CEPR - Center for Economic and Policy Research
Home
Relief and Reconstruction Watch

Haiti: Relief and Reconstruction

Questions? E-mail haiti(at)cepr.net.
 facebook_logo Subscribe by E-mail 


Cholera Continues to Spread as Response and Surveillance Weaken Print

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.”
Read more...

 

 
Several Adults Killed in Forced Eviction, With Little Notice by International Media Print

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):

Read more...

 

 
A Closer Look at USAID Food Aid Programs in Haiti Print

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

Read more...

 

 
AP Investigation Finds Lack of Results and Transparency in Haiti’s Reconstruction Print

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.
Read more...

 

 
104 Members of Congress Call for the UN to Take Responsibility for Cholera Print

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.

Read more...

 

 
<< Start < Prev 1 2 3 4 5 6 7 8 9 10 Next > End >>

Page 9 of 32