the quake

The Quake

Marcela Gaviria and Martin Smith

Will Cohen

Martin Smith & Marcela Gaviria

ANNOUNCER: Tonight on FRONTLINE: What happened was catastrophic.

DAVID WALTON, M.D., Partners in Health: The first 24 hours, hundreds of thousands of people died.

KIM BOLDUC, U.N. Humanitarian Coord.: We have never managed a disaster of this complexity, not even the tsunami.

Pres. BARACK OBAMA: To the people of Haiti, we say you will not be forgotten.

ANNOUNCER: Why was relief so slow to reach people?

MARTIN SMITH, Correspondent: The U.N. didn't immediately seek to coordinate efforts. Why not?

EDMOND MULET, U.N. Head of Mission: First of all, we didn't have the capacity to do that.

ANNOUNCER: The tragedy is far from over.

Pres. WILLIAM J. CLINTON, U.N. Special Envoy to Haiti: How are you going to handle the coming rainy season, the coming hurricane season?

EMANUEL: These shelter, you know, they cannot protect the people.

ANNOUNCER: Correspondent Martin Smith reports on what can be done and who will do it.

MARTIN SMITH: Some Americans take a look at this and say, "Look, you know, we've got our own problems. We've not rebuilt New Orleans."

HILLARY RODHAM CLINTON, Secretary of State: And shame on us.

MARC BAZIN, Prime Minister, 1992-93: If you can't help solve this one, what can we expect from you?

ANNOUNCER: Tonight on FRONTLINE, The Quake.

MARTIN SMITH, Correspondent: [voice-over] An earthquake of magnitude 7.0 is apparently not unusual. Every year, there are more than a dozen worldwide. Most pass unnoticed and usually without much harm. What happened this year in Haiti was different.

CHILDREN: [subtitles] Jesus! Jesus!

MAN: Outside! Go! Go! Go!

GIRL: The world is coming to an end!

MICHELE PIERRE-LOUIS, Prime Minister, 2008-09: The first thing I saw was the dust, the dust and then the sound of people really crying- crying out, "Help," and in Creole, " Au secours!" "Anmwee!" "Anmwee!" And I said, "My God, it's bad."

MARIE-LAURENCE LASSEGUE, Minister of Communications: Apocalypse. Apocalypse. All the ministers down, school, hospital, private house. Incredible. Unimaginable.

KIM BOLDUC, U.N. Humanitarian Coord.: There were a lot of bodies all around, a lot of injured people everywhere, people crying, and a lot of people running in all directions.

MARIO ANDRESOL, Chief, National Police: The population was crying, yelling. They didn't know what to do in this kind of situation. And I was really, like, you know, what to do to help them? Nothing we can do.

MARTIN SMITH: The quake struck at the heart of a desperately poor and vulnerable country. An estimated 1 in 10 people in Haiti's capital, Port-au-Prince, had died.

DAVID WALTON, M.D., Partners in Health: The corpses literally littered the streets, just thousands upon thousands of corpses of people who had died, either outside their homes, or inside their homes, and their family had put them out to be picked up.

MARTIN SMITH: The wounded had nowhere to go. Outside one of the few hospitals still standing, a man sat beside two dead children.

NEWSCASTER: This is a very emotional scene here, And there are many more bodies- there are many more bodies- there are many more bodies just laying by the side of the road, and there are people looking over the top and seeing [unintelligible] where Doctors Without Borders operates.

Dr. DAVID WALTON: When we arrived at this hospital, chaos outside of the gates, people really trying to get into the hospital, but the hospital was already full. And of course, no one was in the buildings because they were structurally unsound. There were people lying in the courtyard with the most horrific injuries that I've ever seen. You know, I don't consider myself to be squeamish at all, being in medicine, and you know, this is enough to even stop the most seasoned veteran in his or her tracks.

MARTIN SMITH: At the main hospital, hundreds of bodies were dumped out in the open. Inside, amputations went forward without anesthesia.

MATTHEW PRICE, Reporter, BBC: I've walked into the hospital now, and there are injured people lying all around, a handful of doctors trying to treat them- head injuries, people with broken legs, and amongst them, those who were brought in here injured and who have since died.

MARTIN SMITH: With the airport in Port-au-Prince closed to all but humanitarian flights, we landed in neighboring Dominican Republic and drove to the border. Crowds of Haitians were struggling to get out of the country. As we entered Port-au-Prince, Haitians were just beginning to grasp what had happened.

The images had been widely broadcast, but to see it firsthand was altogether different- schools, hospitals, hotels, office buildings, homes completely demolished. People who live and work here suddenly found themselves in a strange land.

