3 May 2012 Haiti continues to recover gradually from the double tragedies of a catastrophic earthquake and an outbreak of cholera in 2010, which compounded the effects of underdevelopment, poverty, limited institutional capacity and weak governance.
While the overall humanitarian situation has improved, funding for relief work has fallen, leading to some concerns about the ability of the humanitarian community to fully provide frontline services for those in need.
Close to half a million people remain in camps while the cholera epidemic, which already claimed the lives of more than 7,000 people, is expected to surge as the rainy season sets in. Haiti is also exposed to devastating hurricanes and food security remains fragile.
In an interview with the United Nations News Centre, the UN Resident and Humanitarian Coordinator for Haiti, Nigel Fisher, details the country’s vulnerabilities and the risks the people are exposed to and the risks people face as a result of decreasing resources.
UN News Centre: What humanitarian problems does Haiti face?
Nigel Fisher: We have a number of simultaneous challenges. One is still following the earthquake, where we have about 490,000 persons still displaced and living in camps. I must say it is a lot better than at the height of the displacement when we had a 1.5 million people living in camps, so two thirds have gone home – but 490,000 people is still a lot.
I think the second is that we are still in the midst of a cholera epidemic, and WHO [World Health Organization] estimates that we could have up to 200,000 further infections this year, in a worse case scenario. Now again, [thi... to make matters worse, we are in the midst of the spring rains which are proving unusually heavy this year and have already led to further displacement of people and some deaths.s is] much less than last year, when we had almost half a million, which is enormous – and also the infection rates and the death rates have gone down considerably, but we are still in an epidemic situation.
Just to make matters worse, we are in the midst of the spring rains which are proving unusually heavy this year and have already led to further displacement of people and some deaths. And we still have heavy rains and the hurricane season to come later this year. And just to top it off, WHO and FAO [UN Food and Agriculture Organization] are currently doing an assessment with the Government of the food security situation because we feel it is getting worse, household debt is increasing. So there are a number of simultaneous crisis facing Haiti at the moment.
UN News Centre: What challenges are relief agencies facing in their efforts to address those problems?
Nigel Fisher: Well, first of all, on the good news side, I think we have achieved a lot in the two years since the earthquake because, as I said, two-thirds of the people in the camps have gone home, and we estimate that about two-thirds of the amount of debris that was created by the earthquake has been removed. We have many hundreds of thousands of people who have gone back into new shelters and housing. But, as I said, we still have almost half a million people in camps.
The challenge now is that many donors are feeling that the humanitarian phase is over and are focusing on long-term development, and of course that is the long-term solution for Haiti – to focus on improving jobs, the economy, better health care, education. But, in the short term, we still have these crises, and because of the declining funding we are finding that quite a few of our partners, for example, who worked in the camps on ensuring water and sanitation, have actually closed down.
So we are facing something of a crunch this year, where actually conditions are getting worse in the camps and we are very concerned about cholera. Last year camps were the safest place to be because it is where we had the most effective coverage with chlorinated water, where we had latrines which people could use, and these were being cleaned out.
Some of those services have now stopped. We are able to continue in some camps, but not all of them. So that’s one of our concerns where we are looking for additional resources to make sure that camps don’t, in fact, become centres of infection instead of being the safest places to be.
The cholera epidemic – again we are facing a similar situation. We do have a national plan and strategy. We have a national alert system now in place which is able to spot very early on when there are cholera outbreaks.
But the challenges are that, as we hand over to the Ministry of Health, these infrastructures are still very weak. We still need to back that up, so that, for example, when there are outbreaks we still need international partners to come in quickly when needed and set up cholera treatment facilities or to distribute chlorine, distribute oral rehydration salts to communities because rehydration is the most effective early action against cholera.
Again, funds are declining and we do not have the resources we need to enable those partners to continue. So, this is a challenge and we are preparing for the rainy season, and we’ve already had, with the heavy rains in March and the first part of April, quite a few of the camps in which displaced people were flooded.
