Just a clip to give you a sense of the scene. RAM playing after us in Cange, Haiti, March 31st.
A few posts ago I wrote about some Haitian kids singing for us one night in Cange. I remembered them playing a slow, romanticky song—-like a French ‘O Solo Mio’ or something. And I remembered it as this funny moment—-a scene from a 40s movie, French music under a lamppost—-but starring these hilarious teens and taking place in—-deep rural Haiti? With farmers burning their fields on the mountains around us? Hilarious and surreal, but also just nice.
Regine just sent me the link to the song they were actually singing. And it’s such a better memory than I remembered! They were singing this French upbeat folk-rock hit from the 70s—-“The Ballad of the Happy People”.
It was totally just a Coke commercial.
Kanpe is a new organization, one that’s just starting its work in Haiti. Regine is on their board of directors, and the band has given them a fair bit of money. They’re starting their work in Bay Tourib, that rural village we visited—-Fritz Louis, Kanpe’s program director, was with us in that rollicking SUV ride out to the countryside. They’re aiming to be partners in health with Partners in Health. Well, partners in a lot of things, I guess, but health is one of them. I just wanted to be clever. Sorry.
To talk about Kanpe—-well, it actually helps to tell you first about this Haitian bank called Fonkoze. Fonkoze is a microfinance institution. Which means, most famously, that they lend small amounts of money to poor people who ordinarily can’t get loans. But that’s just one aspect of the work (albeit a very important one)—-this is a good summary of their methods.
Now, there is a difference between the very, very poor and the very, very, very, very poor—-or ‘the poorest of the poor’. Basically, if you have a very poor person and you teach them to fish, and you give them a fishing rod—-they will use it to get food for their family. If you have an insanely poor person and you teach them to fish, and you give them a fishing rod—-they will sell the fishing rod to buy emergency rations, or they will have to use it to prop up a corner of their house when the rainy season comes, or they will have to trade it for medicine. That is a simplification, but what can I say, I’m a simple man.
Fonkoze noticed that they had better success with the poorest of the poor in communities where Partners in Health was working. Basically, with free health care, when people got loans, they didn’t immediately go out and buy medicine for their dying families. Because the medicine was free! (Oh, and, mysteriously, when they got the medicine, the families were no longer dying—-and they were able to contribute economically! The CIIIIIIIIIIRCLE of LIIIIIIIIFE!)
And Partners in Health noticed that in communities where Fonkoze came in, the poorest of the poor were slowly becoming just run-of-the-mill poor. Like, people owned more goats and stuff. It was totally awesome. People weren’t just healthy and stuck with absolutely no opportunities—-now, of a sudden, there were small opportunities.
So, since 2004, PIH and Fonkoze have been working in concert more and more. There are a few towns in Haiti now—-Thomonde (next to Bay Tourib) is among them—-that have Fonkoze bank branches next to PIH hospitals.
Kanpe saw this high-five party and wanted in. So in Bay Tourib, all three organizations will be working together. Kanpe will be focused on the 250 or so poorest families in the community—-helping them get from absolute zero to 0.000000001 . This means helping people get access to health care from Partners in Health and financial services from Fonkoze. It also means helping people get secure housing, getting children educated and fed, getting adults educated and fed, and, well, helping with any of the myriad problems that people face in rural Haiti. Now, PIH and Fonkoze tackle those problems, too—-these organizations are pretty ‘whatever means necessary’ in helping the poor. But having an extra set of hands, and almost more importantly, eyes, means that the community can be brought up to a higher level more quickly.
When Partners in Health is alone in a town, it kind of means that there’s a great Department of Health, and that the Department of Health will also act as the Department of Housing, and of Education, and of Sanitation, and of Transportation, etc., if needs be. But having partners? Oh, man, that’d be great!
There’s been a health clinic in Bay Tourib for 3 years, but it’s never opened. It was built by a (domestic, I think) organization using money from a World Bank grant. The understanding was, I believe, that this organization would build the clinic, and the people of Bay Tourib would take care of the rest. Three years later, PIH is coming in to staff and run the clinic.
