ARTICLE - HAITI: ONE YEAR LATER

HAITI: ONE YEAR LATER
(The Non-Profit Times) - By Kate Rogers

Experts say disaster recovery takes more than money

When a catastrophic earthquake hit Haiti last January, the fragile country with a long history of corrupt government and sparse infrastructure was literally shaken to its core. Organizations from around the globe rallied to attempt to salvage the devastated nation. U.S. donors generously contributed again and again, despite their own nation's difficult economic climate and lingering recession.

As the one-year anniversary of the quake approaches this month, charities rallying to rebuild the country should be moving into recovery mode. Instead, despite all of the money pouring in and aid organizations on the ground, the nation is gripped in a cholera outbreak. The deadly bacterial infection spreads through contact with feces-contaminated water, and runs rampant in unsanitary conditions.

The country dodged a bullet with Hurricane Tomas this past November not being as destructive as was originally predicted. However the lingering water from its flooding is an added danger in the cholera outbreak. Coupled with poor sanitation in the tent cities in Port-au-Prince, the infection has caused more than 2,000 deaths and sparked protests among frustrated locals.

Doctors Without Borders has been treating cholera in Africa for years, so when it was first found in Haiti this past October, Jennifer Tierney, development director, said the charity began treating all patients with symptoms as if they had the disease. An emergency response team of 75 international staff and 400 national staff was created specifically to deal with the outbreaks.

At presstime the organization had treated more than 29,000 patients for Cholera-related symptoms throughout Haiti, including 16,000 in the Artibonite region where it originated. The New York City-based charity had more than 1,000 members of its Haitian staff working solely on the outbreak.

"It is so unique to Haiti," Tierney said. "It has really panicked the population and put an additional strain on the work. There is the potential here for there to be a huge outbreak, and the water from the hurricane (Tomas) has exacerbated the problem."

The American Red Cross, headquartered in Washington D.C., launched a massive immunization campaign in the months prior to the outbreak, according to Julie Sell, ARC's Haiti delegation spokesperson. More than 900,000 people were immunized for a variety of diseases, and officials believe this helped to somewhat deter the outbreak from being worse. The cholera outbreak has just extended the organization's disaster response mode, Sell said. Of the $476 million raised for Haiti as of Sept. 30, only $183.5 million has been spent thus far."That is a large amount of money to be spent in nine months, especially in a country as poor as Haiti," she said. "In addition to addressing emergency needs, we also want to invest in programs that will make a lasting difference. Every time we have an emergency pop up like Tomas or cholera, it just extends the needs of emergency relief."

The organization is providing more than 660,000 gallons of clean water per day, and the need for such supplies will only be greater as the Cholera situation escalates.

QUAKE RESPONSE
Save the Children (StC) began to meet the basic needs of refugees in Port-au-Prince, including food, water, sanitation and shelter in the immediate aftermath of last year's quake. Physical needs were the focus during the first four months after the disaster, and the Westport, Conn.-based organization has since shifted its efforts to meeting more long-term needs through creating safe play areas for children in settlement areas, providing safe latrines and showers for women, and creating sanitary water sources. StC President and CEO Charlie MacCormack said public health, pre- and post-natal care for mothers have also become a high priority in recent months. "So many children have been separated from their families, we are just trying to give them some kind of normalcy," MacCormack said.

StC also set up temporary schools for children under weather-appropriate tarps and at the peak of its effort had more than 1,300 employees working in Haiti. Efforts have been phased down to about 800 workers, but the organization is retooling for its long-term plans, MacCormack said. StC raised $83.5 million globally for the disaster in Haiti, and to date has spent $43.4 million on food, shelter, health, nutrition, child protection, education and livelihood.

Much of the havoc wreaked throughout Haiti was due to the lack of development and rampant poverty prior to the quake, MacCormack said. Poor infrastructure, inadequate schools and a thin human resource base were issues before the disaster and have since elevated to overwhelming levels."The quake seriously undermined what little was there before," he said. "It all just got even weaker."

Although the quake hit Port-au-Prince with the greatest force, rural areas have been affected greatly by the influx of refugees who fled the city. Lutheran World Relief (LWR) in Baltimore, Md., has partnered with the ACT (Action By Churches Together) Network of international churches, as well as local organizations, to replenish rural communities. Although LWR has only one country director in the region, it has coordinated its response through World Neighbors and the Partnership for Local Development, two organizations based in Haiti. Carolyn Barker-Villena, LWR's senior program manager for Latin America, said the organization has taken a long-term approach with its response, focusing on the families based in rural areas that are now struggling to accommodate those who fled Port-au-Prince after the disaster. Hundreds of thousands of refugees left the city to return to their communities and families in these rural settings, including the Central Plateau, Artibonite, and North and Northeast provinces, known as departments.

"These people are already impoverished and have limited resources as it is," Barker-Villena said. "There are a lot of needs in these rural areas that existed before the quake, and are even more prominent in many ways now.

