First, UN Secretary-General Ban Ki-Moon is making MDG 4 on maternal health the focus of a $40bil push.  Maternal health is making notoriously slow (if any) progress, and Ban focused his appeal in compelling general terms: “Women and children play a crucial role in development,” he said in a statement. “Investing in their health is not only the right thing to do – it also builds stable, peaceful and productive societies.”

This brings us to a second interesting point, from Jeff Sachs over at Columbia’s Earth Institute:  bilateral aid doesn’t work.

[Bilateral] commitments have come without clear mechanisms for fulfilment…making it hard to monitor and largely unaccountable. Shortfalls are attributed to problems in recipient countries. Even when aid is disbursed, these programmes are scattered among many small efforts rather than a unified national plan, and include an endless spectacle of visiting dignitaries from donor countries, politicised negotiations, and countless headline announcements of support that all too often fails to materialise.

Rather than continue from peak to peak in political leadership structures, Sachs suggests countries pooling their money in financing organizations like the Global Fund to Fight AIDS, TB and Malaria.  The Fund aggregates all the donor countries’ commitments and then has an independent review board for national recipient programs based on scientific and management reviews, i.e. it erases politics from the equation.

Third, and I find this one almost hilarious: yesterday morning, Bhutan’s Prime Minister, Jimgi Y. Thinley, allegedly got the most applause of any speaker since the conference started on Monday when he made a call for a ninth MDG: Happiness.  “Since happiness is the ultimate desire of every citizen, it must be the purpose of development to create the conditions for happiness,” and he called on a proper balance of consumption, leisure, good governance, and attentiveness to nature, biodiversity, and environmental sustainability to achieve this sum of the previous eight goals.

I’m all for it, and this is calling me back to Eric Weiner’s non-fiction travel book, “Geography of Bliss,” in which, if I remember correctly, he concluded that Bhutan was in fact the happiest country in the world.  I can’t for the life of me remember why….

So, in review:

1) Focus on MDG 4: Maternal Health/reduction of maternal mortality and morbidity

2) Pool international funding in funds that independently evaluate national programs and can hold recipients accountable to outcomes without soaking aid in politics

3) Happiness needs its own spot on the list, a summation of all the energies and objectives in the other eight goals.

None of this is especially novel or precise, but rather suggests a paradigm change in development philosophy, and I’d be surprised to hear anyone argue much against it.

These next few weeks, we’ll let photos lead the blog through the pilot clinic’s delivery, installation, and opening. At this stage, it’s a compelling visual story:

It’s been six months since the earthquake, and there’s been lots of talk of progress (or lack thereof) over the last handful of days. In summation, I’d say that the first line of belabored challenges is precisely the obvious:

Rubble: Only 2% of the 26 million m3 of rubble created by the earthquake has been trucked away. There are 300 trucks working daily, but most of Port-au-Prince remains impassable. You can’t build on rubble, and with scarce capital to clear it, we’re looking at a grossly extended timeframe for rebuilding the commercial and political centers.

Housing shortage: The number of people in relief camps has nearly doubled to 1.6 million. Only 5,657 transitional shelters (of a planned 125,000) have been built, and nearly four times as many are awaiting assembly (land and customs clearance are cited as major limiting factors). Hundreds of thousands live in squalid conditions, including the medians of major roadways. It’s untenable, and much more work has to be done to consciously relocate the displaced to more viable sites.

Importing aid shipments: the port’s an arrant Charlie Foxtrot.

The Haitian government is getting a lot of slack for lackluster leadership and the NGO community’s still feeling the heat of deeply imperfect coordination. To be fair, upwards of 30 percent of Haitian civil servants were lost when 28 of 29 government ministries collapsed, and roughly 90% of the NGO community has registered with the Interim Haiti Recovery Commission, co-chaired by Bill Clinton and Haitian Prime Minister Jean-Max Bellerive. Clinton concedes that the paucity of progress is horribly frustrating, and reconstruction remains a pipedream, but promises to be on the phone this week cashing in on the $5.3 billion pledged at the Donors’ Conference back in March. Only about 10% has been delivered to Haiti – most in forgiven debt – which frustrates the commission’s ability to execute programs.

