Thursday, January 21, 2010

Why we didn't all just go to Haiti

I think it's reasonable to say that many of us, when we hear of a crisis, would much rather do something tangible than sit around and weep, pray, or part with our money. And yet, praying and giving money are often some of the best things you can do. This article does a good job of explaining exactly why.

Interestingly enough, much of my work this last year has hinged around this kind of a problem - specifically with medical equipment. So often, wealthy nations or hospitals want to help "the poor starving children" and think that by donating items, they can really be of help. A common idea is that "something is better than nothing." In all reality, that couldn't be farther from the truth.

In disaster situations and even extreme poverty, the infrastructure isn't present to keep even human waste from getting into the water system, much less dispose of expired drugs, medical waste, and unusable food/clothing items. A rule of thumb we often repeat in guidelines for effective medical equipment donations is "if it's not acceptable in the donor country, it's not appropriate for the recipients."

Seems to me we just keep coming back to that simple 'do unto others...' advice.


Disaster do-gooders can actually hinder help
Uninvited volunteers, useless donations can cost money, time — and lives
By JoNel Aleccia
Health writer
updated 7:13 a.m. ET, Thurs., Jan. 21, 2010


No question, the two church-goers from New Jersey had the best intentions in the world when they arrived in Port-au-Prince this week to help victims of Haiti’s killer earthquake.

Trouble was, that was all they had in a land where food, water, shelter and transportation are at a desperate premium, said Laura Blank, a disaster communications manager on the ground for World Vision, a Christian humanitarian aid group with long ties to the country.

“They seemed very eager and very passionate about helping the people of Haiti, but they didn’t have a ride to get out of the airport,” said Blank, who had to direct the pair to assistance.

More than a week after a magnitude-7 earthquake devastated the country, disaster organizers say they’re seeing the first signs of a problem that can hinder even the most ambitious recovery efforts: good intentions gone wrong.

From volunteer medical teams who show up uninvited, to stateside donors who ship boxes of unusable household goods, misdirected compassion can actually tax scarce resources, costing time, money, energy — and lives, experts say.

“Everyone wants to be a hero. Everyone wants to help,” said Dr. Thomas Kirsch, co-director of the Johns Hopkins Center for Refugee and Disaster Response. “It’s not the way to do it.”

Even a medical crew from his own school — Kirsch declined to identify them — arrived in Haiti so ill-prepared they had to seek sustenance from non-governmental organizations.

“They had no bedding, supplies or food,” he said. “They ended up glomming onto some of the NGOs.”

Volunteers simply show up
What to do with well-meaning volunteers is not a new problem. In every disaster, large numbers of people simply show up to help. A handbook published by California disaster officials estimates organizers can count on 50,000 “convergent” volunteers after any severe earthquake. After the Sept. 11 terror attacks, more than 40,000 unsolicited volunteers arrived at Ground Zero in New York.

In the U.S. and around the world, aid organizations are walking a fine line, trying to encourage skilled professionals who can provide indispensable assistance — and waving off those who might not be up to the task. At the federal Center for International Disaster Information, a stern note warns the well-intentioned:

“Volunteers without prior disaster relief experience are generally not selected for relief assignments,” it reads. “Most offers of another body to drive trucks, set up tents, and feed children are not accepted.”

It’s an effort to help would-be Samaritans recognize the reality of the situation, said CIDI director Suzanne H. Brooks.

“It’s very romantic in the TV and movies,” she said. “They think it’s flying in for a weekend. They need to think of it in terms of months.”

Those best suited to help are probably already there, experts said. They’re trained crews who not only have experience working in disasters, but also in developing nations, Kirsch said. The best teams also have a command of Haitian Creole and French, if possible.

When teams arrive without those skills and without their own supplies, they drain resources that could better be used for actual victims, said Dr. Kristi L. Koenig, an emergency physician at the University of California, Irvine, who specializes in disaster response.

“Unless you’re part of a team before the disaster happens with a formal mission, you’re going to be part of the problem,” she said.

Even worse, certain volunteers have required emergency intervention themselves, Kirsch noted.

“Most people do quite well, but about 10 percent don't,” he said. “They end up totally freaking out and having to be evacuated.”

