Love in the Time of Cholera

Earlier, Kacee asked me why it is that so many horrible, horrible things happen so often to so many horribly, horribly poor countries. Specifically, she was speaking in reference of the recent outbreak of cholera in Haiti. She has a friend that works there for Doctors Without Borders (and frankly, they deserve your money. I say that very, very rarely).

Foreign Policy unpacks it.

I'm not entirely sure that I completely agree with this article. I will agree with this in part:

A second factor that predisposed Haiti to crisis was a weakened central government. Both prior to and particularly after the earthquake, the government was largely unable to deliver services. Instead, a precarious web of NGOs and relief organizations took on the job. This patchwork has supported water projects throughout rural Haiti, at various levels of functioning and disarray, meaning that communities often rely solely upon the charity of private groups. When projects fail, there is no accountability.

As I've argued earlier, NGOs and charitable efforts sponsored by foreign governments frequently harm the long term stability and sustainability of countries that they're trying to assist. Providing tons of food aid for example, does not in the long run, lift a country out of a famine. Rather, it makes it impossible for local farmers to make a living, a profit and expand to a point where they can actually feed their countrymen. No one can be expected to compete price-wise when the competition benevolently charges 'nothing'.

The same is true of professional services: pharmacies, doctors, what-have-you. As NGOs move in, the incentive for locals to provide these services vanishes because they simply can't make a living at it.

Couple that with a completely useless, kleptomaniacal federal government and basically, you've got Haiti.

This, I agree with less:

The bottom line is that cholera is avoidable and cholera deaths are preventable. When the immediate crisis is over, attention will turn back to rebuilding Haiti. By listening to the needs of rural residents, by ensuring that planning is participatory and inclusive, by building the capacity of the government to deliver services and fulfill the rights to health, water, and shelter, post-earthquake-rebuilding efforts can reduce vulnerability to cholera and ensure that the Haitian government can protect and fulfill the rights of its people. If it can do that, Haiti can provide an example for countries around the world.

Certainly cholera is avoidable and deaths are preventable but the odds of Haiti serving as an example for countries around the world for anything in my lifetime or your grandchildrens lifetimes are extremely, extremely long. Certainly, hope springs eternal but lets be serious about this.

The problem is that historically, the government of Haiti has been profoundly incapable of delivering services at all. This after all, is a tropical paradise unable to attract tourists. They can't even effectively advertise sunsets over beaches.

The problem is exacerbated by the fact that far, far too many services are being provided by charities that simply have no stake in the economy.

So what ultimately, does this have to do with cholera?

My grasp of it is that cholera is essentially a disease that becomes an epidemic when institutions are incapable of managing it. Pouring money into NGOs that serve as bandaids on the problem solves nothing.