>>INTERVIEW: paul farmer
It's popular to say things like "The Haitians have to solve their own
problems," but it's silly. The Haitians did not create slavery, chronic
interference with their internal affairs, gunboat diplomacy, foreign
occupations and a long history of trade and aid embargoes. The Haitians
did not create unfair economic policies. These were created outside of
Haiti. Erasing Haiti's debt, restoring constitutional rule, ending
arbitrary aid embargoes and sinking significant resources into public
health, public education and public infrastructure would be central to
addressing and indeed solving Haiti's social problems.
Haiti's flooding is a result of the ecological disaster (deforestation)
that's been worsening over the past several decades, and that could be
addressed, too. But exhorting peasants not to cut down trees for
firewood is not the way to address deforestation. How else are they
going to cook their food?
---DR. PAUL FARMER
Haiti now, from the inside:
After the flooding and the departure of Aristide, former Hernando
County doctor Paul Farmer fights more difficulties in providing care to the
By DAN DeWITT, Times Staff Writer
Published June 13, 2004
In January, the St. Petersburg Times visited former Hernando County
resident Dr. Paul Farmer, who has provided health care in central Haiti for
More than 20 years. We interviewed him again recently to ask how his
Organization Zanmi Lasante, withstood last month's flooding and the political uprising
in February, when U.S. troops arrived in Haiti and former President
Jean-Betrand Aristide departed.
Q. The floods have been devastating in low-lying areas of Haiti. What
has the impact been in the Central Plateau?
A. Mudslides and flash flooding have been bigger problems than
groundwater flooding. The road to Boucan Carre (a town where Zanmi Lasante
operates a hospital and several social programs) was impassable last week.
Impassable, at least, to the trucks carrying the building supplies for the housing
project. But the biggest problem for people in central Haiti is they can't stay
dry during the rainy season. The thatch huts just can't keep the heavy rains
out. These houses are just not worthy of the name and need to be replaced with
tin and cement.
Q. The arrival of U.S. Marines seemed to some people in America to be
at least a short-term solution to the chaos of the revolt this winter.
From what you've seen, have the Marines helped restore order?
A. In central Haiti there have been no Marines, and there are no
Haitian policemen. Many of the latter were shot by the "rebels," who are
really the former military who came in across the border near us. And although I hear
there are Chilean troops in Hinche (in the Central Plateau) the other cities
and towns you visited are all pretty much in the hands of former Haitian
military. They are the people who in the past stole our ambulances, took members of
our staff hostage, etc. They've been pretty tame recently, but then again, who is
there to stand up to them?
Q. So at least the paramilitary aren't setting up roadblocks and
hassling your workers the way it did when it controlled the country in the
A. Actually, there have been numerous roadblocks since the beginning
of March, and most of them have been paramilitary. The delivery of
supplies has been interrupted on a number of occasions, and we have been
unable to travel to places like Hinche or Port-au-Prince. We have taken steps
to prevent staff from being harmed in any way. We remind our staff that they are not
obliged to travel on the road when they feel unsafe. We listen to the radio, try to be
prudent and do not travel at night.
Q. Your treatment of AIDS and tuberculosis patients depends on
residents delivering medication to fellow villagers, usually on foot. With the
roadblocks and flooding, have these community health care workers been able to
keep up with their deliveries?
A. Yes, the workers have done a great job. On this score, we have
discovered that good community-based care can function even in times when roads
are blocked. They've been keeping their neighbors alive.
Q. We saw horrible deprivation among the people in the Central
plateau when we visited in January. Has that changed since the arrival of the
Marines and the departure of Aristide?
A. There has been no visible improvement from the vantage point of
the rural poor. The real crises in Haiti are humanitarian and political. As far
as I know, the Marines are not involved in either the humanitarian crises
although certainly they helped bury those drowned last week - or the political
ones. The humanitarian crisis will only be addressed by dealing with hunger,
excess burden of disease, unsafe drinking water and dangerous roads. These
were the problems that were to be addressed by the aid that was blocked by the
U.S. administration for the three years preceding Aristide's removal.
Q. There was promise of restoring aid after the takeover. Has that
happened? Has aid made its way to the Central Plateau or to the governmental
department you work with most closely, the Ministry of Health?
A. I don't know that the aid has been released. Some has been sent to
Port-au-Prince, but has it filtered into the Ministry yet? I doubt
Q. If the living conditions haven't improved and, as you often say,
most of the disease that you treat is caused by poor living conditions, I
guess the Zanmi Lasante hospitals and clinics are still overcrowded?
A. We are overwhelmed. We are seeing people from southern and
northern Haiti, as well as from the area we seek to serve. The health crisis is far
from over, and more bad weather will worsen it by polluting groundwater
and triggering more flash flooding.
Q. You were trying to address the overcrowding with an ambitious
expansion program. Has this proceeded as planned?
A. Perhaps not as planned, but we have proceeded. On the day we were
to open our office in Hinche, one of our vehicles was commandeered by
paramilitary forces. They're still around, but we opened the office anyway. And we
are dedicating the Boucan Carre community hospital and microcredit bank
on July 8, pretty much on time. We're determined to continue our efforts to improve
medical and educational services to the people of central Haiti, and this is not
work we care to see politicized in any way.
Q. You said the humanitarian process can be solved only with more
international aid. How about long-term solutions to the political
A. It's popular to say things like "The Haitians have to solve their
own problems," but it's silly. The Haitians did not create slavery,
chronic interference with their internal affairs, gunboat diplomacy, foreign
occupations and a long history of trade and aid embargoes. The Haitians did not create
unfair economic policies. These were created outside of Haiti. Erasing
Haiti's debt, restoring constitutional rule, ending arbitrary aid embargoes and
sinking significant resources into public health, public education and public
infrastructure would be central to addressing and indeed solving Haiti's social
problems. Haiti's flooding is a result of the ecological disaster
(deforestation) that's been worsening over the past several decades, and that
could be addressed, too. But exhorting peasants not to cut down trees for firewood
is not the way to address deforestation. How else are they going to cook their food?
Q. According to a recent New York Times story, the Bush
administration has spent about $191-billion on wars in Middle East.
At the same time, the U.S. government has cut back on the president's
pledge to dedicate $15-billion to fight AIDS. Do you ever think about
what could be accomplished if some of the military funding had been
redirected to health care?
A. I think about it every day. I never fail to think about it. The
program for rebuilding Haiti, and for taking on the diseases of the poor
globally, would cost peanuts compared to what it's cost to finance the wars you
mention. And of course I'm just talking about the financial costs. As a physician,
I think every day about the human cost of war, too. I can't imagine it's
possible to put a price tag on that.
This email is forwarded as a service of the Haiti Support Group.
See the Haiti Support Group web site:http://www.haitisupport.gn.apc.org
Solidarity with the Haitian people's struggle for justice,
participatory democracy and equitable development, since 1992.