FOR THE PEOPLE, FOR A CHANGE: BRINGING HEALTH TO THE FAMILIES OF HAITI

By Ary Bordes and Andrea Couture. Beacon Press. Boston, 1978. Out of print.

Note, it's an old book--published 11 years ago, it's events taking place between 1965 to 1975. Consequently if you want to get a copy you'll no doubt have to order it, your local book store is not likely to have it.

Review by Bob Corbett
Aug. 24, 1989

This book is the story of the work and rise in fame of Dr. Ary Bordes, a Haitian physician. In the mid-60s Bordes decided to dedicate his life to improving the health of Haitians and introducing family planning to Haiti. The ten year period of the book follows him from his initial work with his clinic in Port-au-Prince through major foreign grants, especially from family planning groups, into the Cul de Sac (just outside Port-au-Prince) where he develops an impressive model program, and finally hinting at the after-1975 period when Haiti attacks a national health and family planning program, much indebted to Bordes work.

This brief cold description doesn't explain what's so extraordinary about this book. The form is a book of 14 chapters. Each chapter begins with some short quote from Ary Bordes. The rest is his story as told by Andrea Couture. His statements are often simply fascinating, and Couture writes as well about Haiti as anyone I've ever read. In fact, her first chapter is a simply wonderful description of the everyday life of the Haitian peasant. The book is worth it just for chapter 1, which has virtually nothing to do with health care.

What I found simply so fascinating I could hardly put the book down, was the detailed story of how Bordes' work grew, and what impressive successes he had in the Cul de Sac work. His attitudes toward development and international developers is one I share in the main and found his positions exceptional.

I have just finished a very long paper on international development theory, which essentially, in more detail and with more argument, says what Bordes says so well in chapter 10:

"I think that what Americans, or people who want to help, should not do is to come and do for us. They should find out who are the Haitians that can do the job--and help them do it. There are many jobs to be done, and Haitians ready for them. There are Haitians frustrated because they cannot do what they would like to do. They see a lot of people coming and doing instead of helping them to do. This to me is the attitude to take: know that in every country there are enough civically-minded people desirous to change the country and if you want to do something--find them; them them. Development is a national endeavor; only the nationals of a country will develop the country. If external development comes, it will be for the benefit of the external forces. The world is not idealistic and people do not give usually...very few people give for nothing. Usually it is give and take. But someone who is trying to give, should be trying to push toward self-development. It is more time-consuming, but more lasting."

Despite my rave attitude toward this book, I am cautious about much of it and don't even believe significant parts of it. No matter. The book is better than its flaws. But, just to record some of my own suspicions so that you not think I'm too naive!:

• Couture was really blown away by Bordes, much like Amy Wilentz was by Father Aristide. This is a book about Saint Ary Bordes, and like much hagiography it is a ridiculous exaggeration of his saintliness and his achievements.
• Bordes' own position that aid is best channeled through Haitian government and power structure channels is a position I think is dead wrong. However, his argument against private aid on the grounds that it is too scattered, often does harm and has little chance of becoming national policy is certainly true. If only there weren't all those thieves in the government!
• The book is a gradual crescendo toward Eden itself. It reminds one of Ravel's Bolero, gradually rising to the skies. Yet health care in Haiti is in total shambles. The "Bordes" model did not take, if it ever did.
• Couture writes as though Bordes is the only humanist in Haitian medicine, yet, does allow that he was not even in on the final planning of the national health plan, which she credits almost single-handedly to him. Contradictions.

And on and on and on. The book must be taken with a whole box of salt. Nonetheless, Couture's ability to record the struggles of introducing health care and family planning into such a primitive culture is spellbinding.

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