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Haiti: Relief and Reconstruction

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As Cholera Continues to Spread, Some Turn to Composting to Help Fight it Print

As of March 4, 2013, cholera has killed 8,057 Haitians and infected nearly 650,000 more. Despite some claims of progress, the epidemic, which was introduced by United Nations troops, has been significantly worse in 2013 than during the same period the year before. From January 1, 145 cholera victims have officially been reported dead, compared to just 22 last year. Worse, this occurred during the dry season, when cases generally taper off. The latest bulletin from the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) noted that compared to February 2012, this year “the Centre department has seen an increase of 67 per cent during this period, while the Artibonite and Ouest departments have seen increases of 38 per cent and 35 per cent respectively.”

Three weeks ago the U.N., after 15 months of dodging and evading, formally rejected a claim brought on behalf of over 6,000 cholera victims for damages. The claimants had also demanded the U.N. provide funding for the new infrastructure needed for the clean water and sanitation that would eradicate the epidemic. A new, 10-year, cholera eradication plan was announced less than a week later. The ambitious plan, if carried out, would provide lifesaving infrastructure, which previously had been blocked due to political pressure from the United States. Yet, while the plan was welcomed as a positive step forward, there is little funding available for its implementation. The U.N., for its part, committed just $23 million, a far cry from the $2.2 billion needed.

While the infrastructure which is needed may be a long way off, some groups are already looking at new solutions to combatting the cholera epidemic and creating a more sustainable country in the process. Isabeau Doucet reports for The Guardian:

"If we can take all the poop that's making people sick right now," said Dr Sasha Kramer as she stuck a thermometer into a large mound of faecal waste in the middle of Troutier, Port-au-Prince's city dump, "and turn it into this really valuable resource that could be used for reforestation or for increased agricultural production, then you really take a problem and turn it into a solution."

Every week, Soil (Sustainable Organic Integrated Livelihoods) collects the human waste from 56 dry toilets built in camps for displaced earthquake victims, and mixes it with chips of sugar cane bagasse, a byproduct of local rum production.

And it’s not just NGOs which are taking part:

The Haitian government recently built several sewage treatment plants that process traditional pit latrine waste in open-air stabilisation ponds. It and sewage treatment companies such as Jedco are experimenting with the alchemy of transforming a potentially deadly substance into a rich and much-needed fertiliser.

In order to treat human waste safely and kill pathogens, the waste must sit for at least seven days at 50C, according to the World Health Organisation. After six to nine months, the potentially toxic waste is transformed, with low carbon emissions, into fertile soil, simultaneously helping to fight cholera and deforestation, and revive food production.

The government has opened two sewage treatment plants on the outskirts of Port-au-Prince and there are a number planned for other major cities in the coming years. The plants are the first ever in Haiti’s history. SOIL is exploring ways to transform their composting process to be able to handle waste from pit latrines, which are currently emptied at the government sewage plants, and not just the dry toilets that they distribute.

In addition to composting, the sewage treatment plants hope to be able to use the water they are treating for irrigation. Together, the reuse of waste could have a large impact on sustainability. Doucet continues:

In Haiti's northern region of Cap Haïtien, where Soil built its first toilets in 2006, there is now a farm and the compost is used to grow peanuts and fight malnutrition. Collaborating with farmers and Scouts, Soil aims to fight Haiti's extreme deforestation – it has only 2% forest cover – by planting 10,000 mango, cashew, orange, lemon and other indigenous fruit trees.

Please see below for a series of pictures from the SOIL composting site in Port-au-Prince and from the Haitian government’s two new sewage treatment plants.

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Another Inspector General Audit, Another Failing Grade for USAID in Haiti Print

The U.S. Agency for International Development Inspector General (IG) last week released an audit of a program to provide loans to businesses in Haiti (available here). The audit is just the latest report from the IG to find significant problems with USAID’s programs in Haiti, following previous findings regarding cash-for-work programs, shelter provision, food aid and USAID’s largest contractor, Chemonics. The Associated Press’ Trenton Daniel reports that:

An audit of a U.S. Agency for International Department program that aimed to boost Haiti's economy by providing loans to businesses has found that the program failed to award loans to intended targets, train workers and keep accurate records.

The aim of the audit released in late February by USAID's Office of the Inspector General was to see whether a USAID loan program was indeed introducing lending practices to overlooked areas and borrowers, particularly in the areas of agriculture, construction, tourism, handicrafts and waste management. Most of the loans were supposed to go toward women, first-time borrowers and small- and medium-sized enterprises.

The loan program provided some $37.5 million in guarantees, of which just over $19 million in guarantees have been extended. According to publicly available data, only about a quarter went to woman-owned businesses, less than 30 percent went to first-time borrowers, and 75 percent were concentrated in the West department, though these numbers likely overstate the reality on the ground. In addition to many other problems, the audit found that “the key monitoring data was outdated, incomplete, or inaccurate,” for example, information on whether the recipient was a first-time borrower was “recorded incorrectly 41 percent of the time.”

The focus of the audit, Daniel reports, was the four largest of the seven guarantees, “worth $31.5 million,” of the $37.5 million total. Of these Daniel notes that two were made after the 2010 earthquake:

They were a Haitian bank named Sogebank, a Haitian development finance institution named Sofihdes that USAID helped create in 1983 and an agriculture-focused outfit named Le Levier Federation.

The audit found that few women and first-time borrowers received loans and lenders didn't make much effort to work with them.

And while the loans were intended to target “development corridors,” Daniel notes,

Instead they stayed in the Port-au-Prince area.

