Guest post by Michael P. Murphy Jr. and Alan Ricks, MASS Design Group
The case is clear for how dire circumstances remain in Haiti since the earthquake and subsequent cholera outbreak. The preconditions for what Dr. Paul Farmer, founder of Partners In Health, calls an ‘acute-on-chronic’ crisis—an acute disease outbreak coupled with poverty, ill health, and low levels of education—are widespread. These barriers paired with nonexistent public systems for water and sanitation, and deforested terrain that increases flooding, created a landscape sinisterly ripe for the spread of disease. Cholera, a treatable, preventable disease, has already killed 8,096 and sickened 657,119 Haitians. Temporary tents for treatment were erected to respond to the disaster, but with best estimates predicting cholera will be in Haiti for at least ten years, the capacity of the tents and a response designed to be temporary is inadequate.
Visionaries such as John Snow and Frederick Law Olmstead first stemmed the tide of cholera and other communicable diseases some 150 years ago through urban planning and design interventions. While their strategies to improve sanitation, water, and spatial design became foundational to the growth of Western public infrastructure they were only sporadically implemented effectively in the global south. And today rapid urbanization, political hurdles, and financing practices present a territory that would be resistant to the type of mega projects envisioned by Snow and Olmstead. Cholera’s incidence in Haiti reveals a nineteenth century problem, but demands a twenty-first century solution that merges the disciplines of technology, architecture, and health.
Public water and traditional subterranean waste infrastructure—like we have in the United States—are monumental federal expenditures that are costly to implement and even more costly to maintain (between $3-5 trillion over the next 20 years). The Haitian government and international partners have outlined a ten year, $2.2 billion dollar National Plan for the Elimination of Cholera, but have struggled to raise even the initial $200 million to finance early programs for the next two years. Furthermore, many experts are beginning to challenge traditional sanitation and water infrastructure models, based largely on the analysis that merely halving the number of people without basic sanitation and clean water would cost a whopping $11.3 billion dollars annually.
A more viable and sustainable model for sanitation and water infrastructure development in Haiti and other developing contexts is needed to truly fulfill populations' rights to these necessary public amenities.
At MASS Design Group, we are working with Les Centres GHESKIO to construct Haiti’s first permanent cholera treatment center that will also treat up to 250,000 gallons of contaminated wastewater annually, serving a catchment population of 60,000. Serving a catchment population of 60,000, this prototype illustrates the potential to scale a decentralized model as not only a sanitation plan, but also a viable economic engine for job creation.
The creation of community sized public amenities would include community toilets, on-site outpatient care center for families in the surrounding area, and access to clean water. This innovation—coming from Haiti—of a decentralized, community-based model of a leaner, more efficient system represents a solution with global implications.
Michael Murphy and Alan Ricks are co-founders of MASS Design Group. MASS is a nonprofit (pending) social impact architecture firm based in Boston, MA and Kigali, Rwanda. MASS seeks to change the expectations and the practice of architecture by involving the community in its design process, using local labor and materials to transfer both economic and human capital to local populations, and advancing the model of public interest design globally. In Haiti, MASS has designed the GHESKIO Tuberculosis Hospital and GHESKIO Cholera Treatment Center, both of which are currently under construction.