Haiti after Hurricane Ike (Radio Nederland Wereldomroep)

June 1 was the start of the Atlantic hurricane season, and experts at NOAA are predicting three to seven major hurricanes.  But, nearly five months after the January 12 earthquake, hundreds of thousands of Haitians are living in fraying tents while the Haitian government continues to work on emergency and evacuation plans.

Dr. Jean Pape, one of the country’s most prominent public health experts, estimates that only 1 percent of the masses stuck in dangerous flood zones have been relocated. - CBS News

According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), “the biggest challenge” in building shelters is “a lack of available land on which to build.”  Much of the land suitable for relocation has been in the hands of a few powerful individuals.  But, that problem reportedly was resolved in late March.  During a visit to Haiti, former U.S. President Bill Clinton told the Miami Herald that Haiti’s President, René Préval, had signed an executive order giving the government the right of eminent domain.

Still, OCHA reports that obtaining needed land and receiving necessary supplies will take “many more months.”  At this point, one is tempted to add…”if ever.”

Staff are frequently requesting mental health services following mandatory debriefing session.  A majority of workers are also reporting physical symptoms of stress including significant chest pains, nightmares, flashbacks, and disassociation.

“I had to spend a lot of time alone. It was a week before I could be in a full social setting. I would go to the ocean and walk on the beach. Exercise. Yoga. Time with my family. Anything low-key.” – Carmen Maria Romero, physical therapist

The Haiti government’s Post-Disaster Needs Assessment, launched February 18, granted one week, March 14-20, for “consultation with civil society and the private sector,” according to the terms of reference. However, the government is to approve the draft plan on March 15. Furthermore, the government has failed to invoke even the token discussions, not consulting civil society in any way except informally with some businesspeople and several non-governmental organizations who do not speak for citizens.

The majority of Haiti’s workers and families, whose cooperation and labor will be essential to rebuilding Haiti, have been left out in the cold, as if they were mere set dressing for the recovery.  Thus, the Haitian people are being disenfranchised on a scale that threatens to make the January 12 earthquake only the second-worst disaster to strike the nation in 2010.

In response, local NGOs and grassroots organizations are organizing to develop a plan of their own, not just for repairing the damage caused by January’s earthquake, but for a just and participatory government.  Ricot Jean-Pierre, director of the Platform to Advocate Alternative Development in Haiti (PAPDA) describes the core problem.

“When the people take to the streets to say that they are hungry, for instance, the state is deaf. When the international community speaks, the state listens. The international community is giving orders. The people need to get the attention of the state, which must respond to their demands and needs.

The solution, says Jean-Pierre, is to “build a model of cooperation.”

“We want to create another world which is based on solidarity and equality between women and men, rich and poor, North and South – not just one above and another below being exploited. We need to learn how we each can complement and learn from the other.

In Haiti, Chile and elsewhere before, potable water could not be provided to victims in reasonable time, and emergency medical facilities dropped off-line just when needed most. The ability to take early action in critical care also has a cascading impact on the whole recovery process. Had basic connectivity to emergency medical care and water, for example, continued in Haiti and Chile (or in other previous catastrophes), reconstruction would have been that much easier.

Thomas points out that nations give far more attention to disaster response than to disaster mitigation.

Some 50 developing countries face recurrent earthquakes, floods, hurricanes and droughts, yet many of them do not recognize that they will recur. International agencies do not acknowledge these risks as a systematic threat to their assistance. Among the countries who have borrowed from the World Bank for disasters, almost half do not even mention disasters in their development plans.

Inattention to making lifelines resistant to disaster is not a problem only of developing countries, however.  It has been a continuing problem in much of the United States, as well.  Unfortunately, the current economic crisis makes it easier for planners to rationalize failing to harden critical facilities.  Thus, it falls upon citizens to insist that government agencies give greater priority to disaster resilience.

The president said that there was a “desperate need” for humanitarian aid in Haiti, describing the quake which killed more than 220,000 people as “one of the most devastating natural disasters ever to strike our hemisphere.”

