Jean-Martin Bauer, Haiti country director for the UN World Food Programme "It’s difficult to believe that a mere two hours’ flight from Miami, a staggering 4.7 million people – half of Haiti’s population – are in the throes of a food crisis. In the Cité Soleil neighborhood of Port-au-Prince, 19,000 people are suffering in the ‘catastrophe’ level on the global scale for measuring food insecurity. In the 1980s, I used to visit Haiti on family trips; my mother fled to the US in the 1960s and I grew up in the suburbs of Washington, DC. The country was very poor then but able to feed itself. Now as I witness its struggle, coordinating the World Food Programme’s response, I cannot deny feeling affected on a deeply personal level.  I speak Creole. I grew up eating djon djon rice and joumou soup. I’ve always been acutely aware of Haiti’s rich history. In the 1990s there was a series of coups and a trade embargo; people risked their lives to leave on boats. Free market policies ruined Haiti’s smallholder farmers and left the country heavily reliant on food imports. A succession of disasters followed, including the 2010 earthquake and cholera outbreak, hurricane Matthew in 2016, and the Southern earthquake of 2021.  Things are now at a breaking point. This crisis will not pass – it needs renewed and robust humanitarian assistance. I am often asked why things are in fact so bad, so close to my family’s adopted home. I answer that Haiti is starving because gangs have taken control of ports and roads. This cut off communities from both the farms that feed them and from essential humanitarian aid. In the past year, food and fuel prices have skyrocketed.  In September, protests and widespread looting erupted. Roadblocks brought the country to a standstill, what Haitians call a peyi lok (lockdown). The peyi lok that began on 12 September felt a lot like the ones that occurred worldwide during the early months of the Covid pandemic – except that people were now forced to stay home by fear and violence, rather than by a dangerous disease.  Armed groups had seized the main fuel import terminal, blocking flows of diesel, the economy’s lifeblood. Humanitarians also came under attack; two of WFP’s warehouses were looted, depriving thousands of essential food assistance. For WFP staff, making it to the office meant navigating roadblocks and weathering threats. During the peyi lok, panic-buying broke out. Supermarkets shelves grew thinner as the days went by. I recently met a group of women in Cité Soleil as they waited for much-needed food from WFP. They said work is hard to come by, that they simply can’t afford to buy the food they need. They were drinking rainwater, they said. For dinner, they sometimes boil water and add salt because there’s simply nothing else to eat. As we talked, shots rang out and bullets flew overhead. Sadly, the people of Haiti have become conditioned to violence and hunger.  Against this backdrop, WFP and its partners have provided food to over 1 million Haitians this year – including over 100,000 people since the lockdown. The only safe way to get in and out of Port-au-Prince is by air. The WFP-managed UN Humanitarian Air Service has helped ferry vital cargo for the cholera response. But while emergency rations and airlifts will keep people alive, they won’t offer a future.  Armed groups are no longer in control of the Varrreux fuel Terminal but still hold swathes of the city. Their stranglehold on Haitian society must stop. The UN sanctions that placed on those who support them are a step in the right direction. But humanitarian work in Haiti needs a change of tack. Above all, we must help Haitian farmers feed their own people. WFP is working with 75 farming cooperatives to provide meals to schoolchildren. Thanks to this programme, on any given school day, 100,000 children receive a locally-sourced school meal. But social unrest is keeping children away from schools and farmers from markets. The peyi lok must end, so that rebuilding Haiti’s shattered food systems can resume.  What Haiti is experiencing now is not merely a bout of instability that will subside as part of some regular cycle the world is inured to. Haiti is experiencing a crisis on an unprecedented scale that can only worsen – unless we act fast and with greater urgency from us all." Learn more about WFP's work in Haiti