Winter coats and high-heeled shoes?
A different but equally pressing problem is the flood of ill-advised donations that aid agencies already are facing, organizers said. A handful of “Help Haiti” food and clothing drives across the country are inspiring cringes among some workers, said Diana Rothe-Smith, executive director of the National Voluntary Organizations Active in Disaster, a coalition of agencies.

“I would strongly recommend that no donation drives be conducted unless there’s an existing organization on the ground, in Haiti, that has asked for the help,” Rothe-Smith said. “It does pile up very quickly.”

Donations of old clothes, canned goods, water and outdated prescriptions are accumulating, said Brooks. While such items sound useful, they’re actually expensive to sort, to transport and to distribute, she said. Cast-off drugs can be dangerous.

Oftentimes, the household items donated are simply not useful to the disaster victims they’re intended to help.

“I guarantee you someone is going to send a winter coat or high-heeled shoes,” Brooks said.

In fact, after the tsunami in Indonesia in 2004, aid organizers in Sri Lanka were forced to deal with donations of stiletto shoes, expired cans of salmon, evening gowns and even thong panties, according to news reports. In Florida, a truckload of mink coats showed up during the 2004 hurricane season, Rothe-Smith said, a likely tax write-off for a retailer having trouble pushing furs.

The compassion behind some donations is understandable — and laudable, she added. People see dire images on television or in news reports and they want to help.

“It seems to make logical sense to go through your own cupboard and gather those items,” Rothe-Smith said.

The reality, however, is that inappropriate donations actually do more harm than good.

“If you buy a can of peas and it costs 59 cents, it’ll cost about $80 to get it where it needs to go,” Rothe-Smith said.

Mathematics of donation favor cash
Many agencies try to motivate donors with the mathematics of the situation. Jeff Nene, a spokesman for Convoy of Hope, a Springfield, Mo., agency that feeds 11,000 children a day in Haiti, urges cash donations that allow his group to buy in bulk from large suppliers and retailers.

“When people give $1, it translates into $7 in the field,” he said. “If they spend $5 for bottled water, that’s nice and it makes them feel good, but probably it costs us more than $5 to send it. If they give us $5, we can get $35 worth of water.”

That’s a sentiment echoed by virtually every aid agency.

“I would really say at this point, honestly, right now, money is the best thing to give,” Rothe-Smith said.

Donors can find vetted agencies helping in Haiti on sites such as Charity Navigator.

Still, trying to direct the flood of compassion can be tricky, Nene acknowledged.

“Some people get a little miffed by it. They think they’re trying to help and when you don’t receive it in that attitude and spirit, they get upset,” he said.

“You just have to tread lightly. You don’t want to crush people when they’re so willing to help.”
© 2010 msnbc.com Reprints
URL: http://www.msnbc.msn.com/id/34958965/ns/world_news-haiti_earthquake/

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Sunday, January 17, 2010

Haiti: Pre-earthquake

In light of the catastrophe in Port-au-Prince, Haiti, I figure I should probably write a little bit about my experience there. Fortunately, the hospitals we were working with are farther inland and all their locations are still standing. This puts them in the position of providing care to many of the wounded. Having worked with the people at Partners in Health (PIH), I would highly recommend sending any support through them if you want to help with the disaster relief. PIH isn't just an outside aid organization, their whole strategy is to train and employ Haitian nationals, from the cleaning staff and community health workers all the way up to the doctors and nurses - and everyone in between.

While in Haiti, we worked with Youdy, their head biomedical technician. I was so impressed with his knowledge and desire for learning. Youdy has completed multiple courses in specific types of equipment, both in the US and via distance-learning. He is training at least 8 young men to work at the different site hospitals and as assistants for him. While we were in Haiti, Billy and I worked with Youdy to repair 3 tabletop sterilizers and help set up an x-ray machine. Once we arrived at home, we were also able to send back the parts for a 4th sterilizer which is likely in service now.

More to come later. For now, here are the pictures from my time there:

Zanmi Lasante Hospital in Haiti



Stand With Haiti


Saturday, September 26, 2009

Polka-dot Umbrella Day

A week after I intended to write this blogpost, I'm getting back to share just a few details of my new Durham home with you all. Today was a mixture of continuing to explore a new city: I found the MASSIVE Southpoint mall; and getting to know good friends even better: Jennifer and I had dinner with our neighbors and some friends, most of whom are new to the area.

