Q&A with Dr. Florence Guillaume: Engaging the Private Sector in Haiti

Editor’s note: The MSH Santé pour le Développement et la Stabilité d’Haïti Project—Pwojè Djanm (“robust project” in Creole) contributes to better health for more than 4 million Haitians, with funding from the US Agency for International Development (USAID). An all-Haitian team is working to increase the availability of health services, reduce internal conflict, nurture livelihoods that contribute to Haiti’s economic development, and build capacity as the foundation for progress. Dr. Florence Guillaume, the Deputy Chief of Party, talked to an MSH reporter recently about how public-private partnerships advance this work. The Global Development Alliance is a USAID mechanism to mobilize the ideas and resources of development partners for greater impact on health. Q: What is the Global Development Alliance (GDA) initiative, and what is the corporate social responsibility aspect of it in the context of Pwojè Djanm? A: In Haiti, we have a private sector that is not really involved in the social sector, and we are trying to sensitize the commercial private sector to make it more involved in social responsibility. Q: Where did the idea come from? A: When we were implementing the earlier project, we thought—in the context of sustainability—about not just involving health NGOs but also getting representatives from the commercial private sector interested in health improvement in Haiti and finding a way for them to invest in the social sector. Even though businesses in Haiti are not really used to this, by talking to people we found out that some organizations were willing to invest in the social sector but didn’t know how to do it. So we had a lot of discussions with USAID. They thought it would be a good idea to try to use the Global Development Alliance experience in Haiti. Q: Are there any specific criteria for involvement from different private-sector organizations? Does an organization need to be in certain geographical areas or have a certain part of its mission dedicated to health, or does it just have to have money and want to do something good with it? A: There are no criteria. We are really open. The first thing is for these organizations to be willing to invest in the social sector and then we will find their area of interest—health, education, safe water. Everything can improve our impact in health because, for us, health is not only service delivery and medical care; health is broader than that. We see health in the context of health for development. That’s why we came up with the project’s name: Health for the Development and Stability of Haiti. Q: Once the organizations are sensitized to the situation, what are the goals of the GDA initiative? A: The ultimate goal is to have the commercial private sector understand that if you are investing in your environment, in the community, your investment will be more secure. And if you are creating economic growth in the community, you are also creating more opportunities for your business. Q: What are some of the visions for how this initiative will help individual Haitians? How will the people in the village or the slums see the results of this? A: I think it will be a relief for them because they will see that they are not alone.
Q: How does this initiative fit with the goals of USAID? A: I don’t think it’s only USAID goals, but it feels to me that the entire external assistance concept [foreign aid to developing countries] is changing. People want to help but they don’t want to help as a charity; they want to help for development. So it will be better, not only for USAID, but also for the European donors, to see that foreign people care about Haiti—and that Haitians also care about themselves. Q: Much more of a partnership? A: Yes. And because of the political crisis we are facing in Haiti now, it seems to me that the state doesn’t have the capacity to respond to all Haitians’ needs. It will be more secure to have private corporations or even individuals who have money involved in the social sector. And because there’s a gap between what the government of Haiti wants to do and what the commercial private sector covers, this will create a bridge. It will help everyone to see the same vision: that we want all the people of Haiti to have the capacity to access health, education, and nutrition in a green environment and have safe water. That vision will improve investment, not only from Haitian businesses, but also from foreign corporations. It will create stability, so it’s really a win-win strategy. Q: Is the Haitian government comfortable with this? Do they support it? A: Why wouldn’t they? In fact, we found out that some commercial private-sector organizations are not routinely paying their taxes, so we thought it might be a good strategy to propose to create a social agreement between the government and the private sector for repayment. Just to give you a concrete example, maybe over the next five years, the business could make social investments approximately equivalent to their owed taxes. A business could choose a sector to invest in—education, health, safe water, environment, sanitation—and provide for example, 50 latrines in an area. We would try to estimate the value of those 50 latrines, and it would be deducted from what the business owes. But we are not at this point yet. Q: Has the private sector ever been engaged like this in Haiti? A: Some of them, but in an ad hoc manner. For example, you might want to build a school, so you sponsor a marathon as a fundraiser, and then you get people writing checks for $500. But the thing is to have more planned social investment.
Q: How important is the planning aspect? A: Very important! Sometimes you get the school as a donation, but you do not have the teachers, the books, and so on. You have only another empty building. Q: What makes you think Haiti and/or the public and private sectors are ready for this? Why is it a good time for the initiative? A: That’s a good question. Personally, I think in every crisis there is opportunity. It’s true that we are facing a kind of national crash, but it’s also something that we can use to make people more conscious about what is happening in their environment. Q: How has the private sector responded? A: You know, they are slow in action, but I can see that they are aware of the importance of the issue. And that’s a very big step. They are not really feeling that they can move yet from talking to action. But they are coming up with very good ideas. Q: What are the mechanics of the interactions working now? How are they happening? A. MSH has a partnership with one of Haiti’s two largest banks. We have also talked with a large cell phone company in Haiti, and they are willing to help improve communications between health facilities. Because of bad roads and difficult geography, it can be difficult to refer patients to other facilities, particularly for emergency care. A patient might leave one facility to go to another one, but when he or she arrives, there’s no doctor on duty and the patient needs to either go back to the first or try again at another facility. It’s very difficult and lost time can endanger lives. With a reliable phone connection, it will be easier to tell patients, “Don’t go there, the center is closed.” We have a plan to include the Haitian diaspora by using not only the commercial sites—particularly the US Unibank branches—but also the Haitian embassies or consulates in Miami, New York, New Jersey, and Boston. Q: How does this initiative relate to the GDA in Washington? A: We thought we would ask the GDA to come here and hold a conference with the commercial private sector to educate them about the GDA. But we found out that before having the experts come to Haiti, we needed to create a vision of what we want to do. Then we will ask for other people to come, show them what we want to do, and ask: “Can you show us the best way to achieve our goals?” Q: What are some of the challenges you’ve faced so far? A: One is a loss of momentum; that’s the biggest one. It’s difficult to sensitize people on one hand and to have what is happening now [rioting]. It’s difficult to keep momentum while businesses are saying that they are losing all their investment. Also, the community is no more patient than they were before, so they are living with a situation that is constantly in some kind of emergency. We are acting in the context of crisis, so everything seems urgent. On the other hand, I’m not sure that politically we understand yet that there’s a new relationship among the health, business, educational, agricultural, and environmental sectors. It might be difficult when we are at the stage where we are asking for larger investments. For example, in education, the other sectors might be against support for education because they worry about their own part. They might not have an integrated vision.
Q: And how are you trying to address this? A: Whenever we are working outside of health, we make contacts with representatives who can bring the other perspectives. But I really think that before having that kind of global vision of things, we need at least to do our part. If we cannot complete the song, at least let’s do one line. Keep working hard, keep dreaming. Let’s do it line by line, and maybe one day we’ll have the song. Examples of Private-Sector Partners