“Many of those displaced still haven't returned home. Funds for rebuilding remain scarce… a lack of basic services, troubles with contractors and skilled-labor shortages complicate the situation” --that was New Orleans a year after Katrina, according to NPR.
“Many survivors have expressed frustration with the slowness of reconstruction, with thousands still living in makeshift tents with little food or sanitation facilities.” This a year after the earthquake in Bam, Iran, according to the BBC.
“A year later, much of Asia struggles to rebuild. Aid and workers have poured in, but experts say more help is needed. And as the painstaking process of identifying the dead continues, the survivors somberly reform their lives, families and communities” suggested CNN, one year after the Tsunami.
It seems we repeatedly expect rapid recovery from natural disasters and we are repeatedly disappointed. Of course we should do better –especially with so many past experiences to learn from. But, as we approach the one-year anniversary of the Haiti earthquake, at least some of the recent frustration with the response might reflect expectations that are perhaps unrealistically high rather than an excessively lackluster response.
That’s especially true given that, in deaths and damage per capita, the Haiti earthquake was almost certainly the most devastating natural disaster to hit any country in the last 100 years or more. And this in a country with wretched institutions and very limited capacity. It was only four years ago that Transparency International declared Haiti the world’s most corrupt country, after all.
The Cholera outbreak has attracted particular scorn. There shouldn’t have been many deaths at all with sufficient pre-planning, and a case fatality rate of 6 percent is already high even in a post-disaster setting. But the outbreak was halted, so that it was a lot smaller than in the Rwandan refugee camps in the DRC, for example. And in times past the extent of Haiti’s post-disaster death toll would have been considered a miracle. The list of diseases that could have spread after the earthquake includes not just cholera, but salmonella, hepatitis, measles, respiratory infections, and malaria. The rest of that list didn’t break out significantly, thank goodness.
Again, Paul Farmer notes in a recent piece how much better we could be doing if we used more aid money to employ Haitians to remove rubble and plant trees, if we put more resources through the Haitian government, and if we actually paid up the money we’d promised. Surely that’s right. In particular, health outcomes in the long term would be improved if the government was playing a coordinating role (as happened with great success in post-genocide Rwanda) rather than being bypassed by a plethora of donors and NGOs. But Farmer also notes that many of the 1.3 million people living in camps are refusing to leave because they are getting a quality of housing, education and health care in the camps that they never got before the quake. He also notes that the donor community has given 1.1 million people access to drinking water and installed 11,000 latrines.
So, the relief operation has been chaotic and inefficient. And we should learn from our mistakes better than we have in the past. But at the same time we should also appreciate the incredible work of Haitian and aid institutions alike that have made a hellish situation so much better than it might have been.
(Thanks to Amanda Glassman for tempered comments on a draft of this post)