“But if you're asking my opinion, I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.”
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Haiti is always talking about decentralization and nothing has been so obvious, perhaps a weakness, as the centralized nature of Haitian society as being revealed by the earthquake. I mean, they lost all these medical training programs because they didn't have them anywhere else.
Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care.
Civil and political rights are critical, but not often the real problem for the destitute sick. My patients in Haiti can now vote but they can't get medical care or clean water.
If you look just at the decades after 1934, you know it's hard to point to really inspired and positive support from outside of Haiti, to Haiti, and much easier to point to either small-minded or downright mean-spirited policies.