Close to 1.3 million remain displaced in 1,354 spontaneous settlement sites across the country
Ten months after the earthquake in Haiti, the situation regarding housing, health services, provision of food, and disease control remains fragile because the population continues living in highly vulnerable and unhygienic conditions. The current cholera outbreak has presented the authorities, the population and the humanitarian actors with a new challenge.
In the coming months the main challenges will be the control of the epidemiological situation, appropriate care of patients, prevention of environmental hazards (water quality, promotion of hygienic and sanitation measures), security in camps, reconstruction, resettlement and preparedness measures for the presidential elections at the end of November. It is expected that a large-scale humanitarian operation will remain a reality in Haiti for at least one year or longer.
Close to 1.3 million people remain displaced in 1,354 spontaneous settlement sites across the country. To meet the health needs of this population, 21 international organizations are covering 266 sites. It is estimated that 661,000 people have migrated and are living with host families. Roughly 12,300 transitional-shelters have been built which house over 60,000 people on newly developed land.
The health cluster has been fundamental in improving coordination and strategic planning among different humanitarian actors, and its partners are working with the International Organization for Migration (IOM) and others to ensure health needs are addressed when families move from spontaneous settlement sites to transitional shelters.
Respiratory infections, diarrhea and psychological trauma are chronic problems in camps and show no signs of abating.
The Health Cluster
PAHO/WHO remains the key liaison between the Presidential Commission and international health partners. Given the continued large presence of national and international health NGOs, the Health Cluster in Port-au-Prince plans to remain operational through early 2011 and likely longer.
Recognizing that relief operations extended far beyond Port-au-Prince, PAHO/WHO, with support from the Ministry of Health, opened a number of field offices to establish subnational health clusters in Leogane, Jacmel, Cap-Haitien/Port-de-Paix, Jimani and the Haiti-Dominican Republic Border. The national and sub-national clusters coordinated treatment of the injured and affected, evaluated short- and medium-term needs, and mapped capacity of health sector activities.
The cluster in Port-au-Prince is chaired by the Presidential Commission for Health with PAHO/WHO serving as the secretariat. In collaboration with technical areas of the Ministry of Health such as mobile clinics, vector control, and malaria diagnostics, cluster leadership continues to craft strategies for health services at the national and sub-national level. Investigations find that many camps still do not have health care services and in some cases the mobile clinics are just tents with a box of drugs. A team of PAHO health services experts are working to address these shortfalls in coverage through training, provision of supplies, and partnerships with NGOs.
In Jacmel—a city in the department of Sud-Est, which borders with the Dominican Republic—27 out of the 42 health institutions were seriously damaged. The most significant damage was suffered by St. Michel Hospital, which serves 500,000 people. It is estimated that the population increased 10% following the disaster.
In May, MSH Spain helped with repairs of the St. Michel Hospital with the construction of two semi-permanent buildings that house the pediatric and internal medicine units, and has also been providing services there along with Save the Children and International Medical Corp.
In Leogane, although the number of NGOs active in this area is decreasing, major institutions like MSF-Switzerland, Save the Children, Merlin, and The Johanniter remain active. MSF-Switzerland is running the only functional hospital in Leogane.
The Haiti-Dominican border has been active since just after the earthquake. PAHO/WHO initially sent a team to Jimani to help the affected population who fled Port-au-Prince and surrounding areas. A field office was established that acted as a logistical hub and also supported local health facilities, which received over 3,000 patients in the first few days. In recent months, PAHO/WHO has been active in establishing the public health services network in the Dominican Republic border provinces. The expected results are a more robust public health response, capacity building for providers addressing nutrition, and strengthening of water and sanitation infrastructure. The PAHO/WHO border project is expected to run through early 2011.
This article is a summary of the report published by PAHO/WHO on 4 October 2010; the complete report can be consulted at www.paho.org/disasters.