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Haiti: Relief and Reconstruction

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Chronicle of a Disaster Foretold? Print
Friday, 24 August 2012 12:16

The latest news from the Associated Press suggests Tropical Storm Isaac may not reach hurricane strength before hitting Haiti:

Tropical Storm Isaac strengthened slightly as it spun toward the Dominican Republic and vulnerable Haiti on Friday, threatening to bring punishing rains but unlikely to gain enough steam to strike as a hurricane.

Forecasters now expect the storm to stay below hurricane force until it's in the Gulf of Mexico, staying to the west of Tampa, Florida, where the Republican National Convention starts on Monday, though there is still an outside chance it could hit there.

In Haiti, the government and international aid groups announced plans to evacuate several thousand people from one of the settlement camps that sprang up in the aftermath of the 2010 earthquake.

Isaac was expected to dump eight to 12 inches (20 to 30 centimeters) of rain on the island of Hispaniola that is shared by Haiti and the Dominican Republic.

"That kind of rain is going to cause some life-threatening flash floods and mudslides," said Dennis Feltgen, a spokesman for the Hurricane Center in Miami.

AP’s Trenton Daniel goes on to describe the Haitian government’s emergency measures and the reactions that some Haitians had to them:

In flood-prone Haiti, where the storm's eye is likely to blow ashore late Friday, Prime Minister Laurent Lamothe urged people to avoid crossing rivers, to tape their windows, and to stay calm, saying "panic creates more problems."

Lamothe and other Haitian officials said the government had set aside about $50,000 in emergency funds and had buses and 32 boats on standby for evacuations.

But among many Haitians, the notion of disaster preparedness in a country where most people get by on about $2 a day was met with a shrug.

"We don't have houses that can bear a hurricane," said Jeanette Lauredan, who lives in a tent camp in the crowded Delmas district of Port-au-Prince.

About 400,000 people remain in settlement camps comprised of shacks and tarps in the wake of Haiti's devastating 2010 earthquake.

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Tropical Storm Isaac Heads for Haiti, Likely to Leave a Spike in Cholera in its Wake Print
Thursday, 23 August 2012 16:02

There has been much discussion in the media over the past day regarding whether Tropical Storm Isaac might rain on the Republican National Convention in Tampa, Florida, and possibly cause delays or a cancellation. Receiving less attention is that 400,000 some people in Haiti are still living in tents, under tarps and various forms of makeshift housing – people who became internally displaced persons (IDP’s) after the 2010 earthquake, and they are also in the storm’s projected path.

Aside from the more obvious threats that flooding and strong winds could mean for IDP camps and other vulnerable communities, Isaac could also bring a spike in cholera infections. As we have pointed out before, along with countless news articles, medical reports, and NGO press releases, Haiti’s cholera infections surge with rainy weather, and tropical storms and hurricanes pose an especially ominous threat. The lack of adequate sanitation and safe drinking water in IDP camps means that drinking water sources are likely to be contaminated by waste water when flooding occurs – along with the tents, tarps, and much bedding and other possessions. And it is not just the IDPs who face increased dangers with heavy rain. As the cholera response has been scaled back, access to cholera treatment centers in rural Haiti has decreased. While flooding and mudslides pose extreme danger on their own, they can also prevent those in need from traveling to secure the care that is needed.

We wrote two weeks ago that the Haitian health ministry reported a slower rate of infection this summer, which it attributed to unusually dry weather, but that they predicted an increase in the coming months as the hurricane season begins. The Pan American Health Organization estimates that Haiti could see up to 170,000 new cases this year, which would mean an average of about 20,000 cases per month over the next five months – 5,000 more cases per month than in the previous three months. We further noted that the UN Office for the Coordination of Humanitarian Affairs was reporting a “very weak” “capacity to respond to potential outbreaks,” such as could occur with a drenching tropical storm.

The United Nations, meanwhile, whose troops caused the epidemic in October 2010, has yet to take responsibility by taking steps to contain and control cholera.

