Administration, management, leadership and professional development
(5ECTS)
FIVE YEARS ON HAITI EARTHQUAKE
Crisis Management – Group Assignment
April 2015
Assignment Submitted By
Tuula Marshalls – Pre-Crisis
Chrstine Ohanga – Intra-Crisis
Stanley Samoei – Post-Crisis
Lydia Osebe – Online Interviews
Prakash Khanal – Critical Analysis and Finalization
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Table of Contents
1. PRE-CRISIS SITUATION .................................................................................................................................... 4
1.1 Geographic Factors................................................................................................................................... 4
1.2 Demographic Factors................................................................................................................................ 4
1.3 Economic Factors ..................................................................................................................................... 5
1.4 National Politics ........................................................................................................................................ 5
2.INTRA-CRISIS SITUATION ................................................................................................................................. 6
2.1 Relief response ......................................................................................................................................... 6
2.2 Challenges on relief response .................................................................................................................. 7
3. POST-CRISIS SITUATION.................................................................................................................................. 8
3.1 Delayed Effects of Earthquake ................................................................................................................. 8
3.2 Spread of Cholera and other infectious diseases ..................................................................................... 8
3.3 Increase in Complex need of Rehabilitation Services .............................................................................. 9
3.4 Safety related wellbeing of vulnerable women and children .................................................................. 9
3.5 Post Trauma and Psychological Consequences ......................................................................................10
4. EXPERTS FROM REPORTS, ARTICLES AND AVAILABLE ONLINE INTERVIEWS ...............................................11
4.1 Was Haiti ever prepared for the devastating earthquake?....................................................................11
4.2 What are the effects of earthquake in Haiti? .........................................................................................11
4.2.1 Healthcare .......................................................................................................................................11
4.2.2 Economic System.............................................................................................................................12
4.2.3 Education System ............................................................................................................................12
4.3 Support from International and National Organizations .......................................................................12
4.4 Health problems that came up as a result of earthquake......................................................................13
4.4.1 Cholera Outbreak ............................................................................................................................13
4.4.2 Lack of access to ARV ......................................................................................................................14
4.5 Measures that put on to control the disease .........................................................................................14
4.6 Shelter and toilet facilities after earthquake .........................................................................................15
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4.7 Measure taken to take care of vulnerable group ...................................................................................16
5. CRITICAL ANALYSIS OF DISASTER RESPONCE IN HAITI .................................................................................16
REFERENCES .....................................................................................................................................................19
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1. PRE-CRISIS SITUATION
1.1 Geographic Factors
The Republic of Haiti in West Indies occupies third of Hispaniola Island positioned between the
North Atlantic Ocean and Caribbean Sea. Haiti shares the island separated from Cuba by 80 km wide
Windward Passage with Dominican Republic. Haiti`s capital city is Port-au-Prince. The country
holds total of 27,560 square kilometers of land with 1771 km of coastline. The landscape is mostly
rough - two-thirds of mountainous deforested area is rich with natural resources, but suffering from
exploitation of nature as charcoal burn, soil erosion and unsustainable water supply (UN, 2004). The
elevation of the country is between of sea level and 2,680 m. Only 20% of Haiti`s land is arable and
Plaine du l`Artibonite close to capital is the most important crops producing area. The population is
heavily concentrated in urban areas, coastal plains and valleys. (CIA – The world Fact Book.) Haiti
has tropical and semiarid climate with some variation depending on the altitude. The country lies in
the hurricane belt. The climate change boosts area to be subject to trade winds, intense rainy seasons
and severe storms for 5 months a year causing occasional flooding and periodic droughts. (Wikipedia
(1).) Deforestation has drastically increased the impact of weather pattern. The weather caused
destruction and loss in lives and livelihoods are often much higher in Haiti than in the rest of the
Caribbean. Lack of sufficient disaster early warning increases the vulnerability. (UN, 2004.) The
Caribbean Plate is also an oceanic tectonic plate. The plate border under Windward Passage is a
strike-slip boundary having frequent history of intense seismic activities as destructive earthquakes,
occasional tsunamis and volcanic eruptions. (Wikipedia (2); Fragala Smith, 2010.) A 2007 earthquake
hazard study concluded with a forecast of major seismic activity.
