MSF: "Shelter, Hygiene and Basic Living Conditions Are Not Being Met"

March 05, 2010

A critical look at the situation in Haiti by MSF (Doctors Without Borders) highlights the “broadly insufficient” aid efforts on the ground in Haiti. Colette Gadenne, manager of MSF activities in Haiti and Christopher Stokes, General Director of MSF in Brussels,  both recently returned from Haiti. Stokes, while acknowledging what has been accomplished, says:

But for a large percentage of Haitians, some two months after the earthquake, it must be said that this solidarity has not always been reflected in actual aid on the ground, mainly in terms of shelter and sanitation.

Gadenne adds:

There are around 20 sites, the largest of which have received material assistance – tents, tarpaulins, toilet facilities, water, food, etc. – and basic medical assistance. The assistance given to these sites is incomplete, and there are dozens of other sites which still lack even the most elementary aid. Thousands of Haitians have still not seen any aid.

The living conditions are described as “very shocking” with people “literally living on top of each other.” With the rains already beginning, the situation is dire:

What’s more, first heavy rains is have started now flooding the country on an almost daily basis. The smells are incredibly bad, since several sites do not have toilet facilities. The lack of shelter and the hygiene conditions represent a danger not only in terms of public health, but they are also an intolerable breach of the human dignity of all these people.

Stokes notes “the immense needs in terms of shelter, hygiene and basic living conditions are not being met”, therefore MSF has started distrubuting 26,000 tents, of which 7,000 have already been given.

While the Shelter Cluster’s plan involves getting people to return to their homes, MSF notes that:

Many have lost their homes and those who are lucky enough to still have a roof over their heads dare not spend the night there. They sleep outside, in front of their houses.

Although they acknowledge that most emergency medical needs have been met, there is still significant post-op surgeries and rehab that must be done. Despite this:

Others have already started to charge the patients who come for care. Currently, a number of medical organisations are in the process of leaving the country, and several have already asked MSF to take over care for their patients. Although it is still difficult to estimate how many thousands of patients will needs post-operative care, the lack of post-operative handling capabilities could quickly become a major problem.

The lack of shelter and sanitation only adds to these problems, according to Gadenne:

When visiting homeless people’s sites, I saw people suffering from serious injuries who were living in atrocious conditions. A young man of 26 for instance, who was operated on in a clinic, is wearing an external fixator (a metal structure embedded in the bone through the skin to reduce a fracture). His state of health requires hospital monitoring, but he is monitored only by an outpatient clinic and lives in a small tent in the mud. In such conditions, there is a major risk of infection.

The report concludes:

The first acute emergency phase is over. At the same time, the international community is discussing the crucial subject of rebuilding. But it will take months, even years, before this rebuilding occurs in real terms. On the ground, there is still an emergency situation. The intolerable situation in which tens of thousands of Haitians are living requires a mobilisation of international aid in the short term too. In terms of shelters and living conditions, needs have been identified. A plan exists to provide shelters to around one million Haitians but this does not mean anything in real terms for the moment, and is likely to take a long time. Results on the ground are needed: shelters, better hygiene conditions, a clear commitment in terms of health and medical care. Haitians’ essential needs must not be forgotten during this transitional period.

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