Written by Sonny Garg, Senior Vice President, Human Resources, Exelon Corporation
The impact of food insecurity in Haiti cannot be overestimated. Haiti ranks along with Afghanistan and Somalia as one of the three countries of the world with the worst daily caloric deficit per inhabitant (460 kcal/day). According to UNICEF, almost a quarter of Haiti's children suffer from chronic malnutrition, which stunts growth and causes long-term developmental damage. In PIH's experience, what is needed is a holistic approach to address hunger and malnutrition in the short term, and food security, agricultural capacity, and economic opportunity in the longer term.
Zanmi Agrikol ("Partners In Agriculture" in Haitian Creole) is PIH's program to treat and prevent childhood malnutrition while improving agricultural capacity and household food security in the areas where PIH works in Haiti. Launched as a small pilot program in November 2006, Zanmi Agrikol has three main components:
- The local production of therapeutic foods (called Nourimanba and Nourimil) to treat and prevent malnutrition.
- The operation of a farm and contracts with local farmers who grow crops (mainly peanuts) used to make these therapeutic foods.
- The Family Assistance Program, an agricultural assistance program for the poorest families whose children are being treated for malnutrition at Zanmi Lasante clinical sites.
The Zanmi Agrikol program currently provides malnutrition treatment and prevention for 5,600 children, employs or contracts with roughly 200 local farmers, and provides agricultural training and support to 1,240 vulnerable families through the Family Assistance Program.
In the Fall of 2009, Sonny Garg and Professor Rob Gertner from the University of Chicago Booth School of Business launched an initiative to develop a business plan to expand RUTF (Ready to Use Therapeutic Food) production in Haiti and explore agribusiness opportunities in Haiti. Now with the engagement and support of Abbott Laboratories/Abbott Fund, PIH will be pursuing the implementation of expanded RUTF production to meet the PIH patient demand and will be considering the possibility of producing additional agricultural products as opportunities arise.
Written by Ann Clark, Nicolas Clark Architects
The Chicago Community is not only busy raising money for a new teaching hospital in Mirebalais, Haiti located just 37 miles northeast of Port au Prince, but several community members are also working on the architectural design and drawings for the hospital.
One of PIH's Chicago Regional Representatives, Ann Clark, and her architecture firm, Nicholas Clark Architects, Ltd. has been collaborating with PIH's Dr. David Walton (originally from Skokie), and dedicated PIH volunteer Jim Ansara, founder and Chairman of Shawmut Design and Construction located in Boston, on the design of the new hospital.
On January 12, 2010, Ann had just left the Shawmut offices having spent the day collaborating with Jim and David in Boston when the earthquake hit. A day after the quake, David and Jim headed down to Haiti to work in Port au Prince to offer their assistance both in the medical arena and Jim offering his expertise getting generators up and running amongst other emergency needs.
It became apparent soon after the quake that the hospital that was on the boards would need to be revisited to accommodate the even greater needs of the Haitian people.
Nicholas Clark Architects continued to work with David Walton and Jim Ansara upon their return to the US to accommodate these additional needs. This effort has required a good amount of flexibility on all members of the team since new programmatic elements were added as they became apparent.
The team has now expanded to include civil, structural, plumbing, mechanical, and electrical engineers, most of who were brought in by Jim Ansara. Clean water specialists from Operation Blessing also joined the team, as did solar panel experts from Solar Electric Light Fund (SELF), who have been working with PIH on numerous projects.
The 180,000 square foot hospital will now house the following:
- 300 beds distributed amongst men’s, women’s and children’s wards as well as a women’s health ward
- An Intensive Care Unit and Neonatal Care Unit
- An outpatient clinic that will serve between 400 - 600 people per day
- A women’s health outpatient clinic that will serve between 200 - 300 women per day
- A surgical center with six large operation rooms
- A community health center that will distribute fortified, peanut butter nutritional supplements to malnourished children and families
- An isolation ward for tuberculosis patients
- An expansive pharmacy depot
- Large meeting rooms and conference rooms to be used as classrooms for medical and nursing students, as well as for community meetings and as an administration center
In addition to the main hospital facility, the master plan for the grounds will eventually include the following:
- Patient/family housing (overnight stays for family members)
- Staff residence to accommodate local Haitian staff as well as visiting staff
- Guest house
- Dining facility to accommodate staff residence and guest housing
- Lying-in center for late term pregnant women who will come prior to due date from distances until they are ready to deliver their babies
- Central administration center
Written by Greg Beckett, Collegiate Assistant Professor in the Social Sciences Division, University of ChicagoIt has become common-place to note the extent of environmental destruction in Haiti, and to reduce this to an effect of over-population or poor land use practices. While the staggering rates of deforestation and soil erosion are due, in part, to population growth and land use, they are also the effects of a deeply entrenched system that has persistently kept rural Haitians poor and marginalized.