This is what my brain says about those three years, and about the clinic building:
1) It’s good that somebody built a clinic.
2) It’s bad that it’s been empty for three years.
3) But, yeah, it’s good that it was built—-now PIH can come in and start up work quickly, and they don’t have to worry about construction costs. Just operational costs.
4) How bad is it, those three years that the building sat empty? I mean, from the Bay Touribeno’s (that seems like a legitimate term, right? ‘Bay’ is pronounced “Bi”, by the way, and Touribenos, in my head, is pronounced with a tilde on the ‘n’—-Bi Touribenyos) point of view.
5) It is at least annoying. I know this because I have driven on highways that say “Your tax dollars at work” that have been under construction for years, which is annoying.
6) This is the sign out in front of the clinic:
Republic of Haiti
MPCE / PL-480 / UCP (World Bank project codes)
National Development Project
Community Participation Driven (PRODEP) (more World Bank lingo)
Name of Project: Construction of Dispensary (i.e. clinic) in Bay Tourib
Location: Bay Tourib
Financing: World Bank / Community Participation of Bay Tourib
Community Organization (OCB) in charge of Execution: the Development Organization of Bay Tourib (ODB)
Supervision: (obscured) Thomonde (nearest medium town) / BTC-HPC (no idea)
Amount of Financing from World Bank:
65(obscured)13.21 Gourds (Haitian currency)
(obscured): 4 months (I assume construction time or something)
[oh, and BTW (btw means “by the way”, btw) all those people standing outside the clinic in the photo? They walked down to the clinic with us after our concert outside the school and hung out while local and PIH folks talked to us about the medical situation as we toured the clinic]
7) That’s basically a “Your Tax Dollars At Work!” sign.
8) Except, it’s definitely more annoying than a highway under construction for three years. It’s like driving on a dirt road for three years, while a completed brand spanking new highway runs parallel—-unused across a barrier.
9) More harshly, it’s like walking 5 hours down a dirt road carrying your dying neighbor on a stretcher, while a nice new highway runs parallel—-unused across a barrier. So it is something more than annoying, then.
BUT. but, but:
A) It’s good that there’s a clinic built, right? Infrastructure! Infrastructure is the bomb, yo.
B) And back to the Bay Touribenos. They agreed to staff and upkeep the place—-and the folks who built the structure, well, it’s not their responsibility to pay for everything, right?
C) Huh. But a tiny rural village, two hours by insane-whiplash-inducing-SUV-ride from a medium town? We are expecting them to pay doctors? There are no doctors from Bay Tourib. Are there even any college graduates from the town? The highest health care professionals (from what I gathered) are four assistant nurses who work in the PIH hospital in Thomonde. Which is great—-that’s a start! But a whole health care system for a town it is not.
D) Well, why agree to pay the upkeep then?
E) Not a lot of bargaining power. If someone is offering you a building—-you take it. An empty clinic is better than no clinic.
G) It is at least annoying, though, that empty clinic.
i) But up again to that sign. It’s a good sign—-look at all that tranparency! You know just who is accountable. Your Tax Dollars at Work!
ii) But it’s not your tax dollars. It’s World Bank bucks. So instead of saying “Gol-dang lousy govmint mis-spending my dollars. I’ma vote those a-holes out of a job.”, you are instead saying, “Huh, well, it’s very nice of these foreign gentlemen to fund this construction. I actually sincerely appreciate this help. But fuck it all to hell, who the fuck do I yell at when this shit is sitting around unused?”
iii) Is the response then anger? Despair? Is it just medium-to-high annoyance? Do you want to yell at the “Development Organization of Bay Tourib”?
iv) I suspect not—-I suspect you’ll probably have slightly more sympathy for your neighborhood organization, and slightly less for the World Bank.
v) But maybe not. Because local politics can be vicious, at least as far as I know.
vi) Or do you just throw up your hands, and are all like, “Whatever.”
vii) And keep in mind, the citizens of Bay Tourib will not be reacting en masse. Some probably throw their hands up. Some are like, “Goddamn it, Jean-Pierre, I told you not to hope for a health clinic. Nothing good was gonna happen.” Some probably say, “Wait, someone built a clinic?” and some say, “That’s a good, solid building they built for us. I’m thankful for it.” and some say, “I wish the World Bank would buy me a unicorn that could shit DVDs that I could sell.” and some say “Come hell or high water, I will figure out how to staff that clinic! I’m sick of my neighbors dying from stupid shit.”
