Wednesday, July 21, 2010

Haiti Through the Eyes of a Local Doctor

Judith D'Amico is a medical doctor who has lived in Haiti for the past 15 years. Her field is public health and community development. The following is information she compiled for a letter she recently sent out.


Haïti continues pretty much as it has been the last few months. The camps are even fuller than before, as people are either returning to PAP or choosing the camps over their homes because of some perceived benefits they might receive. Here are a few details...

Tent camps
There are presently 1.6 million displaced persons scattered in 1,342 camp sites in the earthquake affected areas of Haïti. In Port-au-Prince, there are about 1,000 of the sites. Fifty-four of the 1,342 sites have more than 1,000 households and these account for 29% of the displaced people. Two of those are in Pétion Ville, the town nearest to me. The commune (like a county) of Delmas, which is very close to the heart of downtown, has the highest concentration of displaced persons. There are 200 camps, 11 of which accommodate more than 1,000 families; and with a total of 315,500 homeless persons (19% of all displaced persons) in the camps. The map below gives you an idea of the immensity of the problem. The darkest red is the commune of Delmas near the downtown:












Water and hygiene facilities
The WASH teams have been working overtime to help meet these needs; and despite less than required levels of water and hygiene facilities in the camps, no waterborne infections have been reported--truly God’s grace and a testimony to how carefully the Haitian people work at managing these scarce resources. But the teams believe that they should be able to add enough latrines to provide 1 for every 100 persons by October, a very decent figure. Nonetheless, the teams caution that although the WASH surveillance may be able to be suspended in a few months in the rural areas, It will need to continue for another year or two within PAP, because of the scarcity of resources.

Insecurity and personal safety
One of the most unpleasant parts of the camps has been the insecurity. A couple weeks ago, the National Police teamed up with the UN troops (called MINUSTAH here) in an early morning raid on one of the large camps in the commune of Delmas. About 30 persons believed to be thieves were apprehended, some were escaped prisoners from the national penitentiary whose walls were damaged in the earthquake.

Another part of the insecurity relates to teens and young women who are being forced into sexual relationships. With many family members either dead or dispersed, these young people are particularly vulnerable. Security has increased in the camps, but it is still a concern.

Pregnancy and STIs
Along with the concern about personal safety is a very sharp rise in the number of pregnancies. This has not yet been measured to my knowledge, but we have all noticed the large number of young women walking about in the earlier stages of pregnancy. Of course, if one is vulnerable to pregnancy, there is also a significant risk for sexually transmitted infection, like HIV. In fact, health providers in some of the camps have noted a higher than national average prevalence among the camp dwellers--though it is uncertain whether this is a cluster effect (a higher number of infected persons who just happen to be living in the same camp) or a real increase in prevalence.

Population growth
Along with these concerns, the US Census Bureau released its population projections for Haïti this week. It estimates that the Haitian population is currently 9.6 million (last census in 2003 showed 7.9 million)—and that’s taking into account the loss of about 230,000 persons to the earthquake. The Bureau predicts that the persons killed in the earthquake will be replaced within 2 years; and that the population will continue to grow at a rate of 1% per year, reaching 13.4 million by 2050. Yikes! It’s hard to feed everyone as it is!

Temporary homes
Some of the tents and tarps have been damaged by the large and frequent rains we’ve been having and will need to be replaced. As I mentioned in the last update, people are starting to add more permanent fixtures to their very temporary shelters, like tin doors, wood framing, and the like. Roughly about 2,500 temporary homes (more like a regular home and built to last at least 3 years) have been constructed; but these are mostly in the more rural areas. The picture below shows the situation at hand:


Debris

The Shelter Cluster estimates that all in all there are about 19 million m3 of debris to remove—a m3 is basically the size of a pallet--so that much debris would fill 19,000 warehouses like ours, and we have one of the largest in Haïti! All in all, about 125,000 temporary homes are expected to have been constructed by this time next year, the huge majority of them in the metropolitan PAP area.

Home Structural Assessments
Houses are still being evaluated in order to help persons resettle in their own homes. About 130,000 of the estimated 188,000 damaged homes have been assessed and a good portion are ‘green’, meaning that they can be lived in without first undergoing repairs. Roughly half of the homes that have been assessed as ‘green’ are being inhabited.

The engineers have been reminding families that the homes evaluated as yellow will need some relatively minor repairs to be able to be inhabited; AND that not all those that have been assessed as ‘red’ will have to be torn down! A good number may still be able to be salvaged with the right kind of earthquake resistant technology applied. Now that’s good news! As of right now, 46% have been assessed as ‘green’, another 30% as ‘yellow’, and the rest as ‘red’. The engineers estimate that about 500,000 persons will be able to return to properly repaired homes.

Food
Although food rations are no longer being distributed, there is good news on the horizon! The spring harvest looks like it will be rather productive, which will both increase the availability of food staples as well as decrease the price. The maps below give an idea of the projections concerning the availability of food for the next few months (yes, green is good!). This is very heartening because prices continue to be well above pre-earthquake level—roughly 25% more.















MAY 2010 AUGUST-SEPTEMBER 2010

Jobs
Another brighter star on the horizon. The food for work programs are not only helping to clear the rubble, clean out canals to avoid lowland flooding, and repair rural roads; these 100,000+ people are receiving a reasonable wage with which to help support their families. The need for this kind of work will be there for quite some time in the future, along with labor for reconstruction; and this should significantly help to re-establish families.

But the financial losses have been great here. One thing that helps Haitian people to get by on such limited income is that they do not need to pay great sums for living quarters. But modest sized homes that used to cost perhaps $2,500 per year to rent are now going for $500/month; that is more than the average middle class Haitian person earns in a month! Housing relief, and not just the temporary shelters, must be made a major priority in order to be able to stabilize the country.

Non-profit organizations
Again a reminder: the Government of Haïti is asking all 1,000+ NGOs operating within the country to register. The registration must be renewed every 6 months. If you would like more information on any Government-related business in Haïti, I’d encourage you to either become a member of the NGO Coordination Support at www.oneresponse.info or contact them directly for at ngocoordinationsupport@gmail.com

Some more subjects of prayer:
For everyone’s personal safety, especially for the young and the vulnerable
That food and housing will indeed begin to be affordable, and at levels to meet everyone’s need
That reconstruction can proceed well:
Settling of the land ownership issues
No longer be hindered by such high prices—some materials are up about 50% over pre-earthquake prices, even though there is no shortage
Driving:
That the rains and floods will not do any more damage to roads
That the road damage will be promptly repaired so that it does not take forever, and at risk of life and limb, to travel to and from normal activities. Video games have nothing on the ‘real deal,’ take-your-life-in-your-hands events that regularly occur on the roads here!
That the Lord will give us grace to deal with those few but significant numbers of persons who do not believe that laws were meant for the well-being of everyone. It adds greatly to the stress to share narrow, broken down roads with others who ignore the danger they put themselves, as well as the rest of us, in.

Thanks…and blessings on you!

Judith d'Amico

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