1.2 Demographic Factors
The population had almost doubled from 1980 by year 2010 approaching 10 million. Haiti`s high
population growth has made it the most densely nation in Western Hemisphere. Human Development
Index in Haiti year 2009 was 0.45, about half of the Finland`s HDI. The life expectancy at birth had
increased from 1980 by 11 years mean while the Gross National Income (GNI) per capita had dropped
from 1800 UDS to 1000 USD. For correlation, one of the closest mainland countries, Guatemala, the
GNI was about 4000 USD and USA 42,600 USD. (UNDP, 2013 (1).)
Haiti`s demographic feature is young age structure. In year 2009 two-thirds of the population was
unqualified manpower, younger than age 30 with holding twice higher unemployment rate than
national average. (Daumerie & Hardee, 2010). Though the mean years of schooling in Haiti had
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tripled during last three decades, it was still reported less than 5 years due to low school enrolment
basing on economic factors. (UNDP, 2013 (1).
1.3 Economic Factors
Poor governance throughout history and a long revolution has wrecked the economy of Haiti to date.
The country had suffered from regular major natural catastrophes (latest 2004 and 2008), insufficient
infrastructure and public services, and moreover, extreme increment of unemployment rate from 9.6
% to 40 %. Haiti was and yet is the poorest country in the Western Hemisphere and since 1971 among
the Least Developed Countries (UN, 2014). In early 1980s Haiti becoming one of the first countries
being heavily affected from AIDS (UNAIDS, 2009). The Epidemic caused the collapse of tourism,
national income loss, deepened unemployment and political unrest. Ongoing political instability
caused further radical decline of agricultural productivity (Daumerie & Hardee, 2010) partly
explaining Haiti`s high infant mortality rate and two-thirds of the children being malnourished
(WHO, 2012).
1.4 National Politics
The Haiti`s political history facing the inequality between light-skinned mulattos and the major black
population, brutal dictatorships, U.S. occupation and large-scale brain drain abroad had crippled the
nation`s development. Haiti`s pursuit for democracy was racked despite of the efforts of international
community eventually leaving the country Haitian government remaining ineffectual with ruined
economy. The rulers being incapable of improvements, the political turmoil carried on increasing
public unrest, lawlessness, endemic corruption, gang violence and organized rebel activity. In years
2004 and 2006 international force backed the country to attempt to restore order and to support an
interim government. Several elections were held, candidates selected and again removed. 2008 Senate
voted a prime minister, that international donors considering a competent leader to improve the
infrastructure and boost the economy with foreign aid, though by 2009 yet replaced by other one
going to face in year 2010 the catastrophic consequences of major earthquake, coming presidential
elections and cholera. (Fragala Smith, 2010; Daumerie & Hardee, 2010)
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2. INTRA-CRISIS SITUATION
The earthquake in Haiti which struck on January 12, 2010 was measured 7.0 magnitudes on Richter
scale which left 230,000 people dead. However some estimates that the death toll may have risen
around 316,000. The earthquake struck near the capital city of Port-au-Prince, destroying many of the
most important government buildings, hospitals and roads. Above 300,000 people were injured and
1.5 million people were internally displaced. Despite being built upon a major fault line, Haiti had
no building codes and therefore no way to ensure buildings is safe from earthquakes. As a result,
Haiti’s infrastructure was demolished.
2.1 Relief response
A large scale, international relief operation was launched soon after the quake hit. With the United
States taking charge and sending thousands of military troops to Haiti to deliver supplies assist with
search and rescue efforts and help maintain order Governments and individuals around the world
made donations and pledges for aid to Haiti totaling billions of shilling. As with any significant
natural disaster that has many moving parts, it can take days to get a relief effort underway. A report
by the United Nations (UN) indicated that a day after the earthquake, partner countries, the United
Nations, humanitarian organizations and the donor community, supporting the efforts of the
government and of the Haitian people, mobilized quite an unprecedented response. By end of January,
396 international health organizations had arrived in Haiti to assist the population in various fields.
