ARTICLE - REPORT URGES BIG CHANGES

REPORT URGES BIG CHANGES IN HAITI

Government must be rebuilt along with roads and buildings, Rand Corp. says
(Pittsburgh Post-Gazette) - By Anya Sostek

At the Hopital Albert Schweitzer in central Haiti, the earthquake has changed everything.

Once a regional referral center, the hospital now is host to major surgical and prosthetic operations, replacing both medical facilities and limbs lost in the January earthquake.

As the hospital, operated by the Point Breeze-based grant foundation Friends of Hopital Albert Schweitzer, struggles to reinvent itself post-earthquake, so does the whole country of Haiti.

Rebuilding Haiti will take more than just new roads and buildings, according to a RAND Corp. report released today that highlights the need for significant changes in Haiti's government.

The report -- which was overseen by Pittsburgh-based RAND Vice President Jack Riley -- cites overall institutional problems such as a lack of financial resources, skilled personnel and management systems.

Without fundamental changes to Haiti's government, the report contends, the millions of dollars in foreign aid that poured into Haiti post-earthquake will not be used as effectively as possible.

"State-building may not have the same appeal to international donors as erecting new buildings, but it's got to be done if Haiti is to successfully rebuild itself," said Keith Crane, a study co-author and a senior economist at RAND. "International donors have poured billions into Haiti, but they have not focused on creating sustainable institutions to provide a payoff from those investments."

While international money went to rebuild earthquake-damaged roads, donors didn't initially provide for road maintenance, Mr. Crane said. Similarly, some donor-built power plants have stopped operating because there wasn't enough money collected to pay for fuel.

The report suggests major changes in Haiti's health care system, recommending that it be turned over entirely to nongovernmental organizations such as the Hopital Albert Schweitzer.

It's a recommendation sharply disputed by Ian Rawson, managing director of the hospital. "Our job here is to be collaborative partners and not to run the show," he said, speaking on the phone from Haiti. "The ministry of health has great professionals, has great potential -- it just doesn't have the resources it needs to do its job right."

If health care were left entirely to nongovernmental organizations, Mr. Rawson said, projects might be funded based on the priorities of external groups and not on what's best for the Haitian people.

The report gave recommendations in areas such as health care, education and justice, with some requiring changes in Haiti's constitution.

In Haiti's justice system, the report noted widespread corruption, "horrific" prison conditions and centuries-old criminal codes.

Haiti lags behind other developing countries in indicators such as life expectancy, ease of business development and access to education -- and is the only country in the Western Hemisphere to experience negative growth in gross domestic product over the past three decades. Such indicators only got worse after January's devastating earthquake.

But before the earthquake, there were some signs of progress, said the report, noting five consecutive years of economic growth following the change of government in 2004.

"This progress indicates that, with better policies, Haiti can recover from the effects of the earthquake and embark on a period of improved public security, social well-being and sustained economic growth," the report said.