Humanitarian Bulletin Haiti. HAP mid-term review. In this issue HIGHLIGHTS FIGURES FUNDING

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1 U Humanitarian Bulletin Haiti Issue 30 May 203 HIGHLIGHTS.8 million people remain vulnerable; the revised Humanitarian Action Plan would assist one million of them. Many efforts are ongoing to mitigate risks to potential disasters during the upcoming hurricane season. Displaced people continue to leave the camps. IOM is facilitating return solutions. Decline in national capacities of the government and its partners in responding to cholera; a worrying situation as the rainy and hurricane season approaches. According to the latest FEWS Net report, food insecurity is rising due to low crop production and higher prices for local products. FIGURES Number of IDPs in camps Source: DTM, March, 203. Cumulative cholera cases Source : MSPP, 22 May 203. Fatality cases Source : MSPP, 22 May 203. FUNDING $35 million US$ funded (24, %) 320,05 657,7 Source : FTS-3 may 203 8,096 HAP mid-term review In this issue Humanitarian financing P. Emergency preparedness P.2 Camp management and return P.3 Cholera epidemic P.5 Food security P.6 The mid-term HAP highlights the progress made and the need to strengthen efforts to meet humanitarian priorities Significant progress has been made to respond to the devastating 200 earthquake, subsequent floods and cholera. According to a 202 mortality and morbidity survey, child mortality rates have been reduced from 68 per,000 live births in 2005 to 59 per,000 live births in 202; primary school enrolment increased from 49.6 per cent to 77 per cent over the same period; access to sanitation facilities also improved from 3.6 per cent to 27.7 per cent and access to prenatal services rose from 84.5 per cent to 90.5 per cent. Over the last six months, humanitarian assistance has helped hundreds of thousand vulnerable Haitians. Food aid and nutritional assistance have been provided to an estimated 700,000 people most affected by severe food insecurity; 38,000 people benefited from assistance to leave IDP camps and seek alternative housing solutions; 50,000 victims of Hurricane Sandy received shelter or reconstruction support; an estimated,000 families were prevented from being forcibly evicted from camps thanks to mediation and advocacy efforts; and 20,000 people affected by cholera received adequate medical care. Over 600 desludgings have been carried out in several hundred IDP camps, benefiting over IDPs. Additionally, all IDP camps have been surveyed at least three times for WASH indicators during 203. As part of the surveillance system of residual chlorine (SISKLOR), 059 residual chlorine samples were taken in over 250 sites (including 22 sites in the DTM). From right to left: Obas Hertz, director of the Ministry of Interior Sophie de Caen, Humanitarian Coordinator ai and Johan Peleman, head office of OCHA Haiti. Photo: OCHA. Photo: OCHA. Despite these efforts, over a million Haitians remain vulnerable and exposed to future shocks. These include.5 million people currently facing severe food insecurity. 320,000 internally displaced people remain in camps facing deteriorating living conditions and increased vulnerability to violence. They are in urgent need of return solutions and of basic services in camps to meet the most basic standards of protection and dignity. The upcoming rainy and hurricane season is likely to bring about an increase in cholera cases. Thirty eight cholera alerts have been reported so far with 20,000 affected people. Predictions suggest that up to 20,000 people could be affected by the end of the year. Unfortunately, funding gaps have led to a serious decrease in the capacity to respond.

