Foreign Help? Well. Yes.

By Nora Mertens

The company that I work for, Tonetti Associates Architects (TAA), has recently completed the design for a Family Health and Nutrition Center for GHESKIO (The Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections) Clinic in Port-au-Prince, Haiti. Our involvement in Haiti, in the wake of the destruction left by the January 2010 earthquake, has led us to ask questions about what post-colonial critics call “neocolonialsm,” a term often used to describe developed countries’ involvement in the developing world; it implies a form of contemporary “economic imperialism,” In this article, I will explore these questions, also in light of my recent experience of visiting Port-au-Prince.

My first impressions of Port-au-Prince – after a mere 42 minutes flight from Miami – came from the passenger seat of a car with darkened windows as the driver sped, honked and bounced his way down the unpaved streets from the airport to the GHESKIO Clinic. As I looked out, I saw all that I had heard about Haiti: the poverty, the vast tent cities of those who lost their homes in the earthquake (today more than a half-million people still live in tents), the heaps of garbage bordering the roads. At the GHESKIO Clinic I saw people in pain, patients waiting patiently for their treatment or standing in long lines to pick up their HIV medicine. I heard the deafening city noise and felt the immense heat and humidity that hits you in your face every time you leave an air-conditioned building or car.

During the following days we spent at the GHESKIO Clinic, doctors would mention on a regular basis that they had lost yet another cholera patient.  There was much that was disturbing, but also much that was impressive. I saw beautiful people who showed strength, perseverance, and even humor in the face of suffering. The images of destruction were contrasted by images of great natural beauty, such as the view down into the valley from our hotel terrace, where foreign NGO workers would enjoy colonial breakfasts.

On my flight back to JFK, I became aware of the conversations around me; most passengers were NGO workers, returning home from Haiti. They all seemed to have stories of prosthetic devices or churchy missions that they exchanged with serious yet content countenances. In a New York Times article entitled “Haiti’s New Tourists” (September 6, 2011) the Haitian journalist Isabelle Dupuy writes, “A new form of tourism is emerging. Through hard work, compassion and – let’s say it – a bit of misery voyeurism, it offers redemption with a tan. (…) In exchange for your money and your help, Haiti offers immediate, terrorist-free access to a version of the human condition right near home. You can be digging a well in Leogane in the morning and be telling the tale in Manhattan in the evening.”

I don’t mean to sound dismissive of foreigners’ contributions to Haiti. It seems that without their money, clothes, aid workers, medical knowledge, and yes, perhaps architectural designs, there would be little hope at all in Haiti, especially post-earthquake. However, I have to think of of the words of Philippe Gerard, who writes in his book, Haiti: The Tumultuous History – From Pearl of the Caribbean to Broken Nation, “the answer to this oft-mentioned question – what the United States should do to help Haiti – is simple: As little as possible.”

According to Girard, the term “foreign neocolonialism” is a common refrain in Haiti today, despite the aid-donor’s good intentions.  He explains how foreign help can do more harm than good by creating conditions of dependence.

So what are we left with at TAA in terms of justifying our involvement in Haiti? How can we help developing countries appropriately, when we don’t find ourselves able to turn our backs?

These questions about appropriate aid have particular relevance also to the field of architecture. In a New York Times article entitled “Hands off our Houses” (June 1, 2011), Mathias Echanove and Rahul Srivastave explained some of the issues that may arise when architects from so-called developed countries assist in low-income housing projects in the developing world. Echanove and Srivastave discuss a competition where students, architects and businesses were asked to design a prototype for a $300 house to improve the lives of millions of urban poor around the world. Unfortunately, “the person whose input would matter most is left out of the competition: the person who is supposed to live in it.” Reality is more complex than the contest implies.

Echanove and Srivastave detail the potential problems with the project by discussing its applicability to Dharavi, a slum in the outskirts of Mumbai, where space already is scarce and a typical home is worth at least $3000. Houses are upgraded as income increases, which wouldn’t be possible with standardized $300 houses. Also, because construction is an important local industry in Dharavi, pre-fabricated $300 houses – built with non-domestic materials – would put many people out of business: “The $300 house responds to our misconceptions more than to real needs. The dynamic needs, interests and aspirations of the millions of people who live in places like Dharavi have been overlooked. While businessmen and professors applaud the $300 house, the urban poor are silent, busy building a future from themselves.”

Despite the potential problems articulated by critics like Girard, Echanove and Srivastave, I believe that there is a way for foreigners to effectively assist a country in need, but it requires some thorough investigation. If we want to make a meaningful difference, we should discover people’s real needs, interests and aspirations.  We cannot know and should not assume what people are in need of, but should instead question, listen and watch. We cannot find a deeper understanding of a place, its people and their needs without taking into consideration the results of thorough anthropological research. In my opinion, we can get glimpses of truth if we are willing to make the effort.

As we engage in this process, we must also look to ourselves. Why do we want to intervene? Is it perhaps about control, dependence, superiority? Are we helping in the right places? Since the earthquake, Haiti has had more nongovernmental organizations working on its shores than any nation in the world save India (which is a hundred times more populous). Do we find there is somehow more honor in helping the people of Haiti than in helping the millions of people living below the poverty line in the United States? Is it possible that our state and economic institutions dictate in which direction we are looking, and with what kind of attitude?

We must also question the sources of information that feed these motives. It is important to be aware of what journalist Gbemisola Olujobi calls “disaster pornography.” Reports that are biased and sensationalized sell, even if they generalize, are inaccurate, and dismiss any potential for progress.

A recent study by the Trans Africa Forum that looked at stories on Africa by The New York Times and The Washington Post found that they tended to fall into three categories: “AIDS, development and conflict.” Western media blocks out “Africa’s stock market, high rises, internet cafes, heart surgeries (and) soaring literacy.” This kind of disaster reporting causes negative perceptions that lead to lower levels of foreign investment, which could otherwise contribute to growing a stronger economy.

Despite reliance on foreign help being one of the main causes of Haiti’s misfortune, according to Philippe Girard there are in fact ways in which the United States could help. Besides assisting in short-term disaster relief in the case of a major hurricane or earthquake (here pre-fabricated $300 houses may come in handy as a more sanitary and robust alternative to tents), US businesses could help creating the conditions for lasting self-driven economic growth in Haiti by investing in areas where Haiti has a competitive advantage, like labor-intensive industries, handicrafts and tourism.

So how have we at TAA justified and conducted our engagement in Haiti in light of all of these issues surrounding foreign assistance? For one thing, we responded to a real and immediate need. After the earthquake, cholera and malaria spread easily in the unsanitary conditions of refugee camps and tent cities. The GHESKIO clinic staff asked for our help because there was a lack of qualified architects in the country.

For another thing, we did our research. The TAA staff visited Haiti five times during the design process in order to gain insights into the needs of future patients. We observed the use of the current buildings, had numerous conversations with the clinic’s staff, and used all of this information in the design. Since most of the patients cannot read, we made navigating the interior simple and clear. Additionally, the design incorporates an internal shaded covered street, popular in Haiti, which creates natural ventilation and allows for children to play about during the long waiting times.

Finally, we made sure to examine our motives. We believe that any creative process requires introspection. We have not made any profit from the project, and from the beginning, it was our priority hand over all construction documents to a Haitian construction manager and local contractors.

Through our work with the GHESKIO Clinic and our experiences in Haiti, we have grown personally and as a firm.  Although we did not make a monetary profit, it has been a deeply valuable experience for us. We believe in Haiti’s future and encourage everyone to keep asking, “How can we help?” All the answers are out there.