Around the capital city of Port-au-Prince and in the Region des Palmes, Oxfam has been distributing hygiene and cholera kits to people in need, while continuing to provide information on how to prevent the spread of the disease. In Artibonite, a rural region to the north that was hit hard by cholera when the first outbreak occurred, Oxfam is stepping up its prevention activities. It’s providing equipment to cholera treatment centers, distributing cholera kits to hundreds of families, and collaborating closely with the local authorities.
“Unfortunately, cholera will likely, at a minimum, be endemic in Haiti for years to come,” said Thomas Mahin, a water quality adviser to Oxfam America. “The history of cholera cycles in other countries is that when the outbreak goes from an epidemic to an endemic situation, the number of cases decreases significantly but the percent of cases that are children less than 5 years old goes up. So, while the number of cases will decline eventually, the most vulnerable populations—infants, pregnant women, etc.—will still be at significant risk. So, the total number of cases only tells part of the story.”
The rain Sandy dumped isn’t only affecting the potential for a cholera outbreak. In some areas of the country, rainfall was equivalent to about 50 percent of the yearly precipitation and destroyed houses, bridges, schools, and roads.
In the South-East region, Oxfam is working with local partners to evaluate damage to agricultural areas: Sandy was the third recent weather event to hit the region following, first, a drought and then tropical storm Isaac. The cumulative effects of these crises are devastating to small farmers. Oxfam has launched cash-for-work initiatives for more than 1,000 families. The income from that work can help people meet their basic needs.
]]>Oxfam is gearing up to respond to the flooding and potential for disease outbreaks.
“We are mobilizing all local organizations trained in cholera prevention to prepare a large campaign in the coming days,” said Oxfam’s Amelie Gauthier. “Oxfam is supporting local authorities—the Civil Protection Agency and the National Direction for Water and Sanitation in various localities in the Region des Palmes—providing them with transport, logistics and equipment for now. We are preparing hygiene kits, cholera prevention kits for distribution for some temporary shelters.”
Oxfam is launching an assessment in the department of Nippes—much of it affected by the heavy rain. At least two other departments have also been hit badly by the storm: Grande Anse and South. As of Friday, the country remained under a state of alert across all of its 10 departments.
“In one area in Croix-des-Bouquets (near the capital of Port-au-Prince), we spoke to several families who now live with 160 families—more than 500 people in a fire station,” said Gauthier. “There are pregnant women and young children as part of that one shelter.” She added that many homes have been flooded and families need basic relief items such as plastic sheeting and hygiene kits.
A lack of access to drinkable water and safe sanitation in some urban and rural areas is also cause for worry. Oxfam is monitoring some of those areas closely.
“We’re also concerned at initial reports of destruction of agricultural crops caused by Hurricane Sandy in the south,” Gauthier said. “The south of Haiti is already food insecure because of the drought and impacts of tropical storm Isaac. We’re following the situation closely as this will affect thousands of farmers for the planting season as well as school nutrition programs.”
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]]>Oxfam's Country Director, Andrew Pugh, said: "The worst hit areas are in the east and southeast of the country, but we're recording damage across the board. Isaac didn't deliver the devastating body blow we expected on Friday, but we're still seeing widespread suffering for it's poorest people."
The picture emerging from Oxfam's emergency team assessment is a long list of minor impacts throughout the country that add up to giant setbacks for its most vulnerable citizens.
Oxfam Communications Officer Stephania Musset, said: "For thousands of families, Isaac is still a horrible ordeal. I saw busloads of children without parents still arriving at shelters, and heard from a woman who lost her child as they ran terrified from their flooded home in the middle of the night."
The international agency continues to plan needs assessments in different parts of the country to tailor its response to needs, and ensure it is supporting government-led efforts. Oxfam is also planning a comprehensive cholera prevention push in several areas to reduce the risk of outbreaks such as those that have plagued the country since the earthquake in 2010.
Oxfam Program Director, Yolette Etienne, said, "We're worried that people without clean water are drawing from contaminated rivers. We're also seeing people staying in homes with waist-high water. If steps aren't taken now—including clean water, latrines, and health promotion—the impact of this storm could prove deadly."
Many of those worse affected by the storm are among the 400,000 still living in tent camps, two and a half years after the earthquake that leveled Haiti's capital.
Oxfam Program Director, Maurepa Jeudy, said: "If you're living in a tent, it only takes a puff of wind to blow your house down. Many people who already had little once again lost all. Now they need basics such as soap, toothbrushes, sheets, and blankets, but what they really want is a lasting solution in place of more flimsy tents. This storm is a chilling reminder that Haiti's recovery has a long way to go."