For those who haven't heard the basics, I am living in a neighborhood called Lyon Park - in fact, we are two houses away from the Lyon Park Community Center. It's always a nice break to hear people picking up their kids from after school programs or see the teenagers walking home in the evenings. When I first moved here, there were those who said it was a dangerous neighborhood - and it isn't rich, that's for sure. But as for safety, I see this as my home. People are sitting on their front porches all hours of the day. I talk to the ladies on either side of me, both with lots of children in and out of their houses even though they are long past their own mothering years. There's construction going on up the street on a huge church with gorgeous stained glass windows, and you can hear people playing music late at night - just loud enough to know there's life.

Last weekend I had the opportunity to learn more about my neighborhood and the surrounding area. While searching for a place to buy stamps, I discovered that there was an entire shopping area and street I had managed to miss by driving and riding only on select routes. So I set out with my polka dotted umbrella to buy stamps and see what was there!

On my way, I walked past the community center, lots of rather old little houses, and a few recently renovated places -- mostly from Habitat for Humanity and Self Help, the organization that redid my house. The rain and gray brought out the rich greens in the yards, and even the kudzu covering everything in a few empty lots. One house was particularly striking - it was old, a little run down, and you could tell there wasn't a lot of money there. But there were a few women standing outside with umbrellas, saying goodbye to friends, and someone had taken the time to plan just a few brightly colored flowers in the yard.

Once I reached the main road, the business area wasn't anything like the pristine Southpoint mall. The local Food Lion (cheap local grocery chain) anchors an old plaza with some authentic Mexican restaurants and thrift shops. I ran into a young man at the gas station who made a little pass; the older gentleman who came behind him exchanged a knowing smile with me. On the outskirts of the area, a series of three houses hold a business called The Tuba Exchange.' Someone tell me why they need a house and three full sized garages for tubas? There's also a small shop called Pennies for Change - an adorable thrift shop with funds going to help victims of domestic abuse.

On my way home, I got to meet Ricardo - a man I've seen many days as I drive by - always studying English on his front porch. I stopped to say hi, and we immediately had a wonderful conversation. His wife stuck her head out the door just far enough to see who he was talking to, but she didn't seem to want to speak. Perhaps she wouldn't have been able... I told Ricardo I was interested in learning Spanish - he said that we could exchange language lessons, though I think he is better off learning from the local Catholic church where he said he gets classes. I hope he and his wife do well here. Perhaps I'll get to know them better.

All in all, this neighborhood especially, is beginning to feel like home. I've connected with a friend from high school and am continuing to get to know some great people in the area - students, staff, and a few people like me, who are still trying to figure out what life holds.

Tuesday, September 8, 2009

Comfort Food - Tanzanian Style

A little less than a month after our return from Tanzania, I'm now living in Durham, NC, where I just started working with Engineering World Health at Duke University. I live in a wonderful little green house just close enough to campus to ride my bike on winding roads up and down through the woods.

Perhaps my biggest worry with work was that I would be bored... but that doesn't seem to be the case at all! First day and I already have more than I could want of projects to work on. AND they're all projects I would enjoy working on. What more could you ask for? A salary, perhaps, but that's why I'm babysitting until my North Carolina EMT registration comes through. In the meantime, I'm working on being frugal... kind of a challenge.

That's why I looked up my favorite Tanzanian lunch food: Wali na maharage! (Plain ol' rice and beans). The best part is that once you get a big bag of rice and big bag of beans, you can eat for a long time on minimal budget. In the process of looking up how to cook this beautiful food, I found a website that a peace corps volunteer had put together of many traditional recipes I loved eating this summer! His directions and descriptions are quite amusing and seem to be pretty accurate, too.




Wali na Maharage

Enjoy! Now I just need to find a whole-foods type store to buy my rice and beans in bulk... A farmers market would be nice too, but I think my roommate knows where to direct me. Hmm... now I'm hungry. Mango time.


Sunday, September 6, 2009

Favorite East African hit song!

Pii-pii, move out the way!