LOUISE IVERS, M.D., Partners in Health: I was just astounded, you know, by seeing places where I had often gone, places that I knew well as landmarks. You know, in Haiti, very few people know the names of streets, but they'll direct you, "You turn left at the pink building." And those landmarks gone and just buildings completely pancaked.

MARIE-LAURENCE LASSEGUE, Minister of Communications: I go all around the town. I wonder if there was not a war in the town. I imagine, "Wow, what's happened? Did they- did they- they were bombed on this town or what?"

MARTIN SMITH: The quake had also decimated an already weak and inefficient government, wiping out 11 ministries and the parliament. Even the National Palace, an enduring symbol to all Haitians, had collapsed.

RAYMOND JOSEPH, Haitian Ambassador to U.S.: It was like if a city like Washington, D.C., woke up and the White House is flattened, the Congress is flattened, FBI, CIA, the banks, all the banks, all the communications- communication system, flattened.

MAN: You see that?

MARTIN SMITH: [on camera] Yeah, there's a whole body here.

[voice-over] The world had watched hours of dramatic rescues on television, but the truth was, only a very small fraction of those caught in the rubble survived, fewer than 150 people. Many tens of thousands were buried. Here, men were looking for bodies in a collapsed school.

MAN: [subtitles] Under there are many dead bodies. There are 30 dead people here, mothers, fathers, children. They are crushed down there together. The school fell like this. It crushed their house. No one lived.

MARTIN SMITH: Ninety percent of Port-au-Prince's schools were either damaged or destroyed.

With the city in ruins, makeshift camps appeared everywhere. Every soccer field, public square and parking lot in the capital was overrun. Over one million people - half the population of Port-au-Prince - were now homeless.

WOMAN: [subtitles] Hey, white man, give me some money!

VOICE ON THE RADIO: [subtitles] We need to mobilize the international community to respond to the immense needs of this country.

MARTIN SMITH: As reporters, we were constantly challenged. How were we supposed to respond in the face of such overpowering desperation?

WOMAN: [subtitles] I have seven kids and I'm begging in the street. I can't even get one gallon of water!

MAN: [subtitles] What we need first is a doctor to help the sick and the injured, and water. Food can wait. Water.

WOMAN: [subtitles] We lost everything. We need food.

MARTIN SMITH: We met Emanuel, who was trying to organize this camp. He explained how the young and able went out to search for food.

[on camera] Some of the young men go and find food and then share it with the camp?

EMANUEL: With the camp. But it's, like, not enough. You know, they just go downtown to see what they could get. Sometimes they come back here, they don't get nothing.

MARTIN SMITH: [voice-over] Downtown, in what used to be the capital's main shopping district, we came across hundreds of people in search of food, or anything worth trading. Supermarkets, bakeries, hardware stores all were ransacked. It was an organized collective effort in some places, a free-for-all in others. The policeman standing by was powerless to do anything but shoot into the air.

[on camera] What were the orders to your men?

MARIO ANDRESOL, Chief, National Police: We are not going to shoot at people who are trying to find something to eat. You see what I mean? The orders was clear. Try to stop the lootings. I don't want victims, you know, among the looters.

MARTIN SMITH: [voice-over] With the police unable to control the crowds, shop owners emptied their stores or took matters into their own hands. We were told this man had been executed for stealing. His feet were still bound.

In the chaos, we came across many disturbing scenes. We found this man dumped in front of a police station.

MAN: [subtitles] I am not afraid of your camera. You think you're God. What are you? Zero.

POLICE OFFICER: [subtitles] He was taking people's things. The crowd brought him here, but we can't take him in. We don't have the means to care for him. We couldn't. We called the ambulance to get him. Someone probably brought him here before dawn.

MARTIN SMITH: It wasn't clear what had happened, except that he had been lying here for five hours. We gave him water, but he poured most of it on the ground. A bystander said he was making voodoo signs to ward off evil.

MAN: [subtitles] There it is. I'm drinking your blood. And there's your head.

MARTIN SMITH: The next morning, we were crossing town in an ambulance.

WITLET MACENO, Nurse Volunteer: We want to make sure we cover her nose to help with the dust, OK?

MARTIN SMITH: Witlet Maceno, a Haitian-American nurse volunteer from New York, was ferrying a pregnant woman from a camp clinic to the general hospital.

MAN: Let's get there quickly, but be careful with the bumps.

MARTIN SMITH: She was losing a lot of blood.

WITLET MACENO: Let's just hope we get there safely, we get the transfusion going, and hopefully, we save her and the baby. And that would make me very happy.

MARTIN SMITH: The general hospital had become the city's main ER. It looked more like a refugee camp than a medical center. The injuries were severe. Several hundred people had undergone amputations, many done with a simple hacksaw.