Preval asked for additional help, including designation of a single authority to administer donor funds to be gathered by the United Nations.  Preval also asked Obama to endorse creation of an international rapid response team, a “red helmet” brigade to provide a coordinated response to disasters.

“We must draw the lessons from what occurred in Haiti,” Preval said in the White House Rose Garden. “The massive, spontaneous, generous help was a good response to the disaster. However, its effectiveness must be improved, because effectiveness depends on the quality of co-ordination.”

More:  White House video and transcript.

While Haitian resilience has been duly recognized around the world, few appear to be interested in talking to Haitians about how to rebuild their communities and how the billions likely to be pledged to their country will be used. And no one is talking about what recourse Haitians will have if promised projects are never completed, or worse, pledged money never arrives. [Boston Globe]

But. in ad hoc tent cities, Haitians are already demonstrating their ability to govern themselves.  In many of the camps, leaders and committees are managing activities from food distribution to sanitation to security, and some issue identification cards.

Many times, the best way aid international organizations can help the Haitian people will be, simply, to get out of their way.

Human rights experts are expected to visit Haiti March 9-12 to assess the human rights and aid situation, in preparation for a March 23 hearing before the Inter-American Commission on Human Rights.

The groups are recommending “a rights-based approach… Donor states should act with full transparency and accountability, making information about their plans and programmes available to all, and should work with the Haitian government to set up public monitoring and reporting mechanisms.”

The capacity of the Haitian government to budget, disburse funds, and implement projects in a transparent way should be a high priority, the groups say. They are also recommending the creation of a “public web-based database to report and track donor pledges, disbursed funds, recipients, sector areas, and expected outcomes under the aegis of the Multi-Donor Fund.”

The groups also call for prioritization of programs that help women and children, the disabled, the elderly and other vulnerable groups.

The U.S. Centers for Disease Control (CDC) reports eleven cases of the malaria strain P. falciparum among aid workers and Haitian residents.

“Displaced persons living outdoors or in temporary shelters and thousands of emergency responders in Haiti is at substantial risk for malaria”, said the CDC.

The outbreak gives additional urgency to the need to provide the estimated 1.2 million homeless Haitians with tents with screening to keep out mosquitoes that spread the disease.  At present, only about 40 percent of those left homeless by the January 12 earthquake have received any kind of shelter materials, typically plastic sheeting, tarps or tents.

To date, the U.S. Agency for International Development (USAID) has focused on providing plastic sheeting (or tarps), not tents, although tarps provide no protection from mosquitoes and offer superficial protection from the expected heavy spring rains.

Initially, the UN also embraced the tarp strategy, but on March 1, UN Special Envoy Bill Clinton urged UN agencies to provide tents.  Plastic sheeting is a penny-wise, pound-foolish strategy that saves tens of dollars upfront, but promises to cost thousands of dollars per person in long-term healthcare, and countless lives.

“Falciparum is the killer strain of malaria. It can cause intestinal hemorrhaging, cerebral inflammation or pneumonitis, which is aninflammation of the lungs. Cerebral malaria has a significant death rate”, said Dr. Gordon Dickinson, Chief of Infectious Diseases at the UM Medical School.

President Obama should ask USAID Administrator Dr. Rajiv Shah why his agency ignored advice from its sister agency, the CDC.  CDC advised “sleeping in air-conditioned or well-screened rooms or using bed nets,” to protect against malaria. Nevertheless, USAID provided plastic sheeting and urged other relief organizations to provide the same.

During recent discussions with the International Federation of Red Cross and Red Crescent Societies—the new Shelter Cluster lead—the USAID/DART shelter and settlements advisor emphasized the importance of linking plastic sheeting for emergency shelter purposes to broader transitional shelter assistance. [USAID report]

Over the weekend, drenching rains arrived in Haiti ahead of the expected start of the spring rainy season. But, only 30 percent of the million or so left homeless by the January 12 earthquake have received promised tarps or tents to provide even the most minimal protection from expected torrents.

