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I was managing a USAID-funded project in Haiti in January when the Trump administration shut down USAID. We were in the first year of a five-year project aimed at helping water utilities in Haiti’s towns improve the management of their drinking water systems, thereby enhancing both their service quality and coverage. While Haiti is an utter mess with gangs controlling the whole Port-au-Prince region, the water utilities have been a surprising success. I had managed an earlier project in Haiti, through which we helped several water utilities become profitable by focusing on customer service. We helped them realize that Haitians would pay for water service if that service were dependable. The goal of this new project was to expand the earlier success to a national level, thereby improving water service for at least a million Haitians.

When Trump took office, we expected scrutiny and changes. Each President wanted their priorities reflected in USAID’s activities. In his first term, President Trump sought to align foreign assistance with his vision of national security and to promote self-sufficiency. Under President Biden, USAID had a strong focus on climate change and diversity. Reflecting Biden’s priorities, my project included a component focused on transitioning water production away from diesel-generated power and towards solar power, as well as promoting the role of women in the water sector. We expected there to be a shift away from Biden’s priorities, but we didn’t expect how rapid and brutal it would be.

There were several ways the Trump administration could have enforced its new priorities in international development. The standard route would have been to announce a review of the international development portfolio and to state that all new projects would need to be aligned with the Trump administration's goals. A more radical approach would have been to freeze new funding for projects and to announce that any new funding would have to be aligned with the new goals. Instead, in Trump’s first week in office, his administration ordered all projects to immediately suspend all work and to wait while his administration reviewed every single one of them.

In the early days of this confusion, I was optimistic. The stated purpose of the stop-work order was to allow the State Department to review the projects and determine which ones were aligned with Trump’s priorities and could therefore continue. My project focused on improving access to water in Haiti by transitioning the water utilities towards a private sector-style management approach. With Trump’s top priority being reducing migration, improving basic living conditions in a “shithole” country like Haiti seemed a perfect fit. We crafted justifications for why the project should remain and sent these to USAID. However, the USAID staff were forbidden from talking to us.

As soon as we received the stop-work order, we had to instruct all our subcontractors and suppliers to immediately terminate their work. Three of our subcontractors had staff working in our offices. Their staff was fired without notice. One subcontractor had completed 90% of the design for solarizing the town of Les Cayes' wells. They were not allowed to complete the design. We had ordered the equipment to solarize the wells in Ouanaminthe and had to cancel that order. We stopped all technical assistance and cancelled all training programs. I hoped that this would be a temporary pause.

We had been invoicing USAID on a monthly basis for our work. Due to a change in personnel, USAID had not paid our November invoice in December as usual. When the funding freeze was announced in January, we were owed for both November and December. At the time, DAI had 95 USAID-funded projects. The US government stopped all payments for all of them. Since DAI was no longer receiving payments, they stopped sending money to us. We were fortunate to have sufficient funds to cover our January payroll. Most other projects were not so lucky.

As we entered February with still no funds, we wrote to all our subcontractors and suppliers to apologize for the delays in payment. I told my staff that their pay would be delayed. With no movement on receiving funds from USAID, DAI joined a lawsuit against President Trump, Secretary of State Marco Rubio, and others. DAI’s CEO, Tine Knott, stated that it was unfortunate that DAI was compelled to sue the US government to force it to pay its invoices. Within a week of filing the lawsuit, the judge issued a preliminary ruling requiring USAID to pay its invoices, but the government was slow to comply.

On February 27th, we received a notice from USAID stating that our project had been terminated. There was no rationale given. It merely stated that the US Government had decided to terminate the contract. By then, DAI had begun to receive payments for its November and December invoices. We began the long process of dismantling the project that we had just started.