2 Haiti Humanitarian Bulletin 2 Priority actions reflected in the Humanitarian Action Plan Mid-Year Review (HAP MYR) for the remainder of the year are focused on 935,500 of the most vulnerable people who have not yet received any assistance and the potential victims of cholera and the upcoming hurricane season. Those currently needing assistance include 800,000 in urgent need of food aid, employment opportunities and agricultural support; 20,000 displaced people awaiting return solutions; 20,000 potential victims of cholera and, at least 225,000 people expected to be severely affected by the hurricane season. Key revisions in the 203 HAP strategy for the remainder of the year include: increased details on scenarios, planning figures and critical needs related to preparedness and emergency response to a possible disaster during the hurricane season; revised planning figures for all key sectors particularly food security as well as the alignment of the cholera objective of the HAP to support the implementation of the recently developed cholera contingency plan. HAP requirements have increased from USD 44 million to USD 53 million, of which USD 50 million have so far been funded. USD 4 million of the USD 44 million requirements reflected in the HAP 203 had been mobilized as of 4 June 203. Through the HAP MYR, a number of projects previously funded outside of the HAP have now been integrated into the plan. Funding requirements for food security and preparedness and response to the hurricane season have also increased. A rainy and very active hurricane season has been forecast this year; up to 600,000 people could be affected. As a result, the HAP MYR reflects requirements of USD 53 million, of which an estimated USD 50 million have received funding so far. Efforts to prevent and respond to cholera particularly the reinforcement of health activities are the least funded component in the HAP, with only 9 per cent of requirements met so far. This is followed by food security and nutrition activities which have received only 22 per cent of critical funding requirements. Whilst resources to facilitate return solutions for 00,000 IDPs by the end of the year are likely to be met (taking into account funding to HAP projects and projects outside of the HAP), funding to provide basic services in camps remains a critical gap. Preparations underway for the hurricane season Partners strengthen contingency plans for the upcoming hurricane season The Haitian government and its partners have been reviewing and strengthening contingency plans at local council and national levels in preparation for the hurricane season (June to November). Population likely to be affected (DPC) According to forecasts from the Directorate for Civil Protection (DPC), some 600,000 people could be affected and 200,000 displaced by adverse weather conditions this year. The Nord, Nord-ouest, Artibonite and Ouest departments will be most vulnerable to heavy rains, winds, floods and landslides. Preparations for the 203 hurricane season are mainly intended to strengthen the organizational and operational capacities of central and decentralized entities of the national disaster and risk management system (SNGRD) in general and the DPC and the Permanent Secretariat for Disaster and Risk Management (SPGRD), in particular. 600,000 people in need 225,000 in emmergency shelters 42, Total numbers of people People in need People in temporary shelter ,000 Jérémie 9,000 GRANDE ANSE 70,476 55,000 24,000 SUD Deaths Les Cayes Missing 3,50 32,500 NIPPES 66,278 NORD OUEST 2,000 28,000 0,000 Miragoâne Port-de-Paix 57,02 Gonaïves ARTIBONITE SUD-EST Jacmel NORD Cap-Haïtien Port-au-Prince OUEST NORD EST Hinche CENTRE Sources: Planningassumptionof thedirectiondelaprotectioncivile (DPC) Institut HaitiendeStatistiqueet d Informatique (IHSI) ,529 45,000 45,000 2,000 97,050 23,500 35,000 5,000 67,863 35,000 35,828 7,500 Fort-Liberté 22,000 8, ,462 22, ,760 7,500 75,000

3 Haiti Humanitarian Bulletin 3 Six working groups - mitigation, contingency planning, SIMEX, information management and data processing, public awareness, evacuation and temporary shelters - were set up in March 203, to this end. Five joint simulation and response to natural disaster exercises (SIMEX) were planned for 203 to test the capacities and response mechanisms at local and national levels in four departments (Sud, Nippes, Grande Anse and Nord-Est) and one at the national level. The first SIMEX was held from 22 to 23 April in Les Cayes. The exercise brought together Haitian national authorities, humanitarian agencies and MINUSTAH personnel to respond to a simulated crisis. The State University of Colorado s (USA) projects a more active than average hurricane season for 203 than for the period. It forecasts about 8 cyclones including 9 hurricanes and four major hurricanes for 203. The U.S. government ends training on emergency operations The U.S. government has wrapped up training for Haitian professionals of the national disaster and risk management system. The month-long training for 35 