The Health Cluster 4, led by the World Health Organization (WHO), is the main mechanism through
which these organizations were coordinated. Seventeen rural hospitals, among which 11 were
managed by military groups, provided care to thousands of patients in the affected areas (UN, 2011)
Overall Status of the Relief Effort Experts broke relief operations into these phases: search and rescue;
treatment and survival; relocation and rehabilitation; early recovery; and long-term reconstruction. In
the first two weeks following the earthquake, priorities were focused on;
a. Search and rescue assistance, including teams with heavy-lift equipment and medical
assistance and supplies
b. Addressing a critical need for food, clean water and sanitation, medical assistance, and
emergency shelter; and
c.
Setting up key infrastructure and logistics operations.
A month after the disaster, the relief effort remained an immediate and critical priority. Humanitarian
supplies were coming in to Haiti via Port-au-Prince and Santo Domingo, Dominican Republic. The
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airport in the Dominican Republic was used as a humanitarian staging area to help with the
coordination effort and allow for relief teams and supplies to get to Haiti by land. Medical Evacuation
by the U.S. military airlifted the ill and injured Haitian earthquake victims. The weeks after the
disaster these airlifts had brought non-U.S.-citizen Haitians to Florida for medical care that was
unavailable in Haiti. These patients, who often had very serious injuries, were admitted to a number
of non-federal hospitals, principally in south Florida. (Taft, 2010)
2.2 Challenges on relief response
The operation was not without challenges. Relief efforts were hampered by earthquake damage to
roads, communication systems and the Port-au-Prince airport and main port. Delays in transportation,
extremely limited communications systems and congestion, lack of transportation infrastructure,
bureaucratic problems, and lack of access all can cause bottlenecks at key points in the system.
Working conditions remain hugely challenging for aid personnel. The concerns about security and
potential for looting and violence were sporadic. Reports of rape cases in camps, roadblocks and fake
tolls along roads, and other possible gang activity points the involvement of criminal activities. The
2010 Haiti earthquake illustrates several ethical dilemmas for the early responders.
There were an inordinate number of crushed limbs and compound fractures. The international medical
relief did not become operational until 3 days after the earthquake. By then, many patients had
overwhelmingly infected wounds, dead limbs, and life-threatening sepsis and septic shock. The
absence of early intervention, coupled with the widespread destruction of healthcare facilities, forced
earliest rescuers to amputate necrotic limbs, often without proper anesthesia or analgesia and under
makeshift or unsanitary conditions. It is estimated that between 2000 and 8000 such amputations
occurred in a country notoriously unkind to its handicapped citizens. Most medical-relief personnel
made a serious attempt at obtaining informed consent. Some unaccompanied patients, however, who
were in septic shock and obtund, did get operated on without informed consent. This raises the
difficult question of ethical appropriateness of such no consented interventions under utterly chaotic
conditions. Another issue in Haiti was how to discharge patients who could leave the hospital but had
nowhere to go, and how to provide them with additional follow-up care (Ernest Benjamin, 2011).
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3. POST-CRISIS SITUATION
3.1 Delayed Effects of Earthquake
Inconsistent wound care and rehabilitation for trauma victims and amputees resulted in a multitude
of patient visits for infections, disabilities, and complications from delayed treatment, such as
gangrene and sepsis. The dust and smoke in the air led to respiratory illnesses, including severe
asthma, flares of chronic obstructive pulmonary disease, bronchitis, and pneumonia. According to the
World Health Organization (WHO), respiratory infections are now the main cause of illness, followed
by trauma or injury, diarrhea, and suspected malaria (WHO, 2010).
Crowding and poor sanitation in rapidly growing tent settlements were creating or exacerbating
medical problems, particularly in children. In addition, the chronic diseases that patients had been
ignoring since the earthquake were rearing their ugly heads. Several patients arrived after having
interrupted their treatment for tuberculosis or HIV, with no records of their previous regimens. Large
numbers of patients some who had had no regular health care before the earthquake and others whose
care had been interrupted now presented with acute manifestations of their uncontrolled chronic
diseases, in the form of hypertensive emergencies, strokes, seizures, and diabetic ketoacidosis.
Although many medications were available, donors had provided a supply of drugs that generally
were not targeted to chronic health problems, the medications in highest demand such as basic
antibiotics, asthma inhalers, and hypertension and diabetes medications became scarce, while boxes
of others, such as intravenous amiodarone, remained untouched (Dominique et al. 2010).