By the end of May, the project was completely closed down. We had canceled all of our subcontracts and procurements, laid off all of our staff, donated all of our laptops, vehicles, and furniture to the local water utilities, and even managed to pay most of our debts. It was a painful process that left a trail of broken promises behind. Cancelling our project is a small part of that $150 billion that DOGE claims to have saved, but it came at a steep cost. We were fortunate that we had not started any of our construction work; DAI had other projects that were forced to abandon half-built facilities. However, having spent 11 months starting up a project, only to shut it down after three months, meant that the US had little to show for the millions of dollars spent, except a lot of broken promises. 

My favorite line about the Trump Administration is that they have all of the wrong answers to all of the right questions. Cutting off foreign assistance was the wrong answer to how the US can best protect its own interests in a globally connected world. 

Last month my son had a major operation. As we checked him in, I asked the person processing the paperwork for an estimate of how much this would cost. She replied, “I don’t know, but don’t worry your insurance covers it.” We are now receiving a steady stream of bills from each different doctor, the anesthesiologists, the hospital, and on and on. There are currently 29 separate insurance claims related to this visit. Naturally, most show up as fully covered but others do not. This is a crazy system.

I’m lucky. I have good health insurance. I understand enough about the system to know that if a charge isn’t covered by my insurance it is likely due to a mistake. I am fluent enough in English and bureaucracy fighting that I am confident that I will get it resolved.  

I would like to suggest three different reforms that we could do to our health insurance system that would not involve doing away with all private insurance but could make things better:

1. Require health care providers to offer the same price to everyone: One of the biggest benefits of insurance is that it is a discount club. Each of the hospital or doctor’s bill comes initially with a very high amount which is then marked down to the insurer’s negotiated rate. An initial bill might be $1500 that is marked down to $500. So who has to pay the higher amount? The uninsured—the people least able to pay. How does this make sense? Do we really expect the uninsured to subsidize the cost of healthcare for the rest of us? Instead, why not require hospitals to fix their prices and publish them. Everyone pays the same price for the same service.
2. Require all insurance companies who sell insurance to the federal government to offer the same plans to everyone: We get our health insurance through our employers since that is an easy way to lump a lot of people together. Some companies have given me good insurance and others have given me poor insurance. I do not like being dependent on my employer for this choice. Since, the federal government is one of the largest purchasers of health insurance. Why not make this same insurance available to anyone who wants it? Small businesses would not need to negotiate their own deal. Individual employees could opt to buy from the government list instead of from their employer. This would give us many more options than we got from the Affordable Care Act and would not require any extra government funding.
3. Offer Medicare to anyone who wants to buy it: Medicare is supposedly the least expensive health coverage. Why not offer this bare bone insurance to anyone who would settle for it? It should be priced to fully cover its cost. If it works as well as some of the democratic candidates think it will, then people will switch to it. But no one will be forced to switch.

I’ve always suspected that the most vocal defenders of our current system are those who either don’t use it or profit from it. Reform is hard but if we can continue to make incremental progress we can slowly make this work better without risking breaking it all.

1. We will double the number of judges reviewing immigration cases. Within a month of being picked up or applying for asylum, an immigrant should have his or her case resolved. We need enough judges to be able to conduct hearings fairly and quickly. We will work quickly through the backlog and establish a fair system to ensure that we can sort through those who are allowed to stay and those who are not.
2. We will increase the security on the southern border. We have made great strides to reduce this number, but haven't solved it. Before 9/11, we had 1.6 million people coming across our southern border in a single year. We built fences and barriers and have reduced that down to 400,000. But that is still too many. Some of the barriers we built have fallen apart and people have found new routes across the border. To increase border security, we will increase electronic surveillance, hire more border guards, and reinforce weak points along the border. We want to be sure that we know what is coming through our border crossing points and what is trying to cross outside of those points.
3. We will continue to improve vetting at our consulates around the world: Anyone is welcome to apply to come to the United States, regardless of their race, nationality, or religion. However, we get to choose who we allow to receive those visas. We will carefully vet each applicant. If we have any doubts about a person or their application, we will reject it. We recognize that this makes it difficult for people from countries with weak governments to satisfy our requirements. However, we have to keep our country safe.
4. We will limit chain migration: Anyone born in the United States is a US citizen. However, anyone with a US relative is not entitled to US citizenship. Relatives of US citizens can apply for visas and citizenship in the same way that anyone else can apply. Their claims will be processed as will any other applicants.

