DEC Response in Haiti following the Earthquake in January 2010
Final report – May 2013
Summary The earthquake that struck Port-au-Prince and the surrounding areas took place now more than three years ago. It killed more than 200,000 people and left massive destruction of Haiti’s infrastructure. Over 500,000 people sought refuge in the rest of the country and 1.5 million people were displaced to what were originally thought to be temporary settlements. DEC launched a public appeal on 14 January 2010. This fundraising effort raised £107m from the British public - £72m was donated to the DEC itself and £35m to member agencies. In the light of the challenges survivors faced in rebuilding their lives, the DEC agreed that the funds it raised could be spent over three years. Of the £72m raised directly by the DEC, our member agencies spent £19.1m within six months of the earthquake and £40.4m in the following 18 months. The assistance effort was divided into two phases. Phase 1 ran for 6 months between February and July 2010 and Phase 2 (2.1 and 2.2) ran for 30 months between August 2010 and January 2012. The second phase was expanded (2.2) because of the substantial longer term reconstruction needs in the country. In the first phase over 1,800,000 beneficiaries were provided with emergency assistance. In the second phase around 849,346 beneficiaries were reached with recovery assistance. All DEC members launched activities in response to the earthquake and large numbers of survivors benefited from different types of shelter assistance, improved water supplies, solid waste management, education, healthcare, livelihood support and other assistance. With its comparatively low level of development and the severity of the 2010 earthquake, Haiti faced a long recovery phase. In terms of volume of work, provision of water and sanitation, shelter and healthcare absorbed most of the resources, helping people to return to pre-quake conditions as soon as possible. A number of other activities aided in this regard including training, education and livelihoods particularly cash-for-work around the removal of rubble and debris. Overcoming the challenges that remain is a question of how to push forward social and economic development in a chronically poor country with a troubled past. Most DEC agencies will continue their developmental work in Haiti long after emergency funds are exhausted. Haiti has been subjected to other disasters since the devastating 2010 earthquake, including hurricanes and flooding. A cholera outbreak that began in October 2010 represented a new threat and is now estimated to have killed about 7,000 people. Seven DEC members responded to the cholera outbreak, helping to bringing the epidemic under control with both preventative and curative measures however cholera is now endemic in Haiti. Several of studies and evaluations were carried out on the Haiti response by DEC member agencies. These revealed a number of lessons learned and recommendations. Examples include adjustments to strategy to in light of the urban environment where the disaster took place, the need for continued innovative approaches to programming (e.g. use of technology) and the importance of collaboration including with local government. These are elaborated along with details of the response here in this final report.
2 DEC – Haiti Earthquake Response: 2010-2013
Background Haiti’s 2010 earthquake created the largest urban disaster in modern history. It left massive destruction in terms of human lives and suffering, killing tens of thousands of people and displacing over one out of every five Haitians from their homes. Later that same year, a cholera epidemic swept the country claiming thousands of lives. By June, the hurricane season commenced bringing violent tropical storms and causing damage to housing, livestock and crops. The earthquake would have been a huge challenge to any country, but Haiti is the poorest nation in the western hemisphere, and has suffered decades of weak government and corruption. Even before the earthquake at least 200,000 people lived on the streets and many more were tenants with few rights. With some 78% of its population living on under US$2 a day and beset by huge societal inequality and weak governance, Haiti’s underlying conditions of vulnerability have led to a protracted recovery period and the country continues to deal with the aftermath of these events. At the time of writing 320,000 people remain homeless in the camps that sprang up in the immediate aftermath of the earthquake.
