OCHA BULLETIN - 6 MAY - 3 JUNE 2011

OCHA HUMANITARIAN BULLETIN - 6 MAY - 3 JUNE 2011

OVERVIEW

• Cholera alerts on the rise, including in Port-au-Prince

• Les Palmes and Nippes highly vulnerable to flooding

• Survival strategies of vulnerable households exhausted in some areas

• Specific needs of disabled and older IDPs overlooked

CHOLERA RESPONSE

CHOLERA ALERTS ON THE RISE

The number of weekly hospitalizations nationwide has increased from an average 1,700 to 2,600, reports PAHO in its latest bulletin dated May 27. The South-East, Grande Anse, South and West are the departments most affected by outbreaks of cholera with a surge over the past three weeks in the number of daily alerts received from partners in the field. In the South-East department, the number of hospitalization has tripled over the past two weeks, with some of the cases coming however from neighboring West Department.

From 21-23 May, a significant increase of cases in Port-au-Prince metropolitan area has also been reported. As of 2 June, close to 2,000 cases and 13 deaths had been reported. Some donors including ECHO and USAID have indicated the availability of new funds to respond to further cholera outbreaks.

PAHO is noting that it is too early to say whether there is a change in the tendency of the epidemic.

The rise in the number of alerts might be due to the closure of Cholera Treatment Units (CTUs) and Centers (CTCs), resulting in the accumulation of cases in other health infrastructures still open.

Given the early detection of alerts, a prompt response has been implemented. PAHO/WHO is coordinating the response through the Preparedness Emergency and Disaster Relief (PED) teams deployed at the departmental level. Those teams are tasked with distributing prepositioned emergency stocks, coordinating with the Ministry of Public Health (MSPP), and deploying rapid response teams, in collaboration with several NGOs, for initial control of the health situation and epidemiological surveillance. In coordination with UNICEF, PAHO/WHO is supporting the installation of oral rehydration points, particularly in Port-au-Prince.

As of 1 June: 53 Cholera Treatment Centres
195 Cholera Treatment Units

As of 22 May: 1.7% mortality rates nationwide
314,539 cumulative cholera cases
5,332 number of deaths

CONTINGENCY PLANNING
AWARENESS CAMPAIGN ON SEISMIC AND TSUNAMI RISKS CONTINUES

The awareness raising campaign on seismic and tsunami risks reduction, which started last February under the leadership of the Direction de la protection civile (DPC), moved to the North, North-East and Nippes departm nts. From 7 to 13 May, hundreds
of school children and individuals from major cities, including Cap Haïtien, Ouanaminthe and Fort Liberté, attended conferences and public debates with the participation of specialists from the Bureau des mines et de l’énergie (BME) and
the Service maritime de la navigation d’Haïti (SENAMAH). Public screenings of documentaries were also conducted at Place Notre Dame in Cap Haïtien. These activities were organized by the Thematic Committee on Education and Public
awareness, in coordination with local authorities.

May 7th coincided with the commemoration of the 159th anniversary of the 1842 earthquake and tsunami which destroyed the city of Cap Haïtien. The earthquake killed 5,000 people, and the tsunami 300 individuals.

In the Nippes department, about 150 young volunteers marched through Miragoâne on 18
May. This third consecutive edition of the event was also attended by delegations of students and volunteers from the Ministry of Youth, Sports and Civil Service.

Professor Eric Calais of Purdue University, commissioned by the United Nations
Development Program (UNDP) since July 2010 to provide technical support to the Haitian Government on seismic risks, and engineer Gerard Métayer, held a panel discussion on earthquake and tsunami risks on 17 May. These activities were conducted with the support of UNDP, Plan Haiti, and the participation of the
National Haitian Police (PNH) and the Alliance pour la gestion des risques et la continuité des activités (AGERCA).

