When it comes to international aid, attempts to improve public health, assist in development, and respond to natural disasters can be thwarted by political strife and global economic inequality that stretch far beyond the control of the individuals whose lives are at stake. In this context, expertise in the culture, history, and language of a country, in addition to scientific and medical knowledge, can go a long way toward improving the potential success of public health policies and interventions.
The cholera epidemic that spread in Haiti nine months after the 2010 earthquake, for example, was started by U.N. peacekeeping forces, but only six years after its initial outbreak did the U.N. admit it played a role in the affair. In an effort to understand how deeply-rooted assumptions about a culture can have significant impact on public health policy, Lesley S. Curtis, Vital’s Editor-in-Chief and scholar of Haitian Studies, interviewed Jonathan M. Katz, the journalist whose investigation first revealed the U.N.’s responsibility for the epidemic and the author of The Big Truck that Went By: How the World Came to Save Haiti and Left Behind a Disaster.
In August 2016, Katz’s revelation that the U.N. was finally admitting to its role in the disaster made the front page of the New York Times. Recently, talk of compensation for the victims began. Vital asked Katz about his experience in Haiti, his methods as a journalist, and how narrative can shape health policy.
Thanks for agreeing to speak with Vital. As a freelance writer and journalist, you are probably best known for your writing on aid and development in Haiti after the earthquake of 2010. Would you mind explaining how you came to do that work?
Sure. I was the Associated Press correspondent in Haiti for 2 ½ years before the earthquake hit. In that period, I had spent a lot of time covering aid and disasters. There were a number of major hurricanes, for example, that happened while I was there. There was a major school collapse, which happened right behind my house. I had been cultivating expertise in this area in the way that journalists do. You become an expert on whatever you’re writing on at the time. And because Haiti is a republic of NGOs, there were constant stories to do about international aid and the U.N. system. After 2 ½ years, I was supposed to go to Afghanistan, but the earthquake hit, so I stayed. I spent another year in Haiti covering the aftermath of the disaster and, obviously, the cholera epidemic in the fall of 2010.
The earthquake and then the cholera epidemic were serious events with tragic consequences. How do you see your role as a journalist? Are you an objective eye or a worker involved with relief efforts? How do you balance your obligation to the story versus the needs of suffering people?
I see myself first, second, third, and fourth as a journalist. My ideas about objectivity could take up this whole conversation! First of all, no one is an unbiased observer. Even if you put a camera down on the ground and let it run, recording everything that it sees, the camera has bias. It’s shooting at a certain angle, with a certain frame, and there are things happening that it can’t see.
There is no way to gather information without having it come from a perspective. But that perspective doesn’t have to be political. There doesn’t have to be a policy end that you perceive. In the practice of objectivity as a journalist, you try to make sure that the information you’re presenting is correct. When you gather it, you verify its accuracy and test your assumptions. Consequently, the story becomes objective in a way that you, as an individual, cannot be.
Objectivity is not neutrality, however. This came into play in a major way in my coverage of the cholera epidemic. I did not see my role as being neutral between what actually happened and what the U.N. was trying to say happened. I don’t think I’m impartial. I’m extremely partial to the truth—at least as close as I can get. Once the facts that I have gathered and verified are revealing a certain reality, it’s my job to be partial to that reality. If other people want to deny that reality, that’s fine—I can quote them, but I’m under no obligation to treat their version of reality as equally valid.
The idea that objectivity does not equal neutrality might be another way to explain that you, as the person covering the story, are also necessarily part of that story. Correct?
Right. I am not an aid worker. I am not a politician. I don’t see myself as participating in the relief effort any more than I see myself as running in the elections that I cover. And yet, I am part of the relief effort simply by the fact that I’m covering it. For example, in the way that I wrote The Big Truck, I made myself a fully-fledged character. In large part, I did this in order to reflect this complexity.
In the earthquake, I was also a survivor. Certain events don’t just happen independently. In some cases, I actually made things happen. When I describe myself in the book as a person covering a story, I’m giving the reader a description of who I am and what I did so that they can interpret it through that frame.
Speaking of your actions as a journalist, do you feel that in your reporting, there are distinct challenges in forging an understanding between the experiences of people on the ground and various medical or policy bodies?
Honestly, as a journalist, I don’t really think about it. When your job is to talk to lots and lots of different people and lots of different kinds of people, you don’t have to sit down and strategize how to do it. You approach everyone on their own terms, looking for the way that the facts, pieces of evidence, and perspectives fit together.