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Durable Housing Solutions Hampered by “the Project Syndrome” Print
Tuesday, 21 August 2012 15:23

Last week Deborah Sontag of the New York Times reported in depth on the lack of sustainable housing solutions in Haiti since the earthquake:

Two and a half years after the earthquake, despite billions of dollars in reconstruction aid, the most obvious, pressing need — safe, stable housing for all displaced people — remains unmet.

In what international officials term a protracted humanitarian crisis, hundreds of thousands remain in increasingly wretched tent camps. Tens of thousands inhabit dangerously damaged buildings. And countless others, evicted from camps and yards, have simply disappeared with their raggedy tarps and rusty sheet metal into the hills.”

Sontag notes that $500 million was spent on transitional shelters that were “not built to last”, meaning “All the money spent on T-shelters will be melted away,” as H. Kit Miyamoto, an engineer working in Haiti, told Sontag. Meanwhile, although some 200,000 houses were damaged or destroyed:

international aid has led to an estimated 15,000 repairs and 5,700 new, permanent homes so far. Most of the new houses are outside greater Port-au-Prince, where it was easier to obtain land, and some have yet to be occupied.

Though many are quick to tout the decrease in camp population as a sign the housing and displacement crisis is being met, it is clear the number of new housing solutions can only explain a fraction of the camp population reduction. The lack of adequate housing has led 33 international organizations to sponsor the Under Tents campaign. Working with Haitian grassroots groups, the campaign seeks to win housing rights for the hundreds of thousands of Haitians who remain displaced or living in unsustainable housing.

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Cholera Continues to Spread as Response and Surveillance Weaken Print
Thursday, 09 August 2012 15:50

The latest data from the MSPP (Ministry of Health) shows that the number of cholera cases and resulting deaths continues to rise. As of August 2, there have been a total of 583,871 cases and 7,497 deaths reported since October 2010 and this almost certainly is an underestimate. While the number of cases this summer has not spiked as high as it did last year, there have still been 377 deaths and nearly 45,000 cases reported in just the last three months.

The MSPP attributes the slower rate of infection this summer to unusually dry weather; however they predict an increase in the coming months as the hurricane season begins. The Pan American Health Organization estimates that Haiti could see up to 170,000 new cases this year, which would mean an average of about 20,000 cases per month over the next five months. Over the previous three months, the average number of cases has been over 15,000. Despite this, funding for the cholera response, as well as for the infrastructure needed to stem the spread of the disease, has been inadequate.  At the end of July, the Comite de Coordination des ONGs Internationales en Haiti (CCO Haiti), which is made up of many international NGOs operating in Haiti, released a statement on the situation:

The cholera outbreak that has already claimed thousands of lives all over the country remains a major threat to public health. Cholera prevention and response should be a key priority for the Haitian Government.



Furthermore, many public health workers in the Cholera Treatment Center (CTCs) have not received salaries for several months and there are reports of strikes by front line medical staff to redress this situation. This is a serious issue negatively affecting the effectiveness of the cholera response and it needs to be urgently addressed. In addition, there is evidence that the MSPP struggles to carry out its work efficiently due to poor logistics and inefficient fleet maintenance. This seriously hinders the material distribution within the CTCs, Cholera Treatment Units (CTUs) and Acute Diarrhea Treatment Centers (ADTCs), and affects the appropriate collection of cadavers. Necessary arrangement should be made to correct the situation. Overall, the MSPP must once again reinforce its leadership and coordination roles at both central and departmental levels.

Donors must provide sustained and adequate funding to support a comprehensive and integrated approach to cholera prevention and care.