"Rural and urban populations are interconnected in this disaster aftermath, she said, because refugees are traveling between the decimated tent cities in Port-au-Prince to rural communities, and then back to the city in search of housing and jobs. The rural communities do not have the kind of income or infrastructure to accommodate those seeking relief from the quake, even one year later.

"The populations are in such fluctuation that its hard to adapt to for the rural communities," she said. "There is a lot of interdependence between the rural and urban communities. Before, money was sent to rural families for support from cities, and now the rural families are sending food to urban communities, and money to support kids in school."

Aside from its long-term approach, LWR sent more than $1 million of material resources to Haiti including 30,000 health and hygiene kits, 25,500 quilts, 35,700 school kits, 17,500 tarps and 39 large tents for temporary schools. An additional 35,000 health kits that were assembled at Lutheran summer camps this year were expected to be distributed this month. In the 60 days following the earthquake LWR raised $4,296,216, and from the 60-day point on they raised $2,948,811.

Doctors Without Borders had been established in Haiti for nearly two decades when January's earthquake hit, damaging its Port-au-Prince facilities. Tierney said the first order of business was to get its capacity back up to speed to respond to the patients flocking in search of medical assistance. A giant shipping container became a surgical room and several hundred tons of materials were shipped to Haiti, along with an inflatable hospital, which is still in operation.

"We tried to create areas that were actually feasible to do surgery in, creating a somewhat appropriate setting," Tierney said. "Water sanitation and shelter became secondary. There was just such a vast need not being met."

The organization also administered vaccinations, provided pre- and post-natal care, mental health care and primary healthcare through its 400 international staff and 3,000 Haitian staff.

Doctors Without Borders does not raise money for individual disaster and emergency situations, however it had a strong response to the quake bringing in $120,012,467 through April 30 and $18,231,723 from April 30 through Nov. 8.

"Haiti was the biggest historical fundraising anomaly in this organization," Tierney said.

The Salvation Army moved into its long-term recovery phase in Haiti as of Sept. 1, according to Maj. Ron Busroe, director of Recovery and Development in Haiti. The organization is providing mental and spiritual care to the displaced, and enhancing the services in areas outside of Port-au-Prince by creating wells, medical clinics, and upgraded schools. Busroe said the charity operates 48 schools in Haiti with more than 11,000 students, and two of the schools were damaged by the quake.

"We have to give them access to these things so that if they have left the city they won't have to move back," he said of building up the rural areas. "Everything must now also be handicap accessible due to the amount of amputations done after the quake."

Rebuilding and expanding its Port-au-Prince clinic is also a priority in the year to come, Busroe said. At this point less than 5 percent of the rubble in the city has been removed, so construction on schools, housing and clinics can't even begin to take place, he said. The Salvation Army has committed to three years in Haiti working strictly on disaster recovery, although it has already been established in the country for more than 60 years.

As of March 11, the Salvation Army had raised $16.5 million, and as of July 23 that number went up to $20.5 million. After July there were no significant donations. The amount spent was not available.

THE ROAD AHEAD IN HAITI
LWR is committed to Haiti for the next five years, although Barker-Villena said she believes the plan will be extended at a later date if funding allows. Donors have expressed concern at the pace of Haiti's recovery, asking why refugees are still living in tents, she said.

"When you look around (Haiti) you get the impression that people are going to be living in tents for a long time to come," Barker-Villena said. "Look at how long it took after Katrina, and Haiti has a government that barely functions at all. Plus, there are a huge number of people -- it's a daunting task."

To build back a population that is sustainable, and not as vulnerable to catastrophe and political unrest would take at least 15 years, estimated Save the Children's MacCormack. "To deliver education and health to 90 percent of the population, you need to start training that 90 percent now that would make it work," he said. "Each year you have 5 to 10 percent more, so it will roll out."

He expressed concern that both donors and nonprofits will take a short-term approach to ameliorating the situation in Haiti, and funding will dry up.

"Just to deal with getting the 1.5 million impacted people in some kind of stable situation, it's going to be a five-year process," MacCormack said. "My fear is that the bulk of funds will be spent on this stabilization. It's handing the people a fish, instead of teaching them to fish.

"Understanding that investing now will reduce the magnitude and severity of crises down the line. If we don't do that, we will be gnashing our teeth forever."

The Salvation Army plans to implement its long-term strategy during the next three years.

Busroe compared the situation in Haiti to the devastation Katrina caused in New Orleans, and the slow recovery process that has since taken place.

"We are five years plus out of there, and if you go to the 9th ward its empty, and that is the U.S. we are talking about," he said. "My guess is that we are looking at a decade or longer to get people out of these tent cities into decent affordable housing in Haiti. Hopefully, it won't take that long."

The American Red Cross' Sell echoed Busroe's thought process, adding that the organization will remain rebuilding in Haiti until every one of its donated dollars is spent.

"Look at New Orleans," she said. "It's a major city in the richest country in the world, and there are still people there who can't return home. It takes more than money, commitment, and resources to make things happen."