Carolle’s present for my 50th birthday was to take me to see Queen perform. Freddy Mercury is gone and instead they have a young replacement, Adam Lambert. It was great fun to hear the song that I’ve known since high school and to be with a crowd of thousands cheering and singing along. What made the concert special was that Adam Lambert seemed to be genuinely happy to be performing and honored to be singing with Queen. The guitarist, Brian May, has been playing and singing the same songs for 30 years and still seemed happy to be on stage. Having completed my first 50 year,, that is the attitude that I hope to keep—proudly passionate for the life I lead and the work that I do.

In the immediate aftermath of the earthquake, it seemed as
if the city of Port-au-Prince had been completely destroyed. There was talk of
relocating the capital or of bulldozing large swaths to make way for new
construction. As the rubble began to be cleared, it became clear that for each
building that was severely damaged, there was another with only slight damage
and a third that was basically untouched.

I brought Dr. Kit Miyamoto of Miyamoto International,
one of the top seismic engineering companies in the world, to Haiti a week
after the earthquake to help with the early response. Initially Kit focused on
the main government buildings including the National Palace and the different
Ministry offices as well as the main private sector buildings including the
hotels and factories. PADF had Kit train two engineers to evaluate the houses
used by all of PADF’s staff in an effort to help them to rebuild. As we began
doing these assessments, it became clear that many people were sleeping under
tarps not because their house was actually unsafe, but because they were afraid
that it was. We realized that we could get large numbers of people out of camps
and tents and back into their homes if we could convince them that their house
was safe.

We had been working closely with the
Ministry of Public Works (known by its French Acronym of MTPTC) and proposed to
them the possibility of conducting a detailed assessment of the buildings that
had been impacted by the earthquake. The Ministry of Public Works embraced the
idea. Miyamoto brought in the United Nations Operations (UNOPS) with funding
from the World Bank, and PADF obtained funding from the United States Office of
Foreign Disaster Assistance (OFDA—part of the United States Agency for
International Development—USAID).

UNOPS obtained their funding first and set up the basic
operations. They established the basic infrastructure that was used throughout
the program including the use of GPS-enabled PDAs as data collectors and the
central database.

Miyamoto developed a slightly modified version of the ATC20
form, the standard form used in California to rapidly assess earthquake damage,
for use in Haiti. They then began training Haitian engineers to conduct the
evaluation. The trained engineers were equipped with a PDA and sent in groups
to completely canvas a neighborhood. At each structure, the engineer would use
the PDA to take a picture of the building and the GPS coordinates. They then
inspected the building, going through every room, and completed a short
questionnaire on the building directly on the PDA. At the end of the
inspection, each building was spray-painted with a highly visible tag that
indicated whether the building was safe for use (“green-tagged”), damaged, but
stable (“yellow-tagged”) or unstable (“red tagged”). Each engineer was able to
inspect an average of 10 structures a day. At the end of each day, the data was
downloaded directly into the central database.

Initially, owners were reluctant to allow the engineers into
their homes and were suspicious of the program. PADF worked closely with its
partners in the poor urban areas and had to convince the people in their
neighborhoods to trust in the program. As the program grew and became better
known, owners began seeking out the engineers and asking for advice. 

Another important development as the program progressed was
that the Haitian inspectors became very familiar with the different types of
damage caused by the earthquake and the importance of better construction
techniques.

Through this program, over 400,000 structures were
tagged—nearly every building in the Port-au-Prince metropolitan area that was
impacted by the earthquake. The assessment showed that 53% of the houses were
safe for use (green-tagged), 26% needed minor repairs to be made useable
(yellow), and only 24% were unstable and needed either major repairs or to be
demolished and rebuilt (red).