WITLET MACENO: It was not a place I would call a hospital. You had patients that had dressings that was not changed since probably the quake happened, the day it happened. Maggots were coming out some of them. I mean, it was definitely crazy.

Even getting your leg cut off, we had no pain killers to give you except for aspirin or Motrin. How do you take care of somebody whose main issue is pain after they get their leg cut off and you have nothing to help them alleviate their pain?

MARTIN SMITH: On the morning we were there, aftershocks had rattled nerves. Fearing the hospital would collapse, patients demanded to be taken outdoors. They now lay in stifling heat.

WITLET MACENO: Move this! Move this!

MARTIN SMITH: Maceno had brought his patient here for a blood transfusion.

WITLET MACENO: She was losing blood. If she did not have blood the next hour or two, she was going to die along with the baby.

Keep in mind we're dealing with a six-month-pregnant woman. So it's a whole different issue as to how you go about doing that.

Went to the Swiss. The Swiss had no blood. We went to some different groups. They had no blood. And I went directly to hospital administration office, said, "Well, here can we find some blood?" I thought they'd have blood. They said, "We don't have any blood."

I'm going to check with the Red Cross to see if they have anything now because they don't have anything.

MARTIN SMITH: [on camera] No blood?


Chaotic. We just run- run in circles, find out that the Haitian Red Cross, that was actually not too far from where she was, had blood.

You are wonderful!

How come none of the doctors and all the people out here knows that they have blood right there? This is ridiculous.

MARTIN SMITH: Maceno said this was one of his few success stories. Too often, the needed supplies didn't arrive.

It was impossible to understand the scale of the disaster and to imagine the enormous challenge of distributing whatever aid was available. And for people on the ground, there was no way to know if any help was on the way. To make matters worse, their president, Rene Preval, refused to formally address the nation during that first week. For the most part, he remained out of sight.

MARC BAZIN, Prime Minister, 1992-93: He was panicked. Preval was in emotional stress, where he was telling his wife, "You think I should say something? Well, what can I say?" You had a feeling hat Preval did not know what to do.

MARK DANNER, Author, Beyond the Mountains: In the wake of the earthquake, Haiti's government was almost non-existent to most Haitians. They didn't see it. They didn't see Preval. They didn't hear him much on the radio. In a sense, the weak, corrupt Haitian government became almost the invisible Haitian government.

MARTIN SMITH: No one, it seemed, was willing to speak.

MICHELE PIERRE-LOUIS, Prime Minister, 2008-09: The churches, the private sector, the university, you know, all the elite of this country- there was a lot of silence.

[Graffiti, subtitles, "Preval = excrement"]

1st WOMAN: [subtitles] We don't have a government because no one has talked to us about anything because we don't really have a president.

2nd WOMAN: [subtitles] What would I say to that drunken [expletive]? He's drunk all day and night. I'm not afraid to say this because I'm already dead.

MAN: [subtitles] Other countries need to take charge because Haitians alone can't rebuild. Even when the government had resources, they couldn't do it.

MARTIN SMITH: The Haitian government had set up a temporary headquarters under some mango trees at a police station near the airport. I asked to speak to the president. I was taken to the prime minister.

[on camera] There's a lot of anger on the streets from ordinary Haitians about the performance of the government.

JEAN-MAX BELLERIVE, Prime Minister: I'm pretty amazed that there is- that the anger- the anger is not greater. I believe that the people are supporting with a lot of calm, of a lot of serenity, the situation they are in.

MARTIN SMITH: Why hasn't the president particularly, as well as yourself, spent more time on the streets with people? You've- you've said yourself that, "We didn't do a good enough job of communicating with people, of being among the people."

JEAN-MAX BELLERIVE: It's a choice. There is so much to do. There is so much to organize. There is so few people to help you to do the job. And time is a very rare commodity for the government right now.

MARTIN SMITH: [voice-over] With the government largely absent, the United Nations stepped into the breach and tried to set up food distribution. Here, hundreds gathered outside a food depot. People were growing ever more desperate.

1st MAN: [subtitles] I need to eat! I need to eat!

2nd MAN: [subtitles] This morning, an 8-month-old boy died from hunger in my own home.

U.N. SOLDIER: [subtitles] There are many people, my friend, in your situation.

MARTIN SMITH: As trucks emerged from the gate, they were swarmed by the crowds. Haitians fought Haitians for whatever they could get. At another distribution point, people waited for hours in a line that snaked for blocks.

BBC REPORTER: The aid is beginning to flow in more regularly. The airport here in Port-au-Prince and another one in Jacmel are now-

MAN ON CELL PHONE: [subtitles] Here's how things are, my dear. I'm sleeping in the street, too.

MARTIN SMITH: And at the end of the long wait, water and crackers. And even those soon ran out.

