Foreign Aid Hurting Haitian Doctors


Dentist at work in Haiti

Jerry and Marlon Bitar ought to be just the kind of success story that Haiti builds its future on. The identical twin brothers, profiled today in The Washington Post, studied medicine in France and returned to their home country to practice. They built a successful private practice serving Haiti's wealthier families, while also starting a clinic that served the poor free of cost. Since the January earthquake, they've performed 900 free amputations and other surgeries. They're running into a bit of a problem, though, as the international relief effort rolls on:

The Bitars ask what appears to be a simple question: How can the country's medical structure be rebuilt when hundreds of humanitarian teams are still providing health care for free? The surgeons say they have no income—not from the poor and not from their private practice. For one, 700,000 people are now homeless with no access to funds. For another, the hospitals, the Bitars and others say, are finding it hard to compete with the visitors. With no end in sight, some of the nation's doctors have already left, and others are considering leaving.

"We have not been able to make payroll for two months," Jerry Bitar said.

Marlon added: "I am very worried that many of our good doctors will leave. The humanitarian hospitals, they don't ask for any money. Yesterday, I went to one and saw two of my private-paying patients getting treatment there."

The Bitars are caught up in one of the ongoing problems with emergency relief operations, the relief-to-development gap. Haiti is a perfect illustration: what little medical infrastructure there was has been severely damaged, and many medical professionals killed. The foreign intervention is saving thousands of lives, but if Haiti is ever going to stand on its own there is going to be some kind of transition from the aid agencies to Haitian professionals. Do it too quickly, and people will suffer and die for lack of medical assistance. Do it too slowly, people like the Bitars will flee and Haiti will never develop its own health care system.

How exactly to make that transition remains a difficult question, though. As Elizabeth Ferris, co-director of the Broookings-Bern Project on Internal Displacement, said at a recent panel discussion on Haiti: "Frankly, we haven't gotten it right just about anywhere."

More from the Reason archive on Haiti.

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  1. Libertarians hate free health care AND me

    1. The free health care isn’t going to last forever; when it goes away, if all the native doctors have bailed, the Haitians will be boned.

      Besides, why should wealthy people be consuming charitable health care resources when there are for-profit clinics available to them?

  2. Caption Contest!

    “I know you were hungry, but did you really think a fish hook looked like food?”

  3. “Yeah, my dick will fit in there.”

  4. “”We have not been able to make payroll for two months,” Jerry Bitar said.”

    This is as hollow as ObamaSpeak. Given that 700,000 people are now homeless with no access to funds, are we to believe if the outsiders left, suddenly there’d be a huge infux of domestic dollars going towards Hatian doctors’ payrolls?

    1. No kidding. It reminds me of this story from the Mises Institute website, about complaints over charitable donations to poor African countries:

  5. Why can’t Doctors without Borders hire unemployed Haitian doctors? It would probably be cheaper than flying in and maintaining foreign doctors.

  6. Maybe I’m just too simplistic in my thinking but wouldn’t it be possible for some aid agencies to hire and pay the local Haitian professionals? It would almost certainly be less than they were making before but it would be part of the transition. A common component of missions-based economic development (both religious and secular) is spending and hiring in ways that support the local economy.

    1. I agree with the idea of private charities hiring the local doctors, at least while the relief effort is under way. Nothing’s perfect, but this seems better than the present situation.

    2. Sounds like a great idea for a libertarian humanitarian effort. I’d scrounge up a few bucks. Would any other folks around these parts be willing to help?

  7. This was completely unforseeable.

  8. I think my sarcasm detector is broken on this thread. Or are people really blaming the doctor for leaving because he can no longer earn a living? Equating a reduced income due to the disaster to a non existent income due to foreign aide with no end in sight?

  9. Doctors Without Borders maintains a local staff in all of their operations including Haiti.

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