CORE COUNTRY DATA SOCIOECONOMIC DEMOGRAPHIC MORBIDITY*

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Haiti before the earthquake Background Haiti became the world's first black-led republic and the first independent Caribbean state when it obtained its independence from France in the early 19th century. However, decades of poverty, environmental degradation, violence, instability and dictatorship have left the country as the poorest nation in the Americas. A mostly mountainous country with a tropical climate, Haiti's location, history and culture once made it a potential tourist hot spot, but instability and violence, especially since the 1980s, have severely dented that prospect. From the mid 2000s, the international community, following years of political crisis, reestablisheds its cooperation. Soon after, the United Nations established the MINUS- TAH, the UN peacekeeping operation, with a mandate to support security, stability, governance and promote democratic elections. Haiti is considered as a fragile state and the 2010 earthquake further weakened the Haitian institutions, increasing risks of social unrest. Vulnerability to natural hazards Climate change, deforestation, topography, poverty and lack of public structures make Haiti especially vulnerable to natural hazards (tropical cyclones, flooding, and mudslides). From 2001 to 2007, tropical cyclones and floods left more than 18,000 dead and 132,000 persons homeless and approximately 6.4 million people were affected (the total population of Haiti is 10 million). During the 2008 Atlantic hurricane season alone Haiti was devastated by Tropical Storm Fay, and Hurricanes Gustav, Hanna and Ike, all of which hit the country within a month. Eight out of ten departments were severely affected and approximately 800,000 people required assistance. Additionally, thousands of dwellings, livelihood assets such crops and livestock and infrastructure were badly damaged. It is estimated that 2-3 million Haitians were already food-insecure, with 22% of the population suffering from chronic malnutrition, and 9.1% from acute malnutrition. 2009 CORE COUNTRY DATA Source: - PAHO. situation in the americas. Basic Indicators, 2009. - UNDP. Human Development Report 2009. - *EMUS 2004/2006, Haiti. DEMOGRAPHIC Total population (millions) Crude birth rate (1000 population) Annual pop grow (%) Urban population (%) MORTALITY Infant mortality rate (< 1 year) Children mortality rate (< 5 years) Maternal mortality rate (2006) Haiti The Americas 10 27.3 1.6 48.2 16.7 1.6 80.1 Haiti The Americas 57 14.8 76 19 630 63.7 SOCIOECONOMIC Proportion of pop below intern. pov. line (%) Pop with access to drinkin water sources (%) Pop with access to sanitation facilities (%) Annual GDP growthrate (2006-2007) Higesth 20% - Lowest 20% income ratio MORBIDITY* Prevalence of under weigh children under 5 (%) Proportion of one year old children immunized against measles (%) Proportion of birth attended by skilled health personnel (%) Haiti The Americas 65 58 19 1.4 25 34 94 87 3.1 13.6 Haiti The Americas 22.2 7 57.7 93 26.1 86

Haiti before the earthquake Humanitarian assistance in Haiti: 81 million, 1995-2009 81 Million 1995... 2009 JAN 2010... MAR APR... SEPT 2010... AUG 2011 25 20 Floods/ Cyclones 28% DRR 7% Social crisis 65% Million 15 10 5 0 1995 1996 1997 1998 1999 2001 2002 2003 2004 2005 2006 2007 2008 2009 The European Commission, through its Humanitarian Department, DG, has been supporting vulnerable populations in Haiti for the last 15 years. This assistance, totalling approximately 81 MEUR, has focused on responding to the emergency needs caused by natural hazards and socio-economic crisis, as well as disaster risk reduction. DG responded swiftly at the end of the 1990s and in 2004 to social and economic problems caused by political instability, to the 2004 hurricanes and floods in the countryside and Gonaives, and to the three consecutive hurricanes in 2008. In 2008, due to the high level of vulnerability that was identified in the country, DG re-opened a field office to more closely manage humanitarian operations and step up efforts to identify and address malnutrition and mother-child mortality through a comprehensive multi- sector response.

