By Roger Annis, October 26, 2011
The latest bulletin of the Office of Coordination for Humanitarian Affairs (OCHA) (1.) of the United Nations presents an alarming description of the health conditions and trends in Haiti's earthquake survivor camps and in overall cholera treatment and prevention in the country.
Health indicators in the camps are declining as international organizations end their funding of health promotion programs. According to the latest survey of 626 camps (two-thirds of the total number of camps) by the National Directorate for Water and Sanitation (DINEPA) of the Haitian government and the Water, Sanitation and Hygiene (WASH) cluster of Haitian and international organizations, access to potable water, sanitation and hygiene services is declining.
In August, only seven percent of the surveyed camps had access to clean water, compared to 48% in March. Out of 12,000 latrines needed, only 4,579 (38%) were functional. Many desludging activities (cleaning of latrines) ceased at the end of August for lack of funding. Drainage infrastructure in the camps is deteriorating.
Available hand-washing stations in camps have reached their lowest point since the cholera outbreak in October 2010. Only 12% of camps have them, compared to 20% in March. In August, 29% of camps had at least one organization promoting hygiene, compared to 36% in May.
Across Haiti, only 54% of people have access to safe drinking water and 34% to sanitation (latrines).
Food insecurity and children without schools
The OCHA report also looks at other social indicators of health.
According to a national survey conducted in April and May of this year by the National Coordination for Food Security in Haiti, 4.5 million Haitians, approximately half of the population, is food insecure. (The definition of food security is a subject of much debate in development circles; a simple definition is "when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active and healthy life.") That's up from somewhere between 2.5 and 3.3 million people one year ago, according to an emergency survey conducted at the time.
Nearly one million people have no regular access to basic food staples.
The decline in food security is attributed to many factors, including:
- Increase in food prices (Haitians are almost entirely dependent on market purchases for their food)
- Loss of agricultural production due to Hurricane Tomas, which struck in early November, 2010
- Disruption to agricultural production and marketing due to the cholera epidemic
- The departure of growing numbers of humanitarian organizations from Haiti
Seventy six percent of children in displaced persons camps are in school. But that figure drops to 48% in the earthquake zone (Port au Prince commune). Three hundred and sixty schools damaged by the earthquake are still requiring debris removal to be functional; another 500 operate under heavily deteriorated tents. That's more than 20% of Haiti's estimated 4,000 schools.
Only 18% of damaged schools have been rebuilt or rehabilitated. The OCHA report states, "Many parents cannot afford to buy learning materials, and schools are overcrowded and in poor condition, often without proper water and sanitation facilities, exposing children to the risk of cholera and other epidemics."
The worsening conditions in the camps was the subject of a one-hour press teleconference hosted by the global health agency Partners In Health (PIH) on October 18. It reported a sharp decline in the number of international organizations providing assistance for cholera treatment and prevention in Haiti - from 128 in January of this year to 48 in July.
The cholera epidemic is placing a severe strain on the financial resources of PIH and the other, large international organizations providing treatment and prevention (including Cuba's medical mission and Doctors Without Borders). In July alone, PIH's Haitian partner organization, Zanmi Lasante, treated 12,629 cholera patients.
Close to half a million Haitians - 5% of the population - have contracted cholera. More than 6,500 have died.
According to an Oct. 19 financial appeal issued by PIH, the organization has a two-pronged approach to cholera treatment. In the short term, it consists of:
- Finding cholera victims where they live and treating them at well-equipped, well-staffed facilities Giving people the information they need to protect themselves, to know when they've been infected, and when, where, and how to get treatment
- Providing emergency access to clean water and sanitation (latrines) to communities in most dire need
- Launching a pilot oral vaccination program for 100,000 people, an emergency, live-saving measure that complements longer-term efforts. (One estimate shows that 30% vaccination coverage in Haiti would decrease cholera cases by 55%.)
DINEPA is stepping up its distribution of water purification tablets as it revises optimistic expectations that the cholera outbreak would be under control by now.
The PIH financial appeal urges readers to demand that the international and Haitian governments assist in providing clean water by digging wells, capping springs, build safe water systems on a national scale and treat waste through widespread access to latrines and waste treatment facilities.
PIH is also demanding that international donors live up to their financial commitments to earthquake recovery made at the Mar. 31, 2010 international donors conference in New York. At that time, $4.6 billion in pledges for recovery in 2010 and 2011 were made by governments and UN agencies. To date, only 43% has been delivered or committed.
Dr. Paul Farmer, Partners In Health's founder, told the Oct. 18 conference call: "Some years ago, PIH and many sister organizations began talking about the right to water. We did so because those of us who are clinicians, we can sit in our clinics and work in our hospitals and wait for people to come in sick with complications of water-borne diseases, or we can work with public authorities and appropriate NGO partners and others to build real water security in Haiti. We've been sounding that drum for some years now."
Roger Annis is the coordinator of the Canada Haiti Action Network (CHIP). He can be reached at rogerannis(at)hotmail.com. This article first appeared in Oct 26, 2011 edition of the weekly Haiti Liberté, published in New York and Port au Prince, www.haitiliberte.com.You can listen to the one hour, Oct 18 teleconference of Partners In Health at this web address: http://bit.ly/uZ6STI.
1. OCHA Humanitarian Bulletin, Sept 21-Oct 18, 2011 http://reliefweb.int/node/453758