To me, it seems like you are just trying to understand something and you keep gathering information until it comes together as a whole. I don’t think of it as crossing boundaries. If I want to know what it’s like to live in a tent camp, then I need to talk to someone who lives in a tent camp. If I want to know how a disease spreads biologically, then I need to talk to an epidemiologist.
Are there sources of information that people tend to believe more readily than others? For example, do you have to work harder to validate information received from certain people based on class, education, or status?
No. A similar process of fact checking occurs no matter what. For example, the leaders of one of the tent camps that I went into a couple weeks after the earthquake were making claims that they hadn’t received any aid. I came back the next day and went into the back of the camp and, instead of talking to the leaders, I talked to other people. They gave me a different story. I could see that there were food wrappers on the ground and, as I was leaving, there was a truck delivering hot food that had come from the Dominican Republic. I got a different story by talking to more people. You have to check everything out.
You can talk to scientists and see similar problems. On the cholera story, for example, there were plenty of experts who were telling other journalists that inquiries about the epidemic didn’t matter, or that we could not find a source, or that the whole thing had been spontaneously caused by climate change. This was not true. In journalism school, they tell you, “If your mother says she loves you, check it out.” This is the case for everyone, no matter what.
In your experience reporting on Haiti, do you find that there are many stories that do not get reported?
Certainly. There are 10 million people. There are plenty of stories to tell. And there are also stories that get told over and over again at the expense of others. This happens often because people want to know about the suffering. That’s the narrative that people are interested in: the desperation; the hunger.
Those are things that exist, certainly. Most people live in circumstances of material deprivation that are extremely difficult. There is an everyday drama to survival. This is true everywhere, but in Haiti it can be particularly visceral. People are interested in that. And I understand that. But at the same time, there is a ton of other stuff going on.
Anything that you can imagine that exists in a society, there’s some expression of it in Haiti. And those stories don’t tend to get told. Let’s take a random example: there’s an interesting bodybuilding culture in Port-au-Prince. Few people talk about Haitian bodybuilders. And when they do, it is often told through the aforementioned lens of suffering by focusing on, for example, the rundown state of the gym where they are working out.
That’s the story that people want to hear over and over. Often, you find yourself being forced to tell a story in that mold; it can be very difficult to break free from it. Even if it is your intention to tell a different story, you find yourself having to pay some kind of homage to the frame that is expected. People get stuck in narrative traps.
Do you find that this leads to misunderstandings?
Yes. Nuance is hard for audiences—even for intelligent audiences. For example, trying to explain that Hurricane Matthew struck in a different part of the country than the earthquake is difficult. Or, on the topic of Haitian politics, people have expectations that everything is always corrupt. Someone on Twitter the other day mentioned a dictator, but Haiti hasn’t had one for decades. It doesn’t even really have a president now. It’s hard to convey nuance.
Things are not all bad or all good. Perhaps, most importantly, things are not necessarily bad in predictable or inevitable ways. An assumption of failure and a need to argue against that assumption—those are not new realities in Haiti’s history. Writers, politicians, and historians even in the 19th century had to first argue that their country’s revolution, which ended in the founding of the first anti-slavery postcolonial nation, was an exceptional moment in history. Émeric Bergeaud, Haiti’s first novelist, argued this in his 1859 novel, but he also had to argue that his novel, itself, was good and that he, himself, was capable of writing good literature. There seems to be a centuries-old narrative—or perhaps, as you call it, a narrative trap—with deep influence.
Exactly. Haiti is not a theater of suffering. That’s an idea that gets imposed on Haiti from the outside. And it denies Haitian agency in the process. Not that there aren’t problems. There is a lot of poverty in the United States, too, and there is some wealth in Haiti. It doesn’t break down as neatly as people would like it to.
What do you wish the average U.S. citizen understood about the challenges of humanitarian aid to Haiti? Many of our readers are educators and medical students. Is there an approach or a message that you wish researchers, educators, scholars, and care providers knew more about?
Because I lived in Haiti and wrote a book about it, family and friends are now coming to me to ask where they should donate because of what they have heard about Hurricane Matthew’s impact. I wish people would understand that that isn’t the right way to look at the problem.
According to this mentality, it’s as if Haiti is a poor, isolated place whose citizens are doing nothing until something terrible happens, and then when disaster strikes, the rest of the world is supposed to come in and save them. This is not the case. It’s hard to get people away from this idea because it is part of a larger, complex worldview.