2010 Haiti earthquake 120 Million 1995... 2009 JAN 2010... MAR APR... SEPT 2010... AUG 2011 Nord-Ouest GLOBAL QUAKE FIGURES ((1) (1) 222,750 dead 105,000 houses destroyed and 208,000 houses damaged 60% of hospitals destroyed Around 5,000 schools destroyed (23% of the total of Haiti) Affected population (estimation): 3 million Displaced people in settlements up to 1.7 million Total impact cost around USD 7.8 Billion = 2009 GDP (1) Source: Government of Haiti Nord Artibonite Cent re Nord-Est ACHIEVEMENTS Adequate coverage of basic needs rapidly ensured including: Access to life-saving health services Emergency Shelter distribution in camps and host families Water distribution and access to sanitation facilities General food distribution and blanket preventive supplementary feeding Avoidance of malnutrition increase, epidemics outbreaks and potential civil unrest Reduction of vulnerability in camps CONSTRAINTS Grand'Anse Sud Sud-Est Port-au-Prince Ouest Unprecedented size and complexity of a crisis in an urban context (capital city) High toll of the earthquake on national authorities and humanitarian actors capacities Lack of accurate information on needs and ongoing response Complexity of population movements and fluctuation: camps/spontaneous sites/ sheltered population/migration at national level Needs on Emergency Shelter exceeding global humanitarian stocks National health system overwhelmed Lack of logistic means (transportation, warehousing and communication) and access (rubble removal and roads) Perception of security issues HUMANITARIAN AID CIVIL PROTECTION DG Amount: EUR 30 million (EUR 3 million immediate assistance + EUR 19 million emergency assistance + EUR 8 million refocussed from pre-earthquake funding) Beneficiaries: 2,830,000 Geographical areas of intervention: Port au Prince; Gressier/Leogane/Jacmel Triangle; National (Coordination & Logistics) Sectors of intervention: Shelter, Camp Management, Non Food Items, Water, Sanitation and Hygiene, & Orthopedics, Nutrition, Food Assistance, Coordination and Logistics/Telecommunications, Protection, Disaster Risk Reduction Partners: UN: OCHA, UNOPS, PAHO, WFP Red Cross National Societies: Spanish, German, French, Finnish, Austrian INGO: OXFAM GB, MdM, TSF, ACF, ACTED, AMI, CARE, CONCERN, HANDICAP BEL, HANDICAP FR, JOHANNITER, MALTESER, MapAction, PLAN, RedR, SOLIDARITÉS, Welt Hunger Hilfe h p://ec.europa.eu/echo/index_en.htm en.htm 25 European countries involved in the relief effort and channeling assistance through the EU Civil Protection Mechanism (MIC). 3 EU Civil Protection Teams were deployed on site to coordinate European assistance, carry out needs assessments and support the international relief effort in close cooperation with the UN. The Civil Protection assistance included 12 urban search and rescue teams, 7 assessment teams, 38 medical teams and supplies, 2 field hospitals, shelter, 6 water sanitation units, 2,334 tents for approximately 20,000 persons and 1 Base-camp with a capacity of 300 people. In addition to coordinating Member States' assistance, the EC directly deployed a water purification unit and 5 advanced medical posts with surgery. EU co-financing for transport of assistance requested or approved so far reaches a total amount of EUR 4.5 million.

2010 Haiti earthquake Immediate response 1995... 2009 120 JAN 2010... MAR APR... SEPT 2010... AUG 2011 Million Food 22% Coordination & logistics, 10% 6.6 M 3 M DRR 5% 1.5 M 7.8 M 5.2 M 17% 6 M Water 20% Shelter: 7.8 M Emergency Shelter: Distribution of tents, plastic sheeting and building materials Distribution of Non Food Relief Items: jerry cans, blankets, kitchen sets, mosquito nets, etc. Camp Management and Protection: Site identification, site planning and reorganization Coordination and data collection in camps and sites (including security) Shelter 26% : 5.2 M Provision of primary health care services (preventive and curative) in the directly affected areas through: Emergency Units (basic health care unit and cirurgical unit) Mobile clinics Support to existing health facilities Support to orthopedics, prosthetics and physiotherapy programmes Psychosocial support and baby tents Provision of essential medicines and medical supplies to national authorities and humanitarian actors Support to Cluster coordination Food: 6.6 M Food: Provision of Ready to Eat Meals (January 2010) Contribution to the global response targeting 4.5 million monthly food rations (February and March 2010) Food and/or Cash For Work activities (April 2010 onwards) Nutrition: Treatment and prevention of acute malnutrition in settlements (Ready to Use Therapeutic Food) Blanket supplementary feeding for under-5s Vouchers for access to fresh food available in markets Breast feeding promotion Disaster Risk Reduction: 1.5 M Reduction of vulnerability through: Community based disaster preparedness (DIP) Hurricane preparedness Mitigation works in camps Advocacy for building back better Water, sanitation & hygiene: 6 M Water Distribution of safe water Chlorination of water Distribution of buckets Sanitation & Hygiene: Provision of emergency latrines Provision of de-sludging trucks Distribution of hygiene kits Hygiene promotion and training of promoters Coordination & logistic : 3 M Coordination: Support to general humanitarian coordination including data collection, needs assessment, coordination of response and mapping. Security coordination and training Logistics: Provision of joint logistical services for all humanitarian actors: air, sea and land transport and warehouse facilities. Import facilitation Facilitation of communication between humanitarian actors and military actors Provision and establishment of telecommunications for humanitarian actors Provision of free telecommunication services for affected population