participants, provided by the Louisiana National Guard, covered emergency center operations, management communication, humanitarian logistics and disaster simulation exercises. The participants are expected to play a central role in emergency center management activities. The program is part of a cooperation agreement initiated in 202 between the DPC and the Louisiana National Guard. It follows a long-term cooperation program with the U.S. government through the Southern Command (SouthCom) of the Armed Forces of the United States which supports emergency response capacity building. SouthCom has already funded the construction of crisis operation centers across the country. Some of these centers will be operational during the 203 hurricane season. IDPs return process on track The IOM return project, funded by ECHO, will assist the return of more than 7,500 families by December 203 More than three years after the 200 earthquake, some 320,000 people (over 8,000 families) still live.5 million IDPs in 385 camps in Haiti. An ECHO/IOM project for victims of the earthquake supports return and Number of IDPsin camps relocation operations to neighborhoods with better,555 Camps housing, notably through provision of rent subsidies. 320,05 The project, which was designed by the Haitian Number of sites government through the Unité de construction de logements et de batiments publics (UCLBP) and IOM supports the reintegration of IDPs in host communities. It thus, aims to bring to an end as fast as possible the continuous movement of IDPs since Jul Mar. 203 January 200. Source: DTM Report, March 203 While it enables the displaced to have a fresh start in new housing, rent subsidies also build a sense of self-worth for those who have spent years in camps. The subsidies allow families to finally enjoy better protection against the elements, in a country known for its inclement weather. The project also helps to ensure Haitians renewed access to many public spaces and some owners an opportunity to recover their land. 700 families being readied for return at Camp Tè Roche Number of IDPs from Jan. 200 to March 203 In camp Tè Roche (Tabarre, metropolitan Port-au-Prince), IOM is currently facilitating the registration process for the return of displaced families. IDPs are also being provided with medical services and counseling to better prepare them to be relocated to news homes and neighborhoods.

4 Haiti Humanitarian Bulletin 4 OIM facilitates the signing of a lease between a displaced family and a landlord. Photo: OCHA. Each of the 700 families will be provided with a USD 500 rental subsidy for a year. Chiara Milano, the IOM project coordinator commends the assistance provided by Tabarre municipal services in the relocation process. "The full involvement of the Tabarre municipality is a great way to help raise awareness and help people appropriate the project," she says. Marie Love, a municipal agent and colleagues help in the registration process, sensitize the IDPs on various aspects of the project and resolve conflicts. "We have received a hundred complaints about the selection process so far, but less than 5 per cent meet the criteria for selection, says Marie Love. As part of the pre-return activities in Tè Roche, IOM also carries out sensitization on sanitation and hygiene, infrastructure assessments and maintenance services, so as to ensure a "clean environment for IDPs during their stay in the camp and during the final camp closure, Christine, an IOM/WASH staff explains. The most difficult phase of the return/relocation process remains the identification of new housing for the displaced. Most IDPs would rather return to their places of origin where they have family. Once the IDPs choose their housing, IOM officers conduct an assessment to ensure that the new dwelling meets basic criteria - solid construction, no environmental risks, access to latrines and water. The owner and prospective tenant are then briefed on Haitian rental law. If the conditions are met, IOM records the GPS readings of the property and facilitates the signing of a one year contract between the owner and the beneficiary family who move into the new housing after dismantling their tent. Six to eight weeks later, IOM makes a surprise visit to verify that the family still lives in the selected house. "Reintegrating IDPs in a community and overcoming the psychological trauma of the past 3 years are real challenges facing these destitute families as they have been used to living in terribly poor conditions for too long," says IOM s Chiara Milano. Between August 202 and May 203, IOM has facilitated the return of more than 3,600 families in 53 camps in the municipalities of Port-au-Prince, Tabarre and Croix des Bouquets. Twenty six camps have been closed and about 2,500 people have been relocated to new homes. The project plans to return at least 7,650 families in 60 camps by December 203. The cost of the project from August 202 to December 203 is 8.22 million Euros. Based on the assistance provided since 20 and current funding, IOM hopes it