I think it is important for healthcare providers and aid workers to know, too: we are not responsible for saving Haitians. We should not see ourselves as messianic figures who have the power to redeem Haiti from suffering. In part, this is because we are complicit in the suffering. In our history, both recent and in a more distant past, we have been the cause of a considerable amount of suffering in Haiti.
But that isn’t the entire answer because the interactions are very complex. Certainly, some aid really does help and other assistance is fairly neutral. And some aid does harm or never fixes the problem. If someone is going to offer foreign aid, it’s essential to do so while understanding the complex cultural and historical framework within which they are operating and to follow, as best they can, the lead of the people whom they are helping.
In Haiti, do you see the power of this disaster narrative influencing perceptions of aid work as well?
Yes. For example, criticizing the American Red Cross for not building houses in Haiti, and using that fact to falsely imply that, as a result, Haitians have been homeless for the last half decade requires believing that no Haitians were able to build their own houses. The criticism took for granted that the organization was supposed to be some kind of savior. Haitians build their own houses. That’s what they did. There were ways that the process should have been improved, certainly. It would have been useful if a lot more money had gone to helping restore Haitian incomes, subsidizing durable building materials, improving zoning and land use, providing oversight for building codes, and so on, instead of going to organizations like the Red Cross that don’t know the first thing about building houses. So much of this criticism—accusations of money being lost, many of the baseless rumors about the Clinton Foundation—ignores Haitians’ agency in the same way the aid effort did.
It seems that at the root of the narrative—or perhaps the narrative trap, as you describe—is a denial of the fact that Haitians live, work, and do things for themselves.
Yes. And, what’s more, when Haitian agency is mentioned, it’s often as an accusation. For example, with the cholera epidemic, many of the U.N.’s defenders tried to shift blame by talking about Haitians’ poor sanitation practices and lack of infrastructure, which are important to talk about but have precisely nothing to do with how the cholera bacteria were imported from Nepal and introduced into Haiti’s waterways.
Are there ways that economic inequality and racism hindered Haiti’s self-determination during the cholera outbreak? Is there an international hierarchy based on economic inequality and racism?
Yes! In big, gold letters. This was one of the clearest, glowing, burning examples of how, to many people in power, black lives still do not matter. At this point, there are somewhere around ten thousand people who have died. It’s possible that that number is twice as high. That is an enormous number of people. If that had happened in the United States or a Western European country, the situation would be entirely different. I cannot predict precisely how the situation might have been handled differently, but I do know that the quality and the intention of the conversation would have been different.
People in much of the world have extremely low expectations for what life can and should be like in Haiti. And a lot of that has to do with the fact that the people who live there are black. And not just any black people—the founders of the first black republic, who had much of the world rooting for them to fail from the very beginning.
I basically had this cholera story to myself for the first six months because the question [of how cholera arrived in Haiti] was one that most people did not even think needed to be asked. There were some people who did not want to look into it because they did not want to know the answer. Or maybe because they already knew the answer. On the other hand, there were many more people who thought that asking where a disease related to poor sanitation came from was somehow redundant in Haiti. People seemed ready to focus immediately on how to provide spot treatments rather than to assess where the disease was coming from—which is generally speaking the first question you ask in a waterborne epidemic—even though there were clear indications from the start that its source was not in Haiti.
Perhaps I was uniquely well positioned to answer this question, too. I had been in the country for years. I had heard rumors about the U.N.’s behavior and had witnessed their wrongdoings. I got to know people as people. It made sense that there was something going on. I was wondering why people were dying; I knew there had not been a cholera outbreak in the country in my experience and learned quickly that there had never been one documented before. It would be hard to argue that this situation would have happened the same way had the victims not been black, poor, and Haitian.
You mention having to verify all information as a journalist, even details that are often assumed to be scientific fact, as you did in the story about the cholera epidemic. Do you see a way that scientists, researchers, and providers might benefit from this journalistic, critical approach to information?
Yes. I think in general that you have to be clear about what you think you know and what you don’t know. There is a similarity between science and journalism. You’ve got to examine where information comes from, try to tear it apart, share information with others. This is also the practice of science, really.
The difference is that when you are in a position of making decisions that determine people’s well-being, you have to be that much more careful. That’s why it’s important not to understand yourself as a savior defined by the excellence of her intentions. Not in Haiti. And not in science in general. Humility can make a huge difference.
Featured Image by Laura Wagner