Six-months out, hope remains for the alliterative plan to build back better, but it’s discouraging that something as fundamental as clearing out the rubble isn’t a lower-hanging fruit. Still, theoretically, because of the scale of devastation and the dire situation preceding it, Haiti has a tabula rasa and we know how to bench our expectations.

Grace Children's Hospital and the C2C Plot

There have been a couple delays to the installation schedule, which had a soporific effect on the blog.  The delays came in two broad strokes, most of which was out of any one person’s control, none of which was specifically anticipated, and all of which is par for the course given the context:

1) Getting the clinic cleared through USAID takes a variable – but almost certainly considerable – amount of time.  Because Haiti has entered hurricane season there’s been an influx of aid to the country, and a good deal of it is consigned to USAID.  All the shipping documents, which – we learned the hard way – have to be originals, shift through many offices and get stuck in a fair amount of bureaucratic gook before they’re cleared by the Haitian government.  Far from the break-neck speed with which we thought we’d clear customs, this has truly been a marathon.  The clinic *may* get cleared for delivery later this week, but USAID, the US embassy, and the Haitian customs office are all backed up, and meanwhile, our containers continue to make their unmodified peers feel inadequate:

A clinic moonlighting as a lego in Port-au-Prince. Container 1 is buried a few rows back.

2) Until the end of last week, even if the clinic had cleared, the site wouldn’t have been ready to receive it.  So robust is the NGO support for Grace Children’s Hospital that we too suffer the coordination-snafus plaguing the general aid effort in Port-au-Prince.   It took the better part of my last two weeks in Port-au-Prince to get all parties on board to our vision for the site layout and preparation.  Then there were the added challenges of scarce resources, which [ironically?] includes the “rubble” (the engineers’ word, not mine) with which we’re leveling the land.

Now the land is prepped, the NGO environment mapped, and once the clinic gets the green light from USAID/US Embassy/Haitian customs, it’s full steam ahead…”full steam,” of course, calibrated for a Port-au-Prince speedometer.

I thought people might be interested to hear a little about one of the Haitians currently working with Grace Children’s Hospital and Containers to Clinics.  As a volunteer, I had the opportunity to rub elbows with some of the convivial doctors and hospital management who oversee the clinic’s future home.   I also spent some mornings with the Grace Children’s Hospital’s land preparation team over the last couple of days.  The hospital is independently expanding its infrastructure to replace buildings and offices lost in the earthquake and it is exciting to see the new projects that will work in conjunction with the C2C clinics.

In the many moments I spent escaping the sun, I met Alex, one of the land-prep workers shoveling next to me.   He smiled a big smile and started rattling off some questions that I had a hard time keeping up with as I used my hard hat as a bench and chased my breath.  I think he could tell that I was lost, so he started over, we shook hands, and the conversation began in earnest.  His cadence was quick and it was clear that he knew English very well.  His energy eclipsed mine.  This was not any sort of surprise; this city is rugged but effervescent.  Most of the Haitians I have met are vivacious and expressive.  It’s a city where when Brazil scores in a World Cup match the cheers of their supporters rise across the city to a cacophony that surmounts the walls and windows wherever you are; then lingers.  Alex seems to be one of Port-au-Prince’s own, without a doubt.   

We bantered over the usual opening subjects in Haiti: soccer, the possibility of rain, how long I would be in town.   He asks where I am from and when I mention my mother’s Japanese descent, he is quick to ask for phrases.  We try a few out and he is a quick study, smiling all the while.  He throws some Creole back I try my hand at the amalgamation of streamlined French and some words that seem to lack European etymology.  He jabs with a quick phrase and I fail to see the connection.  Arabic?  Yes, he speaks Arabic, oh, and Spanish.  You don’t?   No, I laugh, I don’t.

As we spend some time talking over his background, I learn about his upbringing with an adoptive Canadian father and supplemental education with various non-profit programs.  At one point, he worked in the office for the UN.  He was born and raised in Port-au-Prince, but educated by people from all over the world.   Alex has a propensity for languages, for sure.  Right now, he seems content to have a well-paying job that also puts his hands into rebuilding the city and country where he grew up.  So we talk some more (he likes to talk), and prepare the land.

Alex with the ICC crew