U.N. SOLDIER: [subtitles] No more. No more.

MARTIN SMITH: In the first week, only an eighth of the population had received food and water.

U.N. SOLDIER: [subtitles] No more water. No more food.

MARTIN SMITH: The reason that the U.N. had been so slow to respond was that they, too, had been decimated. They lost their headquarters and 101 people, including the chief of mission and his deputy. Now in charge was Edmond Mulet.

EDMOND MULET, U.N. Head of Mission: The fault line of this earthquake came down from the national palace, a building that was very solid, pure concrete, built in- I believe in 1916. And then it went all the way up the hill and hit our headquarters. Apparently, that fault was really underneath our own building.

Even in the worst case scenario, we always thought we would be the first ones to respond. We never thought that we would be the victims of such a- such a situation too.

MARTIN SMITH: The U.N. set up a temporary base near the airport and tried to deploy their now limited resources.

KIM BOLDUC, U.N. Humanitarian Coord.: [January 16, 2010] I think that under the circumstances, the best has been done, the best we can.

MARTIN SMITH: Mulet's aid coordinator, Kim Bolduc, first hoped she could rely on supplies stockpiled by the World Food Program.

KIM BOLDUC: There was enough- like, 8,000 tons of food- because WFP did not only stockpile for the hurricanes, WFP is a regular food supplier to Haiti.

MARTIN SMITH: [on camera] How many tons of food?

KIM BOLDUC: There was, like, 8,000 tons of food, but the warehouse had collapsed. A number of them were damaged.

MARTIN SMITH: And 8,000 tons of food, how many people can that feed for how long?

KIM BOLDUC: It could feed something like a million people for 10 days.

MARTIN SMITH: [voice-over] Without any available stocks in country, the U.N. depended on aid streaming in from the outside and on thousands of volunteers joining NGOs already based in Haiti. But with the port down and the roads congested, the airport was overwhelmed. In the first three days, flights were not prioritized.

LOUISE IVERS, M.D., Partners in Health: Who was making decisions initially about who could land and who couldn't is unclear to me. Some of the large organizations, I think Red Cross and others, were not able to get their equipment in at the airport.

MARTIN SMITH: It was a mess. Television reporters landed before doctors, shoes and clothing before bandages.

Capt. DUSTIN DOYLE, U.S. Army: This is something where you've got to take a point of chaos and you've got to turn it into some type of order.

MARTIN SMITH: When we visited, the U.S. Army had taken control of the airport but was struggling to establish order.

Capt. DUSTIN DOYLE: A lot of this cargo was not here yesterday. It's in the process of moving right now.

MARTIN SMITH: [on camera] And what is here?

Capt. DUSTIN DOYLE: You have food. You have water. You have logistical supplies. We have some medical supplies. So it's all coming in here right now.

MARTIN SMITH: [voice-over] Even when relief supplies did arrive, it was hard to get them moved out. In the time we were there, about 90 minutes, only one load of water left the airport. But instead of going to Haitians, it was headed to relief workers at the U.S. embassy.

[ Watch this program on line]

REPORTER: [January 22, 2010] Is the airport starting to clutter up with goods and materials and products that you're not quite sure what to do with?

EDMOND MULET: This first week, it was very urgent to have as many people who could come on the ground and help and assist. And the coordination of that, of course, is impossible. And it's not desirable.

MARTIN SMITH: In a satellite press briefing, Mulet admitted that in the first week, the U.N. deliberately decided not to coordinate aid.

[on camera] Why not?

EDMOND MULET: How can you coordinate- I mean, the border was open with the Dominican Republic, thousands of volunteers coming in, airplanes landing. Imagine if the government or the U.N. or any other organization had tried to coordinate that. We would have bureaucratized the whole process, and I think it would not have been effective.

MARTIN SMITH: You would have prevented aid from getting through? Is that what you're saying?

EDMOND MULET: We didn't have the capacity to really organize the whole thing. And it was such good will and generosity from everywhere, and I think it would not have been effective.

KIM BOLDUC: Two days after the disaster, our main priorities remain-

MARTIN SMITH: [voice-over] Mulet and his aid coordinator, Bolduc, came in for a lot of criticism.

KIM BOLDUC: We need to strengthen the coordination capacity-

MARTIN SMITH: [on camera] The lack of coordination puts you squarely in the gunsight, really.

KIM BOLDUC: I'm always on the spot. This is a position that gets all this kind of finger pointing. This is part of the job. When it's fair, I do accept that. I'm not a superwoman. Nobody is.

MARTIN SMITH: [voice-over] Well into the second week, shortages prolonged suffering. At the general hospital's post-operative tent, the situation was distressing. Innocentuno Valbrun is a 16-year-old boy. His mother told me he dreamt of becoming a soccer star. He lost his foot when he went back into his crumbling home to rescue his sister.

