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on July 12, 2011
Farmer is never more so at the top of his game than now in the newly released Haiti after the Earthquake. Poignantly written, Farmer articulates his first hand account of the January 12th earthquake. With detailed descriptions of the redevelopment efforts in post earthquake Haiti, Farmer simultaneously calls attention to the broken and empty promises and efforts made by the international community while celebrating the heroic efforts of so many in the hours just after bagay la (the thing). Noting the unpreparedness of the international community for such a disaster, the reader is able to not only sympathize but feel the immense frustration that so many on the ground felt in those first few hours. The second half, equally moving and inspiring, is told from others' points of view and reveals the hopes and dreams for a Haiti built back better. A must read for anyone interested in Haiti and the redevelopment efforts, or for those frustrated with the seemingly slow pace of reconstruction who are looking for optimism amidst the crushing rubble.
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"You have made the earth tremble;
You have broken it;
Heal its breaches, for it is shaking." -- Psalm 60:2 (NKJV)

Our church teams with its counterpart in Port-au-Prince to operate an orphanage there. Naturally, we've heard a lot about the terrible earthquake and its aftermath. In addition, our pastor has helped coordinate some relief activities as have some church members. They have added perspectives, too.

Because of the great respect I feel for Dr. Paul Farmer and his humanitarian work in Haiti and Rwanda, I thought it was important to find out what he recommends should be done in Haiti. I'm glad I did because he has provided a valuable document combining many perspectives on Haiti's history, its vulnerabilities, what happened during and after the earthquake, and prescriptions for how to build a better Haiti from the rubble and pain. My understanding greatly increased. I especially appreciated the comparisons to Rwanda, which is another nation that concerns me for which and for whose people I also regularly pray . . . as I do for Haiti and its people.

If you don't know any Haitians, you should get to know some. They are fine people who deal with problems in a patient way. They also want to create a better nation. And they can . . . but some changes are required.

It's not all heartwarming in the book. You'll read some things about some journalists and relief "workers" that may make you feel angry and sad. In addition, the scope of the misery and devastation portrayed (the reality, not a false perception) is broad and unrelenting.

But you can help make a difference.

Start by reading this book. Then, pick something you can do to help Haiti . . . and keep doing it for the rest of your life. I think you'll be glad that you did.
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on July 14, 2011
A heartbreaking account of the devastating earthquake that ripped Port-au-Prince. Farmer combines thoughtul analysis on policy and historic aspects that contributed to Haiti's precarious situation with on-the-ground accounts of the human deminsion of the tragedy. Sorrowful accounts that affect even the most harden. A great, and important, read.
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on May 16, 2012
I write about this with some ambivalence. Having been recently to Haiti for a reporting project on the aftermath of the earthquake, this book was a valuable first guide. It starts out very strong, evoking the carnage, the initial pulling together, and the incredible efforts of relief workers to save lives and locate bodies. There are some extremely moving essays by witnesses, many of them medical workers whose life work has been ruined or badly damaged. The death toll was almost unprecedented, some 300,000 died within the first weeks - it was one of the only recorded major earthquakes ever to occur in a capital city at 7 on the richter scale.

The first days occupy 120 pages. At first, I was with it, but after 70 pages it was almost too much. The book then degenerates into a helter skelter commentary that mixes policy, individual medical cases, and the personal efforts of the author, Dr. Paul Farmer of Harvard University. It is part lament, part prescription, part cry of anguish, part triumph, but leaves the terrible question of what can really be done. Not only is it difficult to get a clear idea of what is happening, but there are gaps in coverage, outdated observations, and factual errors. For example, in my reporting project, I was investigating the establishment an internal displaced persons camp, Corail, which was established as a temporary site but is becoming a permanent ghetto - they took homeless people there to avoid rain-induced mudslides, but it too is in a flood plane. Farmer said the project was considered and then unfortunately abandoned. Moreover, the role of the US military is barely covered, and they provided crucial rescue and medical services in the first 3 months, truly a triumph for American aid. Indeed, there is no clear idea about the policy questions raised, such as who was in charge, what the Haitian government did or could have done, and even what the options were. I know that it is easy to criticize in retrospect, that Farmer was pressed in the maelstrom of catastrophies about him, but I must mention these failures.

