Cholera Continues to Spread as Response and Surveillance Weaken

August 09, 2012

09 Agosto 2012

The latest data from the MSPP (Ministry of Health) shows that the number of cholera cases and resulting deaths continues to rise. As of August 2, there have been a total of 583,871 cases and 7,497 deaths reported since October 2010 and this almost certainly is an underestimate. While the number of cases this summer has not spiked as high as it did last year, there have still been 377 deaths and nearly 45,000 cases reported in just the last three months. The MSPP attributes the slower rate of infection this summer to unusually dry weather; however they predict an increase in the coming months as the hurricane season begins. The Pan American Health Organization estimates that Haiti could see up to 170,000 new cases this year, which would mean an average of about 20,000 cases per month over the next five months. Over the previous three months, the average number of cases has been over 15,000. Despite this, funding for the cholera response, as well as for the infrastructure needed to stem the spread of the disease, has been inadequate. At the end of July, the Comite de Coordination des ONGs Internationales en Haiti (CCO Haiti), which is made up of many international NGOs operating in Haiti, released a statement on the situation: The cholera outbreak that has already claimed thousands of lives all over the country remains a major threat to public health. Cholera prevention and response should be a key priority for the Haitian Government.…Furthermore, many public health workers in the Cholera Treatment Center (CTCs) have not received salaries for several months and there are reports of strikes by front line medical staff to redress this situation. This is a serious issue negatively affecting the effectiveness of the cholera response and it needs to be urgently addressed. In addition, there is evidence that the MSPP struggles to carry out its work efficiently due to poor logistics and inefficient fleet maintenance. This seriously hinders the material distribution within the CTCs, Cholera Treatment Units (CTUs) and Acute Diarrhea Treatment Centers (ADTCs), and affects the appropriate collection of cadavers. Necessary arrangement should be made to correct the situation. Overall, the MSPP must once again reinforce its leadership and coordination roles at both central and departmental levels.Donors must provide sustained and adequate funding to support a comprehensive and integrated approach to cholera prevention and care.Although less severe than the cholera outbreak last year, the current situation on the ground is much worse than statistics portray. And yet, a shortage of funding has translated into fewer health partners and created serious gaps in coverage. From August, 2011 to May, 2012, the number of Cholera Treatment Centers (CTCs) has declined from 38 to 20, and the number of Cholera Treatment Units from 205 to 74. In their latest humanitarian bulletin, the UN Office for the Coordination of Humanitarian Affairs (OCHA) noted that, “national capacity to respond to potential outbreaks, especially during the rainy season, remains very weak. The country has only 468 beds for cholera admissions, with 233 of these already occupied. At the height of the epidemic in June 2011, 2500 beds were available.” Despite this, OCHA notes that “significant progress has been made especially in the surveillance and reporting of the epidemic as well as in the integration of cholera care in the national healthcare system.” Despite OCHA’s positive assessment of strengthening the national health care system, as CCO Haiti pointed out, MSPP is still facing serious issues in their response to cholera. One reason why the Haitian government has had a hard time leading the response is that the international community largely bypassed the government in their provision of funding for cholera. The government of Haiti received only $4.9 million in funds for the cholera response, while the Red Cross alone received $6.1 million. While CCO Haiti calls for increased funding from donors, it is imperative that this money not simply be channeled to international NGOs, but through the MSPP. As the UN Special Envoy has noted, “aid is most effective at strengthening public institutions when it is channelled through them.”

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Several Adults Killed in Forced Eviction, With Little Notice by International Media

By CEPRCEPR

August 07, 2012

07 Agosto 2012

The killing of four adults, and – according to some reports – disappearance of four children in a violent forced eviction on July 23rd has gone all but unnoticed by the major English language media, but some details have emerged through Haitian and some i

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A Closer Look at USAID Food Aid Programs in Haiti

