In 2015, Fonkoze’s CLM team launched a pilot designed to evaluate whether our approach can help persons living in ultra-poverty who are also living with disabilities. We undertook the experience in partnership with the office of Haiti’s Secretary of State for the Integration of Persons with Disabilities. Our close collaborator and largest source of financial support for the undertaking was Texas Christian University. It was a great experience.
Prior to that point, our official position was that our program could not serve those with disabilities. We thought that they needed extra or different supports that we did not know how to provide. Haiti’s most excluded citizens – rural, ultra-poor, and disabled – were thus excluded, in principle, even from CLM.
In practice things were more complicated. Since the only criterion for exclusion from the program that we could apply to disabled persons was whether a woman whom we were considering would be able to do the work, our field staff was left to make decisions on a case-by-case basis. We would come across a mother who was hard of hearing or had limited use of one of her hands or partial immobility, and she’d end up in the program. And that’s just physical disabilities. We had no tool to diagnose intellectual disabilities – we still don’t – so women with such problems would enter the program and go as far as their own and their case manager’s intelligence and imagination could take them.
The pilot allowed us to spend time focusing on how our approach works with persons with disabilities. We reviewed it extensively, releasing two detailed evaluations. And we learned some important lessons. We concluded that we should make finding and working with persons with disabilities a goal of our program, as long as they are poor enough to qualify otherwise. We added looking for them to our selection process, and now work with them as part of our cohorts, even if they are without dependent children and even if they are men. Otherwise, our program serves only women with children.
It can be challenging for our case managers, who do not have special training for these cases. Our team knows how to access adaptive materials – like crutches, wheelchairs and walkers – from the Secretary of State’s Office or from Partners in Health, and we can link members to physical therapy where it’s appropriate, but otherwise members and their case managers have to face the obstacles that disabilities create the same way that they face all the other obstacles – whether unique or common – in the lives of those living in ultra-poverty. They sit across from one another, thinking about specific solutions to specific problems, and then work hard to make them succeed.
We are halfway through our 18 months process with a very small cohort of 50 women who live near downtown Lascahobas, the commune immediately to the east of Mirebalais. There are no men in the group, but four of the women have disabilities of various sorts. In three cases, they have mobility issues. One woman is missing part of one of her legs, a second has a partially paralyzed leg, and the third has a slightly misshapen leg that leaves her limping on one shorter leg and one that is longer. As they sit in the circle at a three-day training workshop, the three are hard to distinguish from the other women. And that’s also true of the results they have achieved in the nine months they’ve been with us so far. They have made more or less progress, depending on their effort, their planning, and their luck, but nothing really sets their situations off from the range of situations experienced by others in the group.
Hermite is a little bit different. She is blind. She lives in a very small, very shaded yard with her three children. A slight, light-skinned woman, she rarely roams very far. When you ask her how things are going she says that things are good. And when I press she explains that even though her pig died, her two goats are pregnant. She is also living in a new house, with a good tin roof, so she is no longer drenched by the frequent tropical rains, and she and her children have a latrine to share.
More important has been the change she’s seen in her younger children’s health. Both of her younger ones, a four-year-old girl and an infant boy, were diagnosed as severely malnourished. They were at risk because Hermite could not keep them fed. We referred them to a clinic run by Partners in Health in downtown Lascahobas, where they were treated with fortified peanut butter. After a few months of weekly visits, both children were pronounced healthy. This success story is all the more amazing because Hermite would not take them to the clinic herself. She is accustomed to thinking that she couldn’t because she is blind. Instead, she would send them in the care of their under-sized 11-year-old sister, who would carry the baby in one hand and guide the little girl with the other on the long walk to the clinic and back.
But there is a lot to be concerned about, too. Hermite says that her goats are pregnant, but she doesn’t really know. They are not in her care, but in that of her children’s father. It isn’t uncommon for women’s partners to help with the work. In fact, it can be ideal. Women with good partnerships have a much easier time of things. A man who manages some of the assets we provide can free the CLM member to focus on other things. But in Hermite’s case, it seems less like an sensible division of labor than a reaction to a belief by both of the that Hermite’s blindness means she couldn’t do the work herself. And we had experience with a blind program member during the pilot that proved that it’s just not true.
Moreover, the man turns out to be part of her problem in other ways. Hermite is not his only partner. He has another woman nearby whom he seems to consider to be his wife, though he is probably not married to either. That other woman receives the larger measure of his support, even to the point that we suspect that resources that we are making available to help Hermite end up leaking into the other woman’s household through him.
He makes most of his money by buying wood and turning it into charcoal for sale. He borrowed money from Hermite, promising to use it to create steady revenue for her in his charcoal business. When Josiane, Hermite’s case manager, didn’t se the revenue materialize, she asked some questions. He claimed to have used it to buy a door for Hermite’s new house, even though the other CLM husbands in the area had all been able to get a door on the new homes using their own resources. This should have been especially easy for him because he himself earned much of the money that we set aside for construction of her home by doing work himself, rather than hiring a builder.
The lack of independent revenue is especially troubling, as is Hermite’s resignation to the fact. She is a member of her local Village Savings and Loan Association, and the rules of the association stipulate that she buy at least one 50-gourd share per week. That’s less than $1, and she reports that she can go a week or two at a time, unable to scratch together the money to buy a share. What’s worse, she reports that food is still sometimes scarce around the house. And with her young children just recovering from malnutrition, that is especially troubling.
Josiane thinks that the solution would normally be small commerce. Even quite a small one could net her 50 gourds a week for savings and help feed her kids. But Josiane worries that it will be difficult for Hermite to manage one if she can’t see either her merchandise or the money she’s paid with.
But we know that she can do other tasks that one might expect to depend on good eyesight. Her neighbors tell us, for example, that when Hermite does her laundry, she can be counted on to get all the stains out. And there are sorts of merchandise that one could control without vision, and denominations of Haitian money that are hard to mistake.
So Josiane is committed to working with her during the nine months that remain for her in the program to help her develop a model. We feel a lot might depend on her success.