1) What is this situation like? Is it like, you really need a car, and one day your dad comes home with a Volkswagon Golf, and is like, “Here’s your new car, but you’re gonna have to pay for gasoline and upkeep out of your allowance!”
2) Is it like a stranger hearing that you need a car and sending you a PT Cruiser with an empty gas tank? I mean, thanks for the car, but a PT Cruiser? And, sigh, I guess I have to walk to the gas station to fill it up.
3) Is it like a neighbor coming over and saying, “Hey, man, I heard about you needing a car. I’d love to help out.” And then helping you buy, within reason, a car of your choice?
4) Is it like your fucking rich ass neighbor coming over and saying, “Hey, man, I heard about you needing a car. I’d love to help out. But I’m not fucking paying for tires, okay? You’ve got to buy the fucking tires on your own. And I’m not gonna fucking help you pay for gasoline, are you crazy?”
5) Is it like, you’ve got this car that this nice stranger gave you, but you can’t afford gas. And there are no tires on the car. And your friend is dying. So you put him on a stretcher and walk him five hours to the hospital.
6) But then, three years later, somebody comes with a tank of gas and a set of tires.
I mean, that’s the good news. Whatever was going through people’s heads for the last three years as they saw a health clinic sit empty in their town—-the clinic won’t be empty now.
And don’t get me wrong—-this isn’t like, a mondo hospital or anything. It’s no Mirebalais. It’s just a four room country clinic that probably won’t even have a full doctor in attendance every day of the week. But it’s an infinite step up. And it’s gonna be totally awesome.
We had brought amps just in case, but the generator was out of gas. A couple of townspeople offered either to find gas or to get another generator (I couldn’t grasp the details), but we were like, “You know what? Don’t worry about it.” We were impressed that they’d even had a generator to run out of gas for. It would have been really fun with the amps, though—-we were gonna rig two small guitar amps like PA speakers, and then run everything through this small 6 channel board, and hopefully everything would come out sounding all distorted (in a nice, warm, way) and amazing. But, whatever, we’ll play acoustic, I guess. I mean, it would have been cool if you’d had gas for the generator and stuff. But whatever man, it’s cool. It’s not like we brought these amps or anything. No, it’s cool, seriously, whatever. I mean, it’s just that I came all the way out here to Haiti? And, um, anyway, whatever, man, it’s cool.
We had arrived in town to the sounds of kids practicing a musical welcome for us. When they were ready (and we were ready), we all filed in to the school and they sang for us. You can hear the full presentation here. It also came out that today wasn’t a school day, but that they’d asked the kids to come in to sing for us. Sorry kids! We’ll make it up to you, I swear. Though they didn’t seem that upset.
We set up in front of the school, up against a fence, and everybody just circled around. This is what our little show looked like from a 5 (?) year old boy’s perspective:
And this is what it looked like to someone standing right in front of Richie:
(I think this is before we started playing—-Richie jury rigged a guitar strap out of electrical tape for the show)
There was one particularly solemn group of boys who had climbed a tree to watch us play. Maybe 6 kids up in a tree, stone faced, like they were watching the mayor sign a solemn certificate declaring this “National Cotton Month.” But I guess they must have been entertained. They were in a tree, right?
This lady really liked the show, at least:
We played some covers: The Tide is High, La Bamba/Twist and Shout (we’ll count that as one song), the Last Time. Did we try Everyday People? We might have. We played Haiti and Sprawl II and Wake Up, and a little later on Stand By Me.
We gave the school teacher (slash choir director slash general town leader) Regine’s accordion and asked him to play something for us. “But we just know church songs!” he protested. So play us a church song! Which everybody sang. This little group of boys got really into one call and response section. It was pretty cute.
