Thursday, Jan. 14, 2010

Haiti's Agony: What It Will Take to Rebuild

Tragedy has a way of visiting those who can bear it least. Haiti is the poorest nation in the western hemisphere, a place where malnutrition is widespread and less than half the population has access to clean drinking water. At 4:53:09 p.m. on Jan. 12, at a point 15 miles southwest of the capital, Port-au-Prince, the Caribbean tectonic plate pushed against the neighboring North American plate along a line known as the Enriquillo-Plantain Garden Fault system. On the earth's surface, the enormous energy created by that tremor — an earthquake measuring 7.0 on the Richter scale — tossed the car that Bob Poff, the Salvation Army's director of disaster services in Haiti, was driving down the hill from the suburb of Pétionville to Port-au-Prince "to and fro like a toy." When the shaking stopped, Poff wrote on a Salvation Army blog, "I looked out of the windows to see buildings 'pancaking' down ... Thousands of people poured into the streets, crying, carrying bloody bodies, looking for anyone who could help them."

Within the next few hours, the scale of the worst earthquake to hit Haiti in more than 200 years became apparent. Just as cell-phone video cameras brought the horrors of the Indian Ocean tsunami to the world in real time five years ago, so Twitter feeds and blog posts did the same for the Haiti earthquake, reporting on what had happened, asking if anyone had heard from loved ones, calling for medical supplies and Creole speakers. Louise Ivers, clinical director for Haiti for the NGO Partners in Health, wrote, "Port-au-Prince is devastated, lot of deaths. SOS. SOS ... Please help us." Ian Rodgers of Save the Children posted, "We could hear buildings still crumbling down five hours after the earthquake."

A day later, the death toll was unknown and — as is always the case with earthquakes, which bury their victims — unknowable. But more than one Haitian official told news organizations that they thought the final count of the dead would be more than 100,000. The next day, Vincenzo Pugliese, a spokesman for the U.N. mission in Haiti, summed up what was known thus far. The earthquake, he said, had caused major damage, destroying the National Palace, the main cathedral and many government offices. Hotels, hospitals, schools and the capital's main prison had all been wrecked. "Casualties, which are vast," Pugliese said, "can only be estimated. Tens if not hundreds of thousands have suffered varying degrees of destruction to their homes." A nation that was already on its knees had been knocked to the ground.

Making a Tough Place Worse
The quake was not unexpected — but then, the tragedy of earthquakes is that none of them are. The world's fault lines, those dangerous boundaries between the slabs that make up the earth's crust, are well mapped. Haiti, a nation of 9 million people, sits atop the junction of the Caribbean and North American plates, which "are shearing the island, crushing it, grinding it," says Michael Blanpied, an associate coordinator for the U.S. Geological Survey's (USGS) earthquake-hazards program. "And as that occurs, earthquakes pop off."

That they do. Historians reckon that there have been about a dozen massive earthquakes in the Caribbean over the past 500 years. The damage they can do is well understood; in 1692, a quake caused Port Royal, Jamaica, to disappear under the Caribbean Sea, where it lies to this day. But knowing that a quake will happen one day is of little use to those who want to know if it will happen tomorrow or next week or next year. An intense, high-tech exercise in the 1980s by the USGS and the state of California to study a particularly unstable stretch of the San Andreas Fault provided absolutely no telltale signs of a quake that hit in 2004. "Earthquake prediction," says Blanpied, "if it can be done at all, is very difficult."

The Haiti earthquake was not just unusually powerful for the region; it was also shallow — a fact that, combined with the soft ground and corrugated, muddy hills around Port-au-Prince, made its impact even worse. In the city itself, sturdy buildings like the cathedral and the National Palace could not withstand the tremor, which meant that many hastily constructed concrete structures collapsed like houses of cards, killing many — the Archbishop of Port-au-Prince, for one.

