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Take 5: Dr. Patricia Wolff on Haiti two years after earthquake

This article first appeared in the St. Louis Beacon, Jan. 12, 2012 - Two years ago today, a 7.0 magnitude earthquake hit Haiti, killing more than 200,000, according to press reports, and leaving millions homeless. A few days later, Dr. Patricia Wolff, a St. Louis-based pediatrician, arrived in the country to find that everything had changed.

Wolff, who founded the nonprofit Meds and Food for Kids in Haiti in 2003, treats malnourished children with a ready-to-use-therapeutic food (RUTF), called Medica Mamba in Haiti. Since the earthquake, she says, MFK has given away 19,000 kilos (or almost 21 tons) of the peanut-butter-based food to 1,500 malnourished children and more than 5,000 children and adults recovering from medical interventions.

On Tuesday, a few hours before catching a plane back to Haiti, Wolff took a little time to talk about about what's changed in Haiti since the earthquake -- and what still needs changing.

"Progress is being made," she said. "It's not rapid, but look at Katrina, what's happened in New Orleans, in the United States of America. Where poor people are concerned, trying to rebuild their neighborhoods ... is not that easy."

This interview has been edited for length and clarity.

Two years ago when the earthquake hit Haiti, where did you think the country would be now, and where is it now?

Wolff: I thought it was one of those opportunities just to shake everything up and start over again, and I guess I'm moderately surprised how difficult it's been to get everybody to agree on how to start over again. Everybody agrees conceptually, but the process has identified issues, like land ownership and lack of real secure records in the government, that have made a huge impact on the delays that have occurred. So lots of well-meaning people have had lots of ideas, but it's almost like a hyper-democracy, not actually unlike our Congress, where lots of people have lots of ideas and then there's gridlock.

The more I think about it, the more I realize it mirrors our problem in Congress, where nobody agrees with anybody and the Congress doesn't agree with the president. I don't know what's going to happen there in the same way that I don't know what's going to happen in America. The difference is: America is such a big, complex country with lots of people that life goes on. But in Haiti, it's not such a big country, and the only life that continues is the small merchants and nonprofit activities, while the government deals in gridlock. That's disappointing, but just uncovering this and having some dialogue have moved the ball forward a little bit.

What is the situation you see now in Haiti with recovery? What are the major issues that need the most attention?

Wolff: The acute humanitarian issue is abuse and rape of women, violence against women in the camps, in the refugee camps. That is a horrible thing. It's not like it doesn't happen all over the world in refugee camps, but it's in my back yard now. It's very troubling, and no one seems able to get a handle on that and make it go away. So that's one thing -- about law and order and the status of women.

Then the other thing: How do you house people who never had a house before? They were squatters before, then they lost their squatting spots, and now they're in these refugee camps. You know we have a history of failed housing in St. Louis, for example, and you can't just take a whole bunch of people who are poor and put them in a place where there are no jobs, no education, no schools, no transportation, no way to sell things on the street. So they all want to stay in Port Au Prince so they make their dollar a day selling things on the street where the population is dense.

Nobody's really come up with a very good solution. What do we do in America when this happens? Basically, we don't go for housing, we go for jobs. Then people live where they want to live. You can't just fix it for them, it's not fixable like that in a long-term way.

What has to happen is jobs and why are there no jobs in Haiti? Because the government sees the pie as not big enough to divide any more ... It could really enlarge. They may understand that intellectually but don't feel it in their gut. They're run by fear and insecurity, feeling like, even though today, the rich people have money, by tomorrow it could be gone.

That's something I don't think most rich people in America live with. If you have food and shelter, education and good health in America with some sort of retirement, you pretty much expect that that's in place. And if you have expendable income, you could give it to charity, you could go to Haiti to work because you're not worrying about your own basic requirements. I don't think that kind of notion is part of the thinking of the people who are rich in Haiti, and these are the same people who run the government. Not knowing what comes tomorrow makes people want to get their share today.

One of MFK's main projects is treating malnourished children through ready-to-use therapeutic food. Do you feel that work has made a difference in recovery efforts? What else has your organization been working on?

Wolff: After the earthquake, we gave away 19,000 kilos of Medica Mamba not only to stranded children and orphanages but also to hospitals to help the people heal. They had been poorly nourished before the earthquake. Then the earthquake came and it took them a couple weeks to get medical treatment and then they get amputated because it's the only treatment available to them, and then they can't heal up from their amputation because they don't have good food.

We responded to the acute emergency by making and giving away Medica Mamba and kept up our malnutrition programs. We couldn't really start any new ones because everyone was so taken up with their grief and their rebuilding. Lots of people died, and lots of programs were disrupted. It took everybody about a year to get their feet back on the ground. In 2011, people started to get new programs and go back to their old programs. They were able to begin again to do what they'd done before.

To the credit of the big donors, like InterAmerican Development Bank and World Bank, they're going for big ideas, like education. USAID (the U.S. Agency for International Development), the InterAmerican Development Bank and the government of Haiti are working to put up an industrial park in the north, which is close to where we are, so that's going to employ a lot of people.

Does it feel like Haiti's been forgotten?

Wolff: It's not on the top of people's brains anymore, but actually, in a funny kind of way, more people are more savvy about Haiti now than they were before the earthquake. So even though people ask you a lot of questions, they're much more sophisticated questions than before the earthquake. They're more engaged intellectually with Haiti and the problems but maybe not quite so acutely emotionally. I don't find that people have totally forgotten Haiti at all. Fewer people call us, but when we call them, they know what we're talking about better.

What does Haiti need now?

Wolff: Jobs. Education. Everything depends on that. Education, training and jobs, and then everything will follow from that.

Kristen Hare