And then we put the gear back in the car and walked down to the health clinic to, like, learn some stuff.
Our last full day in Haiti (also known as “our second full day in Haiti”—-we were there too short, it’s true) started with a trip to Bay Tourib.
Let’s do some amateur Google Maps anthropology! First off, a horribly embarrassing admission: I can’t find Bay Tourib on a map. It’s really hard to Google! (You get a few more results when you try “Baille Touribe”, but still, pretty slim pickins.) I kept telling myself the whole trip in Haiti—-you gotta find a map, son, and get someone to show you where all this stuff is. But like I said, it was a damn short trip.
BUT, I’ve emailed my PIH friends to fill that particular gap in my knowledge. (My guess? It’s over here.) BUT, still, we can still learn a bit about the region, can’t we? Let’s start with this guy. Let’s call him (and to be clear, I haven’t met this person, and am not sure anyone even lives in this house) Charlemagne. He lives out in the rural Central Plateau of Haiti. Zoom out a couple clicks, and look around at the landscape. You can see it’s agricultural, if you look for it—-oblong and irregular fields. These fields are tended by hand, and often created and kept by burning. Any weird looking edge you see in that satellite photo—-that’s the edge of a field. It’s the hand-powered, Haitian equivalent of the Kansas quilt. But also, keep in mind, these Haitian fields are scrapped out of the sides of hills and mountains. The prairies this ain’t.
Zoom out a little more. Oh, Charlemagne isn’t so isolated after all! He’s about a mile walk from a public school. Remember, it’s a hilly, mountainous walk, but it’s no worse than what Granpa had to do. Here’s Abricot (Charlemagne’s town) compared with Elbing, KS, population 208. (Note that the scales don’t quite match up—-Abricot appears relatively larger because it’s slightly more zoomed in.) Notice about Elbing (scroll around a little)—-it’s built on a grid, there’s industrial equipment and grain silos in evidence, there’s a post office, a large what-looks-to-be-private school with a track and field track. I suspect the census data for Abricot is not that accurate, so I don’t know if Elbing has more or less people—-so the comparison isn’t necessarily all that meaningful. But compare these towns we will!
Also, note that the roads in Abricot are definitely just paths, not roads. You can tell by the wear patterns and the bodacious intersections.
[Also, note that while it’s great that Charlemagne lives near a public school and won’t have to pay tuition fees for his kids—-he will still have to pay for uniforms and textbooks and miscellanea]
Just south of Abricot you can see that Google Maps has marked a road (through the town of Roche Plate). This road is worse than any road you have driven on in your life. (probably). Let’s zoom in on a section of that road. That’s it in the middle of the map (I took the label off it). You could probably drive a dirt-bike down it, if you were good at riding dirt bikes. It might make more sense to ride a burro. We drove similar roads to Bay Tourib in SUVs with high repair bills.
Let’s follow this road to a bigger road—-to a highway, maybe. Oops! We hit a river. I guess we’ll just have to drive through it. If there’s been rain lately, well, you will have to wait to drive farther. Or to walk farther. Or to ride your burro farther.
But, ultimately, you’ll hit National Highway 3 and you’re home-free. Keep in mind that 3 or 4 years ago, Highway 3 was still worse than any road you have driven on in your life (probably). It wasn’t just a dirt road. It was a road made solely out of boulders and pot holes. It went through streams not crossable when raining. It was slightly better than the road to Bay Tourib is currently, but the road to Bay Tourib is like riding on a slow mechanical bull for 2 hours.
But that’s all driving, and Charlemagne is probably walking. What does Charlie do if he needs to go to the hospital? If we zoom out again, it looks like the closest village of some size is Hinche—-about 7 miles as the crow flies, over mountains and streams and all that jazz. So it’s a bit of a stroll for a sick man to make.
The people in Bay Tourib, when someone needs to go to the hospital, they carry them on a stretcher for 5 hours. So you can imagine how sick somebody needs to be in order to convince 4 people to carry them on a stretcher for 5 hours. And maybe you can imagine how well they’ll hold up on that journey when they reach that point.
