408: Island Time 

Ira Glass

From WBEZ Chicago it's This American Life, and distributed by Public Radio International, I'm Ira Glass.

Ira Glass

This week I talked to a Haitian journalist, Romuald Felix, over his cell phone as he recorded himself walking around one of the tent cities where some of the 1.3 million displaced Haitians are still living. This was a small tent city in a plaza in the Place Saint Pierre crammed with people.

Ira Glass

Four months after the earthquake, Romuald says that some people were working, selling fruit, charging cell phones for money on the street, but lots aren't. The rainy season-- which everyone has been dreading-- finally started in earnest last week. He was trapped in his office one day by water three feet deep. Camps get muddy. Water gets in the tents. People have trouble sleeping with it so wet.

In this camp, people still have to bathe where everybody can see. There are only six toilets for a thousand people, or maybe it's a lot more than a thousand, so lots of people go in plastic bags. And in the six camps that Romuald visited this week, aid agencies had stopped giving out food.

Ira Glass

It was 5:00 at night. Romuald asked these four children if they'd eaten today.

[ROMUALD SPEAKING FRENCH WITH HAITIAN CHILDREN]

Ira Glass

When I talked this week to Nan Buzard-- who runs relief operations in Haiti for the American Red Cross-- she was unsurprised to hear that people aren't getting food and services, with over 1,000 makeshift camps, there are a lot of gaps. She'd just returned from Haiti the day before we spoke and said that now that they're shifting from the immediate disaster relief to the rebuilding of the country, the decisions have gotten very complicated.

Ira Glass

Today on our radio show-- there's been this fantastic outpouring of money and goodwill from around the world. Nearly half of all American households have donated to Haiti, according to one survey. Haitians and foreigners have dedicated themselves to rebuilding the country. And now the question is, how exactly do you do that? Even with all this money and expertise, it's incredibly complicated. And today we join the people on the ground as they try to figure out what would be best. Next. Our show in three acts. Stay with us.

Ira Glass

Act One, 10,000 Brainiacs. We're all used to the basics. Haiti is the poorest country in the western hemisphere, one of the 10 or so poorest countries on earth, with the special designation of being one of the few countries in the world that-- for decades-- has gotten poorer and poorer over time. This despite billions in foreign aid, despite the fact that even before the earthquake there were approximately 10,000 non-governmental organizations trying to do good in the country. Two of the reporters that you hear a lot on our show doing economic stories-- Adam Davidson and Chana Joffe-Walt-- have been trying to figure out how it is possible Haiti is still so poor despite all that. They've been traveling back and forth to the country following developments over the last few months and have this story.

Chana Joffe-Walt

Here's something that happens a lot in Haiti. You meet someone poor and they tell you the sad reality of their life, some challenge they face every day that keeps them poor. You hear the details and you just can't believe the magnitude of the problem, not because it's big and complicated, because it is so, so small.

Adam Davidson

For example, we met a farmer at this farm, a dusty, patchy field, nothing valuable growing on it, except in the corner, mangoes.

Chana Joffe-Walt

The farmer tells us, two trees is barely enough to make a living. She wants more trees. She has the space for 100 trees. She has the time to tend them, but she has no water. Mango trees need water.

Adam Davidson

But then we walk across the field. And right at the far end of it is this roaring river. Right there. Right next to her farm.

Adam Davidson

We talked about this question for a long time. It was really confusing. It just did not make sense to us that she couldn't come up with some way to get water from the river right next to her farm onto her farm.

Chana Joffe-Walt

At one point I thought, is she lying to us? Why would she lie? Is she just lazy? Does she not have a bucket? So many questions.

Dozens of questions and a consultation with the local mayor--

Adam Davidson

Who happens to be a self-proclaimed, amateur, mango specialist.

Chana Joffe-Walt

Yes, that all ultimately reveals a wildly undramatic truth. She needs a canal, some guys with shovels to dig a trench, some concrete to protect it.

Adam Davidson

The world's simplest, shortest canal. It's a little tricky. The water needs to sit in a particular way around the roots of the mango tree, so you need some control over the water. But it's not that tricky. It's technology the Sumerians probably took for granted 5,000 years ago. It would cost-- at most-- $2,000. And if she gets a canal, she and her family go from being some of the poorest people on earth to much better off.

Chana Joffe-Walt

This is what kept striking us in Haiti, just a little upfront investment and people could be living so much better. And with 10,000 organizations in the country doing nothing but trying to make people's lives better-- 10,000 organizations whose mission is to do things like building canals-- how come the average Haitian makes half as much as they did 50 years ago? How come life wasn't improving even before the earthquake?

Adam Davidson

Well, to answer that, we have to leave the farm for a couple minutes-- we will be back-- and meet a businessman name Jean-Maurice Buteau and watch him try to work with one of those non-governmental organizations-- NGOs-- to solve one problem for Haitian farmers. The story begins two years ago.

