Humanitarian
Emergency Needs
HAÏTI
Context
D
espite a more than 90% reduction in the reported number of cholera cases between 2014
(27,388 suspected cases) and 2011 (350,000 suspected cases), Haiti continues to host the
largest cholera epidemic in the Western Hemisphere and remains at risk of a major outbreak in
late 2015. Two main factors are contributing to the increased risk of major outbreaks. The first, is that
we are starting with a higher number of suspected cholera cases than at the same period in 2014,
which increases the risk of transmission and therefore outbreaks (20,509 suspected cases were
registered between 1 January to 1 August, compared with 7,718 recorded for the same period in 2014source: DELR, MSPP). The second, is that most of the Haitian population still lacks access to both
improved water sources (42%) and improved sanitation facilities (72%) and therefore faces a similar
level of vulnerability that was observed in 2010 when the first cholera outbreak occurred. It is clear that
the cholera epidemic in Haiti remains an emergency.
In addition, while we have observed a 96% reduction in people living in camps in the Metropolitan area
of Port au Prince since July 2010, there still remains approximately 65,000 people in 2015. Living
conditions in the remaining sites remain harsh and represent a serious risk during the hurricane
season.
The Dominican Republic (DR) stopped its Foreigners Regularization Program (PNRE) on 18 June
2015. An increased number of people arriving on the border between the Haiti and the Dominican
Republic was observed, both through the official and unofficial entry points. According to the
Government of Haiti through the Directorate of civil protection, more than 20,000persons have already
returned to Haiti between 22 June and 31 July.
Several departments of Haiti report a severe drought putting about 660,000 persons at risk of food
insecurity according to the Ministry of Agriculture. Specifically, as a result of the drought agriculture
production will likely be reduced by more than 50% during the main agricultural season of the rural
population). Signs of malnutrition are already visible in the affected departments, suggesting that
approximately 7,000 children will need immediate therapeutic feeding to save lives and some 70,000
require supplemental feeding to prevent a slip into crisis.
Finally, the above mentioned threats also coincide with the tropical hurricane season that started on 1
June and continues to 1 November as well as the ongoing legislative / municipal (August/October) and
presidential (October/December) elections in Haiti. UNICEF Haiti country office fears that the
international community as a whole is not sufficiently resourced and prepared to protect the children
and their families in the event of major humanitarian crisis.
This document is aligned with the United Nations urgent needs appeal launched in August 2015.
UNICEF is therefore urgently requiring an additional US$ 8.8 to meet the humanitarian needs of Haiti’s
children and women in 2015 and part of 2016. Funding mobilized by UNICEF since January
2015alone is insufficient to cover the wide range of needs described below.
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UNICEF Haiti Country office's framework
for humanitarian preparedness and response
Partners
Ensuring a rapid
and effective
response to cholera
outbreaks requires
US$ 4.1 M for the
next 6 months
Government: MSPP, DINEPANGOs:
ACF, ACTED, Red Cross, OXFAM,
SI,ZL
Partners
Government: DPC, MENFP
NGOs: stand-by agreement with usual
partners
Reducing disaster
risks and
strengthening
emergency response
for protecting children
and women of Haiti
requires US$
0.588.500 for the next
4 months
Protecting
children's
health
and safe
development
Ensuring protection
of children and
women and basic
services for persons
deported from the
Dominican Republic
requires US$
2,240.050 for the
next 6 months
Partners
Government: IBESR, MSPP,DINEPA
NGOs: GARR, JSM, OXFAM,SI
Partners
Government: MSPP,CNSA
Drought monitoring
and treatment of
children with severe
acute malnutrition
requires US$
1.861,800 for the
next 12 months
ACRONYMES
MSPP: Ministère de la Santé Publique et de la Population
DINEPA: Direction Nationale de l'Eau Potable et de l'Assainissement
DPC: Direction de la Protection civile
IBESR: Institut du Bien-Être Social et de Recherches
MENFP: Ministère de l'Éducation Nationale et de la Formation Professionnelle
CNSA: Coordination Nationale de la Sécurité Alimentaire
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1. Ensuring a rapid and effective response to cholera outbreaks
Context
Cholera remains a very serious threat for the most vulnerable Haitian’s. According to the latest data
released by MSPP there have been 20,509 suspected cases and 175 deaths registered between 1
January and 1 August 2015. Incidence stands at 1.88 cases per 1,000 persons (0.188 per cent) and
institutional fatality rate has decreased to 0.74 per cent. A WHO/PAHO and UNICEF analysis found
that there was stabilization throughout the first half of 2015 following the large outbreak that peaked in
November 2014 (7,399 reported cases), such that cases have once again declined to below 2000
cases/month since May (1, 716 reported cases). Thanks to a well-coordinated and effective alert and
response mechanism the effective nationwide rapid response operations also helped to rapidly
control cholera outbreaks during rains in March, April and June.
