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.