Remnants of Foreign Aid

Live_MSF_Down_w_Cholera

On the wall of a cemetery near the local private hospital: "Live MSF. Down with Cholera."

By Lydia Bradford '17

Published July 14, 2015, last updated on April 7, 2020 under Voices of DGHI

Blan! This is what I hear as I walk down the streets in Léogâne, as I am working, and basically anytime I am in the community. It sets me apart from the community. I am a foreigner, a blan.

However, blan has more connotations than just that. Haiti, labeled as the poorest country in the Western Hemisphere, has been the object of much foreign aid, especially after a devastating earthquake in 2010 followed by a terrible outbreak of cholera 10 months later.

My title of blan follows me around and with it comes expectations. Often, there seems to be a chorus of ban mwen manje (give me food) or ban mwen kòb (give me money), followed by calling me chichan (stingy) when I refuse. As part of our research, we take people’s blood pressure to assess the scope of hypertension in the Léogâne area. When people see our equipment and what we are doing, they often assume that we will give out medication for high blood pressure as well. These expectations seem to come from years of foreign aid where aid was being handed out. Listening to current development workers in the Léogâne area now, one hears them talk about a culture of dependency that poorly executed foreign aid has created in the area.

One such topic that is often discussed is health care. After the earthquake, an international relief medical aid organization set up a relief clinic here in Léogâne, offering free care. This organization has been in Léogâne for five years now, much longer than normal relief aid would last, but they are finally getting ready to leave. However, the free health care that they have provided for the past five years has allowed the community members to become accustomed to not paying for their health care, which has led people to not set aside money for when they may need to go to the clinic, and has also taken away patients from the local private hospitals, hurting the economy of the local healthcare providers.

One of our translators told us that she believes the relief medical aid organization is much better than the local private hospital in the center of town. She said that when her sister was pregnant, care at the private hospital was going to be quite expensive, whereas the relief medical aid organzation did her birth for free. Why pay a lot of money, when care is free in another place? Some development workers point out that the majority of people in the area have cell phones, so why can they not save and pay for their own healthcare? But when some care options are very expensive, it begins to make sense and if health is a human right, then do the development workers have the right to complain about people wanting to seize their right? Tout moun se moun—all people are people—so then why would health be limited by money as it so often is?

As I ponder health as a human right and this conundrum between free and private health care, I am led back to another remnant of foreign aid: the power play between the community and the giver of aid. In my travels in Haiti, I have come across many short-term mission teams that come to Haiti and do things that may or may not truly be needed in the community. My team, including our translators, recently had a conversation about the causes and consequences of such teams coming to Haiti. We came to a conclusion that there is an unbalanced power play in place, where the givers of aid (typically the “blan”) have an agenda and the Haitians just go along with it because it is better than no aid.

Yet, this power play goes further than just this one mission team. It seeps into our everyday work as we take surveys. I am continuously conscious of ethically presenting our research so that the community members do not feel that they are required to participate. It also is one of the major conundrums in the question of health as a human right here, because the free health care is coming from outside, through the blan, which helps maintain this imbalance of power.

Therefore, as of right now, I cannot say what is better, whether free care should continue to be given, or whether the people should have to pay and possibly suffer to protect the Haitians who are working hard in the health care sector here. However, it is clear that this debate of the right to health needs to take place among the people and the government of Haiti.

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