But here’s the bright side: Roads can be built, and clinics can be built, and clinics can be STAFFED (important!), and, heck, anything can be built. It just takes time and money. I mean, you gotta do it proper, don’t get me wrong—-don’t just slap down a road and watch it wash away in the rainy season. Don’t just build a school and HOPE that teachers will come teach there. But—-starting from zero is sometimes easier to imagine than starting from a place like Port-au-Prince—-where there’s so much haywire infrastructure and way too many people.
But starting from zero—-Cange started as a squatters settlement, and now it has an amazing hospital with a high standard of care. It has trees and roads and nice paths. It has young adults that, well, they still don’t have jobs, but they’re educated at least. So starting from a hard-scrabble rural settlement? That’s a fine place to start. Our friend Charlemagne just might get lucky (or maybe his kids. Or maybe his kids kids, depending on the next few hurricane seasons).
Also, as a bonus Google Maps ramble (you didn’t get enough rambling up above?), compare the rainy vs. dry season on the satellite view. We were there when it was dry.
The road to Bay Tourib is……bumpy. It took two hours to drive what would probably take, what, 25 minutes on a normal paved road? It’s beautiful, though. And don’t let these photos deceive you—-it’s not always some barren moonscape you drive through. We just happened to be in Haiti at the butt-end of dry season. You might notice that there are no trees on any of those mountains. That doesn’t change with the seasons, sadly.
Bay Tourib (Baille Touribe, sometimes) is an isolated rural town where Kanpe and Partners in Health and Fonkoze (a bank/micro-lending organization) are going to work together.
After a feast of a meal (the slice and a half of custardy rum cake I had at the end put me particularly over the top), a bunch of us felt the need for a stroll. Besides which we hadn’t seen any of Cange. It was night when we arrived and we had only taken the time to unload our luggage before we went down to dinner.
At the top of one of the staircases there were three kids with a guitar hanging out under a streetlight. (since Cange is so safe and so well lit, there are always kids hanging out under the streetlights. Often times they are up to all hours reading or doing their homework. And then a different shift comes in before dawn to read and do their homework). These kids looked like they were in their early/mid teens. The tallest of the group (who didn’t look like the oldest—-just the one who had gotten his growth spurt first) remembered Win and Regine from their other two trips. “Play me that song that you played—-the one with the guitar part……” and he played the riff from La Bamba. Win and Regine had played La Bamba at an impromptu concert a couple of years ago—-unprepared, it was one of the cover songs they could fake off the cuff. And people had flipped out. Imagine if you had never heard La Bamba before—-it’s a pretty good song.
The kids all spoke a little English and good French (and of course Creole, which none of us did). “Why don’t you guys play us a song instead?” we proposed.
"I don’t know. Do you want something in French or in Creole?"
They conferred for a minute in Creole. “Ok.” And they played us a song. It sounded like a folk song, since it was three dudes and an acoustic guitar singing in a language I didn’t understand. But I guess it could have been a modern R & B track from Haitian radio. Then we made them play us a French song—-they picked a slow, romanticky one—-like a French “O solo mio”.
And then they made us play. So we sang La Bamba, and Richie sang Runaround Sue with the rest of us on backing vocals (Hey! Hey! Womba didda didda Hey! Hey!). The Haitian kids joined in on the heys towards the end of the song. Those ’50s songs are pretty easy to figure out.
And then we continued our walk. Regine split off towards the guest house, and me and Win and Richie and Tim kept heading up. Win said there was a nice look-out platform at the top of the hill above Cange. So we kept climbing those stairs. At a certain point the streetlights ended, and everyone pulled out their iPhone to light the path.
I mean, it was night, so we couldn’t exactly see much from the lookout. Cange and it’s network of paths glowed down below us (and not like far down below us—-just 50 yards or something. It wasn’t like a big hike). We all sat down—-either on the ground, or there was a nice ledge around the space.
There were fires burning on all the hills around us in the distance. Farmers clearing their fields to plant. It reinforced this sense of Cange as an oasis—-ringed by fire, and here in the center, a gentle breeze rustling through trees that had been allowed to grow.