Overview of DEC Appeal and Members’ Response The Disasters Emergency Committee (DEC) launched an appeal within the UK on 14 January, 2010, two days after the earthquake. Since that time, DEC members reached more than three million people with DEC-funded aid. All but one of these organisations are still providing a wide range of support to survivors as they continue to try to rebuild their lives. The initial response, Phase 1, ran for 6 months between February and July 2010 and Phase 2 (2.1 and 2.2) ran for 30 months between August 2010 and January 2012. The second phase was expanded (2.2) because of the substantial longer term reconstruction needs in the country. Overcoming the challenges that remain is a question of how to push forward social and economic development in a chronically poor country with a troubled past. Most DEC agencies will continue their developmental work in Haiti long after emergency funds are exhausted. Activities and Beneficiaries Reached All fourteen DEC members launched substantial earthquake response activities across a number of sectors. Large numbers of survivors benefited from different types of shelter assistance, improved water supplies, solid waste management, education on cholera prevention, healthcare, livelihood support and other assistance. Water and sanitation (WASH) represented the largest sector implemented by DEC members, both in terms of funding and people reached. A significant number of people received support to provide emergency shelter (most often in the form of plastic sheeting and other supplies) and then later transitional shelter and permanent housing. DEC members have also helped local communities secure land for housing and sought to defend the interests of those facing forced evictions from camps with nowhere else to go. Health was another major sector and the protection of children, vulnerable women and the elderly were also addressed through various efforts. Smaller numbers of people received cash grants, loans, training or other assistance to set up or expand small businesses. Much of this livelihood support work has revolved around small scale construction and has included training on how to make homes more resistant to earthquakes and hurricanes. Table 1 provides the number of beneficiaries reached by sector activity and Table 3 shows member highlights in Haiti.
3 DEC – Haiti Earthquake Response: 2010-2013
During the response, DEC members also worked through partners (discussed further below) and made a special effort to help relevant government agencies, especially those responsible for water, sanitation, and healthcare, to take over the services delivered earlier by NGOs. Table 1: Beneficiaries reached by DEC Members1 Phase 1 Shelter (all types) Emergency supply kits Water, Sanitation & Hygiene promotion Education and training Over 1.8 million people Livelihoods Health Protection Phases 2.1 & 2.2 beneficiaries Water and sanitation 557,463 Shelter 18,514 Livelihoods 111,874 Health 495,340 (of which Cholera Response is 358,353) Food 4,859 NFIs 20,435 Capacity building and Protection 83,322 Education and training 13,635 DRR 58,356
Funding DEC fundraising efforts raised £107m: £72m was donated to the DEC itself and £35m to member agencies. In the light of the challenges survivors faced in rebuilding their lives, the DEC agreed that the funds it raised could be spent over three years. Of the £72m raised directly by the DEC, member agencies spent £19.1m within six months of the earthquake and £40.4m in the following 18 months. Remaining funds raised by the DEC directly were spent by January 20132. The breakdown of these budgets is shown in Table 2. Table 2: Utilization of DEC funds by member organisations (GBP)
ActionAid AGE UK BRC CAFOD C Aid CARE Concern Islamic Relief
TOTAL allocation (Phase 1 & 2) 4,850,503 3,788,001 10,010,104 3,936,810 5,198,015 3,909,737 3,788,330 2,010,450
TOTAL Expenditure (Phase 1 & 2) 4,850,503 3,788,001 10,010,103 3,936,810 5,198,015 3,909,738 3,788,320 2,010,788
Variance 0 0 1 0 0 -1 10 -338
1
Please note that some of the beneficiary numbers are approximate due to the nature of some activities and record keeping. 2 Two agencies will complete their DEC project by July 2013 (see Table 2)
4 DEC – Haiti Earthquake Response: 2010-2013
MERLIN OXFAM SCUK Tearfund W Vision TOTAL
3,956,540 13,359,871 7,943,545 5,090,990 4,118,275 71,961,171
3,956,825 13,359,910 7,943545 4,954,511 4,118,273 71,837,919
- 285 - 39 123,902* 136,479 2 207,192