3.2 Spread of Cholera and other infectious diseases
The earthquake that struck Haiti on January 12, 2010, decimated the already fragile country, leaving
an estimated 250,000 people dead, 300,000 injured, and more than 1.3 million homeless. As camps
for internally displaced people sprang up throughout the ruined capital of Port-au-Prince, medical and
humanitarian experts warned of the likelihood of epidemic disease outbreaks. In August 2010, the
U.S. Centers for Disease Control and Prevention (CDC) announced that a National Surveillance
System that was set up after the earthquake had confirmed the conspicuous absence of highly
transmissible disease in Haiti, In October 2010, more than 55 miles from the nearest displacedpersons camp, 60 cases of acute, watery diarrhea were recorded at L'Hôpital de Saint Nicolas, a public
hospital in the coastal city. Cholera had not been seen in Haiti in at least a century and may never
have been recorded in laboratory-confirmed cases, it had somewhat unexpectedly emerged in a
densely populated zone with little sanitary infrastructure and limited access to potable water (WHO,
2011).
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The 2010 Haitian cholera outbreak has pressed local and international experts into rapid action against
a disease that is new to many health care providers in Haiti. The World Health Organization (WHO)
has time tested management protocols for emerging cholera outbreaks. These protocols have been
used by the Haitian government to fight an epidemic that is merely one of several recent tragedies in
Haiti. The cholera outbreak took most people by surprise. Unexpectedly, it was centered in rural Haiti
and not in the displaced-person camps, after the earthquake, more than 182,000 people moved from
the capital to seek refuge with friends or family in the Antimonite and Central regions, increasing
stress on small, overcrowded homes and communities that lacked access to latrines and clean water
(David et al. 2011).
3.3 Increase in Complex need of Rehabilitation Services
The initial success of the international response led to the survival of a population of people who
sustained complex injuries such as amputations and spinal cord injuries, among others. A small
number of local and international NGOs provided rehabilitation services, but the exponential increase
in complex rehabilitation needs in post-earthquake Haiti has outstretched much of the existing
capacity and resources. Hence, there currently exists a critical imbalance between the need for
rehabilitation, and the capacity of the country to supply these services from financial and human
resource capacity. The events in Haiti have raised awareness of the importance of rehabilitation
services, and highlighted the need to incorporate rehabilitation into response planning for future
humanitarian catastrophes. Many organizations were determined to address the extreme need and
supply imbalance for rehabilitation by partnering and strengthening established organizations in
Haiti. As an example, the Toronto Rehabilitation Institute (Canada) has been working with Healing
Hands for Haiti to specifically address rehabilitation needs of individuals who sustained spinal cord
injuries during the earthquake (Michel et al., 2010).
3.4 Safety related wellbeing of vulnerable women and children
Child trafficking has emerged as a major concern following Haiti's 2010 earthquake. 32.5% of Haitian
households with children included orphans and vulnerable children. The earthquake's aftermath may
have introduced unique and additional adversity to the lives of these children who were already
vulnerable. Gender-based violence against children and women can heighten in post disaster settings,
especially when there is, lack of public order, population displacement and increased economic
insecurity. For instance, in rural Haiti, where residents tend to be poorer, widespread concern over
food scarcity has surfaced because rural families are reportedly spending their savings to provide for
displaced children (Grupta et al., 2010).
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A recent survey conducted in one rural area after the earthquake found out that individual families
are taking in an average of five earthquake victims, such additional stressors may heighten violence
and abuse against women and children within these rural households (Sonda, 2010). Sex trafficking
is likely to be a critical threat to vulnerable children, particularly girls, in the aftermath of this disaster.
Both familial violence and economic insecurity are conditions that traffickers tend to manipulate to
their advantage when coercing or luring young girls into precarious situations, such as sexual
exploitation. Reports of rape of young women in Haiti's earthquake refugee camps have already
spread. These precarious situations place girls at risk of HIV infection, additional sexual and physical
violence, mental trauma and poor reproductive outcomes, including unwanted pregnancies (Grupta
et al., 2010).
