Haiti and Disaster Relief

May 28th, 2013
A couple months ago the New York Times published an article about the disappointing progress of relief and recovery after the Haitian earthquake. Three years in, with nearly $10 billion donated, Haiti is still a mess: how can the international community have failed so badly?

The truth is, helping people in the aftermath of a disaster is extremely difficult. The resources of a healthy society that a charity could otherwise draw on are stretched to the breaking point or beyond. A major natural disaster like Haiti's earthquake can destroy the ports you need to bring in supplies and the roads you need to transport them. Hospitals that would be available are damaged or crowded beyond capacity. The government is overtaxed and past its ability to coordinate effectively. This doesn't mean that immediate aid is impossible, or that the need isn't great, but money spent after a disaster doesn't go nearly as far as it could if it were spent at other times or in other places.

Rebuilding after a disaster has less of these issues, but still has problems of its own. You're trying to accomplish twin goals: putting things back how they were before the disaster and making people better off. While these aren't generally at odds with each other, they're also not generally going to be best accomplished by the same projects. For example you might be dividing funds between building permanent housing and hygiene education. The housing clearly helps recover from the disaster while hygiene is working on a problem that, while certainly exacerbated by the disaster, was an issue before and is only partly related. Yet housing is very expensive for the amount it helps people while hygiene promotion is both cheap and effective. [1] This puts aid organizations in a very awkward position: people are donating because they want to help the people affected by the disaster rebuild and move on, but often the opportunities to help people the most are in other problems that existed before the disaster.

With this in mind, it is frustrating to read an article that in every tradeoff focuses on the negative, even to the point of arguing against both sides when a situation comes up repeatedly. For example, they first point out the harm of delay in school construction and transportation improvement:

Surrounded by half-built cinder-block walls, jutting rebar and piles of stone and sand, some 480 students cram into 10 makeshift classrooms illuminated only by the natural light that seeps through the gap between the partial walls and the tin roofs. Then, no strangers to life's setbacks, they trudge miles home over muddy, treacherous mountain roads as darkness descends.
Only paragraphs later, however, they object to the amount of aid money spent on:
... big-ticket, multiyear projects that were not directly related to the earthquake, among them improving the education system, developing agriculture in central Haiti and building roads all over the country.

Granting that much of the negativity of the article is warranted, however, in that the money spent on earthquake relief really hasn't gone very far, it's illuminating to look at GiveWell's blog post from the day after the quake:

According to the Disease Control Priorities Project, emergency aid is one of the worst uses of donations, despite being one of the most emotionally compelling. For more, see our post on the cost-effectiveness of disaster-focused aid.
In short, disasters aren't where you can do the most good with the money you can donate. The next time there's a major disaster, perhaps try to focus the emotion of the tragedy into giving to a well-reviewed charity working on a problem that is less likely to make the news.

[1] The NYT article cites an estimate that minimal houses, without plumbing or electricity, can be built for around $6000 per family. The Disease Control Priorities Project reports that hygiene promotion can cut the incidence of diarrhea in half with education costing an average of $1 per person every five years. (They estimate $3.35/DALY, and while I doubt it's actually that good it would be comparable with the most cost effective interventions at even 10x the cost.)

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