Jeremy Hobson: There have been so many huge natural disasters in the last couple of years that the catastrophic 7.0 earthquake that devastated Haiti in January of 2010 seems a distant memory.
It's not for Dr. Paul Farmer. He's the U.N.'s deputy special envoy to Haiti. He's also a professor at Harvard Medical School. And he's the author of a new book about the multi-billion-dollar relief and recovery effort being carried out by the international community. The book is called Haiti After the Earthquake. Paul Farmer, welcome to the show.
Paul Farmer: Thank you for having me.
Hobson: Well bring us up to date, first of all. You've recently been in Haiti, what's it like 20 months after the earthquake?
Farmer: Well there is some progress being made both in terms of the acute relief -- that is what we all did and what so many people did after the earthquake -- but also in terms of recovery. But of course, there are enormous problems as you might imagine, especially around safe lodging for people displaced by the quake and there's a cholera epidemic ongoing. We're still very much in recovery mode.
Hobson: And of course, when it comes to paying for the recovery, you're relying on a lot of money that's coming in from the outside. I was surprised to read in your book that only 15 percent of the pledges that people made have actually been fulfilled.
Farmer: It may be a little more than that now, but this was very instructive to me to see after international pledging conferences in general -- not just the one after Haiti -- the number of pledges that are actually kept often is less than 50 percent. And again, this is not just true of Haiti.
Hobson: Is there any way for Haiti to go after that money? When a country says that they're going to give something, do they have any legal obligation to do so?
Farmer: My guess is that the legal strategy is not going to work anywhere as effectively as making sure the money is used wisely and implementing. One of the best things that they could do and we could all do is get these projects up and running and move them forward. That would probably speed up other groups keeping their promises.
Hobson: When you respond to a disaster of this magnitude, you're not just rebuilding, you're sort of building a new Haiti. But how do you make sure that the Haitians have a stake in their own future if all of the decisions and all of the money is coming from the outside?
Farmer: That is really the crux of the matter right now. You know, you need rules of the road. For example, how much of the money pledged actually goes to create local jobs to make sure you're, whenever possible, favoring things like local procurement. If you look at food security, their food aid is all imported food. There are local farmers and producers who would like a chance to participate in this kind of recovery and also food security, and it's definitely not yet a part of the rules of the road of development work.
Hobson: Put on your professor hat for me for a second, Dr. Farmer. If you were teaching a course on international aid after a disaster, would Haiti be a good example or a bad example?
Farmer: Haiti would be an example of a lot of goodwill and some good practice in humanitarian relief. I don't think it would be, to date, a good example of how to recover from a disaster of this magnitude. I'm going to give an example of cholera since I'm a physician. We're working as hard as we can, we're saving a lot of lives, but we can't replace public water systems. And again, we can say well, we can find a lot of reasons it hasn't happened, but the fact that of the very substantial amounts of money being put into responding to cholera, too little of it has gone into public sanitation efforts and that hasn't happened yet.
Hobson: Dr. Paul Farmer, he is a professor at Harvard Medical School and the author of the new book, Haiti After the Earthquake. Paul Farmer, thank you so much for being here.
Farmer: Thank you for having me.