*SCUK is currently finishing their DEC funded project. All funds will be expended by July 2013. The breakdown of these funds can be further seen in Figure 1 in terms of sector allocation. Figure 1: How DEC funds were spent in Haiti by sector
Early Response by Member Agencies In the immediate aftermath of the earthquake, organisations rallied to address the most pressing basic needs. Many of the DEC members mobilised their response within hours of the quake, taking advantage of their long established presence in the most-affected provinces. All but two of the DEC-funded members were present in Haiti prior to the earthquake. Immediately following the earthquake, spontaneous self-settled camps were formed by those made homeless in the capital’s open spaces. In these places population numbers rose rapidly in sites that lacked even the most basic water and sanitation facilities, serving to create a situation where there was a serious risk of the outbreak of disease. Due to the sheer volume of needs of the population, a common objective in the immediate response was to assist people living in camps to have a healthy and safe environment. This 5 DEC – Haiti Earthquake Response: 2010-2013
included the need for basic food and non-food items (e.g. buckets, kitchen sets, and hygiene kits), as well as shelter, water and sanitation, and the provision of clinical health care. As the entire population in the affected areas was in need, many organisations moved to support lifesaving and life sustaining measures. Concern Worldwide’s activities In an urban disaster such as that experienced in Port-au-Prince, focused on WASH, capacity using a multi-sector approach to build synergy can have building and technical dividends. According to Islamic Relief’s final report, the cash-forassistance. CAFOD, work project had three significant positive impacts. Firstly, rubble as another example, focused on cleared from housing sites gave people space to start rebuilding five main activities with its their homes. Secondly, some beneficiaries reported that the partners in the initial phase. cleared space allowed children to play football and other games, These were provision of water to bringing a sense of normality back into their lives. Finally, the 50,000 people in camps and tonnes of rubble that were cleared during this project were sent to the airport, which was intended to speed up the process of its critical institutions, such as development. (Source: Islamic Relief Phase 2 Final Report, schools installation of 227 pit September 2011). latrines for 29,446 people, construction of one hand wash station per latrine block and provision of solid waste refuse collection services to Sphere standards in 10 displacement camps. CAFOD also provided hygiene NFIs to 10,000 families and established five child-friendly spaces (CFS) in three camps and thus assisted 1,213 children on average per week. Oxfam’s water, sanitation and hygiene activities scaled up effectively, thanks to the experience of its staff in responding to emergencies in both camp and urban settings, and to logistical support from within the Oxfam International confederation. From the fourth day, Oxfam was tankering water to multiple camps and by the end of fourth month Oxfam’s water supplies were serving 130,000 people. Special efforts were made to address the needs of separated children, the elderly and the disabled particularly when agencies had a clear focus on these groups as part of their organisational mandate.
Response in Recovery Phase With its comparatively low level of development and the severity of the 2010 earthquake, Haiti faced a long recovery phase. In terms of volume of work, provision of water and sanitation, shelter and healthcare absorbed most of the resources, helping people to return to pre-quake conditions as soon as possible. A number of other activities were complementary to recovery in this regard, including training, education and livelihoods, in particular ‘cash-for-work’, which provided people with cash in exchange for the removal of rubble and debris. Haiti is the first humanitarian response where the concept of baby tents has been delivered to scale and in a context where women had suffered significant trauma and where the use of infant formula was often prioritised over breastfeeding practices, a space which offered privacy, care and counselling and which could advocate for and educate women on breastfeeding (and where this wasn’t taken up, could monitor the use of infant formula) provided potentially life-saving services in addition to strengthening uptake of breastfeeding. (Source: Evaluations of Concern’s Response to the Haiti Earthquake, October 2010.)
