[News] Waiting for helicopters? Cholera, prejudice, and the right to water in Haiti

[Anti-Imperialist News]

Waiting for helicopters?


Cholera, prejudice, and the right to water in Haiti



Deepa Panchang

2012-07-05, Issue <http://www.pambazuka.org/en/issue/592>592

<http://www.pambazuka.org/en/category/features/83352>http://pambazuka.org/en/category/features/83352

Aid workers’ stereotypes and prejudices about 
residents of displacement camps in 
post-earthquake Haiti stem from an acute 
disconnect between NGOs and the people they are 
there to work with. These misperceptions have 
perpetuated deliberate decisions to deny water 
and sanitation services to desperate survivors.

“Where you stand,” goes an old Haitian proverb, 
“depends on where you sit.” This article, the 
second in a series, will examine aid workers’ 
stereotypes and prejudices about residents of 
displacement camps in post-earthquake Haiti, 
stemming from acute disconnect between NGOs and 
the people they are there to work with. We 
explore how these misperceptions have perpetuated 
deliberate decisions to deny water and sanitation 
services to desperate survivors.

The context is complicated by the transnational 
flow of both bacteria and aid dollars. Scientists 
have shown that the cholera pathogen came to 
Haiti in the bodies of foreign UN troops whose 
military base was dumping its sewage into a 
nearby river. The imported disease has claimed 
more than 7,000 lives and continues to ravage 
communities across Haiti. Two and a half years 
since the 2010 earthquake, the country still 
faces a severe dearth of water and sanitation 
services, further fueling the epidemic. The 
crisis is playing out among the nearly 400,000 
internally displaced people (IDPs) still living 
in makeshift camps under tarps or torn tents, an 
ideal environment for cholera. The situation 
raises serious questions: why, with billions of 
dollars in post-earthquake aid and hundreds of 
humanitarian NGOs in the country, do so many 
people still lack the most basic of services? 
What factors are guiding NGOs’ decisions to provide or withhold them?

The first article of this series described how 
NGOs in Haiti decided to relax humanitarian 
standards for provision of water and sanitation 
and to deliberately withhold these essential 
services in IDP camps, in the middle of the 
epidemic. By spring of 2011, the WASH cluster 
(the UN-run group of NGOs coordinating water and 
sanitation response) had decided to terminate 
water provision. It had also decided to abandon 
the international minimum requirement of 20 
people per toilet, instead setting a goal of 100 
people per toilet. Predictably, cholera surged, 
as it has done again in the rainy season of 2012. 
What were NGO officials’ underlying perceptions 
and attitudes that could lead them to such 
decisions? Here, we describe more results from a 
study I conducted in 2011, based on 52 interviews 
with officials from NGOs and residents of displacement camps.

“EVERYONE STOPPED WAITING FOR AID”

Stopping in the middle of an interview, one camp 
resident and mother of three looked me squarely 
in the eye and asked: “Who would like to live 
under a tent for one year with the heat, sun, and 
rain falling, water passing under your tent 
soaking all your clothes? 
Do you think anybody 
would like to live this kind of life?”

People in camp after camp used nearly the same 
words in describing day-to-day life. While IDP 
camps have been the main locale for 
earthquake-affected Haitians to rebuild their 
lives and communities, this rebuilding has been 
fraught with suffering. The majority of camp 
residents I interviewed said they were skeptical 
they would ever receive more services from NGOs, 
but they stayed in the camps because the scraps 
of tents and the fragile communities of 
interdependence that had emerged were their last 
resort – their only option for survival. “As of 
six months ago people stopped waiting for aid and 
left,” said one camp resident in early 2011. 
“Those that are here are those who can’t return 
home, who don’t have anything.”