According to world report on health and violence, very few resources in Haiti exist to care for children
who are forced to endure violence in their homes. As part of rebuilding efforts, infrastructure must
be developed to address the safety of children. In response to fears of child trafficking, child
protection hotlines have been established. Additional creative solutions must be developed to address
both child trafficking and family violence, because many of the most vulnerable children in such
circumstances may not have access to telephones. Again, this would require a more comprehensive
approach to address gender-based violence. Women must be offered protection as part of an effort to
create safe and nurturing environments for children. Rebuilding efforts should include bolstering legal
protection, increasing women's social and economic opportunities, and integrating violence-related
services e.g., counselling and screening into health programming. Such initiatives will be most
successful if Haitian women and children are given a voice in the rebuilding process (WHO, 2010)
3.5 Post Trauma and Psychological Consequences
Much has been reported about the devastation and anguish in Haiti after the tragic earthquake, but
thousands of survivors are suffering emotionally without mental health professionals to help them
deal with the trauma. Recognized New York clinical psychologist Dr. Judy Kuriansky was in Haiti
soon after the tragedy to answer this much overlooked need. "The survival needs are so extensive
with people desperately requiring food, water and medical care that the psychological damage is put
aside," stated Dr. Judy. "Research and clinical experience in such disasters proved that survivors
suffer emotionally and need attention to their psychological trauma" (Kuriansky, 2010).
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4. EXCERPTS FROM REPORTS, ARTICLES AND AVAILABLE ONLINE
INTERVIEWS
4.1 Was Haiti ever prepared for the devastating earthquake?
Excerpt from: Congressional Research Service, February 2010
Long before the earthquake struck, Haiti was a country socially and ecologically at risk. It has some
of the lowest socio-economic indicators in the world. Haiti was already in an acute environmental
crisis. Only two percent of its forest cover remains intact. Following the hurricanes of 2008, the
President of the Inter-American Development Bank (IDB), Luis Moreno, called Haiti the most
fragile of IDB’s member countries, saying that “no other nation in Latin America and the Caribbean
is as vulnerable to economic shocks and natural disasters as is Haiti.” Haiti had been making
progress, however. The UN Secretary-General commissioned a report, published in January 2009
that recommended a strategy to move Haiti beyond recovery to economic security. Indeed, the UN
Security Council conducted a fact-finding visit to Haiti in March 2009, and concluded that there was
“a window of opportunity to enable the consolidation of stability and the undertaking of a process
of sustainable development.”
4.2 What are the effects of earthquake in Haiti?
4.2.1 Healthcare
Excerpts from Doctors without Borders, Haiti Earthquake Web and ‘The Washington Post’
Haiti’s healthcare system was already inadequate before the earthquake. It was plagued by poor
hospital infrastructure, few medical personnel since there was poor payment and the healthcare
workers were on strike, many Haitians lacked access to the basic healthcare services. Most healthcare
services were concentrated in Port-au-Prince and so when the disaster struck the impact of the
earthquake was enormously felt. Exacerbated by poverty, political instability, inadequate hospital
infrastructure the natural disaster quickly led to widespread devastation. The ministry of health lost
their building and 200 staff members. In collaboration with other organizations the doctors without
borders had been working in Haiti even before the earthquake in the provision of healthcare services.
It continues to manage four hospitals to replace the temporary structures that were put immediately
after the initial disaster. Thousands of people continue to receive high quality care from these
facilities which are likely to be given back to the government any time soon.
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4.2.2 Economic System
Excerpts from Doctors without Borders, Haiti Earthquake Web and ‘The Washington Post’
The earthquake put an already struggling economy even into a worse situation and left the survivors
in a tough spot. Also according to the United Nations (2009) Haiti was already the poorest country
in the western hemisphere three-fourths of the population lived under the poverty line. Most people
have been left homeless and unemployed with nowhere to go. Supplies for example food and clean
water have been difficult to get. Damage of this earthquake are estimated for a disaster for both
200,000 and 250,000 total dead and missing using Haiti’s demographic data. The approximated loss
is US$8.1 billion hence recovering such a loss would require many donors, excellent coordination
of funding and execution will be key to ensure the efficient use of funds .Haiti’s economy still is in
the hands of foreign nations giving aid for since it is in no position to start generating revenue .
4.2.3 Education System
Excerpts from ‘The Washington Post’
The education system in Haiti has been damaged so greatly by the earthquake the ruined capital had
schools built in the French model most of these schools were affordable even to the poorest parents.
Now there are no schools in Haiti and education officials estimate that there are thousands of
campuses that were erased by the earthquake and the census show that there was loss of teachers by
75 % and many other staff who worked in various schools.