Basic story of the song - he is in traffic, wants to get home and see his baby because it's been a long time and he's tired of calling on the phone, etc.

We always loved hearing this one playing in cars, bars, homes, and even our own computers once we figured out how to download it. This is the video that was also playing on TVs constantly.

Monday, August 17, 2009

Shani No. 406

Monday the 17th of August and I am sitting the Indianapolis International Airport with my 'Indy Style' popcorn (cheddar AND caramel corn) and a diet coke pondering the meaning of names. You know what I mean - when parents name their kid something that means 'bitterness' and her life turns out to be a huge mess, or someone whose name means 'victory' and they seem to win at everything... I've known of this self fulfilling tendency, and yet I still named this blog Shani, which indicates adventures of the misadventure flavor. Should've known.

I successfully made it home from Tanzania, even after taking 4 weekend trips that involved catching planes, then the various flights to and from... If you total it up, I took 12 flights this summer, and even more than that if you count transfers. Finally, this morning I was dropped off at my home airport, a small place that was recently redone and perhaps made more efficient? No. I was late, but so were the other 10 people checking in with and even after me. I rushed to security, but not particularly stressed, asked one of the TSA ladies if I could go through more quickly since my plane was taking off in 15 minutes. Apparently I wasn't stressed enough, because she blew me off. I pulled my shoes and computer out of the x-ray and took off at as much of a sprint as I could at 7am with backpack and without breakfast. Too late. The guy at the ticket counter had actually hand delivered the claim ticket for my bag of souvenirs to the plane, thinking I was sitting in my seat. As he printed up a standby ticket, he commented on how calm I was... What's the point in freaking out?

However, 9 hours later, after watching flight 406 pull away without me because they had oversold and everyone showed up, I decided I might-could freak out. My cell phone battery has died, the charger is in my bag that successfully made it to Denver.....

On the other hand, I've now got a standby ticket for flight 667, I've got my computer and free Wi-fi, and I've been able to start a job search, email people, and talk to an 83 year old lady from Muncie. I guess if anything, I made someone else's day. I've also had a leisurely breakfast with good coffee, talked to a lady handing out free samples who told me about the smudges I'd managed to get on my face while standing at the top of the parking garage singing to the sky and myself... All in all, I suppose it could be worse.

(If I don't manage to get to Denver tonight though.... ask me later.)

Monday, August 3, 2009

Scattered Thoughts

Sorry for my incredible lack of writing this month -- and no, I haven't really been keeping a journal either, except for our work log, so I hope I can remember things as I get the time to write them down.

Just a few thoughts from recent work:

*This morning Merete and I spent nearly $100 USD on lights and replacement parts for fixtures in one of our hospitals from damage done by a power surge. This basically uses our parts budget and secondary project funds, which I can totally justify, saying that light is an integral part of medicine working effectively and things being done well. On the other hand, it's a classic case of treating the symptoms without addressing the disease. We fixed the parts and are putting in the new bulbs, but in the case of another power surge the hospital will once again be out of luck as things blow. As we were working, I got to talk with one of the technicians about the only real solution: a system-wide surge protector. This technology is available, and he even has the card for a guy in Nairobi who can do it. However, who's going to take the initiative to do it? My thoughts are perhaps this is something that a charitable organization could take up, or even the hospital itself! Inevitably, there are things that get replaced with budget money over the course of a year. It would take planning and probably some creative working, but it would save money in the long run if the actual root of the problem was treated! ...right now wishful thinking, but I'll keep musing on this one....

*As an engineer in the hospital, my life an exposures are relatively clean and tidy -- I see the patients that are mobile, talk to the doctors, and socialize with staff at tea and lunch breaks. Yet today, as we walked towards the large shipping container turned AIDS clinic, a hopeless weeping was very clear. The woman looked to be in her late thirties, and I can only speculate as to what might have been the problem, but it was a good reminder that life is not clean, neat, or easy and sometimes it is just downright miserable. I wish I could think on my feet and figure out some profound conclusions from this, but for now I'm just left with the picture. What will my response be?

*Lots of thoughts and struggles in what it means to be a white American here, and how people perceive us/me... I don't really have time to expand on this -- maybe later.