A Prerequisite to Posterity: Empowering the Haitian State After Decades of Marginalization

Other than “the poorest nation in the Western hemisphere”, Haiti has another cynical title: The ‘Republic of NGOs’. This nickname arose after the 2010 earthquake that killed 220,000 Haitians and internationals, injured 300,000, and displaced 1.5 million. Non-Governmental Organizations (NGOs) have operated on the island before, but a bona fide tsunami of new and expanding NGOs entered the country, providing healthcare support, relocation and shelter, education services, and more. Now, some 80% of public services are provided through NGOs.

The provision of these services has had tangible benefits, but at such a fractured, engorged scale, it also deeply undermines the state and removes opportunities for it to learn, develop, and grow. To ensure a future Haitian state is experienced and prepared for long-term governance and social services, NGOs must either instructively partner with the Haitian state or allow themselves to be functionally replaced. Continued reliance on a myriad of NGOs for state functions only exacerbates state dysfunction. This is not to argue for the expulsion of NGOs from Haiti, but for a material change in how they operate, so that the Haitian state may take over the provision of the same services.

Fragmentation & Replacement of the State

“The only alternative to state failure … is not… any new or alternate paradigm, but the state itself.”

~ S. Akbar Zaidi, 1999

The dogma defining post-war development within failed or developing states has been one that prescribes NGOs to supplant the state. In fact, this is considered preferable given NGOs’ proximity to the community and therefore higher potential for participatory methodologies, cost-effectiveness, greater institutional adaptability, and a greater ability to reach impoverished populations. However, in Haiti and abroad, this belief has not been corroborated on the ground. When NGOs replace or compensate for the faltering state, they often operate as poorly or worse than the alternative, and establish a cycle of state disempowerment that only hinders development. For example, during the 1915-1934 U.S. occupation of Haiti, driven by the Monroe Doctrine strategy to expand American hegemony in the hemisphere, Americans attempted to establish a sanitation and healthcare system in Haiti by educating Haitian professionals abroad and providing the necessary infrastructure. However, as the U.S. Navy and its partners were incapable of building or managing such a system, they turned to the Rockefeller Foundation for expertise, funding, and administrative talent. This outsourcing of healthcare administration continued until the end of the occupation, leaving the Haitian state with a nearly 20-year-long gap in its development, along with diminished capacity and little funding to pick up the slack. The subsequent ineptitude only further discouraged foreign investment in state-building, engendering a cycle in which the state was unable to demonstrate its capabilities and lacked the support necessary to build them.

Similarly, contemporary health administration in Haiti is characterized by an imperceptible state and a fractured network of “vertically-resourced emergency aid camps and clinics that are spatially-limited in their impact and services,” or, in simpler terms, a web of independent, NGO-led health centers that seldom collaborate, rely on foreign funding, and often do not impact those outside their chosen jurisdiction, however small. This creates a varied and volatile standard of care across Haiti’s departments and little opportunity for cascading development. The challenge for the Haitian state also metastasizes as the number of NGOs increases, broadening the degree of collaboration, evaluation, and engagement necessary for the state to learn from and eventually replace the NGOs as the de facto healthcare provider. This, too, discourages funding for the Haitian state and instead redirects foreign aid to the NGOs, inhibiting critical state-building and leaving the country in a catch-22.

Today, gangs have occupied over eighty percent of Haiti’s capital, Port-au-Prince, and are attempting to replace the usurped government as a means to consolidate power and somehow ward off foreign intervention that they believe is unjust. Allegedly, they use their violent takeover of supply and trade routes, ports, and areas along the border with the Dominican Republic to exploit or commandeer tax collection, goods distribution, and subsequently provide a perverted form of security services (to protect from the violence in which they participate), though the extent to which this is true is unclear. This creates a second arena of state disempowerment, worsened by the evident failure of the state and the Haitian National Police to combat the gangs. The government is portrayed as irrecoverable and untrustworthy, once again dissuading international actors from working with them to lift Haiti out of its many concurrent crises.

Centering the State in Haiti’s Recovery

Assuming the U.S. acts to limit its flow of illegal gun trafficking that arms the gangs, or the newly approved international Gang Suppression Force succeeds in eliminating the gang uprising, there will be a need to rebuild the Haitian government to ensure it is capable of functioning at the same or, preferably, a higher standard than that of NGOs. Doing so may require a new paradigm centered on state and institution building. Barring the infamous corruption, there are several opportunities for this to occur.

The Haiti Fund at the Boston Foundation’s report recommends several improvements to NGO and governmental partnerships. These include the use of Memorandums of Understanding between NGOs and the public sector to encourage shared responsibilities and learning; the integration of municipal officials in NGO initiatives; and the registering of NGO and their projects with the government for wider development planning. Importantly, the funneling of project funds, either from foreign donors or multilateral development banks through the government enables them to build expertise in administering community and economic development while rebuilding trust with disillusioned citizens. 

The work of the NGO “Partners in Health” is a prime example of the implementation of some of these proposals, as its “Accompagnateurs” program, which enrolls 15,000 Haitians in locally taught and administered healthcare training, has built and operated the Hôpital Universitaire de Mirebalais with the explicit intent of handing it over to the state, emblematic of the necessary strategy to enable state operation once it resumes governing.

The poor state of the Transitional Presidential Council and the replacement of the failed Multilateral Security Support Mission by the Gang Suppression Force renders any discussion of state-building premature. However, the topic is worthy of discussion. Careful understanding of the NGOs’ role in undermining the Haitian state is necessary for the long-term sustainability of the nation after the crisis’ resolution. Introducing a paradigm that views NGOs as temporary partners of the state, rather than solely well meaning but interminable custodians of impoverished communities, is the key to the establishment of a trusted, recognizable, and respected Haitian state.

Edited by Max Silveira

Managing Editor: Suravi Kumar