LAUNCH OF THE CYCLONIC SEASON CAMPAIGN

The DPC led Thematic Committee on Education and Public Awareness is also planning the 2011 cyclonic season campaign, which started on 1 June. A concert of solidarity is scheduled for 10 June at Champs de Mars, followed by a luncheon with media companies’ directors, and a literary evening on 24 June. Several training sessions for journalists on how to cover major humanitarian events and a national writing competition for primary and secondary school students are also planned.

LES PALMES AND NIPPES HIGHLY VULNERABLE TO FLOODING

OCHA Information Management Unit’s evaluation mission from 6 to 12 May highlighted high levels of vulnerability in flood prone areas of the Palmes region and Nippes department. The mission was organized at the request of the DPC to provide organizational, operational, analytical, and advocacy support. The mission aimed at
identifying flood-prone areas, analyzing mitigation needs and identifying temporary shelters for vulnerable populations exposed to flooding and hurricane related risks. Seventy five localities or areas at risk were visited in six communal sections, including Gressier, Léogâne, Miragoâne, Petite Rivière des Nippes et Fonds des Nègres.

With approximately 70% of the city built in floodprone areas and the presence of high groundwater level, Léogâne, as well as Gressier, is at permanent risk of flooding. This is compounded by the proximity of the Rouyonne and Momance rivers which banks overflow whenever heavy rains occur. Some 21,738 persons living in Léogâne and Gressier camps are exposed to floods, with little or no temporary shelters to go to, according to IOM latest statistics.

In Petit-Goâve, particularly Place Soulouque, houses are regularly flooded with streaming waters caused by the accumulation of mud and waste when it rains. Mitigation work such as cleaning draining channels of La Digue and Nan Piti Rivers are urgent. Some other activities require large amounts of long-term investments
for upstream and downstream watershed rehabilitation.

The Nippes Department has been hailed as a model for contingency planning. Supported by the Projet d'urgence et de gestion des risques et désastres (PUGRD) and OXFAM-UK, each commune of the department has a contingency plan with mapping of at risk areas. However, there is a need for additional risk mitigation work in areas not entirely covered such as Sous Salé, Bas du Fort, Demizen.

EARTHQUAKE RESPONSE

PROTECTION
IOM SCALES UP FIGHT AGAINST GBV AND TRAFFICKING IN CHILDREN

The International Organization for Migration (OIM) is using US$ 1 million funding from the Swedish International Development Cooperation Agency (Sida) to help prevent and responde to SGBV in 20 priority IDP camps across Port-au-Prince’s seven communes.
Solar lights in key public areas such as camp entrances, water and sanitation facilities and community spaces will be installed to help reduce risks of attack. Skilled training programmes are also being developed jointly with national partners
so that young Haitian women are more self sufficient and less vulnerable to victimization.

Women and girls are most affected by sexual violence in Haiti.
60 assisted by IOM in 2010,

97% - women and girls
3% - men

IOM’s efforts to further protect victims of trafficking are also being scaled up with a $1.6 million grant from the U.S Governement´s Office to Monitor and Combat Trafficking in Persons and UNICEF. IOM plans to assist 1,000 persons. Since January, the organisation has identified close to 400 cases of trafficked children living in
displacement camps in extreme poverty. About 50 % of them had suffered physical and sexual abuse by the time they were rescued. More cases have been uncovered in the most poverty stricken areas of Port-au-Prince and the provinces where many victims of the 12 January earthquake fled. In addition, 30 trafficked Haitian children
were identified and rescued in the neighbouring Dominican Republic.

DISABLED PERSONS STILL INVISIBLE AND NEGLECTED

Disabled persons still invisible and neglected Sixteen months into the 12 January
earthquake, persons with disabilities remain very vulnerable and are in great need of humanitarian aid, noted Handicap International and Christian Blind Mission (CBM)
during their 13 April presentation to the Humanitarian Forum. The ongoing humanitarian situation in Haiti is an opportunity to address issues related to the stigmatization and discrimination against persons with disabilities and ensure their right to decent living conditions,they add.

