HAITI Humanitarian Situation Report
SITUATION IN NUMBERS
Highlights 30 June 2018 • UNICEF in 2018 continues to respond to the immediate needs of children and communities affected by ongoing crises including (i) cholