Some people talk about Haiti as being the graveyard of development projects.

The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.

But if you're asking my opinion, I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.

If access to health care is considered a human right, who is considered human enough to have that right?

We have to design a health delivery system by actually talking to people and asking, 'What would make this service better for you?' As soon as you start asking, you get a flood of answers.

Haiti is always talking about decentralization and nothing has been so obvious, perhaps a weakness, as the centralized nature of Haitian society as being revealed by the earthquake. I mean, they lost all these medical training programs because they didn't have them anywhere else.

The biggest public health challenge is rebuilding health systems. In other words, if you look at cholera or maternal mortality or tuberculosis in Haiti, they're major problems in Haiti, but the biggest problem is rebuilding systems.