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Killing with Kindness details various problems with the delivery of official development aid through partner NGOs. The following is a draft "white paper" for the U.S. government to reform USAID. Haiti is a highly visible example of the need for structural change.

Principles for aid reform

The response to Haiti's devastating earthquake demonstrated a solidarity and generosity never before seen. According to the Chronicle on Philanthropy, private citizens contributed $2 billion to nongovernmental organizations (NGOs), coming from 60% of U.S. households and an estimated 80% of African American households. This generosity was matched by the U.S. government, pledging 1.8 billion in the relief, recovery, and reconstruction effort.

However, as recent articles from the New York Times and Associated Press have documented, promises have not yielded commensurate results. The response to Haiti?s earthquake provides some key lessons and reforms in policy and implementation of USAID and partner NGOs.

  • USAID should strengthen the public sector. According to the UN Special Envoy for Haiti, only 1% of emergency relief aid from January 2010 to June 2011 went to the Haitian government.
  • USAID funds should promote a democratic decentralization process. The Martelly government, citing the expiration of terms, is replacing all elected mayors in the country except for two municipalities, Delmas and Pétion-ville. This provides the Martelly administration with people close to their interests in implementing key decisions while the electoral process continues to be stalled. Meanwhile, there are 565 communal sections, each with an elected council and administration. This most local division is the most likely place for local projects to succeed, given the social ties between elected officials and the population through civic, neighborhood, peasant, and religious organizations, which is one reason this level was selected for the Haitian government?s Katye Pam Poze. Funds can be scaled up after successful completion of smaller projects, and local governments graduated to be regular partners in development projects.
  • When it deems necessary to directly fund NGOs, USAID should fund the public regulatory agencies to coordinate this aid. For example, the Haitian government agency DINEPA coordinated NGOs to obtain full coverage for water and sanitation (WASH) services in the camps in Cité Soleil. Left to their own coordination, NGOs only provided WASH services to an additional 1% of camps in other municipalities in the Port-au-Prince metropolitan area.
  • USAID should demand greater participation of the beneficiary population and local governments in recipient NGO projects. NGOs are increasingly the focus of public protests by beneficiary populations, in camps as well as low-income neighborhoods in Port-au-Prince. Generally beneficiaries? concerns involve lack of satisfaction of needs, failure to deliver on promises, and exclusion of beneficiary populations from decisions.
  • USAID should amend its procurement requirements to allow local firms to obtain primary contracts. According to the Center for Economic and Policy Research, only 2.5 percent of USAID reconstruction funds went to Haitian firms. Local job creation is one of eight pillars of the UN Office of the Special Envoy for Haiti?s long-term approach. In addition to being more cost effective, the money would be invested in the local economy and build local capacity.
  • Local procurement is especially important in food aid. Many studies have demonstrated how U.S. food aid destroys local production. In March 2010, former president Bill Clinton publicly apologized for these policies, arguing that they didn?t work. However, this apology did not translate into action.
  • USAID and partner NGOs need to have greater transparency, particularly to beneficiary populations and local government. The Haiti response has been stymied by a lack of consistent information to the general public, especially Haitian actors. According to the Disaster Accountability Project, only one out of 196 NGOs surveyed provided an adequate amount of information on their website. Some improvements have been made in sharing information with the Haitian government. After efforts from the Ministry of Planning, including publishing a list in the newspaper, the percentage of NGOs who gave their annual report to the Haitian government has increased from 10-20 percent annually to around 50 percent. Beneficiary populations are still ill informed, which might explain their increasing tension and frustration.
No action steps are yet available, but interested people can visit the Haiti Advocacy Working Group's campaign on Aid Accountability: haitiadvocacy.wordpress.com/
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Paul Farmer, from the foreword

"Dr. Schuller’s book suggests new rules of the road for foreign assistance. His prescriptions are the result of dedicated fieldwork and years spent in Haiti living with Haitians, learning their...