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Following the large outbreak at the end of 2014 a large amount of resources were deployed to control
the epidemic and reduce the incidence before the first rainy season (April to June). This has resulted in a
significant gap in resources available that would allow us to increase the level of surveillance and
response for the dominant rainy season (October to November). For example, during weeks 29 and 30
(19 to 25 July) there were 470 suspected cases registered and 10 people died from cholera in a single
isolated outbreak in Grande Anse. In this case a merchant coming from the West department arrived in
Grand Anse with cholera symptoms and subsequently transmitted cholera to his neighbours resulting in
125 cases between 16 and 29 July in an area that had previously had low incidence.
There is a high correlation between rainfall and cholera cases with an increase in cholera incidence
observed during the second part of each year (Figure 1). This year, we will enter this period with a 62%
increase in suspected cholera cases than at the same time last year (MSPP has reported 20,509
suspected cases in 2015 versus 7,718 suspected cases in 2014 for week 31 ending 1 and 2 August,
respectively). The risk is therefore extremely high that during this most vulnerable time outbreaks may
occur in several departments simultaneously.
Figure 1:
Figure 1: Daily evolution of rainfall (blue) and suspected cholera cases (dark orange for the West
department, light orange for the rest of the country) and case fatality ratio from 2013 to 2015. (Source of
cholera data: MSPP. Source of rainfall data: NOAA. Graph by ‘Assistance Publique Hopitaux de
Marseille’).
What UNICEF Haiti is dedicated to do in the next 12 months with your
support?
UNICEF supports the implementation of the 10 year National Cholera Elimination Plan since its
beginning in 2013. The proposed actions are in line with the strategy reflected in the 2 year UN support
strategy for cholera elimination, the 10 year national plan (2013-22) and the 2 year operational plan
(2013-15). UNICEF is committed to provide effective and relevant assistance for 20,000 to 30,000
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people likely to be infected by cholera in 2015, and reach between 1.1 and 1.5 million people with a
targeted with a cholera control and prevention interventions following confirmed alerts, through:
•
Support to the coordination and epidemiological surveillance by MSPP at national and
departmental level,
•
Maintaining the rapid response mechanism provided by the Rapid Mobile teams of MSPP and
UNICEF NGOs partners (5), in all departments during the rainy season and the next dry season until at
least June 2016,
•
Provision of the supplies required for institutional medical care and community emergency
response
•
Support local networks composed of multi-purpose community health workers (ASCP), Civil
Protection brigadiers and volunteers from the Red Cross in order to enhance Community-based
surveillance of suspected cases and immediate local action,
•
Continue the protection and repair of water distribution systems in areas at risk of cholera in the
cities of Port au Prince, Gonaives, Saint-Marc, Cap Haitien, Hinche and Mirebalais to mitigate the risk
of outbreaks in these high-risk urban areas.
•
Supporting DINEPA to identify and develop sustainable solutions for the remaining IDP camps
considered as permanent settlements, particularly in regards to access to improved water and
sanitation facilities in the areas most at risk of cholera in Port-au-Prince.
Budget required : US $ 4,117,146 million
2. Ensuring protection of children and women and basic services for
persons deported from the Dominican Republic
10,000 to 30,000 people will be deported from DR in the next 3 months and will be in need of
humanitarian assistance, including 300 children.
Context
Following the end of the regularization plan of foreigners in the Dominican Republic (Plan Nacional de
Regulación) on 17 June 2015, population movements of irregular migrants have been reported
crossing the border from Dominican Republic to the Republic of Haiti. The majority of whom have been
identified as spontaneous returns (by their own means or under a Governmental transport), with a
number of cases of individuals who have been deported.
It is difficult at this stage to establish clear estimates on the number of people expected to be deported
as there are confusing information and data from government's sources in the DR and Haiti. However,
as per the Government of Haiti Contingency plan, it is estimated that more than 300,000 people will be
at risk of deportation and infrastructures and services at the border are very weak.