By Jake JohnstonJake Johnston

July 27, 2012

27 Julio 2012

A review of publicly available reports and recently released documents obtained via an Associated Press (AP) Freedom of Information Act request reveal that the U.S. Agency for International Development (USAID) has spent over $200 million on Title II food aid in Haiti since the earthquake. Title II food aid, administered by USAID and implemented by NGOs and intergovernmental organizations (primarily the World Food Program - WFP), is “the main avenue for U.S. food assistance.” As can be seen in Figure 1, in fiscal years 2010 and 2011, USAID obligated over $200 million and distributed over 174,000 metric tons of food aid in Haiti. Although most of this came in the form of emergency food aid following the earthquake, food distributions have continued in 2011 as well.Figure 1. Source: USAID, Author’s CalculationsThe NumbersAccording to a report prepared for USAID’s Office of Food for Peace, in fiscal year 2010, USAID Title II food aid totaled 153,000 metric tons (MT), of which over 115,000 came in the form of emergency food aid. In 2011, these totals decreased drastically to 21,430 MT, of which 5,950 MT was emergency aid. According to the report, emergency food aid was distributed through two avenues: Single-Year Assistance Programs and the World Food Program. Based on documents obtained by the AP, USAID obligated over $21 million to World Vision, Catholic Relief Services (CRS) and Agricultural Cooperative Development International and Volunteers in Overseas Cooperative Assistance (ACDI/VOCA) for program costs associated with these emergency distributions. Additionally, USAID, which covers the cost of commodities and shipping, valued these services at over $100 million.Non-emergency food aid takes the form of food distribution, but also often incorporates agricultural productivity, natural resource management as well as other issues related to food security. The majority of non-emergency food aid, which totaled over 50,000 MT in FY 2010 and 2011, came through Multi-Year Assistance Programs implemented by the same partners as the above-mentioned emergency, single-year programs: ACDI/VOCA, World Vision and CRS. These three programs all began prior to the earthquake and are ongoing until at least September 2012. A recent audit conducted by the USAID Inspector General (IG) reveals that, since the programs began in 2008, these partners have spent $46 million dollars in program costs. According to the AP documents most of this came after the earthquake. Together, the three organizations distributed nearly $70 million in commodities.The Inspector General, in its audit of these multi-year programs, noted that “assistance generally has improved conditions for targeted beneficiaries…However, we could not determine whether the effects will last well into the future.” Nevertheless, the IG found a number of problems in the management of these programs, including overlapping with other USAID projects; lack of data management; the use of duplicative, excessive and uncoordinated indicators; uneven and poorly tracked integration of key activities; and other problems. Overall, the documents obtained by the Associated Press show that World Vision, ACDI/VOCA and CRS have received $57 million since the earthquake from USAID for program costs related to Title II food aid, as can be seen in Figure 2. As will be discussed in more detail later, while this data shows program costs, the provision of the actual commodities for distribution and the shipping of those commodities are paid for directly by USAID, and so do not show up in Figure 2.Figure 2. Source: USAID, Associated Press

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AP Investigation Finds Lack of Results and Transparency in Haiti’s Reconstruction

By Jake JohnstonJake Johnston

July 24, 2012

24 Julio 2012

Martha Mendoza and Trenton Daniel of the Associated Press reported over the weekend on the state of U.S. reconstruction efforts in Haiti. The report is based largely on documents obtained through Freedom of Information Act requests. Mendoza and Daniel write: Until now, comprehensive details about who is receiving U.S. funds and how they are spending them have not been released. Contracts, budgets and a 300-item spreadsheet obtained by The Associated Press under a Freedom of Information Act request show:- Of the $988 million spent so far, a quarter went toward debt relief to unburden the hemisphere's poorest nation of repayments. But after Haiti's loans were paid off, the government began borrowing again: $657 million so far, largely for oil imports rather than development projects.- Less than 12 percent of the reconstruction money sent to Haiti after the earthquake has gone toward energy, shelter, ports or other infrastructure. At least a third, $329 million, went to projects that were awarded before the 2010 catastrophe and had little to do with the recovery - such as HIV/AIDS programs.- Half of the $1.8 billion the U.S. promised for rebuilding is still in the Treasury, its disbursement stymied by an understaffed U.S. Embassy in Port-au-Prince in the months after the quake and by a Haitian government that was barely functional for more than a year.- Despite State Department promises to keep spending public, some members of Congress and watchdogs say they aren't getting detailed information about how the millions are being spent, as dozens of contractors working for the U.S. government in Haiti leave a complex money trail. Searching for evidence of success after more than two years and two billion dollars, the AP found lasting results hard to come by as “projects fundamental to Haiti's transformation out of poverty, such as permanent housing and electric plants in the heavily hit capital of Port-au-Prince have not taken off.” Attempting to preempt the AP article, Mark Feierstein, Assistant Administrator for Latin America and Thomas C. Adams, Haiti Special Coordinator at the U.S. Department of State wrote an article, “Progress in Haiti” to combat what they believe to be an unfair portrayal of U.S. reconstruction efforts.HousingMendoza and Daniel note that the reconstruction plan laid out a number of benchmarks, 40 of which were due to be reached this month. But while some benchmarks have been achieved, many have not. One area of particular concern is the provision of shelter. While Adams and Feierstein point to the decrease in the camp population as the first sign of success, AP reports: Meanwhile, 390,000 people are still homeless. The U.S. promised to rebuild or replace thousands of destroyed homes, but so far has not built even one new permanent house. Auditors say land disputes, lack of USAID oversight and no clear plan have hampered the housing effort. USAID contested that critique.The State Department says 29,100 transitional shelters have been built, to which residents are adding floors, walls or roofs to make permanent homes, although homes once again vulnerable to natural disasters. U.S. funds also supported 27,000 households as they moved in with friends or families, and repaired 5,800 of the 35,000 damaged homes they had planned to complete with partners by July 2012. Also by this month the U.S. had planned to help resolve 40,000 to 80,000 land disputes, but at latest count had helped 10,400. As we have previously pointed out, the provision of new shelter options cannot explain the majority of the decrease in the camp population, and many of those that have left the camps have found themselves in even more precarious living conditions, this time out of sight of the humanitarian community.

