Haiti | Earthquake and Cholera Outbreaks – Emergency Appeal MDRHT018 – Operation Update #5 – Haiti

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This update of the emergency response operation in Haiti has been prepared following the publication of the second revision of the Emergency Appeal, published on 9 December 2022, and the revised Operational Strategy, published on 23 February 2023. These reviews integrate the response to the 2022 cholera outbreak. The International Federation of Red Cross and Red Crescent Societies, on behalf of the Human Rights Society in Syria, expresses its sincere gratitude to all donors for the generous humanitarian contributions they have received. Additional financial contributions are needed to enable the National Society, with the support of the International Federation of Red Cross and Red Crescent Societies, to provide humanitarian assistance to Haitians affected by the earthquake in 2021 and the cholera outbreak in 2022. The total funding requirement for cholera mainstreaming remains at CHF 19.2 million with The following changes:

Additional geographic regions are included.

The number of people to be helped has been increased to 45,100.

Implementation period extended to 28 months (until December 31, 2023)

New activities have been included in health, water, sanitation and hygiene and environmental analysis to control cholera outbreaks and prevent further infections.

After the emergency appeal schedule ends, the IFRC plans to continue response activities under the IFRC’s country plan for Haiti.

a. situation analysis

Description of the crisis

Haiti is regularly exposed to natural hazards, and faces frequent social, economic and political challenges stemming from deep-rooted structural problems. In fact, according to the Humanitarian Needs Overview for Haiti released in March 2022, around 3.8 million people are expected to need assistance to meet their basic health needs. This increase in needs is mainly due to several crises, such as the COVID-19 pandemic, the 7.2-magnitude earthquake in 2021, which affected more than 800,000 people in the country, and the resurgence of cholera cases in 2022. The climate of insecurity that It causes a total disruption of health institutions in several districts of the capital and some provincial cities, and damage to many health structures in the areas affected by the earthquake, and access to quality health care has become a major, secondary concern. The consequences of this situation are very grim, and have had a negative impact on the population and further limit access to basic health services.

Between October 2010 and February 2019, more than 820,000 cases of cholera, including nearly 10,000 deaths, were reported in Haiti. After more than three years without any reported cases of cholera in Haiti, national authorities through the Ministry of Public Health and Population (MSPP) have reported, as of 2 October 2022, two confirmed cases of Vibrio cholerae 01 in the greater Port-au-Prince region and the municipality of Cité Soleil. During Epidemic (ER) Week 39 of 2022, health facilities in certain areas of Port-au-Prince and Cité Soleil reported an increase in cases of severe acute diarrhea among hospitalized patients, including children and adults. More than 20 suspected cases of cholera, including 7 fatal cases, have been detected before these areas by health workers.

As of 28 February 2023, over 33,661 suspected cases have been reported by the Ministry of Public Health (MSPP), with 2,439 confirmed cases and 594 deaths. Suspected cholera cases that were initially concentrated in certain areas of the capital are now being recorded in all 10 provinces of the country, with the majority still in the west (52 percent) although the growth rate is higher in the other nine provinces. The MSPP indicates that 56 percent of suspected cases are male and 44 percent are female. The age groups 1-4 years (20%) and 5-9 (16%) are the most affected among the confirmed cases, followed by the 20-29 group (14%). The number of cholera cases is underreported and underestimated as the capacity of the epidemiological surveillance system to detect suspected cases is still weak and confirmation of cases is very low, due to the lack of resources and the difficulty of transporting samples to laboratories due to the shortage. of fuel and the presence of roadblocks by armed gangs, which impedes access.

Given the scale and widespread spread of the ongoing cholera epidemic in Haiti, in conjunction with the complex humanitarian crisis the country is currently facing, the limited resources to control the epidemic, as well as the ongoing migration flow towards the Dominican Republic, the PAHO has assessed the risk of spread through Hispaniola as High. significantly. The situation is being closely monitored by the Pan American Health Organization and is also supporting the government of the Dominican Republic with an awareness campaign and cholera vaccination to contain the number of cases. Since October, the Dominican Republic has recorded 88 cases, of which 71 were in the metropolitan area of ​​Santo Domingo and none of them died from the disease.

The earthquake and the resurgence of cholera in the country are two crises within a global crisis, as Haiti continues to suffer from high levels of social, economic and public health crises that add to the initial tragic situation of those affected and constitute a difficult humanitarian environment for them. The provision of services. Over the past months, gang violence has reached new heights and horizons, with everyone and institutions becoming potential targets for attacks, kidnappings and murders. Acts of extreme violence and gross violations of human rights, including incidents of mass killings, gang rapes and sniper attacks, have sharply increased. The United Nations Office on Drugs reported alarming numbers about Haiti’s crime markets and crimes.