Oxfam is supporting a citizen's watch group that is monitoring Haiti's reconstruction effort and calling for urgent solutions for the 390,000 people still exposed to storms like Isaac that regularly visit Haiti.
]]>Initial assessments of the aftermath of the storm, which cleared the island’s landmass in the early hours of Saturday morning (25th August), suggest the damage has not been as great as was feared.
There have been media reports of four deaths, but there is no evidence at the moment of major damage to infrastructure or significant casualties.
Camps in the capital Port-au-Prince, such as Jean Marie Vincent, have been flooded, as well as towns in the south of the island, including Les Cayes, Jacmel and Nippes. There are reports of electric pylons collapsing and power outages and some disruption on the roads.
However, with exceptionally heavy rainfall forecast in the wake of the storm and with nearly 400,000 Haitians still living in refugee camps after the massive earthquake that devastated Port-au-Prince in 2010, people remain highly vulnerable to the threat of flooding, landslides and water borne diseases, especially cholera.
Oxfam emergency teams are now heading out to the affected areas of the island as soon as possible, allowing workers to carry out more in-depth assessments and to provide aid to those who need it in the form of clean water, hygiene kits and public information about sanitation.
Jane Cocking, Oxfam’s Humanitarian Director, said: “The storm may have passed but living conditions in Haiti remain so challenging for so much of the population that it’s far too early to say the threat is over. People in Haiti have so little that they are incredibly vulnerable to the risks posed by flooding and disease. They remain in desperate need of our help.”
The aid agency is accepting donations to help support its emergency work in Haiti, which is often cited as the poorest country in the western hemisphere with four in five of the population living on less than $2 a day.
]]>Estimable lives in a very small earth-walled home near a drainage channel running along a dirt road. The land around her is almost all mud and the road is under a foot of water in places. Floods plague her village, called Lameau, in the community of Grande-Saline in Haiti’s Artibonite River valley.
This is one of Haiti’s most productive agricultural areas, and over the years, the government and international donors have built a network of canals and channels, to divert water to dry areas, and drain out the wet ones. Small villages line these channels. Just after the harvest, many are drying their rice crop on tarps on the side of the road, near their small homes, some of which are quaint wooden houses that resemble gingerbread cottages. Others are more modest earth-walled dwellings. Children play and swim in the channels, laughing and splashing in the sun.
It looks idyllic but the Artibonite River valley can be a tough place to live, Estimable says. “When there’s too much water in our houses, in our fields, we get upset stomachs. It’s very hard to live here with so much water.” The lack of clean water in 2010 after one particularly rainy period coincided with a cholera outbreak which killed 300 people in this area, according to local officials.
Grande-Saline’s mayor, Erole Romeus, drew up a plan to clear out the mud and vegetation choking six kilometers (3.75 miles) of the secondary channels like the one near Estimable’s house. He’s also hired heavy equipment to widen them to handle more water flow. The project is employing two 132-member work teams in a cash-for-work program that provides much needed wages of about five dollars a day for 12 days. The project prioritizes hiring people living near the channels. About 2,000 people in 400 households live in this area and will benefit from better flood control.
Sansion Morisette is one of the workers; she has just spent the morning raking weeds out of the narrow channel running along the road next to Estimable’s house. “It’s about time we started this work,” she says. “I’m out on the street now because water destroyed my house in Rossignol. Take a look around you, we’re lucky if we can get two bags of rice out of our harvest sometimes, the water just eats everything we grow.”
Mayor Romeus says the project in Grande-Saline should take the community a long way towards reducing flooding, especially during the annual hurricane season. “Every time it rains, we can have 200 to 300 small houses destroyed,” he says standing on a flooded road next to the drainage channel, where scores of workers in white t-shirts are clearing away plants and other debris.
“We started talking about rehabilitating these channels as a means to deliver a durable solution to the people here,” Romeus says. “We came to Oxfam America because it is an organization that is interested in helping vulnerable people reduce the risks of disasters.
“Since we cleared all this out, people will probably have an opportunity to harvest. But if we did not, in another week we would have been in danger: the people, crops, and animals.”
Oxfam is devoting $20,000 for this project, which is covering about half the costs and supports the cash-for-work component, wages for heavy equipment operators, and fuel. It’s part of a larger program to reduce vulnerability to disasters in the countryside, and make it easier for people to make a living in farming, an alternative to the overcrowded conditions in Port-au-Prince.