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104 Members of Congress Call for the UN to Take Responsibility for Cholera

By CEPRCEPR

July 18, 2012

18 Julio 2012

Haiti’s cholera infection and death rates show an alarming recent increase, with official statistics reporting 290 deaths and nearly 40,000 cases in May and June alone, as the rainy season returned. Pressure continues to build for the United Nations to ta

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In MINUSTAH Abuse Case, Cover-Up Goes Unpunished

By Jake JohnstonJake Johnston

July 13, 2012

13 Julio 2012

In March, three Pakistani MINUSTAH troops were found guilty, sentenced to one year in prison and repatriated for the rape of a 14-year old Haitian boy. Although the trial was held on Haitian soil, it was a “military justice procedure…undertaken in accordance with the national laws of Pakistan,” according to the UN. Additionally, Reuters reported at the time that “Haitian government authorities were given no advance notice of the military tribunal.” Had the troops faced a Haitian court, their sentences would likely have been much longer. Had the troops had to face Haitian justice they may also have had to respond to further allegations that the Pakistani UN Mission tried to cover-up the crime, going so far as to kidnap the victim. While some Haitian media and blogs picked up the story at the time, little has been written about the attempted cover-up. Independent journalist Kathie Klarreich, who recently traveled to Gonaïves where the crime took place, mentioned the cover-up in a larger piece about MINUSTAH scandals for the Christian Science Monitor. Klarreich has now provided new details to HRRW on what happened, raising even more questions about the level of impunity for UN troops in Haiti and just how widespread these abuses are. While the Haitian police have witnesses and evidence tying MINUSTAH to the cover-up of rape, the UN has apparently not been cooperative and has failed to adequately investigate and hold accountable those responsible.What HappenedThe UN first disclosed the case in January, announcing that an investigative team would be heading to Haiti. In February, as the circumstances around the case became clearer, Senator Youri Latortue took to the airwaves to call for the lifting of immunity for MINUSTAH and to denounce the apparent cover-up that was executed by the Pakistani contingent. After witnesses of the abuse went to local police, the 14-year-old boy was kidnapped and taken to a MINUSTAH base in Cap- Haïtien with the “objective to prevent the continuation of the investigation” according to Latortue. On January 26, 2012, police arrested Vladimir Alexandre, a local Haitian, for being an accomplice to the kidnapping. Another alleged accomplice is still at large. While the “military tribunal” was conducted behind closed doors and the guilty members of MINUSTAH whisked out of the country, the local case in the city of Gonaïves has gone nowhere. Alexandre, speaking with Klarreich, defended himself, telling her, “All I did was show them where he [the victim] lived. I don’t know anything about taking him anywhere,” adding that he didn’t receive anything from the soldiers in return. But Klarreich said that what he told her directly contradicts what he had told police when they arrested him. According to a copy of his testimony which Klarreich read, Alexandre admitted that he knew the boy, that he’d been in contact with the Pakistani MINUSTAH troops, and that he and the other accomplice had agreed to remove the boy from the area. He also admits that the Pakistanis came to his home bearing gifts for his mother – $100 Haitian Gourdes ($12 US) and a sack of rice.Alexandre remains in the police station jail, held in a room with 111 other prisoners. The Gonaïves police chief told Klarreich that according to Haitian law, Alexandre could be held for up to two months but if no charges were brought then legally he should be allowed to go free. “I am not here to judge,” the police chief said, “but rather to make sure that the justice system works. Let’s remove the obstacles and finish this case.” The local officials in charge of the case continue to seek answers, while the lawyers for the victim continue to seek compensation from the United Nations.