Chana Joffe-Walt

I heard about Jean-Maurice weeks before we met him. We'd been going around Port-au-Prince asking, what are the main industries? Who are the main players? And there aren't a lot of big businessmen in Haiti. The ones that do exist all know each other. They're unusual Haitians in almost every way. They tend to have light skin, they drive cars, have college degrees, speak English. Jean-Maurice though, he's the only one known by a special name.

Adam Davidson

We actually found out later that most people call Jean-Maurice "Mango Man," not Mr. Mango. And Mango Man is one of the biggest mango exporters in Haiti.

Chana Joffe-Walt

Mango Man has a very consistent look. Most any day, any context, he's in a white linen button-down, sunglasses with the strap around the back of his head, and a Bluetooth headset. He talks on the Bluetooth a lot, usually while ramming his Jeep through Port-au-Prince's potholes, even while he's talking to you. It's Bluetooth, you, Bluetooth, you, seamless, and confusing if you're you.

Adam Davidson

And Mango Man has a problem. Fruit wholesalers in New York and Miami want to buy a lot of his mangoes. But he can't get enough to meet the demand--

Chana Joffe-Walt

Which is strange, because Haiti actually grows enough mangoes to send to all of the Floridians and New Yorkers who want them. But most of those mangoes aren't grown on big farms. They're grown by individual farmers with just two or three mango trees each. And every season, those farmers pick the mangoes and then store them in a pile outside their houses, or under their beds, where they wait until some middle man-- usually a local guy with a donkey-- comes by and buys them.

Adam Davidson

Americans-- as it turns out-- don't like mangoes that have sat under Haitian beds. Those usually have bruises on them, marks. And so, two years ago-- long before the earthquake-- Jean-Maurice came up with a solution, a business concept that would double his revenue.

Chana Joffe-Walt

So back two years ago, before the earthquake, the first thing Jean-Maurice did was he took a bunch of crates, drove 45 minutes out of town to a small mango growing village called Casale. And he went to each house one by one. He'd find the mango farmers on some tiny dirt road. He'd get out of his jeep and hand out his crates. Unfortunately, that with an enormous failure.

Adam Davidson

When you talk to Jean-Maurice about the crate problem, it seems confusing why this would ever be a problem in the first place. Just tell the farmers, hey, if you pack your mangoes in these crates, everyone will make twice as much money. And then you actually go to the farms and you meet the farmers and you completely get it. Because you meet someone like [? Jealin ?] [? Jermouse ?].

Chana Joffe-Walt

[? Jealin ?] is that mango farmer from the beginning, the one who needs a canal. And she lives in Casale where Jean-Maurice went and handed out his crates. She didn't know who he was. In fact, it's unclear that [? Jealin ?] even knew that her mangoes are being sent to America.

Adam Davidson

Here's what she did know. Her trees earned her around $600 a year, $2 a day. And in Haiti, $2 a day gets you a house made out of cinder block and metal sheets with a dirt floor on a dirt road. She can only afford to send one of her two kids to school. She chose the younger one. She has no electricity, no running water, no doctor, which makes [? Jealin ?] precisely the average Haitian.

Chana Joffe-Walt

Average in every way but one.

[JEALIN'S LAUGHTER]

It's that laugh. She starts every single sentence with it.

[LAUGHTER]

Adam Davidson

The loudest, laughing mom with the two most sullen, withdrawn teenagers in all of Haiti.

Chana Joffe-Walt

I tried and tried. And here are the only few words I managed to extract from her oldest daughter. She's telling me about her sister's school.

Chana Joffe-Walt

Again, daughter.

Chana Joffe-Walt

Mother.

Chana Joffe-Walt

[? Jealin ?] has no car, no bike, no irrigation, no mattress. So for some white guy from Port-au-Prince-- that's how she sees Jean-Maurice-- for him to show up at Jealin's in his jeep and start handing out crates, she's not going to say, oh OK, this is a tool to increase my earning capacity. [? Jealin ?] doesn't mind bruises on her mangoes. She doesn't know anyone who does. She has no way of even conceptualizing a picky, American consumer. If Jean-Maurice is at about the level of a US exporter 50 years ago, [? Jealin ?] is living in the 1700s, well, with a cell phone.

Adam Davidson

Jean-Maurice realized he was going to need an intermediary, someone who could spend the time to train the farmers how to use the crates, to train them why they should want to use the crates. Basically, someone who can help the farmers accommodate the needs of people living in the 21st century, people these farmers have never met before and can't imagine.

Chana Joffe-Walt

And here is where Jean-Maurice hooked up with one of those 10,000 NGOs in Haiti-- non-governmental organizations. Lots of them specialize in training small farmers in agricultural techniques. In fact, many are focused specifically on mangoes, because study after study shows that mangoes are one of the greatest areas of potential growth for Haiti. So there's lots of money and there's lots of specialists ready to help those mango farmers. And here is where we begin to see what those 10,000 organizations are up against.

Adam Davidson

Now Jean-Maurice-- like a surprising number of Haitians-- does not like those NGOs. He says-- and we heard this all the time in Haiti-- those NGOs have been helping for 50 years. And every year, Haiti is poorer and the NGOs are richer.

Adam Davidson

The one he likes most is called MarChE. Well, it was actually this guy he liked the most, one of the staff named Pierre Brunache. Jean-Maurice liked that Pierre grew up in Haiti, even though Pierre lives in D.C. now. So Mango Man calls Pierre and says, hey, I can't get these mango farmers to use plastic crates. You're the expert. Can you help me?

Chana Joffe-Walt

And Pierre says--

Adam Davidson

Jean-Maurice thought, great.

Chana Joffe-Walt

And then Pierre went on.

Adam Davidson

This is where Jean-Maurice gets nervous. Getting land? Technical assistance?

Chana Joffe-Walt

Pierre explained. You can't just hand out crates to thousands of dispersed farmers. You need a central place with just a simple structure. Picture a carport, a quarter acre of land, with a hose. Farmers will bring their mangoes, learn how to pack the crates correctly, how to wash the mangoes. Pierre says, we have some rules about this because we've done this in other places. We've seen what works and what doesn't. And when you team up with an NGO, you have to follow their rules. So, if Mango Man wants crates, he has to find a farmer with some land that they can build the mango carport on.

Adam Davidson

To which Jean-Maurice replied, have you ever met a Haitian farmer?

Chana Joffe-Walt

To which Pierre replied, and there's one other rule. The farmer can't own the land the center will be on. They have to donate it. The center will become the economic powerhouse of the community, so you need a neutral place. You can't let one family own it. It has to become a cooperative owned by all of the farmers.

Adam Davidson

And so, Jean-Maurice began his campaign to convince some poor farmer to give up some of his precious land. He called someone he knew in Casale to find out who might have some land. The guy talked to his cousin, [? Jealin, ?] the one with the laugh. [? Jealin's ?] family has a very nice piece of land in a great spot, near the road and near the mango farms. Now, this is where the mission to get some mango farmers a few plastic crates goes from involved to complicated. Because the thing is, the land was passed down from a great-great-grandfather. Maybe a great-great-great-grandfather, nobody remembers exactly. The point is, a whole lot of cousins have equal claim to the land.

Chana Joffe-Walt

[? Jealin ?] called a meeting, gathered her family together to decide whether or not they wanted to donate the land.

Chana Joffe-Walt

60 or 80 people all sat under this tamarind tree? Really?

Adam Davidson

Everyone, all the cousins started asking questions.

Adam Davidson

Who is this white guy from the capital?

Chana Joffe-Walt

Why doesn't he buy our land?

Adam Davidson

What if he never does anything with it?

Chana Joffe-Walt

We're going to give away all our land? What will we leave for our children?

Chana Joffe-Walt

There were factions, big disagreements. For a while, Jealin's brother was a holdout. So were the loud cousins, who nobody likes, who left town a while ago but came back when they heard someone was interested in the land.

Adam Davidson

So many meetings under that tamarind tree. Jean-Maurice drove in for many of them.

Adam Davidson

So, we've got the land. We can get those crates here. Training. Those mangoes will be beautiful. The farmers will start earning twice as much, so will Jean-Maurice. He calls the NGO and says, all right guys, you can start building the center.

Chana Joffe-Walt

The NGO says, great, we just need to see a copy of the deed.

Adam Davidson

The deed. So, Jean-Maurice goes back to the mango farmer with a quick, simple request.

Adam Davidson

Nobody knew who the original owner was, who sold the land to Jealin's great-great-grandfather.

Chana Joffe-Walt

Or great-great-great-grandfather.

Adam Davidson

Right. Nobody knew who had the deed now. But finally, [? Jealin's ?] brother remembered, wait, there was that uncle who always kept papers, the guy who left Haiti a while ago.

Chana Joffe-Walt

The brother tells me, that guy sent the paper from his basement in New York with someone he trusts to Haiti. So after weeks and weeks of waiting, they get the paper. But it turns out, to transfer a deed in Haiti involves, literally, hundreds of steps and hundreds of dollars. Transfer of land deed was not in the budget, and if there's one rule every NGO sticks to it's, you do not change the budget.

Adam Davidson

This is where Jean-Maurice loses it.

Chana Joffe-Walt

Can I just remind everyone, we're talking about getting some farmers a few plastic crates? Crates that they want, that Mango Man wants to just give them, that the NGO wants them to have. But to get those crates to the village of Casale, 60 farmers had to donate some precious land. And they did it. Mango Man had to trust an NGO. And he did it. MarChE-- the NGO-- had to be flexible and pay for something that wasn't in the budget. And they did it. Together, all these people had to overcome more than a century of legal confusion, and they did it.

Adam Davidson

Success. They get to the final, last step. December, 2009, a year and a half after they began. [? Jealin ?] and the other farmers form into a cooperative that would own and operate the crate center. They did that. They took all the paperwork, that very final document one last time into Port-au-Prince and delivered it to the government. This all happened at the very end of last year. And then on January 12 came the earthquake.

Chana Joffe-Walt

It was several weeks before Jean-Maurice could even bring himself to go back to Casale to visit the farmers. It wasn't clear if the earthquake destroyed the crates project entirely, or just set it back months, maybe years.

Adam Davidson

But as survivors started to think about their future, they started asking this question we'd hear every now and then-- usually after someone apologized for even thinking it. Was the earthquake the best thing that could've ever happened to Haiti?

Chana Joffe-Walt

The argument goes like this, the world is now focused on Haiti like never before. There's lots of money coming in. Before this, you had those 10,000 NGOs working independently on little projects, making slow progress, maybe, if at all. But what if now there is an opportunity to take all the attention, all the money, and work together like never before? What if this is the shot-- instead of solving one small problem at a time-- to address all the country's problems all at once.

Adam Davidson

Think about [? Jealin ?] and her mangoes. Her problems go way beyond those plastic crates. Remember, she needs a canal. And while we're at it, she needs a road. Once her mangoes get on the truck, they go down this crazy, choppy dirt road. In the rainy season, sometimes the road isn't even there. She really needs a paved road.

Chana Joffe-Walt

But then, if there's a lot more trucks carrying a lot more mangoes, the Haitian port can't handle that. Haiti's main seaport is really old. And they'd need to buy new equipment, which means a better banking system to give loans and more professional folks to operate things--

Adam Davidson

Which means better education to train those professional folks, and while we're at it, health, hospitals. [? Jealin's ?] brother can't help her on the farm because he's really sick. She thinks he has malaria. Thinks. She doesn't know because there's no doctor around to ask.

Chana Joffe-Walt

If all that seems like a lot for the world to take on, seriously, we went to the place where this is truly the ambition.

Adam Davidson

We're in a conference room in a new hotel on a hill outside Port-au-Prince where experts from all over the world are sitting around foldable tables and trying to figure out how to do every one of those things and more. They're trying to figure out how much it would cost to address all of Haiti's problems at once.

Chana Joffe-Walt

Experts are here from the U.N., the World Bank, from all over the world, doing the thing experts do, staring at Excel spreadsheets and writing assessments. And they're all in these tables divided into groups. There's education, water, infrastructure.

And Adam, you and I go table to table asking, what are you going to do for [? Jealin? ?] And everyone has really long, in depth answers. Infrastructure.

Adam Davidson

The health table tells us they're working on a plan for hospitals in her area. Education table? They're working on a plan for more free schools.

Chana Joffe-Walt

At which point, a Trinidadian woman grabs my arm to tell me, kids need more than schools, you know? They need activities, dance classes, that we are offering over at this table.

Adam Davidson

And over at the environment table, they're offering canals.

Chana Joffe-Walt

So the people in this room have their plans. And the world is going to spend billions of dollars on those plans. But now that we've seen how complicated it is to do something basic like get some crates into the hands of some mango farmers, it raises the question, what'll it take for all that money to do something? To actually result in canals and roads and electricity and crates actually getting to [? Jealin? ?]

Adam Davidson

So, let's say you're the US government. You're committed-- as the US government is-- to spending lots of money rebuilding Haiti. You basically have two choices. Chana, the first please.

Chana Joffe-Walt

Number one. You could hire Haitian companies and American companies do build things. The Haitian companies will be the Haitian elite. The American companies will leave after a year or two. And if you're Hilary Clinton, in a year-- the anniversary of the earthquake-- you can point to a bunch of successes, big ones. Hospitals rebuilt and roads that are way better than any Haiti has seen. If you're [? Jealin, ?] you probably still don't know how to pack your mangoes into crates and you probably aren't lucky enough to have your tiny piece of land chosen for a tiny canal either. So, Adam, let's look at number two.

Adam Davidson

Number two, you do what development experts call capacity building. You teach the people of Haiti how to do all these things. You use this rebuilding process to give Haiti the ability to build itself. Which means, do for [? Jealin, ?] what America did for farmers more than 100 years ago, create a class of ag-extension agents who go to farms and figure out the best solution for each one, train farmers and laborers how to do things like build proper canals, create small banks to lend the money to farmers for this kind of investment, and you teach [? Jealin ?] how to pack her produce correctly, to wash it and to sell it directly to the exporter.

This option, capacity building, do I even need to say it? It takes a long time and it's really, really hard. You need foreign money and you need Haitians to believe in the projects and to participate fully. And you need NGOs that are willing to stay for as long as it takes, which brings us to a classic problem with NGOs and foreign assistance.

