On April 8th, 2010, I watched helplessly as the only oxygen machine in a poorly equipped Haitian clinic was taken from a premature baby and given to a woman struggling in labor. The woman gave birth to a healthy girl named Rodsandy. The premature baby died; he had no name.
Now, almost two years later, a stunning, modern teaching hospital with oxygen outlets in the walls is about to open in the town of Mirebalais thanks to a joint effort between Partners In Health, the government of Haiti, and donors from all over the world. Earlier this month, Dr. Paul Farmer (co-founder of Partners In Health) and Dr. David Walton (director of the hospital) took me on a tour of the 320-bed facility. At the very end of this video, Paul pours out his heart in the most succinct, passionate vision of health care equity I have ever heard.
Part I
“Haiti has conducted only a few censuses throughout its history. A survey taken during 1918 and 1919 indicated that there were about 1.9 million people in the country. The first formal census, taken in 1950, showed that the population had reached 3.1 million. The second census, in 1971, indicated a population of 4.2 million“.
Ref: http://countrysudies/haiti/2/html.
The current population of Haiti is 9,719,932, (2011 est.) Haiti has conducted only a few censuses throughout its history. A survey taken during 1918 and 1919 indicated that there were about 1.9 million people in the country. The first formal census, taken in 1950, showed that the population had reached 3.1 million. The second census, in 1971, indicated a population of 4.2 million.
Ref: http://countrysudies/haiti/2/html.
The current population of Haiti is 9,719,932, (2011 est.) Haiti .Rollins
Rollins:
You asked for a solution:
Let's start with this:
Joel E. Cohen, a Mathematical biologist and the head of the Laboratory of Population at Rockefeller University and Columbia University. “How Many People Can the Earth Support?”
“Providing modern family planning methods to all people with unmet needs would cost about $6.7 billion a year, slightly less than the $6.9 billion that Americans are expected to spend for Halloween this year”.
The New York Times, Op-Ed October 24, 2011.
My idea:
Facts
1. In Cuba, condoms are three of U.S.$.01. Ref: Huffington Post.
2. The price to a retail pharmacy for a month's worth of birth control pills is $2.00 to $4.00, they cost less the the British National Health system.
3. There are tens of thousands of market women all over Haiti. Train them, and give them condoms and birth control pills, and other birth control devices to sell at some very low price.
4. The health risks related to birth control pills are vastly less than that of pregnancy or abortion.
Going further, start a two year program for high school graduates to be tubal ligation technicians.
Keep in mind the rate of population growth based on the number of fertile females, not males.
Ask any farmer.
Incentivize those woman who choose to have a tubal ligation. No coercion.
In 1998, Zanmi Lasante launched the world’s first program to provide free, comprehensive HIV care and treatment in an impoverished setting. PIH's Global Health initiative is now a global model for the delivery of community-based treatment for complex diseases within the context of comprehensive primary care. In November 2003, a lengthy article in the New York Times, datelined from Cange, stated, “No program to treat people in the poorest countries has more intrigued experts than the one started in Haiti by Partners In Health.”
In the course of expanding our care of HIV-positive patients and their families, we have also significantly increased our ability to identify and treat patients with other diseases.
Women’s health has always been a strong focus of ZL’s outreach activities, and is one of the four essential components of the HIV Equity Initiative. One of ZL’s first projects was a women’s clinic, Proje Sante Fanm, which offers family planning, pre- and post-natal care, assisted deliveries and caesarean sections, vaccination of women and children, and screening and treatment of HIV, other sexually transmitted infections and cervical cancer.
I asked what he fixed. Has he fixed the problem of an overcrowded, poverty stricken county, filled to people who make their home on a highway median strip?
Or has just increased the number of people who can live long enough to join the hoards of children who are begging on the street?
Has he figured out what to do when an extra million people are added to the population within a half of a generation?
Or does his personal hubris prevent him from addressing birth control?
Or is he worried that someone might object the idea of discussion s-x with people in the third world?
Final question:
How many prescriptions for birth control pills has he written? How many condoms has he distributed? How many vasectomies has he done, or trained others to do? How many tubal ligations has he done, or trained others to do
Thank you for clarifying my position"
When I read the first phrase of your reply, I thought I was going to have to back down, and concede that the all "international aid workers" are not doing great harm.
Your delightful elucidation of the issue was most helpful
It reminds me of a incident in many, many years ago when my then teen-aged brother showed me a package that said, "For Prevention of Disease Only" I had no idea why he was so proud to have that in his wallet.
But I am sure it wasn't because he was concerned about "preventing disease".
I have no doubt that condoms have been extremely helpful in the reduction of the spread othe HIV virus, and has slowed down the spread of AIDS.
However, as almost every person over the age of 20 knows, condums are the least spontaneous, most messy, and least reliabe method of birth control.
Excepting, of course, abortion.