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Reports from Field Highlight Need for Greater Governmental, Non-Governmental Accountability

By CEPRCEPR

July 11, 2012

11 Julio 2012

Vijaya Ramachandran and Julie Walz of the Center for Global Development recently reported on their trip to Haiti, where they further examined aid accountability and the ongoing reconstruction effort, the themes of their recent policy paper which we have p

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Environmental, Labor Concerns Overlooked in Rush to Build Caracol Park, Part II

By Jake JohnstonJake Johnston

July 09, 2012

09 Julio 2012

This is the second installment looking at the New York Times in depth investigation into the Caracol industrial park. For part one, click here. Jobs at What Cost? Sontag reports that while concerns over Sae-A’s labor practices were consistently brought to the attention of officials, the project continued to go forward without a comprehensive review: Before the Haiti deal was sealed, the A.F.L.-C.I.O. urged American and international officials to reconsider, given what it described in a detailed memo as Sae-A’s egregious antiunion repression, including “acts of violence and intimidation” in Guatemala, where Homero Fuentes, who monitors factories for American retailers, calls Sae-A “one of the major labor violators.” The five-page memo “accused Sae-A of using bribes, death threats and imprisonment to prevent and break up unions.” Sontag describes the allegations against Sae-A in some detail, and notes that while “Gail W. Strickler… the assistant United States trade representative for textiles, says she considered Sae-A ‘an exemplary corporate citizen,’” meanwhile “Scott Nova, executive director of the Workers Rights Consortium, calls the company ‘a big player in a dirty industry with a track record that suggests a degree of ruthlessness even worse than the norm.’” Of course, labor rights violations in the garment sector in Haiti are nothing new. In fact, on the same day that U.S., Haitian and development bank officials inaugurated the Caracol park, an investigation by Better Work Haiti found "evidence of violations of freedom of association" at other Haitian textile factories. The most recent Better Work Haiti report, which “uncovered a higher number of violations in the areas of core labour standards than what [was] observed in the previous assessments”, is available here. 11 of 20 factories were found to be non-compliant in at least one of the core labor standards. “American officials said Sae-A would be closely monitored in Haiti because of trade legislation requiring stringent scrutiny through an American-financed inspection program.” As part of the legislation providing duty free access to the U.S. market, the U.S., together with the Better Work Haiti program, provides oversight as well as training to employers, employees and Haitian government officials on labor rights issues. But as Yannick Etienne of the Haitian workers’ rights group Batay Ouvriye tells Sontag, ‘“it remains to be seen” whether the inspection program will have “any teeth.”’Every two years, the U.S. must identify which producers are in compliance with core labor standards and Haitian labor law. The most recent report, which was published in the last month, notes that, “While this is USTR’s fourth report, this is the first reporting period that [non-compliant] producers have been identified.” Yet, giving credence to Etienne’s concerns, this does not mean that the three producers identified as non-compliant on core labor standards will miss out on duty-free access to the U.S. market. As long as the producer shows an effort to improve and work with the U.S. to correct the problems, they will face no sanctions.One resident of Caracol, who went to Nicaragua to participate in a Sae-A apprenticeship came back so disillusioned he told the New York Times that as soon as he found other work, he would quit his job with Sae-A: “The way the Koreans treat the Nicaraguan workers is awful,” Mr. Joseph said. “They just treat them like nothing. Just: ‘Do your job. If you don’t do it, I’ll call somebody else to do it.’ ”

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Environmental, Labor Concerns Overlooked in Rush to Build Caracol Park

