels of global health practices in Haiti are derived from gross ignorance which will not soon give way to a sufficient base of knowledge from which lasting progress can be attained.
It has been seven years since the earthquake. The probing question that needs to come to the forefront is, “Do you believe me or do you believe your lying eyes?” The changes that I have seen take place in the lives of the Haitian children and elders alike, do not even rise to the level of negligible. Of this I am certain. Instead, the situation of those most vulnerable in Haiti has reached the height of misery and dare I say, may even defy the most cynical of people. Haiti has become one of the most vulnerable countries on earth in terms of natural catastrophes. The recent flooding in the South Department of Haiti, Jeremie and Nippes, is evident of how NGOs and the Haitian government have failed to meet their goals. According to the United Office for the Coordination of Humanitarian Affairs (OCHA), after four days of rain, these departments failed, with more than 15 houses destroyed, 10,000 houses damaged, and more than 80% of crops, utterly ruined. This means that Haiti will face another episode of food insecurity, which could be worse than the one we endured from 2014 to 2016.
Poverty Statistics in Haiti:
- Haiti ranks 168 out of 187 countries in HDI (UNDP 2015)
- Per capita Gross National Income is $1.730. The average for the Caribbean/Latin American developing countries is $14.098 (World Bank)
- 59% of the population lives on less than US$2 (WB)
- 7% live in extreme poverty on less than US$1.25 per day (UNDP)
- Poverty is mainly rural at 75.2% vs 40.8% in urban areas (MDG report 2013)
- 50% of children do not attend school (WB)
- Approximately 30% of children attending primary school will not make it to third grade (WB)
- 60% will leave school before sixth grade (UNICEF)
- 30% of the population is considered food insecure (WFP)
- 59 per 1,000 born in Haiti will die before reaching their first birthday. (Haitian Ministry of Health)
This is the real “achievement” of Haiti since the 2010 earthquake, with nearly 13 billion USD in foreign aid invested toward its recovery. By reviewing these points of achievement, it should be evident to even the most casual observer that international agencies, as well as, the Haitian government have played a huge role in the deterioration of living conditions in Haiti. Today, the kind of poverty the country faces is no longer a fact of not being able to buy or sell, but rather cognitive content, lack of confidence, and clear incapability. When people lose the ability to be aware of the deteriorating socio-economic situation they are living in and the capacity of how to escape from it, this is far more dangerous than the inability to buy or sell food. Unfortunately, this is the reality of Haiti and the poverty in which its people live.
Is it possible for Haiti to be independent of foreign aid? Can Haiti promote wealth by focusing on development via sustainable projects? Again, in my experience, I know the answer to this question is, “Yes!” Poverty can be alleviated in Haiti. To reach this goal, however, all the current actors need first agree that they have failed. Times like this demand a reassessment of their work and an urgency, coupled with clarity must renew their commitment to achieve sustainable outcomes.
The Haitian government cannot change this situation on its own. They do, in fact, need the support of the international community to alleviate the suffering of its people, promote sustainable projects, and respond to the basic needs of its citizens. Investing in agriculture may be a good place to start. Self-aware partners who are willing to follow the lead of capable Haitians, create jobs, and reduce the rate of food insecurity among the most vulnerable families. This can be done through business development, responsible use of natural resources, and the rehabilitation of the middle class to enable them to reach their full capacity as the backbone of economic stability within their country.
NGOs need to improve the coherence of their projects. They need to understand they are here to work in partnership with the government and the population, not as an opponent. They should not fear failures, failures are tools in which to learn from. They need to stop pleasing donors, and stick to their integrity. They need to take time to assess and make a correct diagnosis of their progress to gain greater insight on self- sufficiency. They need to give the Haitian people leadership to decide what they want for themselves. Arrogance cannot exist. Talk less, listen more. As soon as they realize this, then they will be helping Haiti help itself.