So again the UN Mission in Haiti, MINUSTAH, together with the agencies and the Government, is now focusing on trying to clean up some of the ravines that cut through Port-au-Prince which are full of debris, soil, rocks, [and] also rubbish; and try to clean up so that the water can flow through the town, instead of spilling over and flooding camps.
We do not have all the resources we need do the necessary mitigation work on the ravines or to prepare evacuation sites, should we need to prepare them, and we are also rapidly exhausting our stocks of things like tarpaulins, which we need as people get flooded out to give them emergency shelter. So, again the team is working together, but the resources are very strained this year.
UN News Centre: What feedback have you gotten when speaking with donor representatives in Haiti?
So, basically, they are telling us that the facts of life are that there are less resources around, and therefore we have to make do with less. That’s why I said, for example, camp conditions – we can’t pretend they are up to international standards. They are not. We have to do what we can.
Some donors have said… if there is a new emergency, then they would be able to find funds for that, but certainly not for preparation.
I have a couple of missions coming in, in the next few weeks, to look at how we manage the humanitarian situation in the future. How we are going to ensure that we can continue to build government and national capacity, capacity of local civil society organizations,[and] at the same time, have a rapid response capacity.
UNDP [UN Development Programme], for example, have been working over the last year or so with the national civil defence organizations and it is much stronger now, is able to coordinate response centrally and locally, but many other partners, many other ministries are still weak.
Obviously we want to more assertively go out to donors, but at the same time we have to realize that the funds are not going to come as we had hoped.
UN News Centre: Can you tell us some more about the water and sanitation situation in the context of the cholera epidemic?
Nigel Fisher: As humanitarian actors facing cholera, what we are doing is sort of patchwork, band-aid work on a fundamental problem. The fundamental problem is when cholera broke in Haiti there was no experience of it and the conditions were ripe for it to spread quickly
Only less than two-thirds of Haitians have access to safe, protected drinking water and only 17 per cent, that is not even one in five, of Haitians have access to latrines and safe waste management, which means people go to the toilet wherever – waste matter is mixed often with drinking water sources, so already we have very high [rates of] diarrhoeal diseases and once cholera was introduced and given these poor sanitary conditions, it spread like wild fire.
What we are doing in the short-term, in terms of treatment, education [and] oral rehydration is necessary, but we all agree that the long-term solution is investment in improved drinking water sources and in waste management.
The Government has declared that these are one of its top priorities and recently, back in January, WHO, UNICEF [UN Children’s Fund], [the] Centers for Disease Control in Atlanta and the governments of both the Dominican Republic and Haiti actually declared the intent to try and eradicate cholera from Haiti. But that demands a massive investment in everything, from food hygiene to water and sanitation to education. It’s long-term and we are working out the details of that.
There is also another initiative under way to try to pilot the use of [a] cholera vaccine in Haiti. It’s quite a controversial issue, but the Ministry of Health has agreed that we need to try that. The aim of that is to show that with vaccination we could start to create immunity which would mean that next time that cholera came around, less people would be likely to get it or [get it] less severely.
So, there are a number of short- and long-term initiatives that we are trying to tackle this basic problem of unsanitary environment.
UN News Centre: What message would you like to send to the international community about Haiti’s humanitarian situation?
Nigel Fisher: Well, in simple words: don’t forget Haiti. I think we have gone off the radar because there are so many other emergencies around, but this is an extremely poor country – 70 per cent of the people do live in poverty, [and] that was the situation before the earthquake.
So, just because are progressing post-earthquake doesn’t mean that the structural problems I mentioned – the weak economy, weak government, most people living in poverty, poor infrastructure, poor services [have gone] – all these long-term issues remain.
We need continued international response to look at the long term. But right now we still have 490,000 people in camps, we are still in the midst of a cholera epidemic where we need immediate action to protect water, to ensure better sanitation, health education – these things can work and we need support for those.
For a pictorial overview of the humanitarian situation in Haiti: Click here