Sancion Morisette is optimistic that the newly rehabilitated channels will help them. “Now I know that when it rains, the water will flow in the channel and go directly to the sea.”
]]>“My friends,” comes the voice from the radio, “take your chairs to sit down and have some discussion about cholera now on your favorite show, ‘Some information about cholera.’”
If it is hard to imagine a show about a deadly disease as your favorite, that may be because you don’t live in rural Haiti. Here, among the beautiful mountains and broad rivers, people live with a frightening reality: it’s easy to catch cholera, and reaching the nearest clinic may take more time than you have.
Without treatment, cholera can be fatal within hours. But in rural Nippes province, what serves as a road may be the bed of a river that after heavy rains becomes a torrent. Or a footpath over steep mountains, where the rocks are sometimes covered in mud so slick that only the most sure-footed can navigate them. Where swift access to medical care is out of the question, cholera prevention takes on special urgency.
“There are some localities where we have to walk three to four hours to reach people. We use horses to go there,” says Jean Bassette, the Oxfam public health officer who hosts the show. “We can’t travel to remote areas every week, but with the radio program we can reach them easily.”
“Ti koze sou kolera,” as the show is called in Creole, invites listeners to call in. The discussions cover whatever cholera issues people want to talk about but usually focus on prevention and emergency treatment.
“If we don’t have oral rehydration salts—or sugar and salt to prepare them—what can we do?” asks one caller.
Stephanie Lormil, an Oxfam public health promoter who sometimes joins the show, explains that coconut water can be a stopgap solution, hydrating the person well enough to make the trip to the hospital.
Sensitive topics like social stigma enter in, as well.
“Treat people who have cholera with respect,” advises Bassette. “Do not humiliate them. People who have the disease need to be able to tell that to the community, and the community needs to support them by preparing oral rehydration salts and helping them get to the hospital. If people with cholera keep the information to themselves, there is risk to the whole community.”
Feedback on the show has been overwhelmingly positive. Local leaders in communities throughout the broadcast area often call in with thanks and congratulations, and people on the street have kind words for the show.
“When we first heard about cholera, we were scared,” says Jose Mira of Petite Rivière de Nippes, who cited the radio show as one of Oxfam’s successful public health efforts. “We didn’t want to live next to people who had cholera. But Oxfam helped us understand the phenomenon of cholera and gave us training. After that, it became easier. We are not scared of cholera anymore, because we know how to protect ourselves.”
Read more about Oxfam's cholera program in rural Nippes.
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]]>“The destruction across the capital was stunning, and the sight of countless camps crowded with families gave me a powerful sense of how devastating this earthquake has been for people,” says Oxfam writer Coco McCabe, who recently returned to Boston from Haiti.
The camps are spontaneous, makeshift neighborhoods, marked out by plastic tarps, cardboard, and bed sheets strung between whatever’s there. Posts to hang materials on are in short supply, so people are scavenging wood from the wreckage of buildings.
“I saw one man with a flat, wide board, working hard with a small hand saw to cut the board into narrower pieces that could serve as poles for sheets, plastic, scraps of clothing—anything that might offer the semblance of a wall or roof to give families privacy,” says McCabe.
Plastic sheeting strung from poles may seem like a minimal shelter solution, and it is. But at this moment in the emergency, it’s something that works. Colored tarps keep off the sun and rain and, unlike tents, can be made to fit whatever space and terrain is available – or whatever other purpose they’re needed for on a given day.
Over the next two months, Oxfam aims to boost the supply of sturdy plastic sheeting, providing enough for at least 4,000 families (20,000 people) – a project that includes a cash-for-work component: we are employing local people to cut giant rolls of the material down to size. Families will get two pieces, each six meters by four meters, along with two 10-meter lengths of rope.
Meanwhile, we’re making plans to assemble and distribute home-repair kits to help those whose houses need patching up, not rebuilding.
But when it comes to figuring out if what’s left of your house is a danger to your family, no one should have to rely on guesswork. Oxfam will assemble a team of structural engineers to survey the damage to homes in Haiti and share their knowledge and suggestions with local residents, builders, and officials.
How long will it take for survivors of the quake to make their way from camp sites to temporary houses to real, permanent homes? For many, it will be years. But if donors continue to support the aid effort generously, Haitians will get the support they need every step of the way.
“Building back all that was lost in just a few seconds,” says McCabe, “is going to require a sustained commitment from us all.”