By Jake JohnstonJake Johnston

July 06, 2012

06 Julio 2012

The first of two installments looking at the New York Times in depth investigation into the Caracol industrial park. Part two will be posted shortly. Deborah Sontag, writing in today’s New York Times, takes a detailed look at the new Caracol industrial park being built in northeastern Haiti, finding that in their rush to show reconstruction progress the plan’s backers have overlooked labor and environmental concerns. Sontag writes: Two and a half years after the earthquake, Haiti remains mired in a humanitarian crisis, with 390,000 people languishing in tents. Yet the showcase project of the reconstruction effort is this: an industrial park that will create jobs and housing in an area undamaged by the temblor, a venture that risks benefiting foreign companies more than Haiti itself. The park, whose main tenant Sae-A expects to generate some 20,000 jobs over the next six years, has been made possible by generous subsidies from the U.S. and Haitian governments and the Inter-American Development Bank (IDB). Sae-A officials were invited to the U.S. embassy in Seoul to meet with Secretary of State Clinton in 2010. One concern the company had at the time was “uncertainty about whether Haiti’s minimum wage for textile workers, scheduled to increase to $5 from $3.75 a day this October, would continue to rise.” Wikileaks cables later revealed that the U.S. embassy in Haiti, along with some multinational companies had “aggressively moved to block a minimum wage increase for Haitian assembly zone workers,” according to The Nation. While the minimum wage has increased, 18 out of 20 factories monitored by the Better Work Haiti program were found to be non-compliant on the minimum wage in their most recent assessment published in April.Despite the “obstacles,” and convinced by legislation providing tariff-free access to the U.S. market, Sae-A officials were soon heading to sign an agreement -- but not in Haiti, in Washington: By late summer, they were flying with their investment plan to Washington for a meeting with Mrs. Clinton and other international officials in a historic treaty-signing room on the State Department’s seventh floor. While Sae-A originally estimated the project would create 3,000-4,000 jobs, American and international officials wanted more: “We would say, ‘We could probably do a factory with about 3,000 to 4,000 people.’ They’re like, ‘Wow. What would you need to make it bigger?’ I [Lon Garwood, senior advisor to Sae-A] said, ‘If we could get a loan for the machines, we could probably double that.’ They said, ‘What about 10,000?’ We said, ‘If we didn’t have to worry about purchasing the land, if we didn’t have to build the factory shells, then we could double it again.’ That’s where the 20,000 jobs figure came from.” In the end, the land was provided free of charge by the Haitian government (evicting some 350 farmers in the process), the IDB agreed to provide $100 million to finance the building, while the U.S. would contribute $124 million for a power plant, housing and a port. Sae-A, which reported $1.1 billion in export business last year, only needs to invest $39.2 million. The $124 million provided by the U.S. is over a quarter of the money the U.S. earmarked for reconstruction.

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Official Displaced Population Decreases, but Where Are They Going?

By Jake JohnstonJake Johnston

July 02, 2012

02 Julio 2012

Last week, the International Organization for Migration (IOM) announced a drop in Haiti’s internally displaced persons (IDP) population to below 400,000. AP reports: The reduction in the camp population is attributed to a combination of forced removals, rental subsidies and voluntary departures, but it is not clear where the bulk of the people have gone or if their living arrangements are better than the camp conditions. While previous reports of IDP population decreases were held up uncritically as signs of progress, this time IOM spokesperson Leonard Doyle provided a more nuanced response. While the government-backed relocation efforts have only reached a small portion of the IDP population, Doyle notes that “As for the rest we don't know [where they ended up],” adding, “[a] lot of these people we know have pitched tents on the side of the mountains.” Indeed, a simple look at the available numbers suggests that many of those that have left the IDP camps monitored by the IOM have not found adequate shelter.The IOM touts a 75 percent reduction in the camp population since July 2010, amounting to a decrease of over 1.1 million people. Yet as of April 2012, only 12,000 rental subsidies were given out, 13,000 houses were repaired and just fewer than 5,000 new homes were constructed. In total, these three solutions account for only about 12 percent of the reduction in IDP population. Additionally, about 108,000 transitional shelters have been built, which would account for an additional 42 percent. However this likely overstates the effects of the transitional shelter, as it is estimated that only about 40 percent of transitional shelters actually went to IDPs.Figure I compares the number of households exiting the camps with the number of new housing solutions completed. As can be seen, the majority of the IDP population decrease occurred when shelter implementation was far too low to absorb all the people exiting the camps. This backs up previous studies which have shown that forced evictions and declining services were the primary drivers of the reduction in IDP population.Figure I.Graph: CEPR, Author's Calculation Source: E-Shelter and CCCM Cluster

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