Adam Davidson

Several months after the earthquake, we meet up with Jean-Maurice at his cousin's hotel, the same place where the world's experts gathered together to figure out how much it would cost to build Haiti out of poverty. The conference room has emptied out and Jean-Maurice-- Mango Man-- told us he got a call earlier in the week from MarChE, the NGO that was helping train [? Jealin ?] and the other farmers. USAID cut their funding. MarChE is closing their doors. Jean-Maurice shakes his head.

Chana Joffe-Walt

This was confusing. There was just a major earthquake and everyone wants to help Haiti. People are sending money, texting money, and USAID is cancelling programs? I called USAID and our conversation with confusing too.

Chana Joffe-Walt

This is Anthony Chan. He's deputy director for USAID in Haiti, and at first he tells me, technically, they're not closing the program. They're just letting its funding run out. Then he tells me that with all this new money after the earthquake, they need to reassess all their programs and think bigger than little ones like MarChE. And finally he tells me, OK, the program is going away, but it's not his fault.

Adam Davidson

That movie has been going on for more than half a century. There's this recent report called "Haiti in the Balance," which documents how time after time, USAID programs are started and then-- before they can actually help anyone-- a decision is made in Washington to send aid in a whole new direction.

Chana Joffe-Walt

The two Marche staff we met left Haiti a couple of weeks ago. Mango season has opened without crates. And this, of course, is how you can continue to have 10,000 NGOs in a country that keeps getting poorer.

Ira Glass

Chana Joffe-Walt and Adam Davidson are part of the Planet Money team. If you like this kind of story-- economics, but interesting. You can be getting it twice a week on the Planet Money podcast and at their blog, www.npr.org/money. It's a co-production between our program and NPR news.

Coming up, a new definition of atheist during an earthquake. That's in a minute. From Chicago Public Radio and Public Radio International, when our program continues.

Ira Glass

This American Life, I'm Ira Glass. Today's program, "Island Time," stories about what happens next in Haiti, now that the world is flooding it with money and help. We've arrived at Act Two of our show. Act TWO, Compound Fracture.

According to the US State Department, there are about 40,000 American citizens who live in Haiti year round. These are business people, NGOs, missionaries. In the 1980s and 1990s, Apricot Irving's family was among them. Apricot's parents were missionaries, agricultural missionaries. They did erosion control farming, reforestation projects. They lived in a town called Limbe, about 150 miles north of Port-au-Prince. It's been 20 years since her family left, but her parents still go back to the north of Haiti every couple of years. And in March, Apricot went with them to see how people are building a new Haiti and how different that effort is from when she was a kid.

Apricot Irving

The missionary compound where I grew up-- that's what we called it, the compound-- is about 15 miles away from where Columbus sank the Santa Maria in 1492. Columbus was just the first of many foreigners with big dreams of how to improve Haiti. We heard a lot about Columbus growing up on the compound because Dr. Hodges-- who ran the missionary hospital in Limbe-- was a huge fan. When I was a teenager, the compound had everything we needed, a missionary school, a TV room, friends. But when I went back this time to visit, it was like a ghost town, a ghost town with a very loud generator.

It is kind of creepy in here. There's nobody around. There's all these houses that used to be full of missionary families and kids running around and there's not really anybody else. There's Joanna. Hi Joanna, how are you?

Apricot Irving

Dr. Hodges died 15 years ago, but his wife Joanna still spends a lot of time in Limbe. She's 87 years old and she's formidable. Everyone thought she'd retire in 2004 when three guys with guns broke into her house. She ended up chasing them down the driveway as they tried to steal her car. One guy broke her arm by beating her with a stick.

Apricot Irving

I can't believe she can laugh about this now. But maybe that's what spending 52 years in Haiti will do for you. I'm really fond of Joanna. I've known her since I was six years old and she's like a grandma to me. She epitomizes the old way of doing aid work, sort of 19th century benevolence. The foreigners-- usually whites-- lead the way, set an example, do whatever they can, and hope the Haitians catch on. In other words, the foreigners are always in charge. It sounds a little crazy, but until a few years ago, Joanna kept the keys to the medical supply storage room on a chain around her neck. When the Haitian doctors needed to perform an emergency surgery in the middle of the night, they had to wake her up. And, because she was in her 80s, carry her over the mud puddles to open it. The hospital is still run by Joanna's son, even though he now lives in Florida and hasn't been to Haiti in years.

Apricot Irving

Far fewer patients come to the hospital now than when I lived here for a few reasons. People really loved Dr. Hodges, and when he died, things changed. The hospital got rid of its old payment system, where you were offered credit if you couldn't pay right away. Instead, they started charging a fee upfront for a consultation. It's not much, about $1. But it was more than a lot of people could afford. People resented it. Things got ugly for a while. Graffiti, threats, some protests. Also, there's more competition than there used to be. The number of small Haitian run clinics have opened up that didn't exist 20 years ago. The hospital feels pretty empty right now. But these clinics are jammed with patients.