One of the striking points that the assessment brought to
light was how widespread the damage was. Rather than having a core area of red
tagged houses surrounded by rings of yellow tagged and then green tagged
houses, nearly every neighborhood is a mixture of green, yellow, and red tagged
buildings. Furthermore, through an analysis of the levels of damage suffered by
the different types of buildings, we found that residential buildings, schools,
and churches were the hardest hit and commercial buildings fared best.

The final map showing the distribution of the green, yellow, and red tagged houses.

Taken together, these points reinforce the conclusion that
the poor quality of construction in Haiti was the main cause of the widespread
building failures.

The most striking impact of the assessment was its role in
helping people to return to their green-tagged homes. The inspectors reported
that before the assessment, roughly half of the houses that became green-tagged
had been occupied. After the house was green-tagged, occupancy jumped to 80%
with most unoccupied houses being in neighborhoods that had predominantly
yellow and red tagged houses.

From 2003 through 2010, I directed a program for the Pan American Development Foundation (PADF) to improve
cross-border cooperation and trade in the Haitian-Dominican borderlands. It was a facinating experience as we worked on issues ranging from cross-border perceptions to cattle rustling to trade policy.

We identified four problems as the most significant challenges for the borderlands

1. Mutual
   mistrust, misunderstandings, and the language barrier have caused both
   countries to ignore cross-border opportunities and treat their border region as
   if it were the end of the world rather than an important commercial crossroads,
   which has in turn hampered development in the borderlands.
2. The
   lack of clearly defined rules of interaction and effective mechanisms for
   resolving cross-border problems are the greatest sources of conflict in the
   borderlands. Fees for crossing the border, customs, and market space rentals
   are not posted, encouraging arbitrary application. Because the enforcement of these
   fees is so inconsistent and because of the innate mistrust between the two
   sides, the person paying the fees assumes the worst of the person collecting
   the fees. The arbitrary enforcement of visa requirements and random roundups of
   undocumented workers are other significant sources of conflict.
3. Poor
   physical and legal infrastructures are the greatest hurdles to increasing
   cross-border trade and production in the borderlands. Although Haiti and the
   Dominican Republic are one another’s second largest market for agricultural and
   nationally manufactured goods, access roads to the border are in bad condition,
   both countries’ customs and inspection facilities are terribly outdated, and
   neither country has laws that facilitate imports across the border.
4. Poverty
   and the consumption of natural resources are underlying sources of conflict
   between the two countries in general. Dominicans are out-migrating from the
   borderlands due to the lack of economic opportunities, while Haitians are
   moving from other areas of Haiti to the border region and migrating across the
   border.

The most successful efforts to resolve these problems came from initiatives that focused on technical issues and began with small
successes and built towards the bigger problems. For example, PAHO helped the
Ministries of Health to develop a system whereby a tuberculosis patient’s
treatment card was recognized in both countries. This allowed the patient to
continue receiving care and to ensure that the disease did not relapse despite
travelling across the border.

This was the key to the success of the PADF’s
cross-border project. They worked with local leaders in both countries to
identify specific local problems and to reach across to their cross-border
neighbors to resolve it. A good example was cattle rustling. When the PADF
began working with the ranchers, the Dominicans complained that Haitians were
stealing their cows and Haitians pointed their fingers at the Dominicans. When the
OAS/PADF brought the two sides together to discuss this issue, the ranchers
came to realize that the cattle rustlers were actually a binational gang. Dominican
rustlers would steal cattle from the Dominican ranchers and then sell them to
Haitians rustlers who would smuggle the cattle across the border. Similarly,
rustling of Haitian cattle was done by Haitians who sold the cattle to
Dominicans. Once the Haitian and Dominican rangers and local authorities began
cooperating, they were able to dramatically reduce the cattle rustling.

