Denaturalizing “natural” disasters: Haiti’s earthquake and the humanitarian impulse

On 12 January 2010, at 16:53 local time, Haiti experienced a catastrophic magnitude-7.0 earthquake 25 km west of the capital, Port-au-Prince. The United Nations Office for the Coordination of Humanitarian Affairs estimates that more than 220 000 people died and 2.3 million were displaced.¹ This earthquake was more than twice as lethal as any previous of a similar magnitude in the last century.² In striking contrast, the magnitude-8.8 earthquake that struck Chile on 27 February 2010 resulted in fewer than 800 deaths, despite its higher magnitude.³

Why was Haiti’s experience so different? Most commentators have pointed to physical factors, such as the shallow epicentre of the earthquake, its proximity to a major population centre, poor building construction and the lack of an adequate emergency response system.^2,4 These undoubtedly played a role in the extraordinarily high mortality rate. However, although many have noted Haiti’s poverty and internal strife, only a few commentators have identified these as key determinants of the level of devastation caused by the earthquake.^5,6 Even fewer have suggested looking at the historical record or where Haiti stands in the current world order for an explanation.

What is considered “natural,” in the context of disasters such as Haiti’s, is seen as independent of human actions. Any analysis of such events must “denaturalize” them by examining the historic, political and economic contexts within which they occur.^7,8 Specifically, health professionals and policy-makers need to understand the unnatural determinants of the problems facing the country and how these affect any form of response. Without such an understanding, the humanitarian impulse informing international efforts to support Haiti’s recovery and development may serve to merely reinforce the historic relationship between wealthy countries and Haiti and may fuel continued underdevelopment.

Foundations of a disaster

Knowledge of Haiti’s history is integral to an informed understanding of the earthquake and its outcome. Only a brief review is possible here; more detailed accounts are available elsewhere.^9,10 Soon after Spanish colonizers led by Christopher Columbus arrived in 1492 on the island they christened Hispaniola—present day Haiti and the Dominican Republic—the annihilation of the island’s indigenous peoples began. Paul Farmer has argued that the triple assault of imported disease, malnutrition and maltreatment set a precedent for the subjugation of human life in Haiti at the hands of wealthy nations.⁹ Plantations of sugar cane became fields of misery for tens of thousands of trafficked African slaves, while Spain and France reaped the profits.¹¹

The French Revolution, which began in 1789, sparked a revolt of Haiti’s middle class and an uprising of its slave majority. In 1804, Haiti became the second independent republic in the western hemisphere, after the United States. Further, it was the first example of slaves winning nationhood through their own resistance.¹²

In abolishing slavery and resisting colonial rule, Haiti was not easily tolerated by European powers or by the slave-owning United States. With its economy ruined by its revolutionary war, Haiti was forced to agree to unfair trading relationships with nations that refused to recognize its sovereignty. In 1825, France sent an armada to retake Haiti; the French invasion was averted only when the young nation agreed to pay 150 million francs as compensation for the loss of the slave trade. This indemnity was not paid off by Haiti until 1947.¹⁰ Similar instances of gunboat diplomacy by the United States, Germany and Britain drained Haiti’s national coffers throughout the 19th century.⁹

Foreign interference and political destabilization have continually undermined governance in Haiti. For example, the United States occupied Haiti from 1915 to 1934; although the Americans have claimed that their occupation improved Haitian economic and governance infrastructure,¹³ contemporary accounts note that the presence of a military force enabled the passing of a constitution that permitted foreign ownership of land.¹⁴ The US Marines also left behind a well-trained army that went on to rule Haiti, installing and deposing leader after leader. “Papa Doc” Duvalier and his son “Baby Doc” would be the last and most horrific of these leaders, using tonton macoutes death squads to establish and entrench their rule between 1957 and 1986. Although foreign aid continued to flow to this regime, the national debt grew dramatically.¹⁵ Historians agree that the Duvaliers were supported by the West throughout the Cold War, ostensibly to help fight against communism but also to support the interests of foreign companies who benefited from low-cost Haitian labour.¹⁶

Against significant odds, Jean-Bertrand Aristide was elected in the nation’s first democratic elections in 1990, overwhelmingly supported by the poor and working class. His government was short lived, as his popular reforms threatened the status quo for Haiti’s oligarchs and foreign interests. He was ousted in a coup after only eight months and sent into exile. After years of Aristide and his supporters lobbying the US government, and the intervention of numerous advocates, he was reinstated as president in 1994. He was re-elected in 2000, only to again be exiled during a coup in 2004. External forces played a role in both coups, leaving Haiti’s political health tenuous ever since.^9,17,18

The humanitarian impulse

With this historical background in mind, one can examine the response of the global community to the 2010 earthquake. Many individuals around the world generously donated funds, propelled by the humanitarian impulse, an innate, visceral urge to help fellow human beings who are suffering.¹⁹ By November 14, over US$3.4 billion in donations poured into international aid agencies.²⁰ As with the 2004 Indian Ocean tsunami, the magnitude of the devastation and the natural aspect of the disaster led to a desire to help by the global community.

