UWM Anthropologist Advises Policymakers on Haiti and Health Care

Paul Brodwin MILWAUKEE — It isn't often that a scientist with extensive field work experience in a foreign country has the opportunity to advise a group of heavy-hitting policy makers.

Paul Brodwin, associate professor of anthropology, got his chance in September when he was invited by the U.S. State Department to address the new ambassador to Haiti, his staff and officials from throughout the U.S. government, including the U.S. Agency for International Development (USAID). The group decides how best to use U.S. aid money for health care and economic development projects in that country.

Brodwin, an expert in Haitian religion and medical anthropology, said he felt honored to speak, but also a sense of responsibility. "Because of their commitment to grass-roots culture, anthropologists face delicate ethical issues when talking to powerful political figures," he said. "I had to make sure that nothing I said could be used to harm the people who helped in my research and the communities where I worked."

He also had the task of explaining that many aid programs fail because they lack cultural sensitivity, especially in Haiti where religious beliefs are held deeply.

"The first thing they should ask is, ‘What were the local people doing first (before the aid was available)?'" Brodwin said in an interview after his trip, "because success of any program depends on incorporating that. The point of this lecture was to underscore the importance of integrating traditional practices."

Haitians strategically use religion to make life more bearable in a resource-poor and politically volatile country, he said. They also view it as more reliable than state, foreign or charitable organizations' programs. For example, the network of Pentecostal churches throughout the world affords opportunities for Haitian church deacons to emigrate, earn a living elsewhere, and send badly needed money back to their families in Haiti.

Becoming a Voodou practitioner - means perhaps earning a living as an herbalist or midwife. By joining a Catholic parish council a person can learn how to keep a budget, run a meeting, or pursue outside resources for the village.

To illustrate this, Brodwin shared his personal experiences in Haiti with the government group.

He related how a multi-year USAID project which planned to build a network of dispensaries around the countryside in the early 1980s replaced a village pharmacy coop that had been launched by a local Catholic priest. Within months, money coming from the Haitian government dried up and the villagers were left with less than they had before.

"In this instance, an American-funded development project subverted a well-running local institution," said Brodwin.

One success story he told the gathering concerned a respected Voodou healer in a small village near Les Cayes. The healer was enrolled in a USAID-sponsored program to train local midwives to deal with medical complications during pregnancy and labor, and to recognize when hospitalization would be necessary.

After the training, she was called upon to determine the ailment of a woman in labor who had gone into convulsions, correctly identifying the problem as eclampsia in time to get her to the hospital. The training paid off, said Brodwin, because the villagers already trusted her and were willing to listen to her new-found knowledge.

Brodwin's more current research centers on bioethics and the link between morality and wellness: how people wrestle with moral questions in health care and how religion affects their health care choices. He also is a co-investigator on a study of genetics and identity politics for the National Human Genome Research Institute. For more information on that study, log onto www.bioethics.umn.edu/genetics_and_identity/.

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