would have assisted in the return of 26,500 families by the first quarter of housing units inaugurated in Morne-à-Cabris Return/relocation and reconstruction project data. Transitional shelters Grantsfor rental houses Repaired Houses Reinforced Transitional shelters Reconstructions Some 20 housing units were inaugurated by the Haitian government on 6 May, as part of its plan to build 3000 housing units in Morne-à-Cabris. The USD 40 million project, funded by Petrocaribe, will benefit 5,000 people (drawn from families of 3 to 5 people) who were victims of the January 200 earthquake and who are still living in camps in Croix des Bouquets and Tabarre communes.,55 3,43 26,025 8,424,702 0,744 33,94 25,42 8,50 7,89 completed and distributed projects planned and funded projects

5 Haiti Humanitarian Bulletin 5 The return programme for the displaced is on course. However, there is urgent need to prioritise improvements in the sanitary conditions in the remaining camps. The cholera epidemic must remain a priority especially as infrastructure for responding to the epidemic is in decline. The UCLBP (Unité de construction de logements et de bâtiments publics), which manages the project has announced the construction of a mini industrial park to boost job creation. As water quality declines in many areas, fears rise with the onset of the rainy season According to findings from the latest assessment carried out by DINEPA, the directorate of potable water and sanitation) and the WASH Cluster water quality has declined markedly in IDP camps between January and May. During the last sampling in IDP in Delmas, 80 per cent of camp residents did not have access to chlorinated water. In Tabarre, the rate was 6 per cent, thus putting the population at heightened risk of waterborne diseases. Sanitation was not better either. The lack of latrines makes defecation in the open the biggest concern for DINEPA. According to Sphère standards, a latrine should accommodate at most 20 people. In 202, the camp population had a latrine for 20 people. The situation worsened in 203 to the point where one latrine now serves 200 people. The situation is compounded by the significant decrease in the number international WASH actors despite efforts by national actors, including DINEPA. Paul Christian Namphy, DINEPA s Project Coordinator for assistance to municipalities, stressed the need to national and international partners during the HAP 203 MYR «to urgently improve the situation as shortcomings in water chlorination greatly increases the risk of cholera in the affected areas". Response capacity to cholera missing Humanitarian community is concerned about the decline in CTCs and UTCs CCO, the NGO coordination platform, is gravely concerned about the closure of a large number of Cholera Treatment Centers (CTCs) and Cholera Treatment Units (UTCs) by the end of 202. The number of CTCs dropped from 84 to less than 30 in Port-au-Prince in 203, thereby drastically reducing the capacity to respond to local emergencies in the area of water and sanitation. According to Action Contre la Faim (ACF), the reduction in capacity is even more critical as emergency response capacities are pivotal in eliminating the cholera epidemic. These capacity challenges have been further compounded by many gaps in surveillance. So far, more than 645,000 (or 6 per cent of the population) have been affected by the onset of the cholera epidemic in Haiti in October 200. It has also resulted in 8,000 deaths, according to the Ministry of Public Health and Population (MSPP). Up to 20,000 people may be affected by the epidemic in 203. This figure is equivalent to the number of cases in 202. The number of cases between January and May 9 stands at 2, deaths were reported during the same period. As the cholera contingency plan is being launched, NGOs such as ACF, MSF and MDM are increasingly drawing attention to the lack of resources allocated to emergency structures. CCO is calling for an urgent re-mobilization of national and international actors and resources to contain the epidemic, as the rainy season sets in. Cholera must remain a major concern in Haiti. Number of Cholera Treatment structures Ouest Artibonite Nord Sud Nord-ouest Centre Grande-Anse Nord-est Sud-est Nippes # CTCs* # CTUs* # CTDAs* (Apr. 203) (Apr. 203) (Apr. 203) Source: PAHO / WHO Number of Cholera Treatment structures (CTC and CTU) from 200 to April 203 CholeraTreatment Center (CTC) CholeraTreatment Unit (CTU) Dec. 200 Dec. 20 Dec. 202 Source: PAHO / WHO 4,0 3,5 3,0 2, Apr. 203