We talked about Haiti, naturally. We talked about the wild contrast between Port-au-Prince and the rest of the sites we had seen. We talked about the……utility of our trip to Haiti. Because we were definitely disrupting operations a little bit, and the cooks had certainly been working overtime. But maybe I’ll get into that utility question in a future post.
We talked about future plans for Haiti, and the ways they might work or not work. We talked about what we might do in the next 40 years—-because when I’m almost 70, there’s a pretty good chance Haiti will still need help.
And then after a while we went down to bed. And complained to each other about how it was too hot to sleep.
We arrived in Cange at night. The PIH hospital complex is like a medieval town—-small buildings connected by paved paths (big enough to drive a car down) or long runs of concrete stairs (it’s all built on the side of a mountain). And everywhere is blazing lit up. Part of it is plain old “don’t trip!” safety—-it’s built on the side of a mountain, as I mentioned, and there are lots of steps to mind. People are running around at all hours of the night. Part of it is “university campus” safety—-more light, less chance someone will try to take your wallet (folks live in the hospital complex, and on busy nights (most nights) there are people sleeping in the courtyards and on the roofs, waiting to see a doctor in the morning).
But part of it is attitude. “Yeah, that’s right. We’re in the middle of f—-in’ rural Haiti. And we are lit up like motherf—-ing New York City. Booyah, asshole, welcome to the triumph of man. Yeah, that’s right. These people are totally poor. But we got f—-ing electricity, and it’s rigged up like a motherf—-er. And you know what else we have? Crazy complex AIDS and TB medications. That’s right. All your crazy rich boy technology? We’re using it in what used to be one of the most destitute sections of one of the most destitute countries in the world. And you know what? It’s totally awesome. How you like us now? We are a f—-in’ island of amazing in a shit-stormed sea of troubles. We’re a city upon a hill, asshole. We’re a f—-in’ candle on a candlestick. Welcome to Cange.”
“We have people who are really good at stone, masonry and tile,” he says, but not so skilled in electrical systems, control wiring, acoustical ceilings and millwork. “We are desperately trying to gather volunteers willing to go to Haiti and work for a week.”
The Mirebalais Hospital is maybe the most purely hopeful sight we saw in Haiti. Such competence! On such a scale! The hospital was already planned before the earthquake struck. After the quake, instead of saying, “Oh, shit, what are we gonna do?” Partners in Health was like, “Fuck that—-we’re gonna make an even better hospital than we were planning. How you like me now, earthquake?” And the earthquake was all, “Oh snap!” and PIH was all like, “That’s what I thought you said.”
First, it’s going to be a big old hospital in a region that needs it (140,000 residents in the area). Second, it’s going to be a teaching hospital, so it’s building up the future medical capacity of Haiti (the only other teaching hospital is the central one in Port-au-Prince, which is in dire straits at the moment). Third, it’s gonna generate a shit-ton of jobs. A SHIT TON. (Heck, it’s already employing a half-shit-ton of people just in constructing the place). Fourth, it’s gonna pull (hopefully) maybe just a little bit of the population out of Port-au-Prince (“Wait, there’s a place we can work?” or, “Wait, there’s a place my uncle is working that I can go and get some money from him?” or “Wait, there’s a place where I can see a doctor?” or “Wait, that town of Mirebalais is on the up and up? I’m headed there.”). Because Port-au-Prince has TOO MANY PEOPLE.
Our frame of mind when we got there: first, it was sunset, and it was beautiful. Second, the freaking hospital is build just under the hill where Paul Farmer and Ophelia Dahl first met and started down the Partners in Health path. The people who owned the house up there, where they met—-their son in law is in charge of the construction of the hospital. So the site was all golden hour lit all beautiful, and there was this beautiful, meaningful story to go with the site, and I was a little sleepy from riding in the bus all day—-maybe I was over susceptible to the romance of the place. But we strolled up the hill (O early evening in the tropics, so happy that the sun is gone, so glad to move and not be drenched in sweat. I swear there was even a gentle breeze), and in the distance there were fields ready for planting. I know it was just a construction site:
Tomorrow: maybe some more technical analysis.