During the rainy season, most of the homes I sat 
in leaked water through the makeshift roof and 
gushed water through muddy gaps between ground 
and plastic. Many had to be re-hoisted, re-tied, 
re-sewed, re-hammered after every storm. Although 
families kept the areas outside their homes tidy, 
nearby drainage ditches brought all manners of 
trash and debris as daily gifts. In the majority 
of camps, respondents stated they had nowhere 
else to go, and a coordinating agency, the 
International Organization for Migration’s survey 
of more than 15,000 camp dwellers concluded the 
same, stating “94 per cent of people living in 
camps would leave if they had alternative 
accommodation.” Part of the difficulty is that 80 
per cent of camp residents were renting homes 
before the earthquake, which made return 
extremely difficult given the massive 
post-earthquake surge in rental prices and the bleak job market. [1]

But how did NGO officials perceive the situation?

“WAITING FOR HOUSES, CARS, HELICOPTERS”

In their interviews, foreign officials from NGOs 
and IOM expressed the belief that Haitians could 
handle the camp conditions and were simply 
waiting for handouts. Many officials stated that 
they viewed signs of day-to-day survival in the 
camps – such as women selling coffee on the 
street and families scrounging up building 
materials from friends – as proof that life was 
back to normal. Where these efforts may have 
provided the coffee vendor with enough money to 
purchase some water for her kids or bought the 
family an extra week before their shelter 
collapsed for the fourth time, many NGO officials 
touted them as “coping mechanisms” which 
indicated that camp residents were doing fine on 
their own. One official evoked the racist 
hypothesis that Haitians were “genetically 
strong” given the “horrendous conditions” such as 
“slavery and torture” they had endured over 
centuries. “You or I would not survive one month 
in one of those camps,” she said.

IOM officials suggested that a large percentage 
of displaced people actually had the means to 
return to their former homes, but remained in 
camps waiting for NGOs to bestow miracles. They 
were “waiting for houses, cars, helicopters,” 
complained one, and “visas to Canada” quipped 
another. One senior IOM official enthusiastically 
but incorrectly asserted that only 30 per cent of 
IDPs were renting homes before the quake, that 
the majority had land they could return to. 
Another high-level IOM official, somehow missing 
the fact that the job market was devastated and 
rental costs drastically inflated, commented, “We 
have to be careful because if they had the money 
to rent before, why now they don’t have it?” 
Suspicion often won out, with worries that camp 
residents were systematically conning the system. 
Many officials I interviewed expressed a fear 
that camps would persist indefinitely. Since no 
one has offered residents an alternative, this 
could be a realistic fear, but one official 
responded to by retracting services so people 
would disperse, rather than pushing more 
vehemently for comprehensive housing solutions.

Officials actually worried about overprovision of 
services as a “pull factor” into camps. Services 
“are like a magnet to keep people there,” said 
one aid worker. Another went as far as saying, 
“In truth, if you scratch the surface, people 
find a way to obtain new lodging.” Many officials 
I interviewed expressed the same opinion, and a 
few all but stopped short of explicitly labeling 
camp residents conniving and conspiratorial. This 
is alarming for a number of reasons. For one, it 
paints the camps as some sort of cornucopia of 
services, when in reality most residents continue 
to struggle for the most basic of needs. It also 
minimizes the experiences of earthquake survivors 
living outside camps in conditions desperate 
enough that they might move to a camp just for a 
bucket of water every once in a while. In 
allowing “pull factor” mentality to dilute their 
commitment to providing services, NGOs could keep 
water and sanitation out of reach of both camp 
residents and their desperate neighbors.

In an unfortunately common case of reverse 
psychology, a management-level official argued 
that WASH services were sufficient in the camps 
since “people didn’t riot and there wasn’t mass 
outbreak of diarrheal disease.” When my research 
partner raised an eyebrow and brought up cholera, 
he responded, “Well, that one didn’t happen in 
the camps, and it hasn’t wiped out camps either.” 
Although the official admitted that he had not 
talked to any camp residents, he said, “I think 
they’re pretty pleased.” Meanwhile, not only have 
cases been documented in which entire camps 
dispersed specifically due to cholera, but this 
should hardly be the minimum qualifier for 
concern. Another like-minded IOM official’s 
observation that “When you go to a camp during 
daytime almost no one is there,” led him to 
conclude, “they all take back their work they had 
before.” Although they do not represent the 
majority, it is telling that such opinions openly 
exist among key decision-makers in the WASH 
response who are clearly placing their 
presumptions above real knowledge of camp conditions.

