Wednesday, October 27, 2010

Special report: Is aid doing Haiti more harm than good?

PORT-AU-PRINCE | Mon Oct 25, 2010 7:23pm EDT

(Reuters) - It was Haiti's premier private hospital, its rooms filled with the latest medical equipment, its surgeons trained in the latest techniques, its thick walls built to withstand an earthquake.

Those walls stood firm when the earth shook on January 12, and for three months after that devastating quake the CDTI du Sacre Coeur Hospital threw open its doors, treating thousands of victims free of charge.

American and French doctors, flown in by their respective governments, worked non-stop in CDTI's operating rooms together with their Haitian counterparts seeing more than 12,000 patients and performing more than 700 major surgeries.

Today, the hospital stands empty, its consulting and operating rooms abandoned, its beds unused, its scanners gathering dust, its two brand new ambulances sitting under tarpaulins in the yard. On April 1, owner Reynold Savain was forced to close CDTI because neither the Haitian nor U.S. governments, nor the United Nations, would agree to help pay his bills.

The echoing corridors of the hospital are a monument to the failure of the Haitian government and the international community to work with the private sector to rebuild. The risk is that billions of dollars of aid will once again fail to leave any lasting legacies in the Western Hemisphere's poorest country.

A cholera outbreak in recent days only underlines the vulnerabilities of Haiti's dysfunctional systems.

Savain said when he asked the World Health Organization to help cover his doctors' salaries, they offered to pay in food and blankets, of no use to professionals who needed cash to pay rent and school fees.

"Philosophically, they can't work with the private sector, that is the real issue," the white-haired Savain said as he opened door after door to empty rooms.

"They want to put everything through the public sector, but they have to find a way to strengthen the private sector."

Friends say Savain made mistakes too in handling the issue, sending invoices to the U.S. Agency for International Development (USAID), as though he had a right to charge every patient his full private rates at a time of national emergency, instead of looking for a compromise.

Nonetheless, nine months after the earthquake struck, there is a strong sense that the Haitian government, foreign donors and non-governmental organizations (NGOs) and the domestic private sector are simply not pulling in the same direction, not even talking the same language.

HEALTH SYSTEM VULNERABLE

Time after time, Haiti has endured disaster followed by aid that did little to build long-term prosperity -- bypassing both the government and the private sector. From corrupt politicians to nepotistic elites and well-meaning outsiders who thought they knew best, there is plenty of blame to go around.

The question is how to break the cycle and rebuild after the quake which killed at least a quarter of a million people and rendered more than a million homeless, leaving vast swathes of Port-au-Prince in ruins.

The disaster drew an outpouring of sympathy from around the world and foreign aid has had significant successes. But it is not providing, and seems unable to provide, permanent private sector jobs. This is nowhere more apparent than in agriculture and in private healthcare

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