Hope for Haiti?

Haiti, if I may be so bold, is a lost cause. Some people just haven’t realized it yet.

Despite it currently being quite fashionable I must dissent and say Haiti will likely never, ever get better. I don’t say this simply to be contrarian – I like agreeing with people. I don’t say it because I dislike the Haitian people – I have no strong feelings for them either way. And I certainly don’t say it because I eschew foreign aid – indeed it’s because I so strongly believe in the benefit of foreign aid that I raise the issue. Were international charity and giving a bottomless trough of endless resources, sure, I would say, give to Haiti. They are not, however, and every dollar, euro, or yen spent somewhere is another pound, krone, or ruble not spent somewhere else. In this sense Haiti is more than just a lost cause; it is a black hole of limited resources. 

To begin, Haiti’s neighbor: the Dominican Republic. It is poor, underdeveloped, undereducated, underappreciated, and lives with much the same historical legacy of colonialism and corruption that Haiti does. In fact those with more than an American sense of geography will even note they share the same island in the same spot in the middle of the Caribbean. Yet despite their similar weaknesses over the past few decades they’ve both gone in dramatically different directions and now consequentially enjoy dramatically different presents. No one talks about saving the Dominican Republic. 

Back to Haiti. Since our actions in the present should be guided at least in part by prospects for the future let us focus on Haiti’s current chances for sustainability. A nation’s economy is not the only indicator or even the best indicator of wellbeing, of course, but an economy – any economy – is an essential part of its foundation for wellbeing. Without some semblance of substantive commerce health, education, development, and consequently happiness are all retarded. In light of this the developing world’s major economic advantage over the developed world, and what will largely allow the developing world to save itself, is its possession of a large, cheap, manual labor force with limited regulation. From this perspective Haiti has got it good. Situated close to the US, the most consumeryist consumer nation on the planet, they arguably have most the third world competitive advantages. Looking closer, however, the advantages are only skin deep for were you to want to do business in Haiti you’d run into some obstacles. To do business in Haiti you’d have to import your raw materials to a port and road system in disrepair using gasoline often in short supply to enable a largely illiterate workforce speaking a language spoken nowhere else using an unreliable electrical supply, an unclean water supply, and an undeveloped healthcare infrastructure to make a product that will be grossly overpriced and once again need shipment via broken roads and inefficient ports to countries that can likely buy the same goods elsewhere cheaper all while negotiating what is considered one of the most corrupt and least law abiding states in the world. And the Dominican Republic’s just right across the border. The end result? It ain’t cheap to do business in Haiti. The cost for us of a “decent” hotel room? $100. The cost of a 4 hour drive between towns? $150 not counting gas. The cost of a meal of goat and plantains and coke? $15. Why then would anyone want to do business with Haiti? How then can Haiti ever be free?

Back to the Dominican Republic. Developing nations have other strengths, however: agriculture, tourism, a tenacious population to name a few. With regards to the DR: yes, yes, yes. With regards to Haiti...? Unfortunately deforestation, soil erosion, and general mismanagement have led to a greater harvest of seasonal mudslides than any appreciable agricultural export. Unfortunately expressionless stares and a foreign tongue in a post-apocalyptic wasteland no matter how tropical don’t do much for tourists when manufactured smiles and a familiar language are right next door. And unfortunately the prevalent brain drain combined with one of the highest birth rates in the Western hemisphere guarantee only an ever increasing population with fewer and fewer capable leaders. Western aid makes up almost two-thirds of the national budget and a large percentage of the economy. This is not sustainable, and when the spigots run dry what will happen? When the population increases but the number of jobs and total arable land remains stagnant what will take place? When another populist election funded entirely by donation comes to pass, who will lead?

I think the most striking aspect of Haiti which makes me give up hope is the thoroughness of its poverty. I have been to a number of poor countries: Mexico, Honduras, the Dominican Republic, India and in all of these places there has been the poor, but there has also been, however small, an upper class and, more importantly, a middle class. There has also been a spectrum of poverty such that there was always the sense that there was at least something better that could potentially be obtained. In Haiti, however, outside the private gated communities of the affluent elite there is only a homogeneous lack. The only class seems to be the lower class. There is undoubtedly some difference between the very poor and the super poor, but it is a difference that if anything only heightens the sense of despair.