As I see it, there were several phases: 1) relief and rescue, body disposal, and peace keeping.; 2) preparing for the rainy season, largely by moving refugees into planned camps from makeshift ones; 3) redevelopment planning; 4) cholera outbreak; 5) stagnation of the effort. The most interesting part of the book for me was the example of Rwanda, where Farmer is also working to much greater success. Rwanda shows that positive outcomes are possible, though it is a cry of despair regarding Haiti. Now, a year after the book appeared, I can say from direct witness that not much more has happened.

I have no doubt that Farmer is a dedicated, indeed, great provider of services to those in need in lesser developed countries. That is why I feel reluctant to criticize this book, which has significant value as a first cut about what was done. But it is only a first step and badly incomplete. It is also written in his capacity as a deputy commissioner for the UN under Bill Clinton. As such, he had to be diplomatic and, I suspect, hold his punches. This is a pity.

Haiti represents a singular tragedy, in a nation plagued by mismanagement, greed, and rapine, the very definition of a predatory state. Only the victims are the citizens. As one observer said, the state isn't strong enough to do anything except exploit its own citizens. The earthquake caused so much damage in large part because the building codes were either ignored or circumvented by bribes. I left the country with great pessimism, at the paralysis of its leaders, the fragmentation of aid efforts, and the escalating violence in the streets. Farmer, who remains committed to the country, will no doubt continue his efforts. He is a remarkable public servant and I envy his intelligence and idealism, his sense of cause.
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VINE VOICEon October 30, 2012
I came to know Paul Farmer's work through Tracy Kidder's book, Mountains Beyond Mountains, which led me to admire Farmer but also to find him a little bit inaccessible in his intensity. I then read Farmer's own Infections and Inequalities, which I thoroughly enjoyed. So when I saw that Farmer had put together a book on Haiti's experience after the earthquake, I jumped at it.

The first two-thirds of the book are by Farmer, and while there are compelling elements, it felt like some of the content was extraneous. On the one hand, Farmer's account of arriving in Haiti immediately after the quake and working to make do in very difficult circumstances was compelling. His work with former US President Bill Clinton to marshal and coordinate resources from the international community, with all of the strange dynamics that entails, was also very interesting. He also includes a brief history of Haiti, which was interesting for me since it's been a while since I read anything on the country.

At the same time, Farmer includes a lengthy obituary of a co-founder of Partners in Health, Farmer's charity. He includes the story of rebuilding in Rwanda after the quake. Myriad characters file in and out, so many that I had trouble keeping track of who was who. Occasionally the book felt redundant. For example, some of the discussion of the US floating hospital, the USS Comfort, is repeated.

The last third of the book, essays by others who worked with Haiti at the time, has shining elements. Two of the essays alone are worth the book's purchase price. Edwidge Danticat, a Haitian writer living in Florida, writes in beautiful prose about the experience of the earthquake for those in the diaspora ("Lòt Bò Dlo"). She tells an amazing story of appearing on Anderson Cooper's news program the night of the quake, and a friend in Haiti watching it on his phone, thus seeing that the quake had not affected the whole world. I want my wife to listen to the audio version of this chapter alone, which Danticat reads elegantly. Timothy Schwartz recounts trying to coordinate donor agencies with wit and palpable frustration, and even manages to conjure a happy ending, a minor victory in the midst of great suffering ("First We Need Taxis").

Two of the other strong essays include Michèle Montas-Dominique's account of dozens of focus groups with regular Haitians. (Until I got to her chapter, I felt that the voices of ordinary Haitians were what this book missed the most. Her chapter went part of the way in remedying that.) Louise Ivers is one of the only people willing to actually level criticism. She discusses one UN hospital that rejected Haitian nationals. She also explores the role of militaries (such as the US army) in humanitarian disaster situations. It was a fascinating essay.

Others of the essays are weaker. Didi Bertrand Farmer writes about the plight of women in the refugee camps, highlighting the danger of rape. This essay held great promise, addressing a crucial issue, but fell short with too many generalizations and not enough examples to carry the weight. She mentions one woman who was repeatedly raped, and it's hard to tell from that the gravity of the problem. The final and weakest essay, Jéhane Sedky, has very little not already covered by Farmer, and seems to equate "building back better" (a great phrase coined by President Clinton) with paying public sector salaries, which has an important place but clearly of itself doesn't obviously lead to a great Haiti. (I'm confident Sedky knows this, but it's weakly expressed.)