MOTHER: [subtitles] Instead of leaving the house to go to the street, he went inside to save his sister. He fell into a hole. His sister died under the rubble. We lost everything.

MARTIN SMITH: Dr. Mitchell Schuster of Boca Raton, Florida, was attending his wounds.

MITCHELL SCHUSTER, M.D., Bicol Clinic Foundation: All these post-op patients require good pain relief now, and they all have to start getting sterile techniques, which is almost impossible, as you can see.

MARTIN SMITH: [on camera] Do you have enough morphine? Do you have enough pain killer?

Dr. MITCHELL SCHUSTER: No, we do not. We have a few doses, but in terms of 24-hour coverage, no. I'll tell you one thing also. Nobody has brought these patients any food or water. We're just hearing rumors coming around that there's food, there's water on the site, but I've seen nobody distribute food and water in here except us.

MARTIN SMITH: You're telling me that the food and water that you brought to sustain you and the other doctors is being used for the patients.


MARTIN SMITH: And nobody has stepped forward to-


MARTIN SMITH: -to give food to the patients.

Dr. MITCHELL SCHUSTER: Again, there might be other sites in the hospital that are providing, but at the post-op care, there's no food and water at this point.

Josh, check here, that he's got a pulse, please.

MARTIN SMITH: [voice-over] For lack of enough beds, this man, wasting and near death, lay on the ground. He'd been found in the morgue, left for dead.

Dr. MITCHELL SCHUSTER: This is a miracle case. He came in yesterday basically looking like he had moments or hours to live. He's now had an amputation. This was truly a horrific wound. You saw just two bones in the middle of the leg and a stump of foot and then the knee above it. And there were flies and maggots. So this was a guy that really was a dead patient brought to life. If he lives a week or a year or 10 years or longer than me, I don't know.

MARTIN SMITH: Not everyone survived surgery.

[on camera] Did she die?


WOMAN: [subtitles] My mother! You're the only one I have, Mother! My, God! My God. My God.

PHYSICIAN: Would you guys take her to the morgue?

HELPER: Take her to the morgue?


WOMAN: [subtitles] What pain I'm in, my God! What suffering!

MARTIN SMITH: The morgue had long run out of space.

Back on the streets of Port-au-Prince, clean-up was under way. But in the rubble, more dead. The bodies were hauled to mass graves just north of town. The quake's death toll is now well over 200,000.

Pres. BARACK OBAMA: To the people of Haiti we say clearly and with conviction, you will not be forsaken, you will not be forgotten.

BAN KI-MOON, U.N. Secretary General: We are with you. We will help you to recover and rebuild.

HILLARY CLINTON, Secretary of State: We will be here today, tomorrow, and for the time ahead.

MARTIN SMITH: There have been a lot promises made about Haiti in recent weeks. But Haiti has a history of frustrating reformers, absorbing aid and resisting change. For many Haitians, their fate rests only in the hands of God.

PREACHER: [subtitles] In just a few seconds, God touched Port-au-Prince.

MARTIN SMITH: One morning, we visited a church in the slums of La Saline.

PREACHER: [subtitles] In just a few seconds, He touched the market of La Saline. In just a few seconds, He touched the Catholic churches.

MARTIN SMITH: In his sermon, the preacher described the power of the earthquake and of God's wrath, regardless of faith.

PREACHER: [subtitles] In just a few seconds, He touched the Protestant churches. In just a few seconds, He touched those who practice Voodoo.

MARTIN SMITH: But then he laid out a vision of what Haiti should be.

PREACHER: [subtitles] In the book of Isaiah, it says the islands should be fertile! Every season, see avocados should grow in our country! Every season, grapefruits should grow in our country!

MARTIN SMITH: Once upon a time, there was a lush and verdant Haiti. But Haiti's story is one of a dream denied. It's a story that begins 200 years ago, when Haiti was ruled by French colonists.

MARK DANNER, Author, Beyond the Mountains: The wealth of Haiti, of colonial Haiti, was legendary. It produced half the world's sugar cane. It produced two thirds of its coffee. It contributed more than half the foreign exchange of colonial France. There was talk in the 18th century of possibly trading it for Canada. It was called the Pearl of the Antilles.

RAYMOND JOSEPH, Haitian Ambassador to the U.S.: Pauline Bonaparte, the sister of Napoleon, had her mansion in Port-au-Prince, just to show you that Haiti was the center of opulence, the center of power.

MARTIN SMITH: Then came Haiti's defining moment.