Mistrust and the idea that camp residents are 
doing fine have made it all the easier to neglect 
humanitarian standards and human rights. It is 
another iteration of how the resilience of a 
people can be used against them. If they are 
somehow surviving, the logic goes, they can take more, and make do with less.

Esaie Jean Jules of the Solino Neighborhood 
Assembly, a grassroots group involved in cholera 
response, did not mince words in putting the 
pieces together: “One measure NGOs have taken to 
get people to leave the camps is to take away 
provision of water and sanitation,” he said this 
past April. “It’s been almost six months since 
anyone has come to de-sludge the latrines, but 
people are still using them. People do not have 
access to any other option. There are almost 
2,000 people, all who lost their homes in the 
earthquake, in one of the camps in Solino. They 
share four toilets. There’s no dignity in that, 
and when it comes to cholera, it’s a danger.”

“AN AGENDA, A PLAN, A PROGRAM”

There are reasons why NGO officials do not really 
take to heart the experiences of those living in 
displacement camps. There is very little 
dedicated time and space for honest contact and 
discussion between the two parties. As if in a 
war zone, NGO rules often restrict their 
employees from walking on the street, barricading 
them in offices or air-conditioned SUVs. This is 
based largely on perceptions rather than reality: 
Haiti actually has among the lowest homicide 
rates in the region. Camp residents, in their 
interviews, often decried these measures as a sign of disrespect and distrust.

Camp residents also told me they have little to 
no input in the decisions made regarding their 
own camps. I used a checklist to ask camp 
committee leaders about their involvement in many 
steps of the project process. Of these, the only 
actual role residents were usually allowed in 
sanitation projects was cleaning the toilets and 
determining where toilets would be placed. While 
this seems more like NGOs pawning off the most 
undesirable or mundane tasks onto camp residents, 
aid workers described this to us as community 
“participation.” More active aspects of the 
project process, such as deciding how to carry 
out the project or follow-up, designing a system 
for maintenance, or even deciding how many 
toilets and what kind, were not up for input by 
camp residents. While NGO officials described 
meetings they held to discuss these issues, camp 
residents countered that they had little actual 
say in these meetings. They were “obliged” to 
take whatever they got, however they got it. They 
had opinions on the way toilets were being 
installed and maintained in their own camps, and 
on the system as a whole. They wanted information 
on how and why the system worked the way it did. 
But, beyond informing the NGO representative – 
assuming such a representative showed up, 
understood them, and relayed the message – camp 
residents had little means to convey their opinions.

One camp resident summed up the sentiments the 
majority of residents expressed to me: “[NGO 
officials] come with an agenda, a plan, a 
program. They can always find people who are 
clients for them who help execute the plan. But 
they don’t meet with the majority of the committee to identify needs.”

“THE MEETINGS ARE ALMOST ALWAYS IN ENGLISH
”

If displaced people have little say in programs 
being run in their camps, they have even less at 
the level of aid coordination and management. I 
asked if camp residents knew about the cluster 
system, the UN-run meetings where NGOs made 
decisions regarding not only water and sanitation 
but also provision of all basic post-quake 
services. None of the camp residents interviewed 
from any of the 16 camps knew what the cluster 
system was. The vast majority of residents 
reported that they do not receive information 
about how the UN and NGOs make decisions regarding them.

 From our observations, the classic cluster 
meeting, for at least a year after the 
earthquake, looked like this: 20 to 30 people 
crowded around a few tables, some 80 per cent 
from the US or Europe, speaking in a mix of 
English and French, communicating through 
powerpoint presentations and humanitarian aid 
jargon. The clusters’ exclusion of local people 
and groups drew criticism in the weeks following 
the earthquake, as it has after previous 
disasters elsewhere in the world. Yet this 
exclusion was so consistent, and the meetings so 
culturally comfortable to them, that aid workers 
came to see it as the norm. Several agency 
officials, in fact, explained that the cluster 
was not designed for camp residents to be 
present, that clusters were meetings for NGOs to 
speak with each other. A few wondered aloud how 
camp residents could be invited to participate 
given that the meetings could turn unwieldy, and 
some argued that the camp residents are in fact 
represented, since the NGOs speak on their 
behalf. Only three respondents stated that lack 
of participation was a real concern for them.

