On Sunday 11 March 2012 I travelled out to a community called Fonds Jean Noel, two hours from the Haitian capital Port au Prince up a jaw-breaking road of loose rocks and scree.
Pere Isaacs met us at his church as the congregation, in crisply ironed shirts and flouncy dresses, thronged towards the open doors. The inside of the church was simple with worn wooden benches and tiled floor, and everything was flooded with bright morning light from the altar window. As everyone settled in their seats and the church band – made up of two electric guitars, full drum kit and tambour – warmed up with the choir, little children wandered the aisles and old women mumbled private prayers.
The oldest sat with the youngest in the front-most pews and the choir was good. Pere Isaacs gave a warm sermon in French while we enjoyed the cool air of St Michael’s church. Afterwards we went to the parish house to eat goat and plantain and pasta.
While there we met a group of American dentists who have been travelling out to Haiti for more than a decade to help people with their teeth for free. In a country where health care is difficult to access and dental care not seen as a priority, this seemed a great enterprise. But chatting further to the leader of this group I found out that they held the clinic in the local school – during term time, so the community’s youngsters were having to miss out on vital education.
I found out from Pere Isaac that this meant pupils were playing catch-up for the next month. I also asked what kind of work the dentists carried out. The team leader replied with unabashed pride: “We extract 400 teeth in a week”. That seemed a lot. “Do Haitians, or this community, have a lot of specific problems with their teeth?” I asked. “Not really,” came the reply, “They’ve got good teeth, but when they have a problem they want the tooth out.”
It seemed a shame for these professionals to come all the way from the USA to do extractions – something I have seen carried out with decent results on every street corner in India with make-shift tools and little medical etiquette. It wasn’t the time to say it, but I wondered why this group weren’t trying to save teeth rather than remove them, helping people understand that toothache can usually have better remedies. And because the dentists were returning every year, they would be able to do check-ups and make sure people were caring for their teeth and problems weren’t worsening.
Then I found out something more disturbing, the team leader brought trainees with him and wanted to expand the number each year so that this trip to Haiti could be a learning curve on extraction skills. Regardless of where this merry band’s hearts were at, that smacked of practising medical procedures on vulnerable, poor, rights-depleted human beings.
Haiti should not be a Western training ground for anything; it is a place where only the best, the most appropriate, the tried and tested information, logistics, skills and people should practise and pass on their expertise. And if fillings are what I get when I go to a dentist practising in a honed legal framework, where I have solid rights, then that is what the community of Fonds Jean Noel should be getting.
Sadly this frankly colonial attitude of great white saviour coming to do good on this side of the Hispaniola island is one of the biggest problems for Haiti. In a country that has already been hobbled by a massive earthquake, that has a long history of poor government and weakening infrastructure, and with annual hurricanes that can flatten communities in one night, the last thing people need are well-meaning groups without experience, without development knowledge, without an understanding of coordinated best practice and without respect for what Haitian people know they need, their order of priority and making people aware of choices they may not have known existed.
CAFOD was founded 50 years ago in response to people dying of hunger on the other side of Hispaniola in the Dominican Republic. In that time we have learned the lessons that experience in the field has taught us, and from this change has been implemented and standards have been rigorously enforced. The most valuable of all the lessons has been that sustainable, long term improvements for people at every level come through working with partners on the ground - the people who live the culture, politics and problems of their own country. It would be a good starting point for any foreign NGO operating in Haiti.
What we have to understand is that it is never only about the giving in situations like these, it is about what is being given, how it is given, through whom, and the positive legacies that remain to ensure people, communities and the country are equipped to get on with the business of life without continued external intervention.
(c) Pascale Palmer is Senior Press Officer (Policy & Campaigns) for the official Catholic aid agency CAFOD - www.cafod.org.uk