MARK DANNER: The great event looming over the history of Haiti, in the mind of every Haitian alive, is the glorious Haitian revolution, the only successful slave revolt in history, when in 1804, a nation of slaves, of 500,000 slaves, were able to defeat the superpower of the day, Napoleonic France, and declare independence, the only black republic on the face of the globe. Every Haitian knows this story, whether they can read or can't read. Every Haitian knows the characters who played the key roles, who founded the country. Every Haitian walks in glory to some extent because they are inheritors of this great slave revolution.

[ Read Danner's full interview]

MARTIN SMITH: The United States benefited directly from Haiti's great triumph. The revolution quashed Napoleon's ambitions for a new world empire. Short of cash, at war with Britain, Napoleon quickly sold a major swath of France's North American territories, the Louisiana Purchase.

RAYMOND JOSEPH: Thirteen states west of the Mississippi, sold it for $15 million, three cents an acre, the biggest real estate deal. That's what Haiti did for the United States of America.

MARTIN SMITH: The Louisiana Purchase doubled the size of the United States. America might have been grateful. Instead, the U.S. refused to recognize Haiti.

RAYMOND JOSEPH: It was, quote, unquote, "a bad example" for black slaves to rise against their white masters. So the United States back then slapped an embargo on Haiti to bottle us up. And they did. And it remained for 60 years.

MARTIN SMITH: In the coming years, Haiti would suffer diminishing wealth and political upheaval. Its mistrust for America would grow.

NEWSREEL: And then in 1915, the United States Marines land in Haiti-

MARTIN SMITH: Over the next century, Haiti would endure 20 years of U.S. occupation, 30 years of dictatorship under the Duvaliers-

FRANCOIS DUVALIER: I have been elected for president for life.

MARTIN SMITH: -failed attempts at democracy, military coups, and in the '90s, another intervention.

Pres. WILLIAM J. CLINTON: The message of the United States to the Haitian dictators is clear. Leave now, or we will force you from power.

MARTIN SMITH: President Clinton's occupation in 1994 deposed a military dictator and reinstated a popular president, Jean-Bertrand Aristide. But America's relationship with Aristide would sour, first under Clinton, then under President Bush, when an aid embargo crushed Haiti's fragile economy.

If things weren't bad enough already, less than two years ago, Haiti was hit by one of the worst series of storms the Caribbean had ever seen. Dr. Paul Farmer saw the aftermath firsthand.

PAUL FARMER, M.D., Co-Founder, Partners in Health: I went to the city of Gonaive, and the city was under water. There were people walking out with bare feet, often, out of the city. There was a whole pilgrimage. And people were saying, "Do you have any water? Do you have any water?" I said, "This is just nuts."

MARK SCHNEIDER, International Crisis Group: There were almost a million people displaced initially. The estimate was the damages were close to a billion dollars. And you didn't have the kind of response that was necessary.

ROBERT PERITO, United States Institute of Peace: It was at that point that Ban Ki-moon, secretary general of the United Nations, decided that the time had come to do something different. The term that was used in the U.N. was there was a need for a "game changer."

MARTIN SMITH: Ban Ki-moon turned to America's highest-profile Haiti hand.

Pres. WILLIAM J. CLINTON, U.N. Special Envoy to Haiti: He said, "You know, we've got to keep interest in this going. I know you care a lot about Haiti. Would you please agree to be the U.N. envoy?" The Haitians have been abused by outsiders, neglected by outsiders, helped but in a paternalistic, ineffective way by outsiders. They've engaged in self-abuse. They've had all kinds of problems. And they wanted finally to seize control of their own destiny.

MARK DANNER: Bill Clinton is a fairly fascinating figure in the story of Haiti. He and Hillary went to Haiti in 1975 for their honeymoon. They had been attached to the country and fascinated by it every since. And then of course, President Bill Clinton occupied Haiti.

MARTIN SMITH: For Clinton, it was a chance to make up for his failed venture. Haitians welcomed his involvement.

RAYMOND JOSEPH: When Ban Ki-moon name President Clinton as special envoy to Haiti, I say good because President Clinton has the leverage to get things done.

MARTIN SMITH: Clinton and Ban Ki-moon wanted to get America's attention. They decided to enlist Hollywood.

Pres. WILLIAM J. CLINTON: We met in southern California, in Los Angeles, with a lot of people from the movie and music entertainment communities. And we said, "What we really want you to do is to help us think of ways to communicate with the American people and people around the world to maintain the interest here."

MATT DAMON, Actor: [September 2008] I know in my heart that if people back home hear what's going on and could see some of these images and some of these things that we've seen, they will help.

MARTIN SMITH: Ban Ki-moon also turned to the author of an influential book on the developing world, Oxford economist Paul Collier.

