Hope for reshaping U.S.-Haiti relations?

If Paul Farmer were to have his way, the answer is yes. Farmer–cultural anthropologist, medical doctor, and health advocate for the poor–testified on January 27 at the U.S. Senate Committee on Foreign Relations hearing on Haiti. Farmer is also now the U.N. Deputy Special Envoy for Haiti, working with the Special Envoy, President Clinton.

Farmer first described the Haitian people’s tragic loss of life and loved ones, their new fear of sleeping inside buildings, the massive logistical challenges in providing for basic needs including food and water and toilet services, the need for emergency health care now and rebuilding clinics for the future, restarting schools that still stand and rebuilding those that collapsed, and enabling farmers to plant their spring crops by replacing tools and providing fertilizer.

He then turned to the financial resources needed from donors and how they should be managed.  He suggests the “potential for an entirely reconsidered relationship between the two oldest independent countries in the Americas.” Such a newly imagined U.S.-Haiti relationship would include the following:

• Disbursement of funds that are pledged:  Only about 15% of the $402 million the U.S. pledged in April 2009 to support the Haitian government’s Economic Recovery Program have been disbursed.
• Reform the structure and goals of U.S. aid within Haiti: lower the overhead charged for operations and trim back NGO involvement unless related to the public health and education sectors; focus on creating jobs for Haitians through “cash-for-work” programs and building infrastructure; work to reduce dependence on aid.
• Debt forgiveness to ease the financial drain.
• Creation of a recovery fund managed in Haiti by the Inter-American Development Bank.
• Share the goals of the Haitian people: social and economic rights, job creation, local business development, watershed protection, access to quality health care, and gender equity.
• Provide cash transfers to women.
• Build resilient housing and provide communities with access to clean water.
• Reforest the countryside.

Near the end of his remarks, Farmer said: “As a doctor, I can tell you that bad infrastructure and thoughtless policy are visible in the bodies of the poor, just as are the benefits of good policy and well-designed infrastructure.”

Image: “Paul Farmer and crowds I,” from flickr user Mira (on the wall), licensed with Creative Commons.

Call for book proposals

From the Anthropology in Action listserv:

Proposals sought for books on the anthropology of Europe

The editor of the EASA (European Association of Social Anthropologists) book series, James G. Carrier, is currently accepting book proposals for the series.

For more information see http://www.easaonline.org/bookseri.htm.

You can contact James at jgc@jgcarrier.demon.co.uk.

Assessing damage and moving forward

This post is drawn from the remarks made by Robert Maguire, Randolph Jennings senior fellow, United States Institute of Peace, and associate professor of international affairs, Trinity University, Washington, D.C., one of five panelists who spoke at Risk, Suffering and Response: The Earthquake Crisis in Haiti 2010. He provided written notes on his presentation which are provided here. The panel was videorecorded and will be available for viewing on the Elliott School of International Affairs website. (Link to follow when it is posted.)

Professor Maguire said that he has been asked by top officials from the U.S. government, the government of Haiti and the United Nations to assess the damage “from afar” as input to the donors meeting in Montreal. He discussed several areas of “damage” that preceded the earthquake:

  1. The effects of decades of misrule by predatory governments and a rigid system of socio-economic dominance by Haiti’s elites, factors which have resulted in extreme disparities between rich and poor
  2. The long-term denigration of Haitians by outsiders, from televangelists to misinformed “experts” who label Haiti as a “basket case” or “failed state”
  3. Misinformed development policies and programs over several decades that used Haiti as a source of cheap labor, have led to severe population concentration in Port au Prince and neglect of land in rural areas, and promoted since the 1980s a Taiwan-style form of development based on urban industries which neglected rural areas and overlooked the fact that Haiti did not share with Taiwan crucial factors such as land reform, improved agriculture, and education
  4. Lack of public investment in services because of uncaring, corrupt governments
  5. By the 1990s, Haiti had become a republic of NGOs

He went on to lay out specific priorities that will help address such underlying “damage” and establish a more balanced country demographically, economically, and socially:

  1. The tragedy offers a context in which one can work to “rebalance” Haiti
  2. Pay attention to the migration out of Port au Prince and work with the migrants to help provide work, services, and restored dignity for them
  3. Institute a decentralized system of “Welcome Centers” in towns and villages to assist and integrate the returnees including providing medical care and continuing education
  4. Equip the Centers to set up a Civic Service Corps to provide work for cash in several sectors such as public works/environmental restoration
  5. It is essential to invest in the rural areas in order to stem the flow of likely return migration to a rebuilt Port au Prince

Image: before-and-after screenshots of the Presidential Palace and an area of Port-au-Prince, from Google.