Although less severe than the cholera outbreak last year, the current situation on the ground is much worse than statistics portray. And yet, a shortage of funding has translated into fewer health partners and created serious gaps in coverage. From August, 2011 to May, 2012, the number of Cholera Treatment Centers (CTCs) has declined from 38 to 20, and the number of Cholera Treatment Units from 205 to 74.
In their latest humanitarian bulletin, the UN Office for the Coordination of Humanitarian Affairs (OCHA) noted that, “national capacity to respond to potential outbreaks, especially during the rainy season, remains very weak. The country has only 468 beds for cholera admissions, with 233 of these already occupied. At the height of the epidemic in June 2011, 2500 beds were available.” Despite this, OCHA notes that “significant progress has been made especially in the surveillance and reporting of the epidemic as well as in the integration of cholera care in the national healthcare system.” 

Despite OCHA’s positive assessment of strengthening the national health care system, as CCO Haiti pointed out, MSPP is still facing serious issues in their response to cholera. One reason why the Haitian government has had a hard time leading the response is that the international community largely bypassed the government in their provision of funding for cholera. The government of Haiti received only $4.9 million in funds for the cholera response, while the Red Cross alone received $6.1 million. While CCO Haiti calls for increased funding from donors, it is imperative that this money not simply be channeled to international NGOs, but through the MSPP. As the UN Special Envoy has noted, “aid is most effective at strengthening public institutions when it is channelled through them.”
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Several Adults Killed in Forced Eviction, With Little Notice by International Media Print
Tuesday, 07 August 2012 16:53

The killing of four adults, and – according to some reports – disappearance of four children in a violent forced eviction on July 23rd has gone all but unnoticed by the major English language media, but some details have emerged through Haitian and some independent English language press. Haïti Liberté has a detailed report in English of the incident at Parc La Visite in Seguin, Marigot, on the southern coast. Haïti Liberté and other outlets’ reports are based in large part on the work of Haitian journalist Claudy Belizaire of the Reference Institute for Journalism and Communication (RIJC), who also took graphic photos of the killing’s aftermath. 

Haïti Liberté reported that the four were killed when 36 “Haitian police [officers] …destroyed seven homes in an attempt to clear peasants from a remote mountain-top park where they have lived and farmed for the past 70 years,” noting that “The bloody confrontation …occurred exactly 25 years to the day after an infamous 1987 peasant massacre near the northwestern town of Jean-Rabel…”

The RIJC reported the four confirmed dead to be “Desire Enoz - 32 years; Nicolas David - 28 years, Robinson Volcin - 22 years and Desire Aleis - 18 years.”

Belizaire, as translated by Haïti Liberté, wrote that three days later, “since this serious incident, no state official has come to Seguin, where barricades have been erected by the people, in protest. The only item known about this negotiation was an envelope of 50,000 gourdes [about $ 1,250] promised to each family (50% before departure, 50% after).”

The $600 before, $600 after moving payments are reminiscent of Martelly's much-criticized cash incentive plan to get people to relocate.  Bureau des Avocats Internationaux (BAI) attorney Mario Joseph describes the government’s strategy in a new letter [PDF] of complaint to the Inter-American Commission on Human Rights (IACHR):

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A Closer Look at USAID Food Aid Programs in Haiti Print
Friday, 27 July 2012 12:47

A review of publicly available reports and recently released documents obtained via an Associated Press (AP) Freedom of Information Act request reveal that the U.S. Agency for International Development (USAID) has spent over $200 million on Title II food aid in Haiti since the earthquake. Title II food aid, administered by USAID and implemented by NGOs and intergovernmental organizations (primarily the World Food Program - WFP), is “the main avenue for U.S. food assistance.” As can be seen in Figure 1, in fiscal years 2010 and 2011, USAID obligated over $200 million and distributed over 174,000 metric tons of food aid in Haiti. Although most of this came in the form of emergency food aid following the earthquake, food distributions have continued in 2011 as well.