The roots of rural poverty lie in Haiti's colonial past. The French colony of Saint Domingue was one of the world's wealthiest colonies in the 18th century. It supplied much of Europe's coffee and sugar, and was a major hub for the trans-Atlantic slave trade. But the colonial system of sugar, slaves, and coffee radically transformed the local geography, making Haiti – like much of the Caribbean – one of the most humanized landscapes in the world. Deforestation and mono-crop production (two of the leading causes of environmental degradation) began under French colonial rule, and they continue today because Haiti remains economically dependent on the global economy. That dependency has been renewed and deepened by successive governments in Haiti and by the international community.
After winning independence from the French in 1804, ex-slaves fled the large plantations, seeking land of their own. Within one generation Haiti became a peasant nation, as the vast majority of the population took up small-scale cultivation. Without a willing workforce, plantation owners sold their land and moved to port towns, where they became an urban merchant class. An alliance between the merchants and the government established a long-standing tradition in which both groups lived by extracting more and more surplus out of agricultural production, at the expense of the peasantry.
This system started to break down in the 20th century, as the agricultural sector began to stagnate and then decline. A series of repressive governments defended the system with state-sponsored violence, and decades of foreign development assistance and food aid kept the mounting crisis at bay. Everything changed in the 1970s, when the United States and leading international financial institutions such as the World Bank and the International Monetary Fund began to write new economic policies for Haiti. (They 'compelled' successive governments to adopt these policies by threatening to withhold foreign aid.) Within a decade, the Haitian economy was radically remade. Trade liberalization removed or greatly decreased tariffs and subsidies that had previously protected local food production. Today, despite the fact that a majority of the population still works in the agricultural sector, Haiti is a net food importer, with chronic bouts of food insecurity.
Many commentators attribute the country's environmental problems to the peasantry themselves. Yet, while it is true that peasants cut down trees (typically to make charcoal to service the urban energy market), it is a mistake to see this as a choice freely made. To do so seems oddly close to blaming the victim. No peasant cuts down a tree without a deep sense of compulsion and a very real awareness of the accumulative effects of deforestation and erosion. After all, it is the peasantry that suffers directly as they live the effects of environmental degradation. Haiti's environmental problem is fundamentally a problem of rural poverty and economic dependency, and no national reconstruction program will be complete without an acknowledgement of this fact.
Written by Betsy Dietel, Dietel PartnersIn early January of this year, representatives of PIH's Chicago Community scheduled a trip to Haiti. The plan was to expand our group and mobilize the money and materials needed to reach our final goal of getting the new Mirebalais hospital built and operating. Then the January 12 earthquake hit. The trip was cancelled, and as events unfolded over those first fateful weeks in February the horrors of the earthquake added a new sense of urgency to our work. The community of support grew exponentially, as complete strangers gathered pallets of medical supplies, wrote emails, and attended events across Chicagoland.
So where are we today? The Haitian people's courageous perseverance, resiliency, solidarity and civility in the wake of this natural disaster are truly extraordinary and inspiring. Grassroots NGOs--many of which lost staff, family members and friends, as well as offices, equipment, and other resources--are working diligently to insure the well-being of survivors and trying to guarantee that justice and equity are integrated into the rebuilding phase.
The international response, particularly from the US and UN, has been less than inspirational. We have fallen short in meeting the people's need for food, water, shelter and protection from abuse. Many mistakes continue to be made; lack of coordination among NGO's; food distribution that undermines local production and employment which could ultimately threaten to destroy local agriculture; delivery of aid and imposition of reconstruction plans that bypass the Haitian government and sideline local control, decision-making and leadership. These are distressing trends.
Now is our chance, to engage and reaffirm our commitment to a different kind of disaster response that will result in a different future for Haiti. Support for organizations like PIH, that are committed to providing a different kind of humanitarian aid is crucial at this juncture. PIH, along with a few other grassroots NGOs, is working hand-in-hand with the Haitian government and the Haitian people, starting with the principle that all aid recipients deserve power and dignity over their lives. In the words of Loune Viaud, Chief of Operations for PIH's Haitian sister organization Zanmi Lasante: "These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating--crucial infrastructure and services--are ultimately owned by the Haitian people."
This type of humanitarian aid is the embodiment of the Hippocratic Oath, "first do no harm." Failure to provide aid directly to the Haitian government causes genuine and serious harm by undermining the Haitian people's confidence that the government is able and that NGOs are willing to respond to their needs and respect their rights. As I write this, demonstrators outside the presidential palace are calling for President Preval's resignation and grafitti on the walls of Port-au-Prince proclaim, "Down with NGOs."
Time is running out for reconstruction business as usual. We need to listen to our Haitian brothers and sisters.
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