Review of the Haiti panel by GW Medical Center writer Anna Miller

Anna Miller, a communications and marketing writer for GW’s Medical Center, wrote about the panel I organized on Haiti in her article “A Nation in Crisis: Learning from the Past and Preparing for the Future.'”

Miller posted her story as a comment on a previous post, but I wanted to add it here as a full post for those who missed it before.

A Nation in Crisis: Learning from the Past and Preparing for the Future
Panelists Discuss “Risk, Suffering and Response: The Haiti Earthquake Crisis of 2010”
By Anna Miller

“Haiti is the poorest country in the Western Hemisphere.” This factoid, cited among prime-time reporters and casual conversers alike, may be true or false. But, at a panel discussion hosted at The George Washington University (GW) Elliott School of International Affairs, Jan. 25, one thing became clear: the liberal use of this phrase only exacerbates the country’s already plentiful problems.

“Having uttered [this phrase], one need not examine the causes and context of poverty in Haiti,” said panelist Dr. Drexel Woodson, associate professor of Applied Research in Anthropology at the University of Arizona. “One can also easily—but falsely—assume that poverty somehow explains corruption, illness, incompetence, ignorance, miseducation, violence and much else.”

The four other panelists—whose expertise varied and whose relationships to Haiti ranged widely—agreed. The recent earthquake, they asserted, has engendered a denigrating caricature of the Haitian population, which, in reality, is “compassionate, resilient and genius,” according to panelist Kyrah Malika Daniels, junior curator, National Museum of American History. And, in order to respond appropriately to the current crisis, a careful evaluation of the nation’s history and culture is vital.
Continue reading “Review of the Haiti panel by GW Medical Center writer Anna Miller” →

A very expensive health question

The Bill and Melinda Gates Foundation has awarded $8.4 million over four years to Boston University’s Center for Global Health and Development to study whether using an antiseptic wash to clean a newborn’s umbilical cord stump, compared to just letting it dry, improves newborn survival rates in Zambia. The Gates Foundation website doesn’t provide many details, nor could I locate details on the BU website.

Yes, it’s true that the first few days of life are very risky for newborns especially in low-income contexts. And yes, it’s true that something seemingly so manageable as care of the umbilical stump can lead to a baby’s death through infection. And yes, there is more to it than using an antiseptic or opting for a dry approach, as a recent study conducted in Bangladesh shows.

So the question is important and more complicated than it appears to be. But $8.4 million dollars?

Anthro in the news 1/25/10

• Cultural anthropologist on key aspect of Haitian devastation

It’s rare that a cultural anthropologist is quoted on the front page of The New York Times or of any of the mainstream media. So it’s especially noteworthy when it happens. In this case, the article is even above-the-fold. “Burials without Rituals” describes the extreme psychological stress of Haitians facing loss of many family members, friends and others. This stress takes on an extra edge given the critical importance of proper burials to ensure good relations with the dead. The article draws on insights from Ira Lowenthal, a cultural anthropologist who received his doctorate in the United States and has lived in Haiti for 34 years. He comments: “Convening with the dead is what allows Haitians to link themselves, directly by bloodline, to a pre-slave past…” With so many bodies denied a place in family burial plots where many rituals take place, important spiritual connections are severed: “It is a violation of everything these people hold dear … On the other hand, people know they have no choice.”

• OMG limited brain capacity for Facebook friends

The Daily Mail, UK carried a piece highlighting the research of Robin Dunbar, professor of evolutionary anthropology at Oxford University. Dunbar is well-known for his work on sociality, grooming and friendship in nonhuman primates and throughout human evolution. He claims that the size of the human neocortex limits us to manage about 150 friends max. This figure has come to be known as Dunbar’s Number. It has been tested in various contexts from neolithic societies to contemporary office environments. Dunbar is now studying social networking sites to see if Dunbar’s Number applies. It seems to. “The interesting thing is that you can have 1,500 friends but when you actually look at traffic on sites, you see people maintain the same inner circle of around 150 people.” The published study will appear later this year.