Figure 1.

alt
Source: USAID, Author’s Calculations

The Numbers


According to a report prepared for USAID’s Office of Food for Peace, in fiscal year 2010, USAID Title II food aid totaled 153,000 metric tons (MT), of which over 115,000 came in the form of emergency food aid. In 2011, these totals decreased drastically to 21,430 MT, of which 5,950 MT was emergency aid. According to the report, emergency food aid was distributed through two avenues: Single-Year Assistance Programs and the World Food Program. Based on documents obtained by the AP, USAID obligated over $21 million to World Vision, Catholic Relief Services (CRS) and Agricultural Cooperative Development International and Volunteers in Overseas Cooperative Assistance (ACDI/VOCA) for program costs associated with these emergency distributions. Additionally, USAID, which covers the cost of commodities and shipping, valued these services at over $100 million.

Non-emergency food aid takes the form of food distribution, but also often incorporates agricultural productivity, natural resource management as well as other issues related to food security. The majority of non-emergency food aid, which totaled over 50,000 MT in FY 2010 and 2011, came through Multi-Year Assistance Programs implemented by the same partners as the above-mentioned emergency, single-year programs: ACDI/VOCA, World Vision and CRS. These three programs all began prior to the earthquake and are ongoing until at least September 2012. A recent audit conducted by the USAID Inspector General (IG) reveals that, since the programs began in 2008, these partners have spent $46 million dollars in program costs. According to the AP documents most of this came after the earthquake. Together, the three organizations distributed nearly $70 million in commodities.

The Inspector General, in its audit of these multi-year programs, noted that “assistance generally has improved conditions for targeted beneficiaries…However, we could not determine whether the effects will last well into the future.” Nevertheless, the IG found a number of problems in the management of these programs, including overlapping with other USAID projects; lack of data management; the use of duplicative, excessive and uncoordinated indicators; uneven and poorly tracked integration of key activities; and other problems.

Overall, the documents obtained by the Associated Press show that World Vision, ACDI/VOCA and CRS have received $57 million since the earthquake from USAID for program costs related to Title II food aid, as can be seen in Figure 2. As will be discussed in more detail later, while this data shows program costs, the provision of the actual commodities for distribution and the shipping of those commodities are paid for directly by USAID, and so do not show up in Figure 2.

Figure 2.

alt
Source: USAID, Associated Press

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AP Investigation Finds Lack of Results and Transparency in Haiti’s Reconstruction Print
Tuesday, 24 July 2012 14:59

Martha Mendoza and Trenton Daniel of the Associated Press reported over the weekend on the state of U.S. reconstruction efforts in Haiti. The report is based largely on documents obtained through Freedom of Information Act requests. Mendoza and Daniel write:

Until now, comprehensive details about who is receiving U.S. funds and how they are spending them have not been released. Contracts, budgets and a 300-item spreadsheet obtained by The Associated Press under a Freedom of Information Act request show:

- Of the $988 million spent so far, a quarter went toward debt relief to unburden the hemisphere's poorest nation of repayments. But after Haiti's loans were paid off, the government began borrowing again: $657 million so far, largely for oil imports rather than development projects.

- Less than 12 percent of the reconstruction money sent to Haiti after the earthquake has gone toward energy, shelter, ports or other infrastructure. At least a third, $329 million, went to projects that were awarded before the 2010 catastrophe and had little to do with the recovery - such as HIV/AIDS programs.

- Half of the $1.8 billion the U.S. promised for rebuilding is still in the Treasury, its disbursement stymied by an understaffed U.S. Embassy in Port-au-Prince in the months after the quake and by a Haitian government that was barely functional for more than a year.

- Despite State Department promises to keep spending public, some members of Congress and watchdogs say they aren't getting detailed information about how the millions are being spent, as dozens of contractors working for the U.S. government in Haiti leave a complex money trail.

Searching for evidence of success after more than two years and two billion dollars, the AP found lasting results hard to come by as “projects fundamental to Haiti's transformation out of poverty, such as permanent housing and electric plants in the heavily hit capital of Port-au-Prince have not taken off.” Attempting to preempt the AP article, Mark Feierstein, Assistant Administrator for Latin America and Thomas C. Adams, Haiti Special Coordinator at the U.S. Department of State wrote an article, “Progress in Haiti” to combat what they believe to be an unfair portrayal of U.S. reconstruction efforts.