6 Haiti Humanitarian Bulletin 6 A joint government and United Nations delegation was in Washington, DC, to present the plan for the elimination of cholera in Haiti A delegation of partners for the elimination of cholera in Haiti was in Washington, DC, on 3 May to present the Ministry of Public Health s two-year operational plan for the elimination of cholera in Haiti and the cholera contingency plan for the 203 hurricane season. The overall objective of the meeting was to highlight critical needs in the fight against cholera and to stress the urgent need to mobilize support from the international community to the government to enable the implementation of the operational plan and respond effectively to the problem. With the hurricane season fast approaching, the Haitian government and the humanitarian community are strongly concerned about lack of resources to cope with a possible upsurge of the epidemic in the country. The CCCM Cluster attributes overall decreases to date to rental subsidies (as much as per cent of total decrease) and other return programmes. 452 families have been returned from the Marassa 4 IDP Camp, leaving behind only 49. Families in Marissa 9 will soon be relocated. The maternal mortality rate in Haiti remains one of the highest in the world. In rural areas, the rate of child-birth in hospitals or other health centres is as low as 25 per cent. The food security situation worsens A decline in agricultural production and the depletion of reserves of poor households have led to a rise in food insecurity The cumulative impact of rising prices of local products, poor harvests during 202, dwindling food stocks and seeds are contributing to rising food insecurity in Haiti, according to the latest report of the Famine Early Warning System Network (FEWSNET). The National Coordination for Food Security (CNSA) indicates that the combined impact of these shocks has increased the vulnerability of poor households which have run out of survival strategies. The situation is expected to continue to deteriorate, especially in the most vulnerable communities, even after the June/July harvest. Partners in cholera response in 203 (Registered partnerswith OCHA and the cluster system in Haïti (May 203) 9,26 Fatality rates (per month).2% 22 May Forty four municipalities have been particularly affected, with over 50 per cent of the population facing high food insecurity. Some 800,000 people suffering from severe food insecurity have not received any emergency assistance. As at now, only 40 per cent (700,000) of the.5 million food insecure people have received some assistance. Jan. 42 partnershealth - Cholera Information on cholera from January to May 203 New cholera cases (per month) 2, %

7 Haiti Humanitarian Bulletin 7 The humanitarian community is gravely concerned that flooding resulting from the coming rainy season could significantly destroy crops and agricultural infrastructure in the mostat-risk departments (Nippes, Sud-est and Sud). Lack of pre-positioned stocks and funding is further compounding the grim prospects. "Food Security and Nutrition" has been identified as a major priority in the mid-term review of the 203 Haiti Humanitarian Action Plan. Strategies have been proposed to alleviate food insecurity (half of the Haitian population living in moderate food insecurity) and malnutrition affecting mainly children under five years (8,600 children under 5 years are malnourished, including 6,200 suffering from moderate malnutrition and 20,400 from acute malnutrition). In brief CAED holds maiden meeting on aid effectiveness The Comité d efficacité de l aide (CAED), a strategic forum of the Haitian government and its partners in the economic and social development aimed at improving aid effectiveness, met for the first time on 0 May to define priorities for the post-earthquake reconstruction and sustainable development of the country. Launched on 26 November, 202, CAED defines the mode of operation and partnership assistance for Haiti s economic and social development in accordance with government priorities. The year 200 was marked by huge financial contributions to Haiti. Following the 200 earthquake and up to 202, about USD 5.37 billion was pledged for recovery activities. Of this amount, 56 per cent, or USD 3.0 billion was paid. Promises of debt relief amounted to USD.0 billion. However, analysis shows that aid has not always aligned with the priorities of the Haitian government. Remembering the 7 May, 842, earthquake - Cap Haïtien still at risk The Ministry of the Interior and Local Government through the Directorate of Civil Protection (DPC) commemorated the 7st anniversary of the earthquake of 7 May 842, by organizing a traveling exhibition on earthquake risk reduction. The 7 May 842 quake was the last great earthquake in Haiti before the 2 January, 200. The 8. magnitude earthquake shook northern Haiti and killed 5,000 people in Cape Haïtien (half of the inhabitants of the city at the time). The commemoration is part of the earthquake plan for the North and is aimed at raising awareness to ensure better preparedness for future emergencies. The northern fault, which was the cause of the earthquake 7 years ago, continues build up energy, according to some experts. For further information, please contact: George Ngwa Anuongong, Chief, Communications Section, ngwaanuongong@un.org, Cell. (509) Widlyn Dornevil, Public Information Officer, dornevil@un.org, Cell. (509) Guillaume Schneiter, Reporting Officer, schneiterg@un.org, Cell. (509) OCHA humanitarian bulletins are available at haiti.humanitarianresponse.info