Beyond the Bottleneck in Haiti

In the first days of the worst natural disaster this hemisphere has witnessed in recent history, much attention and criticism has focused on what has been most visible: the logistical bottleneck at the Port-au-Prince airport. With one runaway and the control tower destroyed, a facility that normally handled 30 daily flights has struggled to accommodate some 200 air shipments a day. The amount of international assistance has appeared to overwhelm the Haitian capacity to receive it.

But as the logjam clears, we risk slipping into a false sense of relief. As tremendous as international outpouring of support has been, it pales -- in fact, is overwhelmed -- by the “surpassingly enormous need” that remains, as U.S. anthropologist and physician Paul Farmer wrote in a recent column in the Miami Herald.

Farmer knows what he is talking about. The Harvard professor, founder of Partners in Health, and United Nations deputy special envoy to Haiti, has dedicated his life to helping and understanding the people of that country.

In his column, just days after the tragedy, Farmer articulates the many hurdles that aid workers face. But with the luxury of a few more days and a few reports, we can discern in sheer numbers how profound the mismatch is between aid supply and demand. And so we can begin to get a sense of what it would really take finding the missing, treating the injured and feeding the hungry.

As of 2 p.m. Wednesday January 20, according to the United States Agency for International Development, a total of 43 international urban search and rescue teams with over 1,700 workers had rescued 122 people from the rubble. Each of those must seem miraculous, but tens of thousands remain missing.
In terms of medical treatment, only the roughest figures are available. Between Jan. 17 and Jan. 20, U.S. medical personnel on the ground treated on average 1700 people daily. Doctors Without Borders says it is carrying out 130 operations a day. There are a handful of other field hospitals set up by countries such as Brazil, Colombia and Israel that can treat similar numbers.

Farmer’s Partner in Health, which has been providing health care in Haiti for two decades, issued an urgent appeal for more medical assistance. The organization’s medical director estimates that due to gangrene and other infections, each day 20,000 people are dying who could be saved by surgery. Overall, the European Union Commission estimates that the earthquake left 250,000 injured.

By Monday, Jan. 18, the World Food Program said it had distributed more than 250,000 ready-to-eat food rations, reaching just a fraction of the 3 million people thought to be without food. Due to the widespread lack of access to cooking facilities, WFP said it needs to deliver 100 million ready to eat meals in the next 30 days. As of Tuesday it had 16 million in the pipeline.

Since the earthquake hit, millions of private donors from around the world have responded. According to the Chronicle of Philanthropy, the 22 largest charities in the United States raised more than $150 million in the four days after the quake, well more than the $108 million raised in the four days following Hurricane Katrina in 2005 and the $30 million raised in the three days following the 2004 tsunami in Asia.

Meanwhile, governments around the world have pledged nearly $1 billion in aid to Haiti, according to an Associated Press count. But Dominican Republic President Leonel Fernandez has estimated that to help rebuild Haiti would require a $10 billion five-year fund, which he called for at an emergency international donor summit held last weekend.

It has taken an unprecedented disaster to focus the world’s attention on the poorest and most forsaken nations on this side of the planet. And while the outpouring of support may also be historic, the painful reality is that it is coming up short.

In his book “Mountains Beyond Mountains,” Pulitzer Prize winner Tracy Kidder writes about Farmer’s lifework of treating Haitians. The author observes that in the midst of their suffering Haitians retain a powerful faith, leading him to ask what many have wondered in recent days: “How could a just God permit great misery?”

To which, Kidder writes, “the Haitian peasants answered with a proverb: ‘Bondye konn bay, men li pa konn separe,’” (God gives but doesn't share). This means, as Farmer explains to Kidder, “God gives us humans everything we need to flourish, but He's not the One who's supposed to divvy up the loot. That charge was laid upon us.”