Housing


Mendoza and Daniel note that the reconstruction plan laid out a number of benchmarks, 40 of which were due to be reached this month. But while some benchmarks have been achieved, many have not. One area of particular concern is the provision of shelter. While Adams and Feierstein point to the decrease in the camp population as the first sign of success, AP reports:

Meanwhile, 390,000 people are still homeless. The U.S. promised to rebuild or replace thousands of destroyed homes, but so far has not built even one new permanent house. Auditors say land disputes, lack of USAID oversight and no clear plan have hampered the housing effort. USAID contested that critique.

The State Department says 29,100 transitional shelters have been built, to which residents are adding floors, walls or roofs to make permanent homes, although homes once again vulnerable to natural disasters. U.S. funds also supported 27,000 households as they moved in with friends or families, and repaired 5,800 of the 35,000 damaged homes they had planned to complete with partners by July 2012. Also by this month the U.S. had planned to help resolve 40,000 to 80,000 land disputes, but at latest count had helped 10,400.
As we have previously pointed out, the provision of new shelter options cannot explain the majority of the decrease in the camp population, and many of those that have left the camps have found themselves in even more precarious living conditions, this time out of sight of the humanitarian community.
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104 Members of Congress Call for the UN to Take Responsibility for Cholera Print
Wednesday, 18 July 2012 14:45

Haiti’s cholera infection and death rates show an alarming recent increase, with official statistics reporting 290 deaths and nearly 40,000 cases in May and June alone, as the rainy season returned. Pressure continues to build for the United Nations to take responsibility for causing the cholera outbreak, which has now killed over 7,418 people and infected over 579,014. Last week, Hollywood took notice of the issue, with some 90 celebrities attending a screening of the Olivia Wilde-produced documentary film, “Baseball in the Time of Cholera” directed by David Darg and Bryn Mooser, and many urged action on the issue via Twitter, leading to the hashtag #undeny becoming a top trend for much of the day last Thursday.

Today, the Institute for Justice and Democracy in Haiti, which features prominently in the film, took “Baseball” to Congress with a screening. The move is well-timed, as 104 members of Congress just released a letter addressed to U.S. Ambassador to the UN Susan Rice calling on her to “to strongly encourage the United Nations to take a leadership role in addressing this catastrophic public health crisis,” specifically by urging “UN authorities to support efficient treatment and prevention of the epidemic and to help Haiti acquire adequate water and sanitation infrastructure.”

The letter, which was circulated by Rep. John Conyers (D – MI) states:

As cholera was brought to Haiti due to the actions of the UN, we believe that it is imperative for the UN to now act decisively to control the cholera epidemic. UN authorities should work with Haiti’s government and the international community to confront and, ultimately, eliminate this deadly disease from Haiti and the rest of the island of Hispaniola.  A failure to act will not only lead to countless more deaths: it will undermine the crucial effort to reconstruct Haiti and will pose a permanent public health threat to the populations of neighboring nations.

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In MINUSTAH Abuse Case, Cover-Up Goes Unpunished Print
Friday, 13 July 2012 10:34

In March, three Pakistani MINUSTAH troops were found guilty, sentenced to one year in prison and repatriated for the rape of a 14-year old Haitian boy. Although the trial was held on Haitian soil, it was a “military justice procedure…undertaken in accordance with the national laws of Pakistan,” according to the UN. Additionally, Reuters reported at the time that “Haitian government authorities were given no advance notice of the military tribunal.” Had the troops faced a Haitian court, their sentences would likely have been much longer. Had the troops had to face Haitian justice they may also have had to respond to further allegations that the Pakistani UN Mission tried to cover-up the crime, going so far as to kidnap the victim.