Beyond the immediate response What are we doing? 1995... 2009 JAN 2010... MAR APR... SEPT 2010... AUG 2011 120 Million Amount: 90 million Beneficiaries: 4 million Areas of intervention: Sectors of intervention: Constraints/ pending: Port-au-Prince; Gressier/Leogane/Jacmel Triangle; Provinces hosting displaced population; National. Shelter, Camp Management, Non Food Items, Water Sanitation and Hygiene,, Nutrition, Food Assistance, Coordination and Logistics, Protection, Disaster Risk Reduction. Delays in Temporary Shelter solutions (land ownership issues, rubble removal in individual plots, lack of suitable public land for organized new temporary settlements) Lack of urban development strategy (mainly Port-au-Prince) Waste management Hurricane season and emergency preparedness Complexity of the transition between acute emergency and reconstruction/development Political and security context requiring presence of UN stabilization mission ZONE 4 National - Transversal Food Assistance & Nutrition Shelters & Non Food Relief Items, Camp Management and Protection Coordination & Logistics Disaster Risk Reduction ZONE 3 Areas hosting IDPs Food Assistance & Nutrition Water, Sanitation & Hygiene Shelters & Non Food Relief Items, Camp Management and Protection 32% 48% 23% 13% 8% 8% 10% 57% 30% 7% 6% ZONE 2 Affected areas out of PaP 24% 3 % 4 % Disaster Risk Reduction Coordination & Logistics Food Assistance & Nutrition Shelters & Non Food Relief Items, Camp Management and Protection Water, Sanitation & Hygiene Disaster Risk Reduction 36% 33% 16% 13% 2% 11 % 18 % 30 % 34 % 90 million Funds committed Water, Sanitation & Hygiene Food Assist & Nutrition Shelter ZONE 1 Port-au-Prince Shelters, Non Food Relief Items, Camp Management and Protection Water, Sanitation & Hygiene Food & Nutrition 34% 50% 33% 15% 2%

Beyond the immediate response 120 Million What are we doing? 1995... 2009 JAN 2010... MAR APR... SEPT 2010... AUG 2011 SHELTER FOOD & NUTRITION WATER SANITATION & HYGIENE Background To date large numbers of people are still living in emergency shelters in spontaneous settlements, however building assessments and population profiling in camps have contributed to stabilize a precarious situation Food Assistance: Pre-earthquake general food insecurity and high dependency on imports temporarily disrupted local markets and imports and destroyed livelihoods assets Emergency food distributions not sustainable and disrupting local markets Nutrition: Emergency response avoided an increase in acute malnutrition, remaining below alert threshold Chronic malnutrition remains a concern Before the earthquake access to water supply was highly limited with insufficient quantity and quality and deficient water networks. Since January a large amount of water has been distributed. Actions Temporary Shelter and/or definitive housing solutions through: Social mobilization to promote return to non-affected houses. Retrofitting to repair slightly damaged houses Installation of temporary shelters on original plots, after having solved legal issues, ownership, renting agreements, rubble removal; to be done in an integrated neighborhood approach with provision of basic and community services (water, sanitation, livelihood) Provision of Transitional Shelter for new organized settlements Food Assistance: Unprecedented cash for work program oriented to rubble removal, risk reduction and protection of livelihoods at national level and with community focus Support agricultural recovery (seeds and tools) Reconstitution of livelihoods assets in affected areas (urban and rural) Nutrition: Nutritional program for children under-5, pregnant women and breast feeding mothers Water: Support to the coordination of the distribution Potable water trucking distribution Support to the coordination of alternative solutions to water trucking: water network repairs, boreholes, connections, tank rehabilitation Rehabilitation of springs, water sources, catchment systems Provision of water and sanitation in rehabilitated schools Chlorination of water Distribution of buckets Sanitation & Hygiene: Support to the provision of de-sludging services in collaboration with other humanitarian actors and national authorities. Clean-up campaigns in settlements Provision of latrines and hygiene promotion Challenges Urban crisis context: Scarce land, swampy or floodable zones, large informal suburbs and slums, inadequacy of existing infrastructure (sewage and drainage, roads, water and electricity network) Build Back Better requirements (technically and socially expensive and time consuming) Insufficient rubble removal assets Difficulties of operationalizing an urban development strategy Food Assistance: Continue to support agriculture and reinforce positive 2010 production trends Avoid disrupting markets that have recovered (food prices stability) Continue to monitor food and nutrition vulnerabilities Ensure transition from Cash For Work to formal and stable employment Nutrition: To promote and strengthen a holistic and multi-sector approach (, Water and Food Security) to reduce nutritional vulnerability Production, management and diffusion of accurate data Switching from emergency free water distribution to neighborhood coverage, linking this to development of an accessible and sustainable water system service regulated by the national authorities. Establishment of a formal waste management system