This is Steve James, Dr. Steve James. I grew up with his kids at the missionary compound in Limbe. For a while, Steve was Medical Director at the hospital there, the Hodges Hospital. The work he's doing now is an attempt at something different, a totally different approach to development work.

Apricot Irving

He spends much of his morning greeting people and kissing them. This is how you start the day in Haiti. Everyone asks how your family is, how you slept last night. You can usually tell who the visiting Americans are, because they're the ones trying to skip the handshakes and get straight to work. But not Steve James. He's been in Haiti 30 years now. Every month, he visits 11 small Haitian clinics, including this one. All the clinics Steve visits are faith-based, community-run organizations, meaning the decisions are made by a board of locals. Steve is not on any of the boards. It's kind of a new state of affairs here. He's a white guy and he's not in charge of anything.

Apricot Irving

He shows me around Ebenezer clinic, which was five miles away from the old missionary hospital in Limbe. It's a small, two story building. But there are at least 100 people waiting to be seen, both inside the building and outside under a tree. The clinic has far fewer resources than the hospital. They don't have a surgery wing. They don't even have a place for patients to spend the night. But they let you pay what you can and give you credit for the rest. After the earthquake, they let everyone in for free, not just earthquake victims. Even though the clinic was already $8,500 in debt.

Apricot Irving

If anyone's in charge here it's Manno. He just got back from doing relief work in Port-au-Prince. Manno's a few years older than I am and I've known him since I was 14. Since I last saw him, Manno has become a doctor. He's the medical director for this clinic, though some patients still want to see the blonde, the foreigner with the American medical degree, the white guy. It happens while I'm standing there and it's awkward. A Haitian pastor comes in and asks for an appointment with Steve who's rushing to make another appointment, so he turns to Manno to see if he can do the consultation instead.

Apricot Irving

You can hear the frustration in Manno's voice. Because of course, this has happened before. It makes Steve uncomfortable.

Apricot Irving

A few days before I arrived, Manno had come back to town with a family of earthquake refugees in the back of his truck, including this three-month-old, who Steve's been waiting to see. Her arm looks terrible. It hangs at a strange angle from her elbow. She comes in with her aunt and her aunt's sister-in-law.

Apricot Irving

She was a month old when the earthquake hit and she was trapped under the rebel for two days. Neighbors could hear a baby crying. What they didn't realize-- until they dug her out-- was that she was cradled in the arms of her dead mother. Steve thinks she might have survived by nursing. The women have brought an X-ray of her arm, taken at another rural clinic Steve had sent them to, because Ebenezer doesn't have an X-ray machine.

Apricot Irving

The X-ray isn't the exact angle he'd asked the technician for. So he can't really tell if the elbow's fractured or dislocated, though he suspects both. Steve wants to send the baby to another clinic-- an hour and a half away-- to see one of the visiting orthopedic surgeons-- an American who came to help out with earthquake relief. He makes sure to consult with Manno first.

Apricot Irving

If Steve had still been director of the hospital in the compound, he could have had everything done at the same place, X-rays, surgery, an overnight room. Instead, he has to send the baby to three different places-- over horrendous roads-- and someone has to pay for all that. It makes you understand why a lot of NGOs still operate the old foreigners in charge way, it's efficient. This way, the opposite of efficient. But what Steve's doing is that term you heard earlier in the show, capacity building, even though Steve would never call it that. He calls it, "building community." If you want Haitians to create and sustain their own institutions, this is what it looks like, slow and sometimes cumbersome.

But Steve knows the pitfalls of the other model. When he was in charge of the old missionary hospital, he found the job so stressful that he even considered leaving medicine. He came to a kind of crossroads and had to make a hard choice. We talked about it in the car.

Apricot Irving

The good news-- Steve says-- is that the slow, cumbersome process is working. There's progress. These clinics are surviving basically on their own, supporting themselves with very little outside help. And when the earthquake hit, that progress paid off. It was Haitians who were on the scene first-- doctors like Manno-- pulling people out of the rubble, distributing water, days before the foreign aid organizations arrived.

Ira Glass

Apricot Irving. She's writing a book about growing up on a missionary compound in Haiti. Right now she's looking for a publisher.

Ira Glass

Act Three, "Hait is Destiny." Ben Fountain is a fiction writer who has been going to Haiti two or three times a year for 20 years. He has close friends there. He's written short stories set there, based on the things he's seen. He returned in March to catch up with people.