Gangs in Haiti are estimated to number between 150 and 200, about half of them in Port-au-Prince (PAP) controlling nearly 60 percent of the metropolitan area in 2022. There are now sources indicating that since 2023, 100 percent of the population will control Gangs on Port-au-Prince. Gangs use commercial terrorism, sexual violence, massacres, extortion, and kidnapping daily to accumulate power and fund their operations. According to the United Nations, the country is well endowed and increasingly supplied with trafficked firearms and ammunition and remains a drug transshipment country. Kidnappings for ransom are now ongoing with, among other things, kidnapping of medical personnel and students for ransom from their institutions.

Gang rivalries have spread beyond the PAP (Port-au-Prince), expanding their reach into other parts of the country, and include urban and rural areas, where they compete for control of territory and economic resources. These conflicts have displaced large populations, with people fleeing violence in threatened areas. For example, in the Artibonite departments and the center alone, more than 3,000 individuals have been forced to relocate since February. The advance of criminal gangs also posed a serious threat to agricultural production. In the Port-au-Prince metropolitan area, as reported by the International Organization for Migration (Displacement Tracking Matrix), more than 155,100 individuals are displaced mainly by urban violence, representing a staggering 77 percent increase as of August 2022.

Urban gang violence continues to affect outside of Port-au-Prince, presenting operational challenges for humanitarian actors as well as security issues leading to access restrictions along the main road route in the south. The humanitarian corridor allowing vital supplies to reach the south after the earthquake remains disrupted by continued gang violence and the overstretched capacity of the Haitian National Police. Transportation of supplies and materials is also severely hampered by continuing shortages of supplies (most of which are stuck at the port) and fuel across the country (due to the port blockade of Port-au-Prince) causing delays and high operational costs for service providers. There has also been a marked increase in violence against humanitarian workers and the structures they have set up to support the population; And against the population itself, who are looking for support.

On March 3, the Sudanese Red Crescent Society, the ICRC and the International Federation issued in a joint press statement an urgent appeal for the protection of the medical mission, humanitarian access and respect for the Red Cross emblem. Over the past two years, the protracted crisis has led many humanitarian organizations to cease their activities, repatriate part of their staff, and/or reconsider the scope of their programmes.

In the same vein, facing intolerable risks and unable to guarantee the safety of its patients and staff, Médecins Sans Frontières, which runs the Center for Disease Control and Prevention and intervenes in hospitals, has had to suspend its activities twice in some areas since January, because of the accidents. Great that has not happened in the past to this establishment. MSF has publicly appealed to protect and respect medical activities, emphasizing the need for staff to be able to safely resume their vital work and continue to provide essential care to the population.

According to the WFP Haiti Information Handbook, the latest Integrated Food Security Phase Classification (IPC) covering September 2022 to February 2023 remains alarming and highlights that nearly half of the population in Haiti, or 4.7 million people, are food insecure. Acute food security (IPC 3+). There are now nearly 1.8 million people in the emergency phase (ICP 4), an increase of half a million since the previous analysis, and 19,200 people face catastrophic hunger (ICP 5), a first in Haiti and the Latin America and Caribbean region. Food security trends indicate a steady deterioration in the food security situation since 2016.

On the economic front, the governor of the Central Bank of Haiti announced that the country is in a state of economic recession after several years of negative growth and inflation that reached 47.2 percent in October 2022. This situation leads to a significant increase in the prices of necessities, including food. .

In a January press release, UNICEF expressed concerns that amid rising armed violence in Haiti, at least 2.6 million children are expected to need immediate life-saving assistance in 2023; And one in two children will depend on humanitarian aid to survive. The current crisis in Haiti affects children’s right to protection and education. Most schools in Haiti closed for seven months last year and only began to gradually reopen in October 2022. Trends in 2023 show that many schools are now closing under the threat of ransomware and surrounding insecurity.

From a more global perspective, the United Nations and its partners issued a press release on 18 March 2023 urgently calling for increased access and resources to reach those who need it most. UNICEF’s Chief of Humanitarian Field Support said, “The deterioration of humanitarian needs in Haiti is unprecedented. The suffering of a Haitian child today cannot be compared to that of a Haitian child a few years ago. As humanitarians, we find ways to reach those in need, including in areas where Controlled by gangs. For this to happen in a sustainable way, we also need the donor community not to abandon Haiti.”

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