PAUL COLLIER, Author, The Bottom Billion: Ban Ki-moon called me into the United Nations and said, "Go to Haiti. See if you can come up with a strategy that the government would find helpful." When I went to Haiti, I realized that, actually, Haiti was a country which abounded in economic opportunities.

MARTIN SMITH: Collier saw promise in agriculture, tourism, and especially basic manufacturing.

PAUL COLLIER: It's a very low-income area just off the shore of the biggest market on earth, so that was a huge opportunity.

MARTIN SMITH: There was new optimism in Haitian politics, too, under President Rene Preval. In 2009, the new secretary of state, Hillary Clinton, ordered a major policy review and addressed a donors conference where $350 million in aid were promised.

Sec. HILLARY CLINTON: This small nation is on a brink. And it, as well as this region, will be shaped to a large extent by the decisions that we make.

PAUL COLLIER: Donors did commit to reasonable amounts of money- not, I think, enough to tackle the problem, but reasonable amounts of money. And Bill Clinton then realized that he could bring in the private sector. And so in October of 2009, he brought in 200 chief executives of major companies to see the opportunities.

Pres. WILLIAM J. CLINTON: My job is to mobilize more interest among global investors to get more private sector investment there. So I said I would do that, and I set about doing it. We were making fabulous progress.

MARTIN SMITH: Clinton invited Dr. Paul Farmer to be his deputy.

PAUL FARMER, M.D., U.N. Deputy Special Envoy to Haiti: I don't want to say we were doing great, but you couldn't get a hotel room in Port-au-Prince in the fall of 2009. It was packed. There was a buzz going around that, you know, there were people from all over the world coming to invest in Haiti.

MARTIN SMITH: Things were improving. In the midst of a worldwide recession, Haiti's economy was actually growing.

ROBERT PERITO, United States Institute of Peace: There was a real spirit and hope that things were at last going to improve. The earthquake really came out of nowhere.

MARTIN SMITH: The earthquake laid bare the weakness of Haiti's political structures. It also raised serious questions about how aid works here and how to move forward. In the past, foreign assistance has gone primarily to NGOs. Per capita, Haiti has one of the highest concentrations of NGOs in the world.

MARK DANNER, Author, Beyond the Mountains: These non-governmental organizations were chosen as a more efficient way to deliver aid, and also as a way to deliver aid that would be less available for Haitian corruption than government-to-government aid.

ROBERT PERITO: The consequence is the government has withered. And so you have this situation where Haiti is sometimes called a Republic of NGOs because there are about 6,000 NGOs that do the work that usually governments do in other countries. And so that's a problem.

MARC BAZIN, World Bank, 1968-86: The whole system is humanitarian. Those guy don't have anything to eat? Let's feed them. They don't have doctor? Give them hospitals. They don't have medics, let's give them some. But about what do we do next? OK, you fed us. That's fantastic. Where are the roads? Where is the development of agriculture? How can we expect a country of nine million people to feed itself with imports?

RAYMOND JOSEPH, Haitian Ambassador to the U.S.: NGOs cannot build the infrastructure of Haiti. They cannot build the roads, the electricity, the water system and so forth. So I've been pleading with international organizations to work with the Haitian government so that they cannot continue to say the government is too weak.

PAUL FARMER, U.N. Dep. Special Envoy: This is an opportunity to rethink how aid works and how we, the most powerful country in this part of the world, can work with our oldest neighbor. So I think all that possibility is built into this tragedy.

MARTIN SMITH: Farmer has been advocating a new model for years. His group, Zanmi Lasante, as Partners in Health is known in Creole, works closely with Haiti's Ministry of Health. Together they operate a network of clinics and hospitals. The idea is to create a reservoir of talent and expertise that belongs to Haiti.

DAVID WALTON, M.D., Partners in Health: Instead of setting up a parallel system, we say, "How can we reinforce the public sector?" It is the government's responsibility to deliver to health care to its population. We see ourselves as buttressing that ability, helping them in their time of need so that eventually, they can do it themselves.

MARTIN SMITH: This approach might work. The problem is that more NGOs will have to give up autonomy and the government will have to step forward.

[ Rethinking foreign aid]

At a press conference, Secretary Clinton stood next to President Rene Preval.

[on camera] I think a lot of people would look at Preval and ask this question as to whether or not he's a reliable partner. He's been through three prime ministers in the last two years. He was largely absent after the quake. He failed to address his people, came in for a lot of criticism. And on the streets, he is very unpopular at this point. Is he a reliable partner?

Sec. HILLARY CLINTON: He is a reliable partner, but he is a partner who has very serious challenges when it comes to capacity.

MARTIN SMITH: What do you mean by capacity?

Sec. HILLARY CLINTON: Well, that he has a government and a political system and a social structure which is very entrenched in the way it has always done business.