Ben Fountain

"Did you think we were dead?" This was the first thing asked me by the 13-year-old daughter of my friend Gary, when I reached them by phone a few days after the quake. "Did you think we were dead? She said, as soon as she came on the line. And I hesitated, it seemed rude just to say to a child, "Yes, I thought you were dead." But there was a firmness in her voice, a focus and calm that showed she was beyond all the finer points of etiquette. For the past several days, she'd been very possibly dead to her family and friends back in the states. And now she was testing it, probing this other reality, the one where she died on January 12. How would it feel to be dead? What would it mean to exist only in old emails, pictures, the minds of others?

Then the phone was passed to her brother, and he wanted to know too. "Did you think we were dead?" But they hadn't died. Their house had held and they'd ridden out the quake jammed in a doorway with their parents and uncle, the five of them lurching and pitching in that tight space like shipwrecked survivors tossed in a storm. But from their front yard, you could look across the neighboring ravine at the remains of 100 houses that hadn't held.

It's like a lobotomy, seeing destruction on this scale. Not just the outsize scale, but the mind-numbing density within the scale. The sheer sensory overload of detail and texture. That football field-sized wilderness of junk and rubble that used to be a trade school, you could find entire geographies of ruin within that expanse. Hills, butes, hummocks, valleys and craters, broad flats cut through with twisting gullies, shredded clothes, shoes, papers, mangled furniture, dark oily clumps of decomposing human matter, rebar twisted and raveled like giant spaghetti balls. And then something impossible and ridiculous, an easy chair, a thickly upholstered loveseat, perched at the top of a free-standing spiral staircase that spun off into nowhere. It didn't make sense. Port-au-Prince was making me stupid.

"I have a new definition of the word atheist," my friend, a Haitian eye doctor, told me. "This is the person who doesn't cry out to God in the middle of an earthquake." My friend, the eye doctor, comes from one of the old Mulatto families. And he may be the one true genius I've known in my life. He's fluent in six languages and proficient in three more, knows long passages of world literature by heart, plays the piano beautifully, and placed third in the Haitian National Chess Championship when he was 12.

I met him almost 20 years ago, when he was a handsome, young doctor with jet black hair down to his shoulders and the slightly mad eyes of a Rasputin or Houdini. He was brilliant and knew it. On finding out he was a doctor, I made some trite comment about all the good he must be doing in his work.

"No," he answered brusquely. "On the contrary, in Haiti, I'm like a jet pilot without a plane." I went to see him as soon as I arrived in Port-au-Prince and found him living with his family in their backyard. Most of their two story house was still standing, though the west wall had sheared away entirely, leaving that side of the house open to the air. And what remained was too shaky for habitation. So now they were living outdoors, sleeping in tents and a re-purposed tool shed and cooking on the stove they'd dragged outside.

"And this is luxury," the doctor exclaimed, "We're the lucky ones." He and his wife and one of their sons had been on their small front gallery when the earthquake struck. And at first, they thought it was a heavy truck going by, some gargantuan piece of construction equipment. And then they told me something I would hear many times in the coming days, "We thought it was the apocalypse or Armageddon. We thought the world was blowing up. We thought this was the end of everything, so we just stood on the gallery hugging one another and waited for it to finish."

Such were expectations in Haiti, where the apocalypse comes more readily to mind than anything so far-fetched as an earthquake. A Danish filmmaker, a long time acquaintance of mine, was on the third floor of his house in Jacmel when the quake started. And he simply couldn't process what his eyes were seeing. The room started shaking. And then the walls started rippling and bending. And he wondered, how can the walls be moving like that? And there was a hole in the wall, and he wondered why there was a hole in the wall. And then the balcony was gone, and how could that be? He sat on his bed, watching it all unfold in slow motion, but his brain wouldn't accept the information. I asked him, did you think you were losing your mind?

"Yes," he cried, "I did think I was losing my mind, because these things I was seeing just didn't make sense."

"You think the one thing that's certain in your life," the eye doctor told me, "Is the ground beneath your feet. You think this one thing at least is solid. And when that starts to shake, you experience real terror."

We sat down at the small kitchen table in their backyard. So how were they doing? "We're surviving," the doctor said with a shrug, though this might not seem so obvious. Their teen-aged sons hadn't had a school to go to since January 12. The wife's video rental business was lost in the quake. The doctor was doing a lot of meetings these days, but he said they were starting to make him feel like a character in a Kafka story. As one of only 50 ophthalmologists in the entire country, he was much in demand by foreign governments and NGOs to consult on health care projects. And after two solid months of meetings, he was going a little crazy.

"What happens at these meetings," he said, "Is that they meet to agree to evaluate the situation, so they can meet to agree to evaluate the situation, so they can meet to agree to evaluate and on and on." He'd been at one such meeting that very afternoon. "I told them it was all bull[BLEEP] and bluff. But even when I insult them, they don't listen to me. They just want a couple of Haitians at the table for decoration. We're there so they can keep on getting their money.