Beyond the immediate response What are we doing? 1995... 2009 JAN 2010... MAR APR... SEPT 2010... AUG 2011 120 Million Background HEALTH The existing health system was precarious with very low coverage rates, high inequity and suffering from a lack of adequate human resources and founds The earthquake increased the pressure on the health system adding new vulnerable groups COORDINATON & LOGISTIC Coordination: The presence of a large number of humanitarian organizations in the country underlines the key importance of achieving a coordinated humanitarian response. DG staff, together with other major donors, has been critical in advocating for strong humanitarian leadership DISASTER RISK REDUCTION Build back better Frequency of disasters has eroded local and national capacities increasing the population s vulnerability. Institutional capacities were slowly developing in the country, nevertheless the earthquake showed the urgency in strengthening preparedness and response Actions Improvement of access to quality health care as well as mental health and psychosocial support Support to orthopedics and prosthetics program Provision of primary health care Clinic rehabilitation Mobile clinics Training Coordination is being also supported through s partners, aiming at: Harmonization of coordination mechanisms Implementation of the Humanitarian Reform Inter-agency collaboration Facilitating communication between humanitarian actors and military actors Collection, processing and dissemination of data Production of situation reports Capacity building and reinforcement of the Haitian Red Cross and the Haitian Civil Protection System Community awareness and preparedness Advocacy for including risk reduction into the humanitarian, rehabilitation and reconstruction phases Logistics: common logistics services have been provided to humanitarian actors (warehouse, trucks, boats) Challenges Ensuring that access to basic health care is provided by the state system rather than by NGO mobile clinics system Mapping new health capacities in the country and elaborating an appropriate exit strategy Bringing health care to new settlements Private versus public health system National capacities still insufficient (means, infrastructure, weak information system, human resources) Inclusion of orthopedic care and physioterapy into the national health structure The very different level of expertise and profile of actors as well as the high turnover of staff and inadequate language skills challenges the quality, effectiveness and efficiency of the response The location of coordination platforms in military bases reduces access by local authorities and civil society The emergency logistical system put in place is no longer valid for the reconstruction process; there is a need to improve the imports and customs system 2010 hurricane season Integration of risk reduction into multi-sector plans and making Build Back Better a real priority Absorption and technical capacities of stakeholders in the country Coordination of multitude of projects and programs

In the aftermath of the quake Envisaged DG strategy onwards Post earthquake multi-sectorial assistance Continued support to earthquake affected population Integrated neighborhood based approach Disaster Risk Reduction (DRR) & Nutrition Consolidation and integration in DG s interventions Strengthening a common DRR approach accross European Union instruments To promote and strengthen a holistic and multi-sector approach in reproductive health and to reduce nutritional vulnerability Production, formatting and diffusion of accurate data DG investing further into consolidated exit strategy Linking Relief, Rehabilitation and Development (LRRD) processes. to new events Reconstruction 460 million 100 million 200 million 100 million 60 million The European Commission has pledged 460 million for Haiti s reconstruction (New York conference 31.03.2010). early non-humanitarian package focused on restoring government capacity (including 20 million from the Instrument for Stability) be reprogrammed from the Development Cooperation Programme increase to the Development Cooperation Programme for unforseen needs to be made available