They are also under the sole control of the male,
Condoms are also the least reliable. One and a half million recalled in South Africa this last week.
How is a fourteen year old boy in the third world, with no income, going to buy condoms?
Or maybe they think their girlfriends of the fourteen year old boys will carry have them at the ready.
Part II
An increase in population from 4.2 million to 9.7 million is a doubling of the population of Haiti in 40 years, or two generations.
The current growth rate is approximately an increase of 100,000 every year.
Ref: Google: "worldfactbook"
Now if Dr. Farmer and his colleagues in the "international social worker industry" thought that the problem they need to "fix" was a lack of population in the country, they have certainly succeeded.
But unfortunately for them, and the Haitians, the country wasn't under populated in 1971. See the movie with Elizabeth Taylor and Richard Burton, "The Comedians". Its set in Haiti at about that time.
It's from a novel by Grahme Green. Also available from Amazon.
Its available from Amazon.
If their goal was to create a country where ten million people could live comfortably, without tremendous pain and suffering, they have FAILED.
Rather than "Fix" something, they have made things vastly worse for the Haitian people, but he did help a lot of soon-to-be-rich doctors.
There are two flights a day from Miami to Haiti on American airlines.
Once you step out of the airport, see how much "fixing" has been done.
You asked me for a solution. Which I like. See next Reply.
Why don't you read up on Partners in Health.
www.pih.org
The doctors being trained are not going to come to the states to work, nor are they going to get rich, most of these people believe with a passion and want to try to help thier fellows.
Being aware of the issue is great, but contributing to help fix the problems is much better, I too am aware of the population pressure the world is facing.
As for tubal ligation, to affect much of the population you would need to do a lot of women, and where would you train these people?
Well one place would be a modern teaching hospital.
It is not a question of what the physcians in their limited perspective and hubris
THINK they are doing, it is what the RESULTS of their work is what's important.
Actually there are plenty of Haitian physcians trained in Haiti, who are now making practicing in the United States.
Their chances of retiring as millionaires at age 55 are so much greater than practicing in France, even though is the language of education in Haiti.
Doing that which will increase the population of an overcroweded country, is the height of Western Hubris.
How can the problems of Haiti be "fixed" by increasing the number of people, without any other effort toward population management?
Is the problem with Haiti is the swarms of beggars aged 4-10 years old is too small?
Rollins, you have not answered any the the questions I have asked.
The Questions are:
1. How is it "helping" to "fix problems" to speed up the population growth of a country that is already overcrowed?
Part II of II
2. Why is birth control a fundamental NOT and basic provision in the plans of all these "international social workers?
Pick as many as you like, or add others"
a) Fear of loss of $$$ from conservative churches?
b) Genuine moral and religious beiiefs against birth control.
c) Discomfort with the discussion of human reproduction in general, or particular discomfort in discussing the subject with non-white people?
d) This is how its always been done, and all of us like it this way.
e) Other. (Please specify)
Rollins, every Reply you make will to me will be responded to by these two questions.
Also see: www.worldometers.info, and Google "worldfactbook", and you don't want to miss reading Rudyard Kiplings, "The White Man's Burden.
Thank you for sharing this story...
It is sad that in places like Haiti they must make even the most basic life and death decisions based upon their lack of medical equipment inventory. Dr. Farmer and PIH are demonstrating that good equipment and the proper application of effort will raise the quality of results.
I was so inspired by the efforts to get the correct medical machines into Haiti that I also shared the story on the CementTrust Blog.
There are many sectors of Haitian society that will need the type of attention and dedication that Paul Farmer is demonstrating in Haiti. This should be a model for international development programs.
Having said that, it would be very interesting to know how they plan to staff this hospital, especially where they will get the specialists, if the Haitian Government will pay the recurrent operating costs including supplies, medicines, human resources, water and electricity and all of those things you need to keep the place operating. And of course, what, if anything is being done to strengthen primary care in the surrounding areas so that the hospital won´t be overwhelmed by demand for ambulatory care services that could be provided at other levels of care and at much less cost. These are the sorts of issues that must be addressed in parallel to construction of the modern hospital, to ensure its sustainability and utility over time.
Numbers please. It is Cuba that provides doctors to Haiti.
Too bad that Dr. Farmer didn't learn as part of his anthropogy training that there is a finite limit to the carrying capacity of any piece of the earth, especially if it is half an island.
Question for all "international social workers".
Has the suffering and decreased or increased because of you work?
Answer if your work did NOT include a strong effort a birth control, and the population has increased more than 20% in the last twenty years, you have created more suffering.
Because in your hubris and beilief in the "White Man's Burden" you have committed atrocious sins against humanity.
See: www.worldometers.infor and Google "world face book" a publication of the United States govenment.
REBUTTAL ANYONE?
Really, I mean it. Lets have everyone whose heart is pure, from the director of the United States Agency for International Developement (USAID) to the young volunteer at a soup kitchen in some povert stricken land. How can you not thing about population control?
