Haiti: Aid in a Time of Cholera
Why has outsourcing disaster relief work to NGOs failed in the case of Haiti’s cholera outbreak?
December 16, 2010
The alarming outbreak of cholera in Haiti is not merely another major tragedy to hit that long-suffering country. It should also be a warning call to the international community to scrap its outmoded, Reagan/Thatcher-era tradition of privatizing relief efforts around the world and outsourcing them to nongovernmental organizations (NGOs).
The current calamity also offers France in particular a chance to make amends for still-prominent wounds inflicted upon the Caribbean nation 200 years ago, and to set an example of global leadership that other powers could — and should — easily follow.
The cholera outbreak began a full ten months after the most devastating earthquake to rock Haiti in modern history. The temblor killed at least 230,000 people and left another one million homeless.
As happens all too often in these situations, the problem was not a lack of public generosity around the world, or a lack of idealism. Rather, it was a widespread lack of coordination and managerial competence in coordinating numerous different relief efforts to get the job done.
It doesn't matter how many outraged shrieks of anger and denial will try to refute that statement. The simple, awkward fact is that, in the modern world, there is no excuse for failing to prevent any outbreak of cholera in any disaster zone months after the event.
And that is especially the case in a small, isolated island society of only a few million people where a swarm of generously funded NGOs have been busily operating for many a year.
Yet as of mid-December 2010, cholera had infected at least 100,000 people in Haiti over the preceding seven weeks — and killed over 2,100. If the disease spreads into United Nations-run refugee camps, hundreds of thousands more Haitians could be endangered.
Cholera is capable of killing millions of people, and still does so around the world every year. Some 38 million died of the disease between the end of the Napoleonic Wars in 1815 and the Russian Revolution in 1917. Relatively isolated outbreaks still affect three million to five million people around the world every year — and kill up to 130,000 of them.
Cholera is initially spread by contaminated water. But for exceptionally low per unit costs, safe water supplies can be set up and maintained to stop it in its tracks. This is essential, as once it gets into the human population, it can spread like wildfire.
Even then, the imposition of strict quarantine controls and proper standards of sanitation and hygiene can rapidly get it under control, provided a sufficient central government exists and has enough international aid and financial resources to implement those policies.
And that's the core of the problem in Haiti: No central government exists. And the United Nations, its own relief agencies and the international NGOs are all too fragmented and — however well-funded — simply too uncoordinated to get the job done. While such organizations are long on good intentions, they are short on hard-nosed execution.
And that's why France should now step in. The Fifth Republic under President Nicolas Sarkozy has a golden opportunity to try and repay a terrible historical debt the First Republic incurred more than 210 years ago.
For the black Caribbean people of Haiti made the terrible mistake in the 1790s of taking the French Revolution seriously. They naively assumed that the magic words "Liberté, Fraternité and Equalité" were also meant to apply to them.
They soon learned otherwise: The corrupt Directory government of the First Republic, followed by the tyrannical power of First Consul Napoleon Bonaparte, sent armies to mercilessly crush and destroy the Haitian freedom fighters.
The result was a decade and a half of war until Napoleon finally cut his losses. Haiti has remained an impoverished and superstition-filled backwater of deprivation, ignorance and despair to this day.
Today, France has much to offer Haiti, given that France has long led the world in researching and stamping out dangerous epidemic diseases. A French doctor, Charles Nicholle, won the Nobel Prize for Medicine in 1928 for discovering the transmission patterns of typhus — ironically, the parasite that destroyed Napoleon's hitherto invincible Grande Armée in Russia in 1812.
It also helps that France's Fourth and Fifth French Republics have both proved outstandingly successful in their ambitious public works and public service projects. Witness the French civilian nuclear reactor power-generating network, the finest fleet and infrastructure of super-fast trains in the world (TGV), and the French Arianne civilian satellite-launching program.
Here then is a golden opportunity for the embattled President Sarkozy to disarm his political opponents at home by showcasing the world-leading medical and engineering expertise of France and the genius visions of national generosity with which France has repeatedly lit up the world.
It could also supply a crucial service, saving perhaps hundreds of thousands of lives where all the vaunted wealth and power of the United States could not.
And most important, it could set a new fashion for government involvement and direct-government-run emergency relief programs after global disasters to replace the laissez-faire chaos that has hobbled previous efforts for decades.
Plus, the biggest charm of all: making up for terrible colonial-era misdeeds.
What's not to like?
The black Caribbean people of Haiti made the terrible mistake in the 1790s of taking the French Revolution seriously.
Some 38 million people around the world died of cholera between the end of the Napoleonic Wars in 1815 and the Russian Revolution in 1917.
In the modern world, there is no excuse for failing to prevent any outbreak of cholera in any disaster zone months after the event.
It helps that France's Fourth and Fifth French Republics have both proved outstandingly successful in their ambitious public works and public service projects.
After France sent armies to mercilessly crush and destroy the Haitian freedom fighters, Haiti has remained an impoverished and superstition-filled backwater of deprivation, ignorance and despair to this day.