A review by erintby
Haiti: After the Earthquake by Paul Farmer
4.0
It’s crazy to me that the tremendous human suffering that followed Haiti’s earthquake happened while I was in high school, and yet I was only vaguely aware of it. This is an interesting book because it was published so soon after the earthquake, still early in the recovery process. Like any Paul Farmer book, I appreciate his frank analysis. He discusses how the global disaster response community, like the global health experts, has been socialized for scarcity. If anyone knows that the “global resource pie” is not as small or rigid as it is often portrayed, it’s Farmer and PIH. In discussing Haiti’s recovery path, Farmer asks whether long-term health and development challenges can be addressed—including building an education system, clean water, roads, and food security, rather than just short-term, “cost-effective” band-aids. His answer: “of course we can, with innovation and resolve and a bolder vision than has been registered in decades.” It may seem hopeless at times, but knowing the history of Partners In Health and all they’ve been able to accomplish regarding the global shift towards treatment for MDRTB and AIDS patients, it really is possible to have hope.
Of course, understanding the history of Haiti and its oppression is critical to understanding why the earthquake was so devastating. Paul Farmer and Evan Lyon (in an essay included in the Other Voices section) are clear about the fact that the devastating catastrophe that Haiti experienced was an unnatural disaster, triggered by a natural event (the 7.0 earthquake), but made what it was because of “an absolutely unnatural vulnerability created in Haiti by centuries of political, economic, environmental, and social forces” (Lyon, p. 325). Or, as Farmer often refers to it with medical terminology, it was an acute-on-chronic crisis. They also make a compelling case for why a much, much higher percentage of global aid following the earthquake (what was actually dispersed, rather than just pledged) needed to be directed to the public sector, rather than primarily to a haphazard collection of uncoordinated NGOs. PIH is all about public-private partnerships, but they understand that there are certain human rights (i.e. health care) that can only be conferred by the public sector.
Overall, it was an interesting read, though I probably would've only given it 3 stars until I got to the "Other Voices" sections. I really appreciated these essays and perspectives, especially Didi Bertrand Farmer’s.
It has been amazing to see that the Mirebalais hospital was completed and opened in 2013, but I would really be interested in a 10-year update or Afterword added to this book, to hear Farmer’s and others’ analysis on how recovery from the earthquake and cholera epidemic has continued. But, if you aren’t specifically interested in the Haiti earthquake and are looking to learn more about PIH’s global health work in general, definitely start with “Pathologies of Power” (2005) or “Reimagining Global Health” (2013). This second one actually has a section on the Haiti earthquake as well.
Of course, understanding the history of Haiti and its oppression is critical to understanding why the earthquake was so devastating. Paul Farmer and Evan Lyon (in an essay included in the Other Voices section) are clear about the fact that the devastating catastrophe that Haiti experienced was an unnatural disaster, triggered by a natural event (the 7.0 earthquake), but made what it was because of “an absolutely unnatural vulnerability created in Haiti by centuries of political, economic, environmental, and social forces” (Lyon, p. 325). Or, as Farmer often refers to it with medical terminology, it was an acute-on-chronic crisis. They also make a compelling case for why a much, much higher percentage of global aid following the earthquake (what was actually dispersed, rather than just pledged) needed to be directed to the public sector, rather than primarily to a haphazard collection of uncoordinated NGOs. PIH is all about public-private partnerships, but they understand that there are certain human rights (i.e. health care) that can only be conferred by the public sector.
Overall, it was an interesting read, though I probably would've only given it 3 stars until I got to the "Other Voices" sections. I really appreciated these essays and perspectives, especially Didi Bertrand Farmer’s.
It has been amazing to see that the Mirebalais hospital was completed and opened in 2013, but I would really be interested in a 10-year update or Afterword added to this book, to hear Farmer’s and others’ analysis on how recovery from the earthquake and cholera epidemic has continued. But, if you aren’t specifically interested in the Haiti earthquake and are looking to learn more about PIH’s global health work in general, definitely start with “Pathologies of Power” (2005) or “Reimagining Global Health” (2013). This second one actually has a section on the Haiti earthquake as well.