Several agencies combined shelter and livelihood (cash-forwork) activities to meet the requirements of the urban disaster found in Port-auPrince. For instance, Islamic Relief successfully constructed a total of 453 transitional shelters. Based on 4.4 people 6
DEC – Haiti Earthquake Response: 2010-2013
per household, 1,993 individuals benefitted. On average, an individual employed for rubble removal worked for 12 days and earned USD 10 (400 Goudes) per day, or 120 USD per two weeks. This project therefore benefitted an estimated 8,725 people. Through this project, 1,983 heads of families were employed in cash-for-work activities. For Oxfam, construction of sanitation activities and solid waste management were a priority. Oxfam installed latrines and washing facilities in challenging urban conditions for 66,000 people and organised regular clean-up campaigns in most of the camps where it operated. After local staff were recruited, hygiene promotion activities scaled up rapidly and by end of Phase 1 had successfully mobilised the vast majority of men, women and children in camps to use and store water safely, wash their hands after using the latrines, and to undertake a range of other activities to protect their health. Disaster Risk Reduction DEC members put a strong emphasis on disaster risk reduction (DRR) in large measure to the recognition that more needed to be done to prepare for future hazards such as hurricanes, flooding, and disease outbreaks. The issue of DRR concerning the structural safety of buildings is vitally important given the seismic risk in Haiti and the country had no building codes to take such considerations into account. There was a definitive focus on community resilience in members work on WASH, livelihoods and shelter particularly during the second phase. All DEC members included DRR programming in their work, either by mainstreaming DRR activities in different sectors or by having stand-alone DRR projects. Tearfund’s activities serve as one example. Twelve communities participated in Tearfund’s Participatory Assessment of Disaster Risks. A district-wide civil protection committee and 12 community-level DRR committees and were established and trained by the Direction de la Protection Civile and Tearfund jointly. The committees mapped out their vulnerabilities and developed response plans. Training workshops were also offered in first aid, environmental protection and other DRR topics. Each community identified and proposed micro-mitigation projects that were funded by Tearfund such as stone wall construction, trees planting and protecting houses from landslides and flooding. Tearfund’s June 2012 Knowledge, Attitudes and Capacity survey identified that 69% of communities are now able to name two or more actions they can undertake to reduce their own risks to future disasters. More specifically 89% can name two or more actions related to an earthquake, 80% to a hurricane, 46% to flooding and 57% to a landslide. Cholera Response A cholera outbreak that began in October 2010 represented a new threat and is now estimated to have killed about 7,000 people. Seven DEC member agencies responded to the cholera outbreak, helping to bring the epidemic under control with both preventative and curative measures. However, cholera is now endemic in Haiti. Most activities focused on limiting the spread of the disease, by supplying clean water and through campaigns to promote safer hygiene practices, but some have engaged in providing medical care for cholera. Several organisations including Save the Children, BRC and Merlin’s activities were further scaled up significantly by setting up and running a cholera treatment centre (CTC) plus community outreach work, once again with financial support from the DEC.
7 DEC – Haiti Earthquake Response: 2010-2013
Accountability Accountability was a central theme of this response. This is part of a wider recognition of the importance of accountable programming in humanitarian practice. In addition, staff from the Humanitarian Accountability Project (HAP) were present in Haiti for roughly a year and were able to impart resources and training to all DEC members. At the same time, humanitarian organisations in Haiti, including DEC member agencies, struggled to adapt their earthquake responses to an extremely challenging urban environment. While “camps” were often easier than standard settlements to support administratively, the lack of space and the infiltration of powerful gangs into the over-crowded urban environments has created a significant challenge to agencies who are more used to working environments where more space is available and where they can manage situations more easily. Most DEC members had dedicated staff to help ensure basic accountability. World Vision, for example, had ‘Humanitarian Accountability Teams’ that worked with programme and monitoring and evaluation teams. Standard methods used included installing complaints and response mechanisms such as placing suggestion boxes in appropriate locations, sharing contact details of partners’ senior staff, providing hotlines and toll-free numbers, displaying beneficiary entitlements at distribution sites and identifying individuals within organisations to whom complaints were to be taken. As part of this effort at enhanced accountability, the Haiti response witnessed widespread use of technologies such as SMS texting and phone apps to provide a multi-channel feedback system so that beneficiaries have a variety of means to make their voice heard.