"On the plus side," he continued, "There was always plenty of food at these meetings," so he rarely needed to eat at home, which was good because he wasn't making any money these days. His office had been destroyed in the quake and the few pieces of equipment he'd managed to salvage sat in a forlorn little pile in his living room. These days, his practice consisted of people randomly dropping by his house. Doc, everything's all blurry. Doc, my eyes hurt. Doc, can you find me some glasses? I lost my glasses in the quake.

Several days a week, he hitch a ride out to one of the tent camps and treat people for free. But otherwise, he sat in his backyard studying Chinese and reading the classics of western philosophy.

"You know what I've noticed," he told me that first evening at his house, "God gives you 205 years to do something with Haiti and if you fail, he passes it on to someone else. The Spanish had it from 1492 to 1697, 205 years. Then the French from 1698 to 1803, 205 years. Then the Haitians, from 1804 to 2009, 205 years." So what was coming next? "Maybe a revolution," he answered cryptically. "Or maybe Haiti would survive as a sprawling industrial park for the international aid complex. Or maybe it would become a satellite of the United States, a kind of protectorate."

And then I brought up the subject of art. The doctor is-- among his many other talents and accomplishments-- an astute critic and tireless promoter of Haitian art. When I asked him whether anything had been rescued from the iconic institutions of Haitian art, the National Gallery, the Centre d'Art, or the murals of the Trinity Episcopal Church, his brow drew down and he brooded for a minute.

"Art is finished in Haiti," he said abruptly, "After what happened here, art has nothing more to say to us." And he went on, "The philosopher Hegel said that before the end of time there will be the end of history, and before the end of history there will be the end of art, maybe this is what we're seeing here, the enacting of Hegel's theory. Haiti is leading the rest of the world to the end of time."

Riding around Port-au-Prince during the day, seeing the sheer biblical scale of the destruction, this could definitely put you in an apocalyptic frame of mind. "Poor Haiti," people say, "So primitive, so backward, so far behind the times." I've been hearing about how backward Haiti is for as long as I've been going. But how about this, what if Haiti is ahead of the times? It seems to be on the leading edge of so many current trends, environmental degradation, serial ecological disasters, crumbling infrastructure, a population that exceeds resources, plus a skewed economic order that channels vast wealth to a privileged few while the great majority of people stagnate and struggle. By any objective measure, Haiti appears well-advanced on the track that the rest of the world seems hell bent on following.

The eye doctor proposed yet another alternative for Haiti's feature which was the extinction of the Haitian people. In other words, no future at all. And why not? Many countries, many peoples have disappeared over the course of history. Why should Haiti be any different? From a sheer numbers standpoint, the earthquake had been a strong push in that direction. And now, he pointed to the mountains looming over Port-au-Prince. Every year there were fewer trees up there. Every year the rains loosened the soil a little more. Unless drastic changes were made, it was only a matter of time before the mountains crashed down in a kind of land tsunami and buried the city whole like a modern day Pompeii, only with mud and rock instead of volcanic ash.

"The terrible thing about existence," the eye doctor told me a few days later, "Is not that there is suffering, but that there's no limit to suffering. I think there's going to be an explosion," the doctor confided, a sentiment that was echoed many times by many people over the course of my visit. Even Haitians, as resourceful and tough as they are, have their limits. They were watching in the camps. They were waiting.

[FRENCH PHRASE] was a line of graffiti you saw everywhere. [FRENCH PHRASE]. We're tired, we've had enough. We're simply, [FRENCH PHRASE]. We're here. That was what people often said when you asked how they were doing. [FRENCH PHRASE] we're here. Or a sassier variation, [FRENCH PHRASE]. Better that we're ugly and here than not here.

All those tents in Port-au-Prince, all those thousands of tents, sometimes I'd look at them and imagine an army was massed out there. The last time I talked to my friend Gary, the one whose children had wanted to know if I'd thought they were dead, he told me a barricade had been erected outside the gate of the warehouse where he works. Gary is a logistics manager for one of the big NGOs, and those his warehouse operation was clearly there to do good, people were protesting, they wanted jobs. Gary had hired all the workers he could, but for the people outside it wasn't enough. For two days running, he'd had to negotiate his way through the barricade to get home. It's getting radical, he told me. And then he added, come back soon.

Ira Glass

Ben Fountain. A few of the short stories that he's written, set in Haiti, are in his collection, brief encounters with Che Guevara.

[MUSIC- "EXHIBIT H" BY JOELL ORTIZ]

Our program today was produced by our senior producer, Julie Snyder with Alex Blumberg, Ben Calhoun, Jane Feltes, Sarah Koenig, Lisa Pollack, Robyn Semien, Alyssa Shipp, and Nancy Updike. Production help from Brian Reed, Seth Lind is our production manager. Emily Condon is our office manager.

[ACKNOWLEDGEMENTS]

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Ira Glass

I'm Ira Glass, back next week with more stories of This American Life.

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