Immediately after leaving Haiti I flew to Fort Lauderdale, Florida, where I stayed at the Marriot Harbor Beach Resort and Spa to attend a medical conference. It was as big a contrast of wealth and poverty as you can get made all the more striking by the fact that a number of the workers and staff there were Haitian. I attended meetings in overly air conditioned banquet halls, lounged along overly manicured poolsides, and ate and drank more calories than I could ever need to burn. Only a few hundred miles away I had been sweating, working, and living in a whole other world. Perhaps in light of all this excess and wealth any money sent to Haiti, even if used inefficiently or wasted, is worth it. Perhaps when we’re spending thousands on luxury it’s missing the point to argue about the few dollars misspent alleviating poverty. I don’t know, but until Haiti shows promise or my robot heart shows softening I’ll be sending my box tops elsewhere. Polio anyone?

 

Crippling need aside, here’re photos!

* In case it were not automatically readily clear, these are my opinions and my opinions alone. I don’t know how my travelling companions feel about Haiti. I never asked them. I suppose they’d have nice things to say.

Volunteer to Make Money

Charity is supposed to be simple. You, in plenty, give; someone, in need, receives. You're hopefully a slightly better person as a result, God gives you a tip of the hat, and the individual receiving can lead a slightly better life afterward. The more you give the better, but every little bit helps. If you don't have money you can give time. Nobody wants your old frumpy clothes. See? Easy peasy.

One part of giving that seems to commonly confound is absolute giving versus relative giving. Should Mitt Romney be praised for giving millions of dollars to charity ($7 million over two years) or should we shrug that he simply gave just above the minimum required of him by his church and only a small portion of his enormous yearly income (16%)? And what should be done of Newt Gingrich who managed despite his professing of Christian values to give only a little over 2% of his similarly impressive intake ($3.1 million)? I'm sure in Mitt's case the rest of the money went to creating jobs and in Newt's well, shucks, he would have given more had he not been loving his country so hard. 

The uninspiring compassion of our politicians aside, I have recently come upon another problem of sorts. As I step further and further down the path to full blown, fully independent doctorhood I am finding it easier and easier to fill my pockets with cash. Cash being cash it is thankfully liquid. It's readily transferable to whichever charitable organization I fancy at the moment and cash in general has undoubtedly built many houses for veteran, one-legged snow owls down on their luck recovering from addiction. The ease with which money comes into my possession, however, has this year reached a critical level. I have arguably passed the point where it no longer makes sense to volunteer.

Now being board certified and fully licensed I have the opportunity to moonlight. I can sign up to work a weekend or night shift as a general internist for an hourly wage. And the currently reported going rate at our hospital: $100 an hour. A twelve hour shift can net you over a thousand dollars. If I were to then donate that to the local food bank for the poor and penniless they could buy chili mac for everyone. Even have enough left over probably to upgrade to frito pies. Heck, if I worked a few shifts they could even buy puppies and milkshakes for everyone. Milkshakes for the puppies too, why not. More pertinent to the point, were I instead to volunteer at the food bank making the same chili mac myself for those same twelve hours I'd arguably have only made twelve hours worth of someone else's donated chili mac. From a slightly different but purely economical -- and perhaps relatively dispassionate -- standpoint for every hour I moonlight I could hire ten individuals $10/hr to make ten times as much chili mac in the exact same time. My choice not to volunteer's friggin' creating jobs now! How then does it make sense sense to ever volunteer for anything else? To tutor a child is simply an inefficient waste of time.

Unfortunately where as I used to obtain a quiet satisfaction from sorting canned goods from boxed cereals I hate the very idea of moonlighting. I do not believe I'd obtain any joy from spending my evening sitting in the ED admitting people for chest pain rule outs. And there in of course lies the problem, charity is not supposed to be about the giver. It's arguably not even supposed to be about the gift itself either, yet the thought of volunteering to dig a ditch rather than volunteering to pay a team of ditch diggers just because it makes me happier seems selfish even if they are both acts of charity. Moonlighting is arguably one of the most generous things I could do right now and yet I still have no desire to do it. Paper Bird would be so disappointed.



Speaking of Paper Bird, here, finally, is a picture. He denotes all his money to charity. What a guy.