Partnership and Participation of Beneficiaries in the Response Partnerships were a key part of the response in Haiti. Where it was a standard approach to do so, many DEC members worked with partners and several DEC members focused exclusively on this approach instead of direct implementation. For example, CAFOD traditionally works through partners and was able to quickly connect and contract with two former international partners from the Caritas agencies: CRS for direct implementation of water and sanitation activities and Caritas Switzerland (CaCH) for permanent rural house reconstruction in rural Gressier with direct co-implementation with a local organisation, ITECA. Another example is Christian Aid who carried out Participatory Vulnerability and Capacity Assessments (PVCAs) with communities, through their partners, who had been trained in this inclusive methodology. The main PVCA training was carried out with 66 people over three days, and involved a wide range of community members including local authority representatives. Contingency plans were created by each of the participating communities. In working with communities directly, the BRC took a similar approach in implementing a neighbourhood development plan where residents were able to prove their ownership. In this way, residents who lost their houses in the earthquake approached BRC once they cleaned the rubble and preparing the land for new construction. In its health activities, Save the Children focused on building the capacity of local actors including community organisations, health workers, school teachers, community mobilizers, WASH committees, and local authorities through trainings. This included the development of a hygiene training manual for community based organisations and conducting training sessions on participatory, hygiene and sanitation promotion, waste management, water chlorination, cholera prevention, and risk and disaster management. 8 DEC – Haiti Earthquake Response: 2010-2013
Merlin consistently worked in support of, and in close collaboration with, the Haitian Ministry of Health (MSPP) at both commune and national levels. The organisation supported the MSPP’s strategy of returning health services to state control, but has also made some strategic inputs at certain levels to try and ensure that the facilities supported are left stronger than previously. Similarly, Oxfam had strategic partnerships with the national water authorities, to the swiftlyestablished but less formalised relationships with numerous community-based organisations (CBOs).
Evaluation and Lessons from the Response The Haiti response was well studied. Age UK, CAFOD, Oxfam, and Merlin undertook external evaluations of their DEC-funded projects in 2011-12 and most other DEC members carried out evaluations more recently. In addition, DEC commissioned two independent studies. In March 2011, a report entitled ‘Urban disasters – lessons from Haiti’ was published and in February, 2013, a study on ‘protection and accountability’ was carried out. While these evaluations and reports are wide ranging, a number of salient points can be gathered. These points represent a combined but not fully exhaustive set of lessons and recommendations: 1.
2.
3.
4.
5.
6.
Context: DEC members gained valuable experience of implementing recovery projects in densely populated urban areas with weak government capacity among a population with high expectations. Many DEC members note that in the context of Haiti there has been no simple transition from the relief phase to recovery. This is both because of the lack of government-led reconstruction and due to the need to be ready to respond to new crises including hurricanes, flooding and a possible resurgence of cholera. Assessment: After the earthquake, for example, there was a common assumption that everyone had the same problems and need when different groups had varying needs. Organisations need to conduct more thorough rapid assessments and continue to update findings as the nature of the emergencies change over time. Information/Data: In the rush to provide immediate assistance in the aftermath of an acute disaster such as the 2010 earthquake, baseline data is not always collected. There is a need for specific data and indicators on beneficiary vulnerabilities so that organisations are better able to advocate for revised funding streams to support protection. Strategy: Developing a clear multi-year programming strategy at country level to facilitate planning, engagement with the authorities, staffing and fund-raising is challenging after a large-scale disaster. As part of this, ensure that, even from the earliest stages of emergency response, the overall programme design and the design of each component are conducive to early recovery. Similarly, one DEC member concluded that it is important to focus on how to manage specific emergency responses with pre-defined priorities and planning for exit strategies and on-going development especially for longer term interventions. Mainstreaming: Once a programme is underway, inserting elements of protection and accountability mid-stream in a programme is not effective. These elements need to be either designed as stand-alone programmes or mainstreamed into the programme ‘as soon as possible’ after the onset of the emergency response. Capacity: Organisations should share tool kits and other resources to build capacity of organisations to better design and implement programmes in emergencies widely with their staff at both the headquarter and field levels, and training should be conducted. According to at least one DEC member, the success of the operation in Haiti has been characterised by good quality and experienced staff, especially those speaking French, who have invested time and energy into solid training support and practical skills transfers. However, 9
