Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers

Abstract

Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants’ conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst’s (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster.

Pandemic Surveillance and Racialized Subpopulations: Mitigating Vulnerabilities in COVID-19 Apps

“…The UNESCO ( 2020 , 2) statement on COVID-19 recognizes that in times of pandemic “vulnerable individuals become even more vulnerable.” Preliminary evidence has shown that vulnerable groups such as racialized people are among those most negatively affected by the COVID-19 pandemic (Office for National Statistics 2020 ; Covid Tracking Project 2020 ). Importantly, scholars of vulnerability (Enarson 2012 ; Hunt et al 2015 ; Durocher et al 2016 ) have argued that responses to disastrous events which do not carefully interrogate vulnerability in the target population risk exacerbating the vulnerability of already marginalized subpopulations.…”

Decentralized humanitarian aid deployment: reimagining the delivery of aid

“…In the Haiti earthquake response of 2010, aid workers experienced the aid magnet phenomenon first hand. They could not distinguish the state of need between those directly impacted by the quake and those who were attracted from outlying areas to the centralized aid deployment near Port-au-Prince because of their existing high states of vulnerability (Durocher et al, 2016). This magnetic connection between centralized aid infusion and disaster migration needs to be presented as highly plausible.…”

“…Since there is minimal, direct research on this supporting point, it will not be a goal to prove this explicitly. Durocher et al (2016) also noted a concerted effort by foreign NGO's to work in a vacuum and recommends replacing these highly reactive interventions with more deliberate and planned mechanisms. "Circumventing local structures may have led to greater short-term efficiency but participants, both Haitian and expatriate, saw this approach as a missed opportunity to reduce future vulnerabilities" (Durocher et al, 2016).…”

“…Durocher et al (2016) also noted a concerted effort by foreign NGO's to work in a vacuum and recommends replacing these highly reactive interventions with more deliberate and planned mechanisms. "Circumventing local structures may have led to greater short-term efficiency but participants, both Haitian and expatriate, saw this approach as a missed opportunity to reduce future vulnerabilities" (Durocher et al, 2016). NGOs made many promises after this disaster to improve local participation but the inequity created by a history of resource centralization was not supported by any change in their governing policies (Hsu and Schuller, 2019).…”

Pediatricians and Global Health: Opportunities and Considerations for Meaningful Engagement

“…27 -31 For instance, in response to the 2010 earthquake in Haiti, practitioners with no previous experience in Haiti, humanitarian relief, or resource-limited settings provided no-cost care outside the Haitian health infrastructure, resulting in a temporary loss of work for many Haitian practitioners and a burden on the local health system that was left to provide follow-up care. 32,33 An influx of volunteers presents an added burden on infrastructure with visitor needs of housing, water, food, sanitation, safety, and other logistic support.…”