• Thanks for the compliment

According to an article in the Chicago Herald-News, studies of social scientists and psychologists point to the nuanced meanings and effects of compliments. Peter Wogan, associate professor of anthropology at Willamette University in Oregon, highlights how gender affects the giving and receiving of compliments. He says that women tend to compliment other women on their appearance while men do not. If men compliment women on their appearance, women perceive it as a come-on and often deflect it. Blogger’s note: I was struck by how heterosexual these patterns sound. So I went to Google Scholar to learn more about Wogan’s research. I think I found the source (PDF file), a brief chapter based on a class project Wogan conducted a few years ago. Students in his “Language and Culture” class collected 270 compliments on the campus in Salem, Oregon. An intriguing glimpse into campus compliments, and a pilot study that would merit replication in different contexts.

• Thoughtful review of Secrets of the Tribe

Secrets of the Tribe is a new documentary exploring the ethical controversies related to anthropological and other research among the Yanomami of the Venezuelan Amazon since the 1960s. It will premiere in Sundance’s World Cinema Documentary Competition. The reviewer comments that the film is “…an often provocative interrogation of how all ambitious people impact the world around them and how difficult (or impossible) it is to be a mere observer.”

• Upcoming event noted in the The Nation

As posted in The Nation, The Palestine Center in Washington, D.C., is hosting a briefing: “Humanitarianism: Prolonging the Palestinian Political Plight?” with Ilana Feldman, assistant professor of anthropology and international affairs, The George Washington University. She is the author of Governing Gaza: Bureaucracy, Authority and the Work of Rule (1917-67). The event is free and open to the public. A light lunch will be served to registered guests at 12:30pm. The briefing and question/answer period will be from 1 – 2 p.m. on January 27. Registration is required.

Continue reading “Anthro in the news 1/25/10” →

My challenge to David Brooks

As you may have heard, New York Times columnist David Brooks recently wrote about how Haiti’s culture is mired down by vodou and is anti-progress. And as you might imagine, his comments drew a lot of criticism from cultural anthropologists and others who have spent time in Haiti and with Haitian people.

Brooks apparently adheres to the simplistic and misleading idea of culture as used by political scientist Samuel Huntington (pictured) and former USAID administrator Lawrence Harrison. Neither of these men is an expert on culture as it is understood by the social scientists whose central mission is to study it, understand it, write about it and teach about it: cultural anthropologists.

Brooks and other conservatives no doubt find comfort in the Huntington-Harrison approach to culture. Pro-progress cultures are winners. Funny enough, they are pro-capitalist cultures along the lines of the United States with its strong emphasis on individual economic success, competitive social relationships and multiple car ownership. Anti-progress cultures are losers: they value some degree of social equality and group relationships that might include, heaven help us, labor unions. Low on car ownership among other things.

The H&H model goes against basic principles in cultural anthropology by labeling “others” in ways that are blatantly U.S.-capitalist-ethnocentric. Moreover, adopting the H&H model means that you will never recognize the viability, sustainability and warmth of so many other cultural systems. In fact, you are likely to directly or indirectly participate in the destruction of those cultures through economic, political and cultural imperialism. This is where Huntington and Hirshman lead and where David Brooks has followed.

So here’s my challenge to David Brooks: take an introductory cultural anthropology course now. Open your eyes and your heart to “other” cultures that may look like losers according to H&H but in fact hold the clues to a better future for all of us. If we would only give them a chance. I teach a six-week, distance ed version of my intro class every summer: Anth 002.10 at George Washington University. Mr. Brooks is most welcome to enroll.

Image: Samuel Huntington by Flickr user World Economic Forum via Creative Commons.

There is no pill against poverty

No pill can cure poverty. This is an old truth but one that needs repeating. Again and again. An article in the prestigious American Journal of Public Health (reprints can be ordered at the journal’s website) reminds me of this need. Three co-authors with Ph.D.s, two of whom have nursing experience, have published a “Field Action Report” assessing the affect of the formation of fathers’ clubs on child health in rural Haiti.

The article summary reports the key findings:

“The presence of a fathers’ club in a child’s birth village had a positive effect on vaccination status, growth monitoring and vitamin A supplementation after we controlled for socioeconomic status, time and the quality of the village health agent. Child weights and mortality were not affected by the fathers’ clubs.”

That pretty much says it all, but let’s break it down.

The study is based on detailed and extensive individual and household-level data gathered by the Haitian Health Foundation (HHF). The HHF was established in 1985 and is now operating in 104 villages in southwestern Haiti. The HHF instituted fathers’ clubs in 1994 in response to the discovery that fathers play an important role in child care in this region.

The clubs were meant to enhance child health and welfare. The fathers meet regularly to learn about child and family health from a nurse or village health agent. Education focuses on the 12 key family and community practices identified by the World Health Organization and UNICEF. The model outlines three pathways through which child health should improve.