The inauguration of a new modernized and fully functional ambulatory emergency room at the Hôpital Universitaire de la Paix (HUP) took place this Thursday, December 15, 2022, in the presence of the Prime Minister, Dr Ariel Henry, the Minister of Health, Dr. Alex Larsen, the Director of the Department of Health Emergencies of PAHO, Dr. Ciro Ugarte and the Representative of PAHO/WHO in Haiti, Dr. Maureen Birmingham. The building, part of PAHO/WHO's SMART Hospital initiative was conceptualized in 2019 to address the Ministry of Health and Population's (MSPP) need for a more resilient, sustainable, and environmentally friendly health care infrastructure to provide timely post-disaster care and reduce disaster losses in the future. “This new facility will help us bring emergency services as close as possible to the population" explained Dr. Alex Larsen, Haiti’s Minister of Health in his inauguration remarks. The new ambulatory emergency room was designed to withstand the natural hazards common in Haiti, including hurricanes and earthquakes. Non-structural, mechanical and electrical services are designed to meet international safety standards. The complex is equipped with solar power and rainwater storage capabilities to maintain operations in the event of a national shortage or blackout. "PAHO’s support to the Ministry will continue. Beyond our technical assistance to the realization of this structure, we will accompany staff capacity building activities and assist its day-to-day operation with the procurement of medical product and equipment.” said Dr. Ciro Ugarte, director of PAHO's Department of Health Emergencies. “We are dedicated to ensure this service can save lives." The 13-bed inpatient facility is equipped with all the medical equipment necessary to provide emergency care services, including a mobile X-ray machine, sterilizers, bedside cardiac monitors, as well as a laboratory, pharmacy, sterilization, sutures and casts rooms. "It is important to mention the challenge that the realization of this project represented. Despite a country-wide blockade COVID 19, socio-political crises, despite the insecurity, the lack of fuel, despite cholera, this project was able to see the day.” declared Dr. Maureen Birmingham, PAHO/WHO representative in Haiti «I want to pay tribute to the will and persistence of the authorities and the generosity of our partners" said Built with the financial support of the Inter-American Development Bank (IDB) and the Government of the United States of America, as well as an equipment contribution from UNOPS, HUP's ambulatory emergency room is the first project of its kind in Haiti. PAHO/WHO's SMART Hospital initiative has already been successfully implemented in the Caribbean region, including St. Vincent and the Grenadines, Dominica, Grenada, St. Lucia, Jamaica, Guyana and Belize.

Claudine* looks across a sweeping valley high above the Haitian capital Port-au-Prince. The lushness of the tropical vegetation, the cool fresh air and the low-hanging clouds are in stark contrast to the dusty, hot and suffocating backstreets of Petionville, lower down the valley, where four years ago she was the victim of sexual abuse which changed her life. “At the time, I was 16 years old and living with my cousin and her husband,” she said. “I looked after their children, like they were my own.” Claudine should have been at school but after her mother and grandmother died had no other option but to become a domestic worker in her cousin’s house. It was there that she was sexually assaulted by her cousin’s husband. “I didn’t know what to do but a friend did report the incident to the police, but nothing was done to find the man.” A year after her daughter was born, Claudine was taken to a refuge for abused minors, many of whom like her were caring for newborns. The refuge, where she has lived now for three years, is run by Rapha House, an organization which is committed to ending the trafficking and sexual exploitation of children. Nahomy Augustin is a project coordinator for the international NGO in Haiti. “Many of the young women here are the victims of extreme poverty and insecurity, to the extent that the lack of basic services and opportunities that they have access to means that they become vulnerable to abuse,” she said.  The refuge, which is located in an intentionally inconspicuous building, in a tranquil neighbourhood above Port-au-Prince, supports the young women in the recovery from their traumatic experiences. “We take a holistic approach,” said Nahomy Augustin, “and provide a range of services, including medical and psychological care, accommodation and legal advice as well as family mediation.” The aim is to help each young woman to return to her family within a year as long as it is safe, but many like Claudine stay longer. The refuge can currently accommodate 24 young women as well as their babies, but a new centre is being built which can provide care to up to 80 people. It is estimated that at least 30 per cent of Haitian women between the ages of 15 and 30 years old have been the victims of sexual abuse or violence. The Spotlight Initiative, a global Initiative of the United Nations supported by the European Union to eliminate all forms of violence against women and girls, is working to transform the lives of Haitian women for the better. The initiative in partnership with the UN Children’s Fund, UNICEF, is supporting this and other refuges for women in Haiti. Geraldine Alferis is a gender-based violence expert at UNICEF. “Haiti, and especially the capital Port-au-Prince, is experiencing a surge in gang violence. Thousands of girls and women are being displaced, which makes them very vulnerable to abuse,” she said.   