It is widely reported that some children are victims of trafficking and have been smuggled across the
Dominican border during normal times. However, there is no current data on how this phenomenon
may be affected by the increased population movements. That said, the risks of exploitation,
maltreatment and child abuse are quite high since the capacity to regulate control and provide support
for institutional and community stakeholders on site is limited and inadequate to prevent such cases.
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UNICEF provides technical and financial support to the Brigade of child protection (BPM) and the
Institute of the social well-being and research (IBSER) in order to strengthen their intervention across
the border. The BPM ensures the control of the travel documents of children who cross the border,
arrests the “passeurs” involved in the trafficking of children, and refers the un-accompanied children to
national structures. The BPM is accompanied in some cases by IBSER personnel for a support, and
there is at least 1 police officer at each border point. IBESR assists the Agents of the BPM to ensure an
immediate response, provide support to the children, and when needed proceeds to assist the family
reunification process in collaboration with other protection partners.
UNICEF also supports DINEPA where urgent needs related to water access and sanitation are
reported. A particular focus is maintained on the border areas close to cholera affected zones. DINEPA
emergency focal points are mobilized in the four main entry points (Anse a Pitre, Malpasse, Belladere
and Ouanaminthe) where they have participated in the assessment missions.
What UNICEF Haiti is dedicated to do in the next 6-12 months with your
support?
UNICEF's humanitarian assistance is included in the UN joint contingency plan developed in May
2015 and matches the Government of Haiti assistance request. Our plan of action includes child
protection, provision of safe water and adequate sanitation facilities, nutrition, access to health
services where required and relevant, through:
Harmonized Vulnerability Evaluation Mechanism (MEHV)
Ensuring appropriate and harmonized vulnerability assessment of migrants after their entrance to
Haiti to confirm their status, ensure appropriate referral when required and assess their immediate
and medium needs.
Child protection: Ensure protection in temporary shelters, family tracing and reunification for
unaccompanied children arriving to Haiti from the Dominican Republic. UNICEF's first aim is to protect
children through ensuring that they are properly take care of during the reunification process. The
support provided by the partners will include basic primary care (food, shelter, clothes, and medical
care) as well as consider the individuals needs for psychosocial and counselling care as part of a
holistic approach to a child's needs; such as recreational activities that reinforce the resilience of
children and help to return a state of normality as soon as possible. In case of specific needs that the
care centre is unable to provide a referral mechanism will be in place through the existing network of
local and international partners present in the areas. Since June UNICEF has also increased support
for the preparation of a possible increase in non-accompanied children through the development of
small scale agreement with local NGOs, already recognized by IBESR as protection partners. The
main activities will include:
Ÿ Reinforce the support UNICEF already provides to IBESR to coordinate and provide quality
control and monitoring of child protection services and expand it to children crossing the HaitianDominican border.
Ÿ Support the system of referral between OIM and IBESR, for the identification of children
Ÿ Support 3 months of activities in the 4 care centres in Anse a Pitre, Malpasse, Belladere et
Oanaminthe
Ÿ Support IBESR in the reunification process of an estimated 450 children in the first phase.
Water, sanitation, hygiene and health services:
UNICEF will support the provision of safe water, sanitation infrastructure and health services for
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preventing water-borne diseases. Agreement with two NGOs have been finalised to be able to deliver
an immediate assistance based on urgent needs. UNICEF intends to support MSPP to ensure
minimum medical services for the most vulnerable, specifically for the immunization of children and
the prevention, screening and treatment of malnutrition.
Budget required : US $ 2,240,050 million
3. Drought monitoring and treatment of children with severe acute
malnutrition
200,000 households living in extremely severe food insecurity and 7,000 children experiencing
severe acute malnutrition.
Context
Approximately 30% of the population in Haiti continues to have significant challenges in meeting their
basic food needs. Further, some 200,000 households dependent on agriculture are severely food
insecure due to the negative impact of drought on their agricultural production during the 2015 spring
season (estimates from the Assessment Report of the agricultural situation and food and nutrition
security by the National Coordination of Food Security and Nutrition; May 2015).
