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Haiti on the Brink

It's really becoming a recurrent theme -- a day that I anticipated would mark another joyful milestone of progress in Haiti's central plateau is sobered at 6 a.m. by The Miami Herald's latest story of Haiti's woes: the threat of donor fatigue; the inability to get aid to the people in need; endless delays from international funders; hints of governmental incompetence and the re-emergence of political in-fighting - all, in the wake of natural and man-made disasters (the floods of last summer and the world financial meltdown), conspiring to reverse the fragile gains of the previous year.

So why, before retrieving my morning paper, did I awake with such joy? Today in Marmont, a small rural community of 12,000 people in Haiti's central plateau, a small groundbreaking ceremony will take place. A new maternity hospital is being built through the efforts of Project Medishare, which was founded with the support of the University of Miami Miller School of Medicine more than 13 years ago. Over that time, many individuals and organizations have supported the work being done by Project Medishare. Because of that commitment, we are now expanding and upgrading our clinic in the central plateau -- a project sure to save hundreds, if not thousands, of lives in and of itself, but more importantly, part of our broader effort to link health and community development in one of Haiti's hardest-hit communities.

It's a wonderful story, really, starting with an invitation to Project Medishare from one Central Plateau community 11 years ago, to help with their overwhelming health problems, then taken to the next level by a Miami-based philanthropy, The Green Family Foundation. We're now in partnership with several communities (serving more than 80,000 people) not just to improve their health, but also working on education and increased agricultural productivity. The circumstances of how the clinic came about are particularly heart-warming for us. A medical student at UMMSM, Elizabeth Greig, traveled to Haiti with Project Medishare three years ago, along with Dr. Barth Green, Project Medishare's co-founder. That one-week experience changed her life. The tales of Haiti she returned with inspired her family, the Greig Family of Boca Raton and Chicago, to finance, entirely, the construction of the new facility! Operations of the new facility will be supported by generous contributions to Project Medishare by the Pechter family of Boca Raton.

So is there anything we can learn from this dialectic, this "sky above and mud below" (to borrow from the title of an Italian film from the '60s) that is Haiti? Certainly, we agree with Ms. Charles that the new administration needs to explore new solutions, as it's clear that the top-down approach will not work. One idea starting to surface is to provide direct funding to institutions of higher learning to generate new knowledge at a community level that can be brought to bear to solve problems in developing countries. This approach is certainly consistent with the "smart diplomacy" recently espoused by Secretary of State Hillary Rodham Clinton. Should this idea morph into reality, we hope, given its need, proximity, the large number of Haitian-Americans now living in the United States and our moral imperative to help our poorest neighbor, Haiti will be a priority.

We all should know by now, however, that governments - in Washington, D.C. or in Port au Prince -- cannot solve these problems by themselves. Philanthropy also needs to get smart - to look at novel approaches and to evaluate the track record of who delivers and who doesn't. Finally, individuals can make a difference. Sure, times are tough, but if you think things are tough here, come spend a week in rural Haiti with us as did Liz Greig. It may change your life. Then follow the lead of the Greig family and pitch in to the degree that your means allow. If there's hope for Haiti, it's going to have to come from the bottom up, one community at a time.

Arthur Fournier, M.D. is the Associate Dean for Community Health Affairs, Professor and Vice Chairman of Family Medicine at University of Miami Miller School of Medicine, and the Co-founder of Project Medishare.