The audiobook is capably read. Many of the essays by women are narrated by Meryl Streep. While I'm a big Streep fan and her reading is certainly capable, her reading is not as exceptional as her acting. It's solid, but she's not Jim Dale (whose narrating exceeds his acting).

Read this book. But if you get bored, skip ahead to Danticat, to Montas-Dominique, to Ivers, and definitely to Schwartz. Don't give up before the good parts.
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VINE VOICEon September 30, 2011
Dr. Paul Farmer, Partners in Health and its sister Haitian organization Zanmi Sante, have transformed health care delivery in rural Haiti. When the earthquake shook Haiti to its very foundations in January, 2010, Farmer and his colleagues were jolted out of the "comfort zone" that they had established in and around rural Cange, and were confronted with the need to respond to the overwhelming acute medical needs that the earthquake had created in urban Port-au-Prince. This book represents Dr. Farmer's reflections one year after the earth-shaking event. His thoughts are supplemented beautifully by colleagues who were impacted in their own way by the ramifications of the earthquake.

Farmer speaks authoritatively from a variety of perspective - as head of a successful NGO, as the Deputy to Bill Clinton in the UN's Office of the Special Envoy to Haiti, as a expert in public health and epidemiology. The book sheds light on many of the decisions and actions that were taken in the hours and days after the earthquake, and the ongoing struggle to respond to what Farmer call an "acute upon chronic crisis" in helping Haiti move from rescue and recover to "building back better." For those of us who love Haiti and its people, this is a "must read" book, for it chronicles with great detail the ways in which the Haitian government, the U.S. government, the international community and NGO's interact with each other. The author has strong opinions about how things should work going forward, so the book is both descriptive and prescriptive. One would expect nothing less from a physician than for him to sign his name to a prescription pad to help alleviate Haiti's suffering.

Like the history of Haiti itself, this memoir is a mixture of despair and hope. I recommend it highly for anyone who wants a glimpses behind the curtain of what is happening (and not yet happening) in re-building Haiti.
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on April 16, 2014
I am a frequent visitor to Haiti representing a mission that helps children with scholarships to school and provides lunches for them. What I've found over the years is how hard it is to understand the culture. It is always great to read different opinions of how things are going. It's hard to imagine how bad the earthquake was or how big the challenges are. Paul Farmer has assembled a number of views of the post earthquake scene in Haiti by people who are very close to the situation. It is refreshing to see the Haitian people wanting to develop their nation in their own unique way. Sometimes this looks rather chaotic to outsiders, but how can they ever feel proud about themselves if they don't do it themselves. Farmer's book gives us glimpses of this and doesn't paint an overly pessimistic picture.
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on June 3, 2014
A loving documentary of a troubled people and raped environment. Farmer takes the first hundred or so pages to layout his compassion for his adopted people and his absolute frustration with the carrying out of rebuilding a post-quake society and a highly disparate culture: Living in the squalor and misery of filth, degeneracy, lies, malaise, self-righteousness, a self imposed poverty, disease - cholera & malaria & tuberculosis, unorganized, superstitious, hopeless, hapless, transplanted indigenous people. Looking at the current CIA website for a current estimation of the counties viability it is said to not be a place that normal civilians should choose go. Paul Farmer and his cadre of committed writers and leaders are too few and too apolitical to really make the changes wanted but unobtainable. Even the Harold Hill of the Clinton Foundation has not seemingly dented the hurt, pain, death, discouragement, and destituteness that is Haiti.
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on October 3, 2014
We know this author from his previous works. What a good man he is and always in the thick of trouble helping others in need. His story is good and tells it without frills. We need more Paul Farmers in the world. His life was very interesting, and he grew up, not a person of privilege but a person who was raised to be good and decent. If asked who I would like to meet nowadays, I would say Paul Farmer. He is right up there with other heroes
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on February 26, 2016
Loving such a sad story is strange. But Farmer is such an expert in his subject - Haiti - and was so involved in the recent history that this book is a page turner. I learnt so much about Haiti and could relate to the places I've been to. This story makes you wonder how so called "AId Organizations" and International Development should work and what is their real effect where they operate. Sometimes eye opening, the book is essential to understanding modern day relations with poor countries.
A must read for anybody either interested and travelling to Haiti or wanting to understand modern international Aid.
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