While the drought has impacted the entire country, the departments of Northwest, Northeast, Centre,
Artibonite and Southeast are the most affected. The drought possibly will also have an impact on food
production in the next agricultural season, particularly affecting vulnerable populations (children
under 5, pregnant and lactating women). Both, acute and chronic nutritional problems are related with
climate inconsistency and change. The consequences of drought on health include an increase in
mortality rates, increase in admissions of severely malnourished children (under nutrition, under
nutrition, protein- energy malnutrition and/or micronutrient deficiencies) and infectious diseases that
can all contribute to create an immense pressure on already weak local medical facilities.
The impact of the drought on child health is not due solely to lack of food but has aggravated preexisting marginal health conditions where the net consequences of weak immunization services, lack
of safe drinking water and poor sanitation often prevail. Even if minimal food deliveries are made,
drought affected populations will remain in conditions of marginal health for the foreseeable future with
continuing high risk of illness and disease.
What UNICEF Haiti is dedicated to do in the next 6-12 months with your
support?
UNICEF will protect children from malnutrition in order to ensure their safe development, we are
therefore committed to:
Ÿ Support the treatment of children with severe acute malnutrition (SAM) using ready-to-use
therapeutic food (Plumpy nut)
Ÿ Support the supplementation on essentials micronutrients and vitamins (iron, vitamin A, zinc)
and an immediate mass campaign for deworming
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Ÿ Support the active community screening for malnutrition using mid-upper arm circumference
(MUAC) through the network of ASCP to reach 500,000 children who are in need of care
Ÿ Strengthen the capacity of MSPP key focal staffs and reinforce nutrition surveillance capacity
(monitoring, field visits in the worst affected areas).
Ÿ Support and advising at least 150,000 pregnant and lactating women on nutrition, improved
infant feeding (promotion of exclusive breastfeeding during the first 6 months of life child) and the
quality of complementary foods and feeding practices through fortification with essential
micronutrients (vitamins and minerals) for children.
In addition, water scarcity is a major and vital issue for thousands of people in those areas. UNICEF is
committed to support DINEPA and its partner's to increase water availability on the most affected
zones. Emergency action to quickly improve water availability and access in the affected areas is to be
implemented through supporting DINEPA and its partners to increase water-trucking capacities,
deepening 50 wells (for approx. 15,000 – 25,000 persons) and drilling 20 strategic deep boreholes in
areas most affected where shallow water is not available.
Budget required : US $ 1,861,800 million
4. Reducing disaster risks and strengthening emergency response for
protecting children and women of Haiti
500,000 people are likely to be affected by the hurricane season (June-November 2015).
Context
Haiti is one of the Caribbean's most disaster-prone countries, affected by hurricanes, floods,
earthquakes, landslides, drought etc. Its location - in the path of the Caribbean Hurricanes - combined
with a strongly degraded environment and a very difficult socioeconomic situation makes the country
and its population highly vulnerable to natural disasters. Every year during the hurricane season
(June-November), on average 12-15 tropical systems pass through the Caribbean area. Between
2004 and 2012 alone there has been one major earthquake, nine notable hurricanes, four tropical
storms and significant flooding related to intense rainfall.
Experts from the Tropical Storm Risk (TSR) have released their predictions for the 2015 North Atlantic
Ocean hurricane season (19 April 2015). The Atlantic hurricane season is forecasted to produce 11
tropical storms, 5 hurricanes and 2 intense hurricanes.
In this context, 52 communes are considered the most exposed according to the Civil Protection
Directorate's national contingency plan which estimates that 500,000 people could – in a worst case
scenario - be adversely affected by hydro-meteorological hazards.
What UNICEF Haiti is dedicated to do in the next 4 months with your
support?
Funds are requested to allow UNICEF to provide a timely and relevant rapid assistance in line with its
Core Commitments for Children (CCCs), the Government Contingency Plan and the 2015-2016
Transitional Appeal Process. UNICEF will undertake the following actions:
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Ÿ Support emergency response coordination mechanism with UNICEF's main partners (DPC,
DINEPA) and sign contingency agreements with experienced humanitarian NGOs,
Ÿ Ensure the availability of contingency stocks that allow rapid assistance in terms of protection,
water and sanitation, health, nutrition and emergency education,
Ÿ Support the DPC, DINEPA, MSPP during the initial phases of rapid assessment ensuring that
children and women's vulnerabilities and specific needs are taken into account,
Ÿ Implementation of disaster risk reduction awareness campaigns in schools.
Budget required : US $ 588,500.00
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HAÏTI
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