Ninety percent of Sogebank's loans were confined to the capital and the bank didn't give loans to other parts of the country. Some 81 percent of the Sofihdes loans were in Haiti's capital.
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When Will the United Nations Pay for Its Actions in Haiti? Print

An op-ed in the Caribbean Journal by HRRW's Jake Johnston reads:

Less than a week after cholera began its violent spread throughout Haiti, a UN military base in the central plateau became the prime suspect for having introduced the bacteria.

The UN was quick to shoot down this theory, claiming the base met international standards. Days later, journalists found sewage tanks and latrines overflowing, with the resulting black liquid flowing into a tributary of Haiti’s largest river.

Still, the UN didn’t hesitate to defend itself; the head of the UN troops (known as MINUSTAH), said that it was “really unfair to accuse the UN for bringing cholera into Haiti.”

But the evidence kept mounting; in January 2011, a scientific journal lent further credence to the theory, in July another, and in August yet another.

Even the UN’s own investigation into the outbreak found that the UN base was the likely source, though the results were obfuscated by blaming the spread on a “confluence of factors.”

In the meantime, Haitians continued to die. By the end of January 2011, just over three months after cholera’s introduction, the official death toll was over 4,300.  All the while the U.N. maintained its innocence.

Read the rest here.

 
Cholera Eradication Plan Announced, But Funding Still in Question Print

865 days after Haiti’s cholera epidemic first began, with over 8,000 dead and some 650,000 sickened, the government of Haiti, with international support, officially launched a ten-year cholera eradication plan today after months of delays. The plan calls for an investment of $2.2 billion in clean water and sanitation infrastructure, with some $485.9 million needed for the next two years. Currently 31 percent of the population does not have access to potable water, while 83 percent lack access to adequate sanitation. By 2022, the plan aims to deliver potable water and improved sanitation services to 85 and 90 percent of the population, respectively.

The plan notes that in the short term, “actions will focus on preventing the transmission of cholera from one person to another through the use of drinking water disinfected with chlorine, and the promotion of hand washing, good sanitary practices, and food hygiene.” Resources will also go to capacity building and training for the relevant government agencies, in particular the health ministry (MSPP) and the water agency (DINEPA). Over the long-term, some $650 million will go to DINEPA to build water supply systems in the 21 largest cities in the country, though most of this would start after the next two years. A breakdown of funding needs by sector, program and time-frame can be seen below. Overall, about 70 percent of the needed funds are to go to water and sanitation provision, though just over 10 percent of that is planned to be spent in the first two years.

The objectives, in terms of cholera specifically, are to reduce the incidence rate to below 0.5 percent by 2014, below 0.1 percent in 2017 and below 0.01 percent by 2022. This compares to an incidence rate of over 1.1 percent in 2012, which translates to about 110,000 cases for that year.

The plan also envisions a strengthening of the public health sector and of the coordination between NGOs and the government. To this end, the government plans to “integrate their support into the national health system.” Through investments in training, capacity building and by channeling funds through the domestic institutions in charge of each sector, the plan aims to create a stronger public sector overall. This could be especially significant given that aid for the cholera response (and for the overall relief and reconstruction effort) has largely bypassed the Haitian government. According to data from the U.N. Special Envoy, only 2.5 percent of humanitarian spending for cholera went through the Haitian government. As noted in the plan, the “lack of investment coming directly from the country’s fiscal budget represents a threat to the stability of the” water and sanitation sector.

There are to be three evaluations of implementation done in 2014, 2017 and 2022 and an audit will be conducted at the half-way point and at the conclusion of the plan. Additionally, a technical committee made up of high-level representatives from relevant government agencies will meet quarterly to assess progress and propose remedies.

Plan Remains Woefully Underfunded

Responding to the plans’ launch today, implementing partner PAHO’s Director Carissa F. Etienne noted that, “For the plan to be implemented, Haiti’s friends in the international community must align their efforts and harmonize around this plan and provide the necessary financial resources.” Yet thus far, meaningful support has been hard to find.

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UN’s Immunity Claim Provokes Outrage Print

The U.N.’s claim of immunity in response to the legal complaint filed against it on behalf of over 6,000 cholera victims has provoked outrage. Author Kathie Klarreich called it “unconscionable and immoral” in a Miami Herald op-ed yesterday, saying the U.N.’s statement “appears more like an apology for a snake bite than an effective response to what is currently the worst cholera outbreak in the world.” Klarreich underscores the urgency of cholera in contrast to U.N. Secretary General Ban Ki-moon’s expressed sympathy:

The World Health Organization expects 100,000 new cases this year alone, and some think that’s conservative, given the data. Many, if not most, of the non-governmental organizations that were involved in educating Haitians about the bacteria have scaled back their programs or closed shop, taking with them the chlorine they had been providing to make drinking water safe, and the soap to wash hands, fruits and vegetables.

Writing for the Atlantic, Armin Rosen suggests that “If a multinational corporation behaved the way the U.N. did in Haiti, it would be sued for stratospheric amounts of money.” As well “They would have to contend with Interpol red notices, along with the occasional cream pie attack.”

Former AP correspondent Jonathan Katz, whose important work in documenting the source of the outbreak is detailed in his book The Big Truck That Went By notes that the U.N. immunity claim is just the latest in a series of efforts to stall and obstruct the efforts of cholera victims to receive justice – and for the U.N. to take appropriate action to stop cholera. Katz writes in Slate:

A more recent tactic has been for the U.N. to shut down talk about the epidemic’s cause by discussing its new effort to eradicate the disease—despite the fact that the primary program it is touting is not actually a U.N. effort, lacks clear goals, and remains almost totally unfunded.

Katz notes that “Secretary-General Ban Ki-moon added a generic statement expressing sympathy for the thousands killed and hundreds of thousands sickened or left unable to work by the disease. His spokesman dodged all further questions.”

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