Kudos to Partners in Health, and Farmer.
Yes, anything the creates more consumers in the world, without regard for the ability of the world to provide for them has two major advantages:
1. It is great for the "international social workers".
2. It is great for interanational mega corporations.
Google: Monsanto Indian suicides
This is a training hospital, so while it treats patients, it trains Hatians to become doctors. Looks to me to address two problems at once.
What difference it makes to anyone but those that suffer and those that teach is purely incidental.
Did Dr. Farmer skip the part of his anthrpology training that discussed the fact that humans live on earth.
Did he skip the biology course that taught that the earth is a biosystem.
Did he skip Psych. 10l And Sociology 101 where they discuss the "Calhoun Rat Study".
Check it out in Wikipedia or just Google it.
Did his courses in anthropoloy skip any mention to the enviroment?
My undergraduate program actually did. Strictly Franz Boaz.
Did his world history course skip any mention of the British "Ground Nut Scheme".
Has Dr. Farmer never read, "Written in Blood", the History of the Haitian People"
It's is still in stock at Amazon,.
Has he never read "Krik Krak" by Edwidge Dandicat. Also available.
Has he never driven through, let alone walked through "Cite Soleil" fomerly known as "Cite Duvalier"?
You are quite correct. But remember the first rule of understanding human behavior in the modern world. "Follow the money".
This is the type of thing that provides, "well paying secure jobs" to all the public and private "international social workers".
Plus all those who make their career in government and academia who make their livlihood supervising, studying and writing about the problem.
Not to mention the military.
A relatively low cost solutio:
Joel E. Cohen, a Mathematical biologist and the head of the Laboratory of Population at Rockefeller University and Columbia University. “How Many People Can the Earth Support?”
“Providing modern family planning methods to all people with unmet needs would cost about $6.7 billion a year, slightly less than the $6.9 billion that Americans are expected to spend for Halloween this year”.
The New York Times, Op-Ed October 24, 2011.
See: www.worldometers.info.
I see construction with foundation blocks and minimal rebar, I KNOW they're not building to a standard that will survive.
Throwing good money after bad because Haitian building codes (that created much of the problem in the first place) are not up to speed, seems rather idiotic.
Soil testing? Etc.
I don't see this sort of thing as progress.
It's just showy waste.
Consider this:
The last earthquake before the current one was before the Revolution of 1803.
Not to worry, this is a country of 9 million people, many of whom were totally homeless before the earthquake and a good percentage were starving before the earthquake.
In twenty years with all the "help" it is getting it should have 2 million more people.
That should push the country into the apacolyse on which it is now teetering.
Don't believe me. There are two round trips planes to Haiti. You don't really have to leave the airport to see what I mean.
There are of course nice hotels and restaurants in Haiti.
All the "international social workers" have to have a place to stay. I'm sure for a long stay they can get their lodgings for under $100.00 a day, the tourist rate.
The nice restaurants have people with AK-47's standing out front to keep out the riff-raff.
Part I of II
I fanned you because you apparently know something that all the international aid workers, private welfare agencies, church groups, and movie stars don't seem to understand in the least.
Now some of them may actually understand that introducing "death control without introducing birth control" is a way to increase, by quantum leaps, the amount of pain and suffering in the world.
If I were a high ranking bureaucrat in a wealthy nation I would sure not want to give up my niche which includes a high salary, full benefits, and a nice retirement by saying what you are saying.
I would be in strict Denial of the harm I am doing.
Don't believe me, Google all the reports of the United States Agency for International Development (USAID), or just use the Huffington Post search box
Part II of II
What YOU, GEEWIZ know seems to beyond the knowledge of the Director of USAID.
For the non-governmental orgainzation, both religious and secular, Haiti provides the perfect "photo op", or if you like, full legth movie "op".
Want unimaginably crowded market places,. Check
Want people bathing in gutters, Check.
Want swarms of kids with bloated bellies, Check,
Want large groups 4 year olds kids begging, Check,
Want slums the are not simply inconvceivable to a "westerner", I'll give the the address, "Cite Solei" fomerly know as "Cite Duvalier".
Its a positive feast for missionaries and secular non-governmental organizations.
Movie stars get to appear in the Huffington Post.
Perfect for American doctors in an effort to save them feelselves good about retiring at age 45 as millionaires.
I met a dentist, on the airplane from Miami who told me that he would come down to Haiti on shorth visits to save souls, and remove rotten teeth.
He told me he had pulled 10,000 teeth and was counting. I'll have to check with God as to the number of souls.
American doctors parachute in for as long as a week or two, and are gone.
Haiti is the bountiful, wonderful fruitfull land for those who harvest money in the name of its citizens. Not really a terrific place for Haitians
What with the pictures and video and the mention of Vodou, every "good doer" can make a good living off of Haiti.