SGMD

Last Wednesday night I was over at a friend's house who happens to have satellite television. The idea of watching live television coming straight from America is very exciting to us, let me tell you. While flipping through the many channels we came across CNN and Anderson Cooper told us that a report on the cholera situation in Haiti by Dr. Sanjay Gupta was coming up. Apparently I've been out of the US for too long, because I had no idea who this dude was, but Justine and Brian were excited. Brian said he had heard earlier in the day that Dr. Sanjay was going to fly in to do a report.

Watching the report, frankly, just pissed me off. I started to wonder if Dr. Sanjay had ever stepped foot in a developing country before, never mind one with a cholera outbreak. I know I had not, until now, and I can't imagine I would have ever be so presumptuous as to be as judgmental of efforts to curb the epidemic as he sounded. And I thought it was pretty rich that after having flown in THAT AFTERNOON (and probably flying back out that night) that he comes in and talks about how preventable this outbreak was and how warehouses are still stocked with supplies that could be used, etc. I thought he was completely condescending and was doing the typical American media fear mongering thing. And then Anderson Cooper jumped in! Anderson! Shame on you. I expect better from you.

At one point SGMD (Yup, that's what his segment on CNN is called. How lame.) interviewed a guy in a blue shirt who had actually spoken earlier in the day at a health cluster meeting I attended. I believe he works for PAHO. At the meeting he was very impressive and looked very tired (along with all of his colleagues) who no doubt have been working beyond overtime and losing countless hours of sleep in their efforts to stop this epidemic and to stop it from spreading to PaP. Dr. Sanjay made this poor guy look like an idiot, unfairly, I thought, especially since this guy's first language is definitely not English. Dr. Sanjay clearly already had his angle on this story (no actual journalism was going on) and was stating things as though they were fact (like that this was preventable) and daring this guy to contradict him, but in 30 seconds or less to make sure it fit into his 3 minute segment. It actually really, really pissed me off to know that people rely on a source like CNN to have some sort of decent reporting standards (unlike a Fox News or equivalent) and to know that they were going to believe this report and buy into CNN's whole "angle" on this story, which was basically that the government and NGOs had failed to prevent this outbreak.

I realize I might sound like I'm taking this personally, but I don't even work on cholera! I am offended on behalf of the many agencies and individuals I know who have been busting their butts to mobilize everything they've got that could possibly help with this outbreak of cholera as quickly as possible. I'm not sure what Mr. SGMD thinks the mentality of most of the relief workers is over here, but I can assure you that for 85% of people it is not, "Gee, Haiti sounds like a posh place to take a job where I can really just sit back and do nothing for a few months/years." Granted, in any organisation in any part of the world there are always the lazy, incompetent, frustrating, why-are-you-here-if-you-don't-want-to-work people, but I can honestly say that I have met few of them here and that most people work insane hours and are amazingly dedicated to doing things in Haiti to help and to doing things the "right" way, and not just for the sake of doing them.

I think what Dr. Sanjay and many other critics fail to realise is just how many factors are out of NGO's hands when it comes to situations like this. When trying to rebuild a country after a catastrophe like the one Haiti has been through, capacity building is key. So although the Haitian Ministry of Health is completely incompetent for the most part, that doesn't give the NGO community the right to just take over the country's health care system (as hard as that is for me to admit, because many times I would just like to). NGOs have to continue to work with the MOH to try and empower them and to try and capacity build as much as possible, especially in emergency situations like this that they will inevitably be faced with in the future. And when a situation like this comes on this quickly, the actual logistics of mobilizing human and material resources isn't as straightforward as it would be in, say, the US. Finding trucks available to transport your materials from PaP to a different region, on terrible roads which may or may not be passable due to recent rains, for instance, are things one usually does not have to worry about in the developed world.

What I have seen so far regarding the cholera outbreak has been, in my opinion, pretty impressive. The MOH declared pretty quickly (in my opinion) that there was indeed an epidemic. My fear was that, even as hundreds of people were dying, they would deny that it was an actual epidemic and therefore prevent lifesaving supplies from getting to the population, just to save face as a MOH/country. The speed with which NGOs then responded in so many different ways has also fascinated me (I say this as an outsider who's NGO has done nothing related to cholera response or prevention and has absolutely no plans to help if it does come to PaP. Not even an email from HQ asking about how we're doing or about contingency plans for ourselves, by the way.). Text messages, radio messages, and posters on how to prevent and treat cholera were all designed in Creole and approved by the MOH for almost immediate distribution. I still get text messages on my cell phone almost daily telling me how to prevent and treat cholera. Community health agents were trained in prevention methods and messages, hundreds of thousands of supplies were mobilized from warehouses in PaP and taken up country, hundreds of thousands of more supplies were flown in to Haiti, trained medical professionals were actively recruited by many different NGOs, emergency meetings and press conferences were held every day and information was widely disseminated to the expat community in English, French, and Creole.

Was the outbreak preventable? Absolutely. Just like the common cold is preventable. Just like pretty much anything, depending on how you look at it, is preventable. Just because it is possible to prevent it doesn't mean someone screwed up and needs to be blamed by not having prevented it. Believe it or not, people are a bit concerned in this country trying to put out whatever fire is in front of them on that particular day. It's triage on an almost daily basis for many organisations, and many don't have the luxury of trying to predict what might become a problem because they're too busy trying to solve what already is a problem. What I think is impressive is that so far the cholera outbreak has been contained in the northern regions and had not made it to PaP. Because, believe me, it will be a whole new level of disastrous if that happens. But NGOs are already on that, too! Contingency plans are in place, community health agents are already trained, cholera treatment centers have been set up, etc, all in case it does come to PaP. I don't know that we (the PaP NGO community) could ever be perfectly prepared for something like that, but it's not like people aren't sitting around thinking about it, which is what SGMD would have you believe.

What I think upsets me most about Dr. Sanjay, is that his reporting style leads me to believe he almost hopes the cholera does spread to PaP, because that would be more proof of the NGO community failing at something and would make good, dramatic TV. Then he could point more fingers and say he told us so. Basically the more death and destruction, the better.

I'm not saying that the cholera outbreak response has been perfect, and I'm not pretending to know the ins and outs of it all. Hell, I've never even visited that region. But as I said earlier, what I find offensive is the implication that the response has been incompetent and inefficient, as though people are idly sitting around twiddling their thumbs because they can't be bothered to help in the response. I think that, given the circumstances of working in a country like Haiti, with the lack of infrastructure, the time of year (just after the peak of the rainy season), and the massive amount of coordination that needed/needs to happen, people are doing the best they can. It's easy to fly in for an afternoon and judge, but it's much harder when you're dealing with the realities on the ground.

I'm already dreading January 12th, the one year anniversary of the earthquake, where every report from The New York Times to the New Yorker (not a broad spectrum, I know) reports on just how little has been achieved in Haiti in the past year. Again, lots of finger pointing will be done by people who have no idea. No idea how hard people are working and how dedicated they are.

And that's my rant on that for today.

(I can't find the link on CNN to the exact video I mention above, but here is a link to a more recent one for anyone who is interested.