MARTIN SMITH: [voice-over] What Clinton is talking about is Haiti's entrenched elite, a handful of families who control everything, from the local economy to many key ministries. And while Preval is not considered corrupt himself, he is weak and many think unlikely to survive Haiti's fall elections.

[on camera] Some Americans take a look at this and say, "Look, you know, we've got our own problems. We have not rebuilt New Orleans."

Sec. HILLARY CLINTON: And shame on us.

MARTIN SMITH: And now we're going to take on Port-au-Prince.

Sec. HILLARY CLINTON: Right. To that I say, because I've had this conversation with many people, this is not the United States coming in and saying, "Oh, let us fix it." This is the United States, along with international organizations and countries from France to Canada to Brazil to Japan, saying, "We all will play a role." Half of- nearly half of all American households have contributed to Haiti relief.

MARTIN SMITH: I know. I hear that stat and I can't believe it.

Sec. HILLARY CLINTON: Isn't that stunning?

MARTIN SMITH: Well, I don't know. Is it true?

Sec. HILLARY CLINTON: It is true. Over $700 million contributed from Americans to their churches or to other organizations that they had confidence in. Plus, the United States has spent many hundreds of million dollars in deploying USAID and deploying the military and so much else. So we are already invested, and we don't want that investment to go to waste. We want that investment to realize a positive outcome.

[ Read Clinton's full interview]

MARTIN SMITH: [voice-over] Six weeks after the earthquake, we went back to Haiti. The disaster was still unfolding. The number of camps had grown. Some were small clusters, others vast tent cities. This one, on the edge of the slums of Cite Soleil, had more than 40,000 people and only one toilet per thousand.

LOUISE IVERS, M.D., Partners in Health: The city for many, many days and weeks, really, just had the stench of bodies in the air. Now the stench has moved from, really, the bodies to the stench of the living because people don't really have the sanitation and waste kind of management that they need to have.

MARTIN SMITH: In this camp, we found Emanuel again. He had succeeded in bringing in a project to build more toilets for his camp.

EMANUEL: This is the kind of toilet that we have right here.

MARTIN SMITH: Each toilet here would be shared by only 60.

EMANUEL: But now we don't know when it's- when it's fulled up, we don't know yet how they're going to clean it for us just to remove the waste. I mean, the poop.

MARTIN SMITH: He'd also wrangled a new water supply, a clinic, and more tents. But the big worry for everyone was the coming rains.

EMANUEL: Now this shelter, you know, they cannot really, I mean, protect these people because it's going to rain a lot. And it's going to be start raining in May.

MICHELE PIERRE-LOUIS, Prime Minister, 2008-09: We are going to get into the rainy season. All the garbage that it drains down to the capital, that's going to be horrible.

MARTIN SMITH: It's not just garbage. The rains will send raw sewage streaming through the camps.

Dr. DAVID WALTON: You have an incredible potential for epidemic disease to spring up. Any type of pathogen that is transmissible is going to be magnified and exacerbated tenfold, a hundredfold, a thousandfold. So it isn't a crisis that is going to emerge, it is a crisis today.

MARTIN SMITH: To escape the camps, those that can are furiously rebuilding, working with bits of rubble to construct new homes. But they are no sturdier, or even flimsier, than what they had before.

YOUNG MAN: We need something for the rain. We've got iron for the wind.

MARTIN SMITH: It's a race against the weather, and it seems anything goes for now.

Before we left Haiti, on the grounds of a damaged church, we found the boy we met at the hospital a few weeks earlier, 16-year-old Innocentuno Valbrun and his parents.

INNOCENT VALBRUN, Father: [subtitles] We are living in a very difficult situation. We are trying to survive because we have nothing but the boy. He must live.

MARTIN SMITH: The Valbruns' home was completely destroyed. Innocentuno's father lost his job. His mother says she worries about her son's future.

JOCELYN VALBRUN, Mother: [subtitles] Sometimes, when his father's away, he complains to me. He says, "I don't want to stay here. I need somewhere quiet." I have to tell him, "Where are you going to go?" We have no home, no shelter. This is our home. That's the problem. It's not easy at all, but we're stuck. That's the problem.

MARTIN SMITH: Tomorrow nations will gather at a donors conference in New York to discuss the way forward in Haiti.

Marcela Gaviria and Martin Smith

Will Cohen

Martin Smith & Marcela Gaviria

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ANNOUNCER: There's more to explore on our Web site, where you'll find two video reports on what new economies might emerge from the rubble by our public media partners at NPR's Planet Money, plus get more background on Haiti's long struggles and the need to rethink foreign aid. Watch this program again on line and join the discussion at

Next time on FRONTLINE, it's time to get the full story, The Mormons.

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posted march 30, 2010

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