In July, the United Nations said that rival gangs in the Cite Soleil neighbourhood of Port-au-Prince were adopting the “systematic use of rape against women and girls as a weapon of war.” “Gang rape is a particularly tragic occurrence and so we work to ensure that the survivors get the help they need,” said Geraldine Alferis. The Spotlight Initiative in Haiti focuses on ending domestic violence, rape, incest, sexual harassment, physical and psychological violence, as well as other restrictions on the freedoms and rights of women and girls. It also aims to provide holistic care to women and girls who are survivors of violence. On a visit to the refuge, the UN Resident Coordinator in Haiti, Ulrika Richardson, said “it was chilling to hear the stories of these young women and girls,” adding that “I also sensed hope and recognized the importance of the services to which they have access.” “I am proud of the Spotlight Initiative and the much-needed assistance it is providing along with our local partners, but what I heard on this visit is a stark reminder of the urgency to tackle the root causes of sexual violence.” At the refuge above Port-au-Prince, the survivors like Claudine are able to study, taking school classes that many missed out on when they were younger. They can also take practical classes to learn skills like sewing or soap-making, which can enable them to make a small amount of money, a first important step towards building their independence. “Going to school is very important,” said Claudine. “If you are working for a family like I did, it is not enough just to receive food and have a bed. You must be given the opportunity to study and make a life for yourself.”  

A community health worker in the Haitian capital, Port-au-Prince, has been describing how she is going door-to-door to raise awareness about cholera prevention. The deadly but treatable disease has been spreading across the country and according to the latest government figures published on 19 November there have been some 8,800 people admitted to hospital and 184 deaths. Esterline Dumezil was trained by the Ministry of Public Health and Population and by the Pan American Health Organization (PAHO/WHO). “I have been working in the commune of Cité Soleil in Port-au-Prince since 2014, so for eight years The situation has deteriorated over time which means life is very difficult for the people who live here. They talk to me about their health concerns, but they also worry about the economic and security situation. They are very fearful about the return of cholera. My job is to walk and raise awareness in the neighborhood. I provide a lot of public health-related information and now that cholera has resurfaced, I go from door to door visiting families at home. I educate people on the importance of using treated water for drinking, cooking at home, handwashing and other measures they can take to prevent the disease from spreading further. Local people have many questions, they also want to tell me about their concerns and problems. I provide reassurance by reminding them that cholera is not a fatal disease and is treatable. If the basic rules of hygiene are observed, then one can fight the disease. When I find a person suffering from diarrhoea, no matter how severe, I refer them to one of two hospitals in the community which have been equipped to receive cholera patients; I know they will be well taken care of. It is very important for me to count suspected cases as well as note the information that local people share with me. I pass on this information to my superiors at the Ministry of Health, which helps our epidemiologists to better understand how people are affected by cholera, all over the country. Helping the most vulnerable We are still on the ground, despite the difficulty of the current situation in the country. Community health workers are not idle, we are trained to help the most vulnerable people. It is a duty, and it's a source of pride for me to be part of this effort. Personally, I like to think that each person can contribute to improving life in our communities. That's why I decided to become a community health worker, because I enjoy helping people and being part of change. It’s also a really important job which can save lives." A range of UN agencies including, IOM, UNAIDS, UNFPA, UNICEF and WFP as well as the UN Humanitarian Air Service, UNHAS, are also supporting the UN’s cholera response. The community health workers, who are known by the French acronym as ASCPs, play a central role in the Ministry of Health’s PAHO/WHO-supported Community Health Strategy. With intimate knowledge of and access to the communities they serve, they have been at the forefront of an integrated response to cholera especially in hard-to-access areas such as Cite Soleil. So far 300 have been trained and deployed on the ground to conduct risk communications and community engagement activities. This intervention was made possible thanks to the financial support of donors who support PAHO's response in Haiti, such as the Central Emergency Response Fund (CERF) and the European Commission's Civil Protection and Humanitarian Aid Operations (ECHO).