The result is that displaced people are simply 
not present to express the challenges they face 
and to advocate for solutions of their own 
creation. This exclusion was replicated at a 
number of other levels in post-earthquake 
decision-making and planning (more on this in the next article).

For most NGO officials, suspicion and 
misperceptions are not due to ill intentions – 
many work long hours and aspire to help those in 
need – but to the extreme disconnect between 
their institutions and Haitians’ reality on the 
ground. This, combined with the fact that 
management-level officials can hold prejudiced, 
sometimes downright racist beliefs, inevitably 
spills over into agencies’ decision-making in the 
form of denial of services and exclusion.

NGOs may claim that they cannot continue 
providing services indefinitely. Notwithstanding 
the fact that many are still sitting on (some 
even making interest on) the funds they raised 
for Haiti, this is understandable in the long 
term. But instead of responding by abandoning the 
people they have assumed responsibility for, they 
could step up in their role as advocates, pushing 
for long-term reconstruction and housing 
policies, for the changes in foreign policy that 
Haitians are demanding, and for the international 
community’s follow-through on its pledges. Some 
groups, such as Doctors without Borders and 
Partners in Health, have been doing this all along.

What are the solutions that Haitians are asking 
for? And how can NGOs adopt models that are 
driven by these demands? The next article will 
take a look at some of the inspiring examples of 
community engagement that Haitian grassroots 
groups are promoting, as well as the exceptional 
international NGOs that have followed their lead. 
We also look at how the dynamics I describe here 
are the continuation of historic trends that 
often implicate our government, here in the US – 
down to the reason why cholera was able to gain a 
foothold in Haiti in the first place.

Sign these petitions telling the UN to take 
responsibility for introducing cholera into Haiti 
and to help stop the epidemic: Just Foreign 
Policy Petition & Baseball in the Time of Cholera 
[url= 
<http://salsa.democracyinaction.org/o/1439/p/dia/action/public/?action_KEY=10401>Petition]http://salsa.democracyinaction.org/o/1439/p/dia/action/public/?action_KEY=10401]Petition[/url][/url] 

NOTE: Respondents’ names are not given as 
interviews for the study were conducted 
anonymously. Esaie Jean Jules was interviewed 
separately by Alexis Erkert. The study described 
was part of a Master’s thesis at the Harvard 
School of Public Health. For a copy of the full 
paper, contact 
<mailto:deepa.otherworlds at gmail.com>deepa.otherworlds at gmail.com 
Special thanks to Professor Stephen Marks and 
Silvan Vesenbeckh at the Harvard School of Public 
Health, Professor Mark Schuller at the City 
University of New York, and Ben Depp for sharing his remarkable photography.

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Deepa Panchang is the Education and Outreach 
Coordinator for [url= 
Other]http://www.otherworldsarepossible.org/]Other 
Worlds[/url], where this article was first 
published. She has worked in advocacy for human 
rights in Haiti since the 2010 earthquake.

* Please send comments to 
<mailto:editor at pambazuka.org>editor[at]pambazuka[dot]org 
or comment online at <http://www.pambazuka.org/>Pambazuka News.

END NOTES

[i] Financial Edge. (2011, April 29). Where's The 
Next Housing Bubble? and Sasser, B. (2011, March 
18). Haiti's housing bubble, more pressing to 
some than election or Aristide. Christian Science Monitor .

[ii] Schuller, M. (2011). “Met Ko Veye Ko”: 
Foreign Responsibility in the Failure to Protect 
Against Cholera and Other Man-made Disasters. 
Retrieved April 17, 2011 from IJDH: 
<http://ijdh.org/archives/16896>http://ijdh.org/archives/16896

[iii] Lindsay, R. (2010, March 29). Haiti's 
Excluded. Retrieved April 17, 2011 from The 
Nation: 
<http://www.thenation.com/article/haitis-excluded>http://www.thenation.com/article/haitis-excluded




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