"Political instability and poor governance [are] the most important drivers of failure from which all other negative consequences follow."
Building roads, school, and hospitals is relatively easy compared to maintaining and running them. The latter takes an educated bureaucracy to manage the never ending tasks associated with governing and running institutions.
Sixteen thousand civil servants were killed in the earthquake, more than 20% of the country's public administration workforce. There is joke in Haiti that those killed were the most dedicated employees as they not only bothered to show up for work, but were still there late in the afternoon when the earthquake hit.
Powerful elites limit institutions because the institutions usurp the elite's power. Instead the elites create patronage networks, based on loyalty to the elites.
Eighty percent of Haiti's college graduates flee their homeland "for the brighter future of elsewhere."
Non-governmental organizations (NGOs) provide 75% of the health care in Haiti.