DEC – Haiti Earthquake Response: 2010-2013
it has also been plagued by a relatively high staff turnover, including at the levels of country director, and this should be a cause for reflection as it has undoubtedly hindered programme direction and continuity, has limited its institutional learning, and has been challenging to its on-going relationships with the authorities. 7. Coordination: Coordination worked in some ways and at certain levels but it was felt by many that this could be improved. Organisations should be encouraged to use and support the Cluster System, while ensuring that their information extends to government ministries at the national and local levels as appropriate following the principles of participation and information sharing. 8. Accountability: Currently, there is an emphasis on accountability to donors and beneficiaries but organisations are lacking in accountability to governments agencies, implementing partners and local staff. The definition of accountability needs to be widened to fully encompass a broader range of understanding. Organisations should continue to build capacity in the area of self-regulation. Along these lines, one DEC member felt that there was some urgency in establishing accountable and representative camp committees and that organisations should continue to work with the cluster to find workable solutions 9. Risk management/DRR: Given potential for existing hazards and future shocks, attention to this area is especially important. Yet the degree of preparedness is generally low, particularly as organisations phase out of emergency programming. Organisations need to look beyond the short term and engage in a longer-term vision for rebuilding the city, and consider how their actions are reducing vulnerability. In doing so, they should prepare for the next 3-5 big urban disasters that will almost definitely occur over the next ten years. Organisations should identify creative approaches to risk management and disaster preparedness as an integrated component of programme design. Organisations should further ensure that an on-going focus of efforts be directed toward DRR in infrastructure preparedness, staff training, planning, education (of staff and of Haitians) and agency coordination. 10. Local and government support: In urban environments, there is an importance to recognise smaller and more decentralised settlements that focus on the importance of community. These benefit from strong links with local authorities and which have strong links with the private sector to ease the process and sustainability of handing over services. Organisations should seek closer ties to the government without compromising target goals. In urban response and recovery, organisations should assume that professional skills and resources might be found locally to some degree. This is especially important to ensure that activities do not further increase the vulnerability of the population by embarking on activities, which may be consistent with international conventions, but do not take into account or respect local traditions and norms.
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Table 3: DEC Member Highlights in Haiti DEC Member Action Aid
Age UK
BRC (British Red Cross)
Sectors Education, livelihoods and food security, WASH (and irrigation), shelter, protection and DRR Health, protection and livelihoods
Health, livelihoods, DRR and cholera mitigation
Primary Locations Mariani StJude School, Petit Goave (Vallue)
Main Programme Activities
Delmas, Tabarre, Croix des Bouquets, Leogane
2 Camps at JMV La Piste and Automeca and Delmas 19
CAFOD
CARE
Shelter, WASH, capacity building
PaP and Jacmel
Shelter/NFIs
Tisous
Christian
WASH,
West and