Prior to the earthquake, there were approximately 800,000 persons with disabilities in Haiti, of whom 200,000 were children, according to estimates from the World Health Organization (WHO). With approximately 300,000 injured, the earthquake
added at least an estimated 2,000 to 4,000 new amputees to the number of disabled persons, according to Handicap International.

In the aftermath of the earthquake, 10,000 persons with disabilities have benefited from 82,000 rehabilitation sessions. Some 25,000 people have attended psychosocial support sessions, 9 medical units have been set up and 900 people have been provided with prosthetic and orthotic equipments. In addition to the distribution of wheelchairs, crutches and canes, tents were provided to over 26,000 people and at
least 36 metric tons of foods were distributed.

Despite the integration of the needs of persons with disabilities in the overall humanitarian response strategy, there still is a lot to be done to improve support to those people.

CBM and Handicap International recommend providing capacity building to local associations of persons with disabilities and local NGOs. Some 98% of Haitian institutions, such as the Société haïtienne d'aide aux aveugles (SHAA), St Vincent,
the Centre d'éducation spéciale (CES), Institut Montfort lost their facilities during the earthquake.

The two organizations also recommend conducting advocacy activities such as urging the Senate to pass the bill on the integration of persons with disabilities which has been voted by the House of Representatives on 5 May 2010.

The policy document Cadre programmatique à l’intention des intervenants actuels et potentiels en matière de handicap from the Secrétariat d‘Etat a l’intégration des personnes handicapées (SEIPH) outlines major areas of focus for disabled person such as health, access to basic social services, security, accessibility of public building, security, protection and education. Like most developing countries, over 90% of Haitian children with disabilities do not attend school, according to UNESCO, and consequently will be excluded from the job market later on in life. This
will in turn, increase their vulnerability and dependency from their families or humanitarian aid.

HOUSING, HEALTH CARE AND FOOD AMONG PRIORITIES FOR OLDER IDPs

Access to housing, health care and food are among the leading concerns of older
persons living in camps, according to HelpAge. The organization stresses that the main desire of older IDPS is to leave the camps due to unsanitary conditions, promiscuity, and neglect in the distribution of humanitarian assistance. The
findings are based on a survey conducted in September 2010 that HelpAge says are still valid today. They served as a basis for HelpAge presentation during the 29 April meeting of the Humanitarian Forum.

Most of the oldest IDPs are people who do not have family members to take care of them and it is expected that their vulnerability will increase with the hurricane season. Priority should be given to their relocation, stresses HelpAge, which
includes providing construction material; rental help for a period of one year; temporary shelters for those who can’t return home; placing the most vulnerable into host families or community based “group homes”.

With 200 home care providers visiting the most vulnerable elderly, HelpAge has been able to refer over 15,000 older persons to health centers and mobile clinics. However, the cost of medication for those suffering from chronic diseases is a
challenge. HelpAge recommends the inclusion of essential medication for chronic diseases when ordering medical supplies during the humanitarian response, the training of medical personnel in the delivery of medical services to the elderly and the creation of a geriatric wing in hospitals, providing psychosocial support to those who have been seriously affected by the earthquake.

The data collected by HelpAge also show that, in the 93 IDP camps and 12 communal sections, particularly in Cité Soleil, Carrefour and Grand-Goâve where the organization work, over 20 % of older people were suffering from nutrition problems or lack of food. With the recent increase in food prices, older people are more exposed to food insecurity.

After the earthquake, many older people lost active family members who used to take care of them. For others, the support they used to receive stopped because the people who previously supported them had lost their livelihoods, their jobs, or had become IDPs as well. HelpAge suggests several options to help older people, including providing cash to the most vulnerable (disabled, those suffering from chronic diseases, those living alone and those taking care of orphans); involving those who can in cash for work activities; granting loans to restart businesses; providing seed and agricultural tools to those living in rural areas.

