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Dr Alvaro Bermejo Headshot

Haiti and the Danger of a Single Story

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I feel ashamed. I had been warned. 'The danger of a single story' is my favourite TED talk but, on a visit last week to Haiti, I found that I - along with many many others - had fallen into the trap.

It's almost three years since the earthquake that left the lives of 3.5 million individuals and their families in tatters and killed some 220,000 people but say the word Haiti aloud among friends and who doesn't immediately still conjure up a visual image of devastation, helplessness, vast tented cities, fragmented aid, foreigners driving white land cruisers and the rubble of a National Palace that has become shorthand for a ruined country, a symbol of collapse. We've heard so many versions of this single story of Haiti, sadly partly true.

But only partly. Look at the country's HIV situation and Haiti has succeeded in halving the prevalence rates in under two decades, from around 4% in 1994 to 2% now. The best, most cost-effective model of integrated HIV care, training and research I've ever seen is Haitian - the GHESKIO centre in Port-au-Prince. Haiti's antiretroviral (ARV) coverage is well over 50%, and they are switching their approach to preventing transmission from mother to child to the improved B+ option which not only provides the same triple ARV drugs to all HIV-infected pregnant women beginning in the antenatal clinic setting but continues the therapy for these women for life.

A forum of local NGOs is coalescing to claim leadership in the AIDS response and to reclaim prevention. Take for example the Alliance's member organisation in Haiti, POZ, which is providing prevention, care and support at community level and, despite the challenges, is determined to scale up its work with men who have sex with men and sex workers if, as seems likely, the epidemic is increasingly affecting these at risk groups and their sexual partners.

In Cap-Haïtien in the north, I was stunned by the Caracol Industrial Park currently being built with multimillion dollar investment from the US government and the Inter-American Development Bank and which will create up to 65,000 jobs in the region in the coming year. Indeed POZ are hoping to run HIV awareness sessions with the construction workers and future employees in the months to come as well as work with people living with HIV on income generating opportunities. This is also Haiti, but such stories are rarely heard.

I've seen plenty of countries with no leadership, where donors do all the heavy lifting. That's not at all what I found last week in Haiti. While Pepfar, the Global Fund and other donors have played an important role in the HIV response, the real accomplishments are down to national organisations working tirelessly to mobilise communities and provide prevention, care and treatment services. I have little doubt that we'll soon count Haiti and its organisations among the great successes of the HIV response. And success in turn will lead to sustainability.

The danger of the single story, as the Nigerian author Chimamanda Ngozi Adichie puts it so compellingly in her TED talk, is that it creates stereotypes, and the problem with stereotypes is not that they are untrue but that they are incomplete and we risk a critical misunderstanding. So if you read the recent Audit: USAID Haiti work 'not on track' article, you may have assumed, as I did, that it's about the problems of working in Haiti. Instead it's about how the largest US contractor working to stabilize Haiti after the earthquake "has a weak monitoring system and is not adequately involving community members". Just another reminder that the single story can be so, so damaging.

We need to put an end to Haiti's single story and let its people find the ways forward. Meanwhile in Myanmar, a single story of a different kind - one where the hope and optimism we all share is dictating the simplified narrative - is in danger of being constructed. But that's a whole other tale, maybe for next time!