ARTICLE - 5 LESSONS

5 LESSONS FROM HAITI'S DISASTER
(Foreign Policy) - By Paul Farmer

What the earthquake taught us about foreign aid.

1. Jobs are everything.

All humans need money -- they need it to buy food and water every day. And no matter how hard the government or the aid industry tries, people will want for all three things until they are employed.

The world pledged some $10.2 billion in recovery aid to Haiti after Jan. 12's devastating earthquake. Imagine how many people that money could employ, putting them to work on tasks like removing rubble (only 2 percent of which has been cleared to date), rebuilding key government buildings, and planting trees in a country that is almost entirely deforested. And yet so far, just 116,000 people have been employed in this way. Haiti has 9.8 million people, and at least half were unemployed even before the earthquake. If we focused our efforts on the singular task of getting them jobs -- even if we did nothing else -- Haiti's reconstruction could be a success.

2. Don't starve the government.

The international community doesn't know best. Local people do. NGOs like the one that I am lucky to work with cannot replace the state -- nor can the United Nations or anyone else. We don't have the expertise, and we won't stay forever. We don't have the same stake in building a community that the locals themselves have. And if aid is to work, it can't fall apart when the expats leave.

On this, almost everyone agrees. But the opposite approach has characterized Haiti relief. The dollar figures tell the real story: A mere 0.3 percent of the more than $2 billion in humanitarian aid pledged by major donors has ended up with local authorities. That money will hardly compensate for the 20 percent of civil servants who died in the quake.

Some donors argue that the Haitian government is rife with corruption and mismanagement -- and that infusing it with money will only make matters worse. But we need to strengthen the public sector, not weaken it. And that will take a working budget. It's impossible to be transparent and track your budgets when you lack computers, electricity, and even the personnel to do so. Until the government has the resources it needs, Haiti will remain the republic of NGOs.

3. Give them something to go home to.

Today, some 1.3 million Haitians live in tent camps amid often squalid conditions -- yet no one has been able to convince them to resettle. Why don't they want to leave? Because there is nothing to draw them back. Many of these displaced men and women didn't own the houses that collapsed around then; they rented them -- often under very unfavorable conditions. They were in debt to bad landlords. They had no schools or clinics.

Enticing them to return home will mean providing exactly what they lacked before: housing, education, and health care. Ironically, Haitians are getting some of those things now in the camps. They have shelter in the 69,700 tents distributed by donors; they have the food and hygiene kits that NGOs offer. The tent camps may well become semipermanent homes if those services don't also exist in the cities, villages, and towns.

4. Waste not, want not.

At least half of aid money probably never reaches its recipients, eaten up by overhead; often it's even more. I know of no other business or enterprise in which this would be an acceptable operational strategy. Equally frustrating, sometimes the money doesn't show up at all. Of the donor dollars promised for 2010, Haiti has so far received a mere 38 percent, or $732.5 million, excluding debt relief. Nine months after the disaster, not a cent of the U.S. donation for Haiti's reconstruction has been disbursed; it's tied up in appropriations. Imagine trying to re-engineer a devastated country when your budget is at the mercy of political whims in foreign lands.

5. Relief is the easy part.

Disaster relief is not reconstruction. We haven't rebuilt Haiti despite giving 1.1 million people access to drinking water; we didn't remake the country with the 11,000 latrines that have been installed. "Building Haiti back better" means sustaining those temporary gains and adding education, health care, services, and good governance.

What's most important in getting started? Economic growth. Yet it is a challenge hardly mentioned in aid documents or strategies -- coming up only twice in the United Nations' most recent 44-page report. Poverty of the kind that was so acutely revealed this January can't be defeated until there is a brighter economic future for the millions of Haitians who are ready to seize it.

**Paul Farmer is a medical anthropologist at Harvard University.