While some Haitian media and blogs picked up the story at the time, little has been written about the attempted cover-up.  Independent journalist Kathie Klarreich, who recently traveled to Gonaïves where the crime took place, mentioned the cover-up in a larger piece about MINUSTAH scandals for the Christian Science Monitor. Klarreich has now provided new details to HRRW on what happened, raising even more questions about the level of impunity for UN troops in Haiti and just how widespread these abuses are. While the Haitian police have witnesses and evidence tying MINUSTAH to the cover-up of rape, the UN has apparently not been cooperative and has failed to adequately investigate and hold accountable those responsible.

What Happened


The UN first disclosed the case in January, announcing that an investigative team would be heading to Haiti. In February, as the circumstances around the case became clearer, Senator Youri Latortue took to the airwaves to call for the lifting of immunity for MINUSTAH and to denounce the apparent cover-up that was executed by the Pakistani contingent. After witnesses of the abuse went to local police, the 14-year-old boy was kidnapped and taken to a MINUSTAH base in Cap- Haïtien with the “objective to prevent the continuation of the investigation” according to Latortue. On January 26, 2012, police arrested Vladimir Alexandre, a local Haitian, for being an accomplice to the kidnapping. Another alleged accomplice is still at large. While the “military tribunal” was conducted behind closed doors and the guilty members of MINUSTAH whisked out of the country, the local case in the city of Gonaïves has gone nowhere.

Alexandre, speaking with Klarreich, defended himself, telling her, “All I did was show them where he [the victim] lived. I don’t know anything about taking him anywhere,” adding that he didn’t receive anything from the soldiers in return. But Klarreich said that what he told her directly contradicts what he had told police when they arrested him.  According to a copy of his testimony which Klarreich read, Alexandre admitted that he knew the boy, that he’d been in contact with the Pakistani MINUSTAH troops, and that he and the other accomplice had agreed to remove the boy from the area. He also admits that the Pakistanis came to his home bearing gifts for his mother – $100 Haitian Gourdes ($12 US) and a sack of rice.

Alexandre remains in the police station jail, held in a room with 111 other prisoners. The Gonaïves police chief told Klarreich that according to Haitian law, Alexandre could be held for up to two months but if no charges were brought then legally he should be allowed to go free.  “I am not here to judge,” the police chief said, “but rather to make sure that the justice system works. Let’s remove the obstacles and finish this case.” The local officials in charge of the case continue to seek answers, while the lawyers for the victim continue to seek compensation from the United Nations.

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Reports from Field Highlight Need for Greater Governmental, Non-Governmental Accountability Print
Wednesday, 11 July 2012 10:02

Vijaya Ramachandran and Julie Walz of the Center for Global Development recently reported on their trip to Haiti, where they further examined aid accountability and the ongoing reconstruction effort, the themes of their recent policy paper which we have previously described.

Among the problems that Ramachandran and Walz noted were:

International NGOs have frequent staff turnover and very high costs.  In the aftermath of the quake, we learned that senior staff came and went, some staying as little as a few weeks.  A new arrival meant starting all over again, often with an individual who had little knowledge of Haiti and no knowledge of Creole (or even French).   The cost of maintaining expatriate staff in Haiti is very high.  According to the Miami Herald, it can cost upwards of $200,000 annually in housing and other benefits to keep a senior-level manager in Haiti. Some of our interviewees explained how NGOs and foreign workers are exempt from Haitian taxes and often do not follow Haitian registration requirements.  Donors have spent billions of dollars trying to repair Haiti’s broken infrastructure, largely with their own goods and labor.  In the meantime, most Haitians in Port-au-Prince spend their day trying to sell a few vegetables or fruit or other goods on the sidewalk, which in most cases, does not generate enough money to feed themselves or their families.


We repeatedly heard stories about the unintended economic and social consequences of the influx of foreign workers.  Housing costs in certain areas have skyrocketed – rentals easily go for over $30,000 per year, with some houses being rented for a lot more. Restaurants and supermarkets in certain areas of Petion-ville cater exclusively to foreign tastes, and prices of basic goods have been driven up to a level that even middle-class Haitians cannot afford.

And:

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