One reservoir and 2 water access points were constructed. A water purification system was installed and functioning. One school was rebuilt and equipped and two schools constructed and equipped. 375 vulnerable head of households received income generating support and 32 received cash transfers. 7,956 individuals in seven target areas increased their knowledge and awareness of good hygiene practices. Community members were equipped with techniques to mitigate the effects of disasters. 45 households received transitional shelter. Older people living in 67 camps and 19 neighbourhoods located in 12 communes were provided with access to quality healthcare at primary level (home, health centre/mobile clinic), and secondary level (hospital). The protection of older people living in 67 camps and 19 neighbourhoods located in 12 communes was improved with age-sensitive community-based social services. The livelihoods of vulnerable older people living in 67 camps and 19 neighbourhoods located in 12 communes was improved through 12 income generation projects run by older people associations, and targeted cash-for-work activities. 810 community volunteers received training health, hygiene promotion and first aid activities, 967 households received bed nets, 7707 people were treated with ORS and 6556 patients treated and discharged in CTCs. 291 latrines were constructed, 108 dustbins installed; 120 individual shower cabins and 3 communal showers installed; 2 community laundry areas constructed; hygiene promotion volunteers made at least 20 home family visits per week; bars of soap, ORS sachets, and aquatab strips distributed. 4,539 shelters were improved to be more resistant to wind/rain, and to provide greater security, 97 schools (18,996 children) received education on cholera 166 latrines were constructed for vulnerable households, 2 latrines built in 2 schools. 3,472 households were supported with grants, 2,689 households benefit from Cash For Work daily wages, 3164 people participated in business training sessions. Literacy classes were provided for vulnerable women and 6,647 children's school fees were paid for one year. Households and institutions were given access to improved water facilities and provided with training on how to manage solid waste in their communities. 76 earthquake and hurricane resistant houses with toilets and rainwater harvesting structures were reconstructed. Local building material enterprises were considered and direct employment has been increased. 150 households benefited from basic mitigation works and infrastructure improvements. 500 labourers were trained on construction and disaster risk reduction techniques. More than 800 skilled and unskilled labourers worked on infrastructure works and benefitted from training and technical advice. 500 householders received technical advice on safe construction practices and reforestation. 150 permanent hurricane and earthquake resistant houses were built with appropriate water and sanitation
DEC Member Aid
Sectors Livelihoods, DRR, WASH
Primary Locations Central Depart. Les Nippes
Main Programme Activities
Concern
Merlin
WASH, capacitybuilding and technical support
Health: PHC, MCH, preventative medicine,
Tabarre, Issa, Martissant, Carrefour, and 5 areas in Delmas in St. Martin Canaan IDP camp, Jerusale, Onaville, Basboen. Petit Goave Carrefour Feuilles and Croix des Bouquets
Oxfam
WASH, livelihood, protection
SC-UK
Livelihoods and WASH
PaP
Tearfund
DRR and Health (HIV/AIDS)
Leogane
World Vision
Shelter/ return, livelihoods (training) and health
PaP: Cite Soliel, Corail
facilities. Livelihood activities were supported to increase self-sufficiency and improve household income levels. The communities understanding of DRR was improved, coupled with an increased awareness of environmental protection. 40 permanent hurricane and earthquake resistant houses were constructed and livelihoods activities supported. The access of 17 communities to water, sanitation and hygiene promotion was improved. Capacity building of community groups in 10 locations (10 groups in total) in disaster reduction strategies was provided. Technical support was given to the WASH Cluster, coordination at a commune level, with local organisations as well as municipal agencies. Access was improved to affordable and quality primary health care. This included cholera response and mobile clinics. Access to preventative health care at the community level was improved. Maternal health services to reduce maternal and neonatal mortality were promoted and strengthened. Merlin’s emergency preparedness capacity and response was strengthen. Excreta disposal was improved, through appropriate and adequate toilet facilities in Merlin clinics. Measurable improvements of the public health were made. Capacity of local businesses was increased. Oxfam contributed to a recovery process which takes into account the needs and interests of women and vulnerable groups. The livelihoods of vulnerable households affected by the earthquake were improved. Increases in water and sanitation-related diseases, including cholera, were prevented for the affected population. The resilience of disaster-prone communities in Haiti was strengthened. The level of vulnerability to natural disasters for the population of the South East province was reduced. The living conditions of families affected by the earthquake and HIV/AIDS were improved. Earthquake affected children were provided with safe school buildings. The number of displaced individuals living in camps was reduced, through supporting their voluntary return, resettlement or local integration. Capacity of existing community-based health services and affected households (IDPs and host families) to respond to health needs was increased. The number of children with access to an appropriately equipped and prepared primary school in Corail was increased.
12 DEC – Haiti Earthquake Response: 2010-2013