Focusing on data from 23 villages with fathers’ clubs, the authors used children born before the clubs were established as the control group and children born afterwards as the “intervention group.” While not ideal, this approach is scientifically acceptable.

The presence of fathers’ clubs is associated with children aged one to two years being vaccinated, having their growth measured and taking vitamin A supplements. Here is what the authors say about this finding:

“Actual weights of children and infant mortality — measures that are arguably more important than the more proximal outcomes of growth monitoring, vaccinations and vitamin A supplementation — did not improve with the intervention. Furthermore, child weights remained flat over the years of study. Malnutrition is still a major problem in Haiti and continues to contribute to high morbidity and mortality in the first year of life. Malnutrition appears resistant to HHF efforts and is instead affected by factors well beyond the scope of a public health services program such as the underlying conditions of economic deprivation in rural Haiti and the political upheaval that has endured in Haiti for many years.”

I don’t need to remind you that the article under discussion was written before the earthquakes of January 2010.

So what to do? The authors mention the WHO recommendation to educate parents about feeding supplements for infants through 24 months. But they note, “This recommendation may not be feasible, given the economic constraints …. Further research is needed to develop programs that can be successful within these constraints.”

“Constraints” indeed. The kind of “constraints” that prevent the usual well-meaning educational interventions to work. At all.

How would you feel if you had a malnourished baby and no money, and someone tried to educate you about the importance of providing more food for your baby?

You might, as I was, be surprised to read the upbeat concluding paragraph:

“In conclusion, fathers’ clubs appear to be an effective strategy in child health programs. The success of fathers’ clubs in Haiti may encourage other global efforts to include fathers in a wide range of child health programs that use a community-based participatory approach.”

What? An “effective strategy” if your goals are limited to increasing the rate vaccinations, growth monitoring and vitamin A intake. But for improving children’s health? No success at all.

I’m all for fathers’ clubs. They may work in ways that this study overlooks: social support for parents (notably fathers) through the regular meetings. But they are not going to put food in the mouths of Haitian babies.

Source: Elizabeth Sloand, Nan Marie Astone, and Bette Gebrian. 2010. The Impact of Fathers’ Clubs on Child Health in Rural Haiti. American Journal of Public Health 100(2):201-204.

Image credit: Flickr user shouldbecleaning, licensed by Creative Commons.

Risk, Suffering, and Response: A Panel on the Haiti Earthquake Crisis

In organizing this panel, I reached out to many people who in turn connected me with yet others. Many of the people I contacted were in Haiti at the time, just returning from Haiti, or on their way there and therefore could not join the panel. Some with close connections to the island have been personally affected by the tragedy and its toll on human life and therefore could not accept the invitation to participate.

My goal is to bring together experts on a range of topics relevant to the earthquake crisis in Haiti who can provide insights for more effective ongoing and future policies, programs and other activities. My hope is to support the people of Haiti in recovering and rebuilding and understanding of the Haitian context, Haitian values, and Haitian priorities.

The panel will be recorded and this will be posted on the Elliott School website next week.

Risk, Suffering, and Response: The Haiti Earthquake Crisis 2010

Monday, January 25, 2010
1957 E Street NW, Lindner Family Commons
12:00 p.m. – 2:00 pm

RSVP: anthropologyworks@gmail.com

Moderator: Barbara D. Miller, associate dean of faculty affairs, professor of anthropology and international affairs, The Elliott School of International Affairs, The George Washington University

Robert Maguire, Randolph Jennings senior fellow, United States Institute for Peace, Associate Professor of International Affairs, Trinity University, “Assessing Damage and Moving Forward”

Erica James, associate professor of anthropology, Massachusetts Institute of Technology, “Dilemmas of Humanitarian Assistance in Haiti and in the Haitian Diaspora”

Julia Frank, associate clinical professor of psychiatry, The George Washington University, “Buffering the Emotional Impact of Disasters: How to Avoid Making Things Worse”

Drexel G. Woodson, associate research anthropologist, School of Anthropology / Bureau of Applied Research in Anthropology, University of Arizona “Shaky Ground(s): Will the Earthquake Prompt Haitians and Foreigners to Negotiate a Pact for Sustainable Reconstruction?”

Kyrah Daniels, junior curator, National Museum of American History, “Haiti: Spirits Unbroken”

This panel is co-sponsored by the Culture in Global Affairs Program and the International Development Studies Program in the Elliott School of International Affairs and the Department of Global Health in the School of Public Health and Health Policy.