In the final year of the program, we published a series of papers to document our understanding of the borderlands. The most important of these publications are the following:

1. The Haitian-Dominican Border in the Post-Earthquake Era: This report summerized all of our findings and was published in English, French, and Spanish. 
2. Sources of Conflict along and across the Haitian – Dominican border (Dr. Gerald Murray): In this study, Dr. Murray found that economic inequalities rather than cultural differences were the main source of conflict along and across the border.
3. Dominican-Haitian Racial and Ethnic
   Perceptions and Sentiments:Mutual adaptations,
   mutual tensions, mutual anxieties (Dr. Gerald Murray): This study was done in parallel to the study on conflicts and focused on how Dominicans and Haitians view each other. He found that skin color was not a significant issue.

In anticipation of his book launch, Jonathon has challenged us to write of "a time where you danced with uncertainty…and won." As I wrote in January of last year, my life changed in an instant when the earthquake devestated Port-au-Prince. Within 24 hours, I had crossed the border from the Dominican Republic into Haiti. I had no idea what I would find nor what would happen next. I knew that I needed to jump. I took over management of our Haiti office and went from running a small program to a large, chaotic one in the middle of the worst crisis in the Western hemisphere.

I knew that I was in way over my head and trusted that I could make my mistakes as quickly as possible and move our operations in the right direction. I leaned in, worked closely with my team, made lots of mistakes, and kept moving forward. The first few months are still a blur. Even a year later, the wild ride continues.

Before the earthquake, we were doing $10 million worth of work a year. The year of the earthquake, we raised only $2 million–a paultry sum compared to most NGOs, yet we rebuilt our systems, developed new programs, and did $16 million worth of quality work. Next year, we will top $30 million! Not only are we doing twice as much work, but the work is better. My Project Directors are linchpins. We are recognized as leaders in our work. Life is good.

Except I still battle the butterflies every day. With growth come new challenges–can we hire new people as good as our existing team? How do we keep moving forward? How do I sell our programs to new donors? Am I really leading in the right direction.

I thank God for the chance to have helped Haiti in the early days after the earthquake and for the trial by fire that has made me a stronger leader. I also miss those days pre-earthquake when my life was quieter and the fights easier. I preordered Jonathon's book, not because I want to go back, but so that I can do a better job of taming the butterflies.

Gonaives following the 2008 floods. Photo courtesy of Matthew Marek/American Red Cross.The air support was provided by Mission Aviation Fellowship. 

In an interview with NPR, Wyclef Jean said: " Because think about it, you've had NGOs in Haiti for over 30 years and you still have no real infrastructure." I've heard similar comments from lots of different people since the earthquake. The problem is that there has never been enough money to fix the damage caused by any of the numerous disasters that have hit Haiti nor to help it rebuild its infrastructure. The situation in the Haitian town of Gonaives is a great example of how foreign assistance fails. Gonaives was badly flooded in 2004 by Tropical Storm Jeanne. Thousands of people died. Immediately after the disaster, a lot of money was poured in to feed the disaster victims. Later some money was put into rebuilding houses and cleaning the city. However, there wasn't enough to fix the damages, much less to make the city safer. 

In 2008, Gonaives was flooded again. Some people complained about how inefficient the aid must have been to have left Gonaives vulnerable to repeated flooding. The truth is, there was never enough money. Imagine New Orleans if the dikes had never been repaired. That is Gonaives today. As Jeffrey Sachs put it so well in The End of Poverty, there is never enough money to really end poverty. However, money is only half the problem. 

The international community cannot take charge of a country. Haiti is a sovereign country with an elected president. Neither the United Nations nor the United States (nor any non governmental organization) can replace a sitting government. We can help and advice, but the host government has to lead. International development assistance is very effective at protecting vulnerable populations, but it cannot make a country develop itself.

Sorry Wyvlef. The international community can't take responsibility for Haiti's future. Yes, we've made mistakes and yes, all countries act with their own interests in mind. However, Haiti's leadership is responsible for Haiti's future. You know that you would not want it any other way.