Haiti is not the only humanitarian crisis where older people’s specific needs are not fully taken into consideration. A study undertaken by Help Age in November 2010 on humanitarian funding for older people, through the United Nations Consolidated Appeals Process (CAP) and Flash Appeals in twelve humanitarian crises worldwide
shows that only 4,9 % of 1,912 projects submitted made explicit reference to older people. Only 0.2% of those projects were funded.

CROSS-CUTTING ISSUES

FOOD
SURVIVAL STRATEGIES OF VULNERABLE POPULATION EXHAUSTED IN SOME AREAS

The cumulative and simultaneous impact of the price increase, financial pressure on households due to school tuition since October, and the reduction of humanitarian aid over the past nine months have contributed to higher levels of poverty of
vulnerable households, according to a study conducted from 4 to 6 and 11 to 13 May. The study was led by WFP, FAO, OXFAM, ACF, in support of the National Coordination for Food Security (CNSA), in the Port-au-Prince neighborhoods of Carrefour Feuilles, Croix-des Bouquets and Camp Aviation, in two villages of Anse Rouge, one village of Saline and the neighborhood of Gande Rabuteau in Gonaïves in the Artibonite Department. All survival strategies to cope with rising prices have been exhausted,
notes the study.

Incomes of most households surveyed, the majority headed by women with children, have
fallen sharply and this trend continues. With rising prices and declining purchasing power, small businesses have become much less profitable, forcing women to buy food on credit or beg to feed their children. In Gonaïves, job opportunities in the
salt marches have also fallen sharply following hurricane Tomas. In Anse Rouge, rural
households experiencing lower poverty levels, and whose main source of income is agriculture, have also seen a drop in income due to higher prices of agricultural inputs, fuel and labor.

Therefore, households’ nutritional status has worsened, the poorest having reduced their number of daily meals from three to two. For the poorest of the poorest, the daily consumption of food has been cut down to one meal a day. The consumption of meat and rice was significantly reduced and replaced by less nutritious food such
as “arbre véritable” and sweet potato. Mothers report that their children are thinner and complain of headaches and stomachaches, which are potential signs of hunger, malnutrition and micronutrient deficiency. Some school principals have observed cases of fainting and reduced attention in class. Those households go to health centers as a last resort because they can no longer afford to buy drugs in pharmacies.

With rising prices, poor households also experience difficulties in meeting school tuition. As a result, a significant number of children were taken out of school since last December. In some classes the number of school children has dropped by half. Almost half of the women surveyed In Rabuteau have taken their children out of school. Some families cannot not even afford to keep children in community schools
where tuition are very low, from 50 to 200 Gourdes per year (1 to 5 US$).

COMMUNICATION
LISTEN MORE TO BENEFICIARIES; SAY INFO AS AID AND CDAC

A study conducted from March to April 2011 by independent consultants, Imogen Wall and Gerald Yves Chery highlights the need for humanitarians to change the way they think about communication with beneficiaries. The preliminary findings of the study supported by Info As Aid and Communicating with Disaster Affected Communities (CDAC) stresses that, while humanitarians think of communication in terms of messaging and information dissemination, Haitians think of it in terms of dialogue, debate and being able to find the information they need to make decisions about their lives.

When they think about communication, aid agencies focus on the outcome of projects. For Haitians, however, the process is as valuable as the outcome – they welcome the ability to communicate even if they don’t find the answer they were looking for. When aid agencies consider feedback systems they tend to worry that they will be unmanageable: in practice, those who have implemented them have experienced improved relationships with communities and found valuable real-time source of data on what
beneficiaries are thinking and worrying about.

Through not listening enough to the beneficiaries, humanitarians are also missing a great deal of information that is vital to their operations. The study therefore recommends that all feedback systems communications strategies should include explicit methods for this feedback to reach senior staff, especially those in operations and policy.