4.3 Support from International and National Organizations
Excerpts from UN OCHA, ReliefWeb, Wikipedia
Aftermath of Haiti earthquake, there arose a massive response from international humanitarian
organization willing to support for the rescue, rehabilitation and reconstruction. Mr. Preval, Haitian
president appealed for help from the international community and the top priority was to conduct
search and immediate rescue of the survivors. The government also requested communication
equipment so that the government officials could better and coordinate response and give better
services. Below listed are some organizations which were there for first hand support;
a. International Medical Corps: sent a medical relief team made of four emergency physicians and four
emergency nurses to go and death with crush and severe soft –tissue injury, severe hemorrhagic shock,
deformed facial fractures, amputation of limbs and debrement of infected wounds, and other conditions
threatening life and limb. Also emergency immunization of the tetanus toxic vaccine was done.
b. Oxfam International: Raised emergency fund to support both short and long term emergency plans.
c. General Douglas Fraser, commander of the U.S Southern Command: sent 80 soldiers including 5medics
to help in the crisis. The soldiers played a bigger role in maintaining order and limiting the crowds of
onlookers thus giving ready access for medical teams to reach the patients.
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d. The Israel Defense Forces (IDF): established a field hospital at Port au Prince the hospital started
operating 89h after the earthquake this hospital operated in mass casualty orthopedic situations with 8
orthopedic surgeons and three resident surgeons. It contained 4 operating tables, 72beds. 1111 patients
were treated.
e. International Committee of the Red Cross: Provided tons of supplies and humanitarian personnel’s to
establish hospitals.
f.
Food for the poor: Provided 7100 tons of food, medical supplies and pharmaceuticals.
g. Mercy and Sharing: In collaboration with local organizations, distributed aid to school children’s and
abandoned orphans.
h. World Vision International: Not only aftermath of Haiti earthquake but World Vision International stored
relief items in Haiti as a preparation of hurricane season. Hence, started distributing and supporting
immediately after earthquake.
i.
SOS Children: delivered 21 tons of aid, managed to receive 1 million pound donation from HSBC for the
Haiti relief, and 14 million dollar support from Sweden based businessmen in order to support and
educated approximately 400 orphan children of Haiti for over 25 years of period.
j.
Humanity first: Sent doctors particularly from US, UK and Canada and the team saw at least 10,000
patients. Provided water to 7000 people daily and also installed filtration units everywhere.
k. Doctors without Borders: helping the country even before the earthquake and after the earthquake, they
started giving immediate care to the people who had been injured. And they put up temporary places to
receive those people who had been injured for emergency medical care.
l.
The United Nations :also came in and provided medical assistance, clean water for drinking and
nutritional support
Besides these, some countries arranged to send relief and rescue workers and humanitarian supplies
to the earthquake damaged zones for example: American, Swiss, Canadian, Norwegian, HaitianAmerican, French, and Spanish volunteer physicians from non-governmental organizations and
universities arrived and worked to bring order to patient flow and treatment. Others sought to
organize national fund raising to provide monetary support for the nonprofit groups working directly
in Haiti. UN OCHA coordinated and tracked the relief response in daily basis. The information was
disseminated through the UN news and Relief Web. As of September 2013, Relief web reported the
total funding of 3.5 billion dollars given and further 1 billion dollar pledged but not given.
4.4 Health problems that came up as a result of earthquake
4.4.1 Cholera Outbreak
Excerpts from Pan American Health Organization, International Medical Corps
The outbreak is considered as one of the worst in recent history since people lived in tents under
poor sanitation. As of 2013, two years after the earthquake, it killed almost 8300 Haitians and
hospitalized thousand from Haiti and neighboring Dominic Republic and other Caribbean nations.
Ten months after the earthquake, the outbreak first occurred in rural area of Haiti, some 100
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kilometers from the capital Port-Au-Prince. By March 2011, some 4500 people were killed by
Cholera. By 10 weeks of the first outbreak, cholera spread in all the 10 provinces of Haiti
hospitalizing thousands of Haitians. According to the Pan American Health Organization, as of
November 2013, there had been 689,448 Cholera cases in Haiti, leading to 8448 deaths.
