ARTICLE - CRISES - LACK OF CLEAN WATER

HAITI'S CASCADING CRISES COME DOWN TO LACK OF CLEAN WATER
(USA TODAY) - By Donna Leinwand

Aid workers in Haiti say the government has done little to improve water and sanitation since a Jan. 12 earthquake, making it likely that the cholera epidemic there will continue to spread.

"The situation has deteriorated. We really need a massive push of political will," says Joia Mukherjee, medical director of Partners in Health, which is helping the Haitian government halt the outbreak that has killed more than 1,100 people. "This can't just be about handing out water purification tablets."

DISEASE:
Haiti's leaders must expand the country's treated water and sewer systems to prevent future outbreaks of waterborne diseases, Mukherjee says.

Oxfam, an aid group focused on water and sanitation, says it's still operating in emergency mode instead of creating permanent water and sewer systems.

"The government does not have a plan," says Oxfam spokeswoman Julie Schindall. "We need them to make decisions."

Installing permanent systems is less costly than delivering emergency water, Schindall says. A $5 million water system that Oxfam built recently in Cap-Haitien serves 100,000 people and will last decades, Schindall says. In contrast, Oxfam has spent $30 million in nine months providing emergency water from tanker trucks and water bladders to 316,000 people, she says.

"Putting in the most basic infrastructure is what will keep people safe in Haiti," she says.

The U.N.'s water and sanitation group had planned water and sewer projects to expand the piped water system and move Haitians away from emergency water. They await government approval.

"I think the cholera epidemic is taking our eye off that right now," says Mark Henderson, chief of the UNICEF Water, Sanitation and Hygiene program in Haiti. "It's definitely set us back."

Political pressure following the outbreak may jolt the government into action, he says.

"They understand that water is a basic need. They recognize it's a good vote-getter," Henderson says. "But sanitation has never been seen as a sexy thing."

Before the quake, more than a third of Haitians lacked access to clean water.

Haiti has a national water and sanitation authority, but the office's reach is limited.

Many people purchase their water from privately owned kiosks and water trucks, paying by the bucket.

Many of those informal water supplies are not chlorinated, says Henry Gray, emergency water and sanitation coordinator for Doctors Without Borders, who tested five private supplies this week and found only one had been treated.

"Latrine building in Port-au-Prince will be a massive undertaking," Gray says. "It's got to be an absolute priority."

Access to clean water has declined since the initial surge after the earthquake, says Louise Ivers, chief of mission in Haiti for Partners in Health. After the earthquake, hundreds of aid groups set up temporary systems or trucked in water to for nearly 1.5 million Haitians left homeless in Port-au-Prince. Water provision was "one of the strongest successes after the earthquake" that emerged in Port-au-Prince, Mukherjee says.

"It's not surprising that there's a large diarrhea outbreak," she said.

After the earthquake, with people living in densely packed camps, the U.N.-led groups in charge of sanitation "gave up on meeting the international standard of 20 people per latrine," Ivers says. "They couldn't find the physical space. There was no place to dig the latrines."

Less than one-fifth of the population has access to a simple latrine or toilet, Henderson says.

In the Artibonite area, where the cholera epidemic began, most people use the Artibonite River for bathing, drinking and going to the toilet, and do not have access to chlorinated water that could kill the cholera bacteria. Many of Port-au-Prince's slums have no running water or sewer systems.

"The conditions in which people live here make them incredibly vulnerable," says Imogen Wall, spokeswoman for the United Nations Office for Coordination of Humanitarian Affairs. "Sanitation in the camps has been a concern since Day One."