Although there still is very limited data, there are indications that the SMS use is particularly far more sophisticated than humanitarians realize. The study shows that SMS use is widespread and popular, especially in rural areas and among women. Twitter is also becoming increasingly important to local media and communities.
Monitoring and evaluation of communications strategies are two areas where humanitarian organizations need to put more emphasis, in order to measure their impact and improve the projects.

Well designed communications work had a dramatic impact on the effectiveness of
operational delivery for a wide range of projects. IOM, for example, found that effective communications was essential to implementing registration in camps, while UNOPS’ engineers carrying out building assessments also now say working without support from the community mobilization teams is impossible.

The study also underlines the need for UN agencies to recognize that the information needed by affected communities will increasingly come from the Government and therefore the focus should shift from how agencies provide information to how to help the government communicate. There is at present no strategy or project for providing support to the government on communicating around reconstruction, and this
urgently needs to change.

A closer and more strategic working relationship with local media would also benefit everyone. Feedback from local journalists indicates that most of them have a strongly developed sense of their role in providing information to their audiences in a disaster. Many local radio stations including Signal FM and Radio 1 demonstrated
immense creativity and a strong sense of social responsibility during both the earthquake and cholera responses, using the airwaves in innovative ways without waiting for support from humanitarians. Journalists are also asking for more humanitarian organizations spokespersons who speak Créole, as well as more actual
information and not just promotion of humanitarian projects.

FUNDING

CAP MID-YEAR REVIEW STARTED

The Consolidated Appeal Process (CAP) mid-year review workshop was held from 26-27May under the leadership of the Office for the Coordination of Humanitarian Affairs (OCHA). More than 100 humanitarian actors, government representatives and donors met to reassess this common strategic planning tool. The exercise was based on an
analysis of current contextual parameters, progress and challenges. A revised document will be presented to donors by mid June.

So far the $915 million humanitarian appeal is 24% funded and 59 out of the 312 projects submitted for 2011 received funding. Some 241 projects were in connection with the earthquake response and 71 with the cholera epidemic.

“The CAP mid-year review offers an opportunity to identify challenges but also focus on those most critical and those that have a real impact on affected populations. The CAP must be strategic, focused and credible, "said Humanitarian Coordinator Nigel
Fisher at the opening of the workshop.

CORRIGENDUM

The average value of the results of active screening for malnutrition, conducted in 31 communes of the West, South, South-East and Nippes between January and April 2011 and ongoing on a regular basis has been erroneously referred to as the national value in OCHA last Humanitarian Bulletin . Values reported should not be extrapolated to the entire commune or department, but only considered as a description of the nutritional status of the children screened in the specific geographic locations. The same is true for the screening results reported by MDM-F
in its recent rapid assessment in Grande Anse.

This clarification does not diminish the importance of the findings and the MSPP is planning a followup assessment of the nutrition response capacity in the Grand Anse with the support of the Nutrition Cluster and cluster partners including WHO, WFP,
UNICEF, FAO, CRS and MDM-F among others. In the Grand Anse with the support of the Nutrition Cluster and cluster partners including WHO, WFP, UNICEF, FAO, CRS and MDM-F among others.

Contact Information:

Head of OCHA Haiti (OIC): Esteban Sacco; Email: saccoe@un.org

Spokesperson/ Public Information Officer: Emmanuelle Schneider;
Email : schneider1@un.org

Reporting Officer: Abdourahmane Diallo; Email: diallo57@un.org/ocha.haiti@gmail.com ,

For more information on the response in Haiti, please visit:
http://haiti.humanitarianresponse.info

United Nations Office for the Coordination of Humanitarian Affairs, (OCHA), Boulevard Toussaint
Louverture et Clercine 18, Port-au-Prince, Haiti.

OCHA Haiti Humanitarian Bulletin
May. 2011 Office for the Coordination of Humanitarian Affairs – http://ochaonline.un.org | 8