Many of the city's finest buildings helped give Haitians their sense of identity and history — now the country must not only figure out how to recover but also try to rebuild its sense of self. Just as what happened on Jan. 12 was shaped by Haiti's unique topography and geology, so the final toll, too, will be determined by the nation's very special conditions. Haiti is an unlucky, star-crossed country. Once a slave colony of France, the world's first free black modern nation was born in blood more than 200 years ago, in a long and bitter war of independence. In the years since then, Haiti has suffered almost constantly from local misrule, foreign intervention and economic exploitation. Haiti was occupied by U.S. forces from 1915 to '34, and then from 1957 to '86 it was ruled by François Duvalier and his son Jean-Claude — Papa Doc and Baby Doc — whose corruption and repression crippled the nation and led to wide-scale emigration among its educated classes.

In 1994 the U.S. intervened to force out a military regime that had ousted the government of Jean-Bertrand Aristide, a charismatic priest who had been elected President in 1990. After a decade of political disorder, Aristide, by then in his second term as President, was forced into exile in 2004; since then, Minustah, a U.N. peacekeeping mission, has been in place — the latest in a long series of outside forces that have attempted to help Haitians establish peace and a measure of security.

What makes the earthquake especially "cruel and incomprehensible," as U.S. President Barack Obama put it, was that it struck at a rare moment of optimism. After decades of natural and political catastrophes, the U.N. peacekeeping force and an international investment campaign headed by former President Bill Clinton, the U.N.'s special envoy to Haiti, had recently begun to calm and rebuild the nation. But the mood of cautious optimism had not yet begun to improve the basic living conditions of ordinary Haitians. For even on its best day, Haiti is a public-health disaster. No Haitian city has a public sewage system; nearly 200,000 people live with HIV or AIDS, and just half of Haitian children are vaccinated against basic diseases like diphtheria and measles.

The quake will make things unimaginably worse. While emergency-response teams have already begun combing through the wreckage, searching for injured who might still be saved, there are ominous longer-term health risks that threaten the island. "In the weeks to come, we may have huge issues with public health," says Pino Annunziata, who is coordinating the emergency response for the World Health Organization in Geneva. Less than a day after the disaster, U.S. Navy and Coast Guard vessels were swarming toward Haiti, ready to spearhead disaster-relief efforts. Up to 2,000 Marines were told to be ready to head there. They will all be needed. In the first confused day after the quake, reports stressed the absence of heavy machinery to shift rubble and shore up buildings; people were scrabbling with their bare hands in the rubble for their loved ones. The U.S. military will aim to make sure airports and seaports are primed to receive the flood of aid that will soon flow in.

As always in the developing world, the first priority will be clean water. With drinking-water distribution systems destroyed — and survivors crammed into camps without sanitation — water supplies could quickly become contaminated. That could lead to rapidly spreading waterborne diseases like cholera and dysentery that can sweep through refugee camps.

With adequate aid, however, the worst might be averted. The world now rarely sees major outbreaks of infectious disease in the wake of disasters. Even in the case of the 2004 tsunami, which killed more than 200,000 people, a rapid and thorough response headed off what could have been a huge postdisaster death toll. Indeed, the sheer amount of international attention on Haiti might ultimately improve its public-health system — as occurred in the Indonesian province of Aceh after the tsunami.

All who wish Haiti well will hope for such a benign dispensation. Many will do more than hope. In a Twitter feed, Troy Livesay, one of the many missionaries who first brought word from Port-au-Prince, described the mood the night after the quake. "Church groups are singing ... in prayer," he wrote. "It is a beautiful sound in the middle of a horrible tragedy."

You don't have to be a believer to hope that the prayers of those Haitians who have long borne sorrows not of their making are answered.

— With reporting by Massimo Calabresi, Michael Scherer and Mark Thompson / Washington; Gilbert Cruz, Jeffrey Kluger, Kate Pickert and Bryan Walsh / New York; and Tim Padgett / Miami