Every disaster poses a unique challenge and, when one occurs, it is a learning experience for all.  Responsible relief organizations review their response to identify deficiencies and incorporate those lessons into written plans and staff training, ensuring that the response to future disasters will save more lives and speed recoveries.

As the Associated Press points out, “Learning the lessons of Haiti is taking on added urgency because planners expect the world’s natural disasters to grow in scope and frequency, as expanding populations crowd vulnerable coastlines and quake and flood zones, and climate change threatens more extreme weather events.”

While international relief organizations are acknowledging inadequacies in the Haiti earthquake response, U.S. officials are promoting a false image of the disaster as one with no significant problems, even as thousands of Haitians face weeks of drenching rains without shelter.  Shame on them.

U.N. humanitarian coordinator John Holmes has ordered a “real-time evaluation” of the response, and the organization’s independent inspectors are planning a long-range review. EU aid commissioner Karel de Gucht has proposed development of a European rapid response force.  But, lack of international cooperation continues to hamper reform.  A key stumbling block is the U.S. government’s continuing obsession with secrecy and control.

Despite its big role, the U.S. military doesn’t coordinate at high levels with the U.N. relief structure. After the quake, it took five days for Holmes’ OCHA to embed a liaison at the Southern Command’s Miami headquarters, in part because the Americans required someone with U.S. security clearance. [AP]

Lack of coordination has been blamed for slow and uneven distribution of food, water, shelter and medical care – all necessities of life.   For the sake of the millions of people who will be affected by disaster this year, U.S. senior officials need to commit to cooperation, coordination and transparency as essential aspects of emergency response.

Cries for help from people digging for survivors in collapsed buildings were drowned out by the roar of heavy-duty engines as the [U.N.] troops plowed through Port-au-Prince without stopping to join rescue efforts, much less lead them.

That was just one of many problems with the international response described in today’s article by Reuters. Inadequate organization, supplies and crowd control hampered food distribution.  Staff shortages, bureaucracy and a lack of packing lists slowed delivery of medicines.  MREs (Meals Ready to Eat) delivered by the U.S. were tossed aside by Haitians because tthe meals had no preparation instructions in local languages.  U.S. troops could not explain because few of them spoke French or brought translators.

Critics of the international response include the U.N.’s top humanitarian aid official, John Holmes.

“We cannot … wait for the next emergency for these lessons to be learned,” Holmes wrote in a confidential email first published on the website of the journal Foreign Policy.

Previously, criticism of the response came from Italy’s civil defense chief, the French Cooperation Minister, Doctors Without Borders, Brazilian officials and retired U.S. Lt. General Russell Honore.

But, the Obama administration appears determined to portray the response as exemplary, possibly for political reasons.  Reuters reports that Rajiv Shah, head of the U.S. Agency for International Development, “touted the Haiti relief mission as ‘the largest and most successful international search and rescue effort ever assembled in history.’”

At a February 12, State Department press briefing, U.S. Ambassador Kenneth Merten, also described the disaster response in glowing terms.

[F]rankly, it’s working really well, and I believe that this will be something that people will be able to look back on in the future as a model for how we’ve been able to sort ourselves out as donors on the ground and responding to an earthquake.

In the question-and-answer period that followed, a reporter offered the ambassador a second chance to be transparent about problems.

Are there things that would have been helpful to you the first day, the first week, the second week? Are there other ways that this could have been handled, perhaps even better?

Ambassador Merten responded, in part, “Those are probably too much of a micro level for you to be interested in.”

But, previously, former president Bill Clinton had acknowledged that relief had been slow.

Former US president Bill Clinton pledged to try to get aid flowing as he was met by angry Haitians protesting the slow arrival of help since last month’s quake.

Clinton said he was sorry that the aid efforts had been so slow, adding he also wanted to understand why more than three weeks after the January 12 quake supplies were still not getting through to desperate Haitians.