4.4.2 Lack of access to ARV
Excerpts from Haiti health census
In 1993, the HIV prevalence in Haiti was 9.4 percent which fell to 3.7 percent in 2003 among
pregnant women tested and to 2.2 percent among all adults by 2008. But unfortunately the 2010
earthquake in Haiti demolished Haiti’s health care system along with everything else. The
government of Haiti estimated that 24, 000 Haitians were under anti-retroviral treatment before the
earthquake but after the earthquake, less than 40% if the HIV cases have access to ARV. Hundreds
of HIV positive people live in tent cities for internally displaced peoples, where their weakened
immunity and the unrelenting heat and rain make them more vulnerable to disease. Even the chances
of HIV and TB co-infection are getting higher. Sex in these camps, both forced and consensual is
likely to increase the spread of HIV. The Executive Director of UNAIDS recently said, ‘The world
has moved on, but the situation in Haiti is not getting better, it is even getting worse.’
4.5 Measures that put on to control the disease
Excerpts from International Medical Corps
The International Medical Corps aggressively rolled out a network of cholera treatment centres
(CTCs) and mobile medical units in Haiti’s most remote and affected areas to care for more than
39,700 cholera patients. Cholera was a new disease in Haiti and the nurses and doctors did not know
how to handle it. The International Medical Corps made the Ministry of Health (MoH) and local
doctors, nurses, and community health workers central to its cholera response. International Medical
Corps trained and mentored more than 1,200 doctors, nurses, and community health workers so that
their network of CTCs were established and staffed largely by local health professionals and could
eventually be handed over to the MoH and be a part of the country’s long-term infrastructure to
prevent and treat cholera. And over the past year, the government of Haiti and the Dominican
Republic supported by the international community put in place crucial prevention and control
strategies to reduce the debilitating toll of cholera and save lives; these strategies include:




Coordination and engagement of partners
Improving surveillance, early warning to monitor the spread of disease and determine actions
Improving access to safe drinking water via chlorinating water at the source and in the home, schools
and other key locations.
Promoting safe hygiene and other public health preventive practices
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


Encouraging safe food handling practices and policies
Improving safe management of excreta and solid waste
Clarifying a role for oral cholera vaccines through vaccine pilot projects
4.6 Shelter and toilet facilities after earthquake
Excerpts from Pan American Health Organizations and USAID
In March 2010, the international community pledged billions to assist Haiti in post-earthquake
reconstruction, with major WASH projects underway in strengthening municipal water supplies,
providing water and sanitation for displaced populations and in health facilities, improving water
quality control, purchasing WASH commodities, and providing health worker training. The United
States committed more than 3 billion dollar in humanitarian relief, recovery and reconstruction
assistance. However, other partners are needed to address the funding gap for water and sanitation
infrastructure. In addition, Haiti’s water and sanitation agency, DINEPA, also developed a strategic
plan in response to cholera that focused on household and community water chlorination, sanitation,
and hygiene and health education.
Significant commitments to water, sanitation and hygiene projects in Haiti have been made by nongovernmental organizations, although most of these investments have gone toward short-term
measures such as water trucking to temporary, make-shift settlements set up after the earthquake.
Additional projects are also underway, such as improving small-scale water supplies, expanding
coverage with household latrines, and improving water and sanitation supplies in health facilities.
These activities are slowly improving the water and sanitation situation, especially in Port-au-Prince.
In Dominican Republic as well, significant efforts have been done to reduce the impact of the cholera
outbreak in Haiti over this country, such as sectorial coordination, communication and community
mobilization, and sanitation and hygiene interventions at the community and school level among
others. The U.S. Government, through the U.S. Agency for International Development (USAID),
has been a leader in the shelter and settlements sector in post-earthquake Haiti, this started during
the earthquake and has been continuing up to now both during the emergency response and in the
longer-term reconstruction effort. In the immediate aftermath of the earthquake, the Government of
Haiti worked with USAID, the international community, and non‐governmental organizations
(NGOs) to provide emergency shelter to an estimated 1.5 million Haitians.
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4.7 Measure taken to take care of vulnerable group
Excerpts from ‘The World Vision’
The World Vision put up a better world for children, shelter, food, and critical healthcare was offered
for the displaced children and families. World Vision supplied supplementary and therapeutic foods
for mothers and children suffering from malnutrition. Also nutritional advice was given to the breast
feeding mothers on how to breastfeed their babies.