The immediate response by the international community succeeded in many ways. Many humanitarian non-governmental organizations (NGOs) and governmental development agencies should be given credit for what they accomplished in the face of enormous devastation. Numerous rescue attempts were mounted in the immediate aftermath, and emergency medical services were operational within hours of the earthquake. In the six months following the disaster more than 4.3 million families received food assistance and more than 900 000 vaccinations of children and adults were carried out. Over 1 million people received daily water rations, and thousands of latrines were built. As a result, no major epidemics have yet occurred in any of the camps for internally displaced persons,²¹ although cholera has recently begun to spread throughout the country.

However, some aspects of the post-earthquake response have been problematic, reflecting the history of Haiti’s relationship with external actors. Media coverage of the disaster and the response often played into the stereotype of Haiti as a cursed nation.²² There was scant recognition of the legacy left by Haiti’s colonial powers and of the role these nations were now playing in the relief effort. The US military assumed the leadership of the humanitarian response almost immediately. It began by coordinating flights at the request of the Haitian government, but its role soon extended to many aspects of the relief efforts. There were examples of medical supply flights being turned away in favour of military flights.²³ Some observers have argued that too great an emphasis was placed on security, at the expense of relief operations.²⁴ Others have noted a focus on the protection of private property, which may have detracted from efforts to ensure access to food and water for those in need.²⁵ Concern about the poor coordination of the response²⁶ has led some commentators to take issue with the role of NGOs and with their agendas for participating in the relief efforts.^27,28 Finally, the focus on the immediate humanitarian response appears to have prevented a consideration of how the groundwork for future development could be best laid.⁶

At the time of publishing, the vast majority of those displaced are still living in tents or other temporary structures and over 95% of the rubble has yet to be cleared.¹ The provision of essential social services by the Haitian government, including accessible education, primary health care and a functioning police force and judiciary, is unlikely in the near future. Concerns about the trafficking of children and the sexual exploitation of women are growing.²⁹ Less than 10% of the $5.3 billion pledged for Haiti at an international donors’ conference in March 2010 has been provided.³⁰ Media attention has long since shifted away from Haiti, and no clear plan is evident for addressing the nation’s long-term concerns, such as economic independence and a political environment free of foreign interference.

Humanitarianism based on actual histories

The humanitarian impulse is too often fitful and fragmented. Furthermore, the involvement of high-income countries in the root causes of the devastation caused by “natural” disasters in low-income countries is rarely examined. The political philosopher Thomas Pogge questions simplistic conceptions of injustice when they are seen primarily as issues of distribution.³¹ He adds a relational element to the conception of justice. Investigations of relational justice seek to identify the causes of disparities, challenging us to look at the conditions and actions that have created them. In Pogge’s reimagining of justice, wealthy nations must address their role in creating the historic conditions that have led to the profound global economic disparities we see today. He calls on wealthy nations to recognize their complicity in the exploitation of human and natural resources, the degradation and oppression of good governance structures within poorer nations and to understand the consequences of their support for corrupt and illegitimate regimes.³² These actual histories should replace the more palatable fictional histories that attempt to explain away wealthy nations’ past contributions to the persistent poverty in the world.³³

How would acknowledging actual histories change the work of health professionals and humanitarian aid providers? Even in the initial response to a disaster, it would change how services are organized, who is leading the effort and who sets priorities. Acknowledging actual histories may have little impact on the technical details of the initial emergency response, but it may make a difference in how relief efforts are subsequently carried out, particularly in the long term. Some may argue that disasters on the scale of the Haitian earthquake wipe out the existing civil society leadership. However, even in such conditions, the affected communities can and should be involved from the start. Actual histories can help organizations to see how the best of intentions can undermine indigenous systems and societies and can help them to understand the difference between providing temporary charity and contributing to self-sustaining, just communities.^34,35

Appeals for funds can be combined with educational initiatives to explain to policy-makers and the public why an event has occurred and how it relates to social, economic and political forces. Resilience should be emphasized over victimhood. Such campaigns could also be linked to advocacy efforts; for example, calls for economic justice could be supported³⁶ or efforts could be made to ensure that elections after a disaster are fair and free of foreign interference.

Acknowledging the actual histories that have led to Haiti’s underdevelopment would require wealthy nations to probe their own political, social and economic involvement—through action or inaction—in Haiti’s underdevelopment. This would also require companies and consumers to ask themselves how they have benefited from Haiti’s underdevelopment. The answers to these questions need to meaningfully inform humanitarian efforts in Haiti for these efforts to address the root conditions that enabled an earthquake to level Port-au-Prince.

Conclusion

Although a laudable humanitarian impulse has driven relief efforts in Haiti, it alone is insufficient for the task of rebuilding the nation. Any lasting efforts to improve life for Haiti’s citizens must be informed by an understanding of the disaster’s foundational causes. A humanitarian response based on actual histories could resemble the work of NGOs like Partners in Health, which has worked toward just, effective and sustainable humanitarianism in Haiti for years. Even better would be a response that explicitly supported Haitian organizations, civil society and government institutions to lead the recovery effort.³⁷

The analysis presented here is certainly applicable beyond Haiti. In numerous countries where humanitarians operate, respecting history and seeing the connection between historic actions and present conditions is essential. Ultimately, standing in solidarity means making a long-term commitment to transforming how we relate to Haiti and similar nations around the world.

Biography

Andrew D Pinto is a community medicine resident at the Dalla Lana School of Public Health, University of Toronto, and a family physician at St. Michael’s Hospital, Toronto, Ontario, Canada.