Excerpts from ‘The Guardian’
After the devastating earthquake various humanitarian organizations came up to help Haiti recover
from the trauma they had undergone. Aid organizations provided psychological counseling to
minimize some of the risks that lead to post traumatic shock syndrome thus enhancing good mental
health.
Excerpts from World Vision and various YouTube videos
The UNICEF worked with children to help them reunite with their families and assist other children
who lost their parents and relatives in the earth quake one of the UNHCR officials says that, it is
only when we have exhausted all the possible options that we have, then we can look for other
alternatives for example adoption. The world vision UK also tried their best to reuniting families and
unlike to the UNHCR those children whose parents could not be found were taken to people whom
they believed were their relatives.
5. CRITICAL ANALYSIS OF DISASTER RESPONSE IN HAITI
The disaster relief response to the catastrophic 2010 earthquake in Haiti was one of the largest
humanitarian efforts ever carried out by the international community involving many governments,
aid agencies, humanitarian organizations and individuals from all over the world. However the
evaluations of this relief response rendered mixed reviews regarding its success and failure.
The collection of about 9 billion dollars in private donations during Haiti 2010 earth quake truly
reflects humanity that sustain within people and how they have embraced world as a global
community. According to Jonathan Patrick, an evaluation adviser for DFID, the Haiti 2010
earthquake response was a significant success regardless of some areas for improvement. He
emphasized that despite underlying vulnerabilities like systemic poverty, fragile governance and
insecurity, the overall targets for the first six months were achieved across all sectors. As part of the
immediate response millions of people were provided with basic humanitarian supports. For
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instances more than 4 million affected people received food, 1.5 million received emergency
shelters, 2.1 million received household basics and more than a million people received cash or other
inputs for work. Apart from these, supplementary feeding, health checkup, psychosocial support,
counseling etc. were also the part of rapid response program.
Conversely, there are much larger groups of people who debate that Haiti earthquake relief response
was not as efficient and effective as it could be. In-fact it has become common to refer the case of
Haiti 2010 emergency response as a failure in humanitarian circles. They criticized the delivery of
international assistance being too slow in the immediate aftermath. As a result there was delay in
search and rescue process which increases the number of death and casualty. Also the critical lack
of food, water and medical care was reported following the earthquake. During any crisis, national
and local authority should play important role in leading and coordinating local, national and
international humanitarian efforts. However that was not the case in Haiti. Lack of strong leadership
and coordination between supporting agencies was clearly evident during the crisis. This lack of
local and national ownership and enormous influx of foreign support particularly US based NGOs
further complicated coordination of humanitarian response. Large number of NGOs and their staffs
with limited knowledge about local context operated independently according their agenda due to
which assistance were distributed haphazardly causing shortage at some point and overlapping
support at other points.
The other widely debated issue in concern with Haiti’s relief response is humanitarian actors’
integrity to address expectations of the affected people. There is no doubt about the massive
mobilization of man, money and material throughout the disaster management phases. Despite this
the gap between result and expectation was observed. There are many direct and indirect reasons
behind this. As mentioned in above paragraph, lack of ownership, leadership and coordination are
one part. But most importantly, it’s the unrealistic or unachievable promises made by international
actors which was hugely responsible for the situation. Many humanitarian actors particularly from
United States desperately wanted to be the part of the play that at some point the humanitarian action
turned to be flag rising game or distributing unachievable dreams like “build back better”, “trade,
not aid” etc. Meanwhile they all forgot that Haiti holds the identity of a chronically poor and socially
unrest country with bad governance and unfair trade regulation. Here the question arises, how ethical
is it for public and private donors from rich country to raise the expectations of better future among
poor Haitians?
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Last but not the least, is the unanswered question about what about those affected people who were
not yet to be resettled? According to Nicole Phillips, a human right attorney with Institute of Justice
and Demography and Haiti, there is still around 360,000 people living in tents. At the same time can
we assure that those who are homeless are the real victim of the earthquake or the victim of Haiti’s
already existing poverty?
In nutshell, there are crucial lessons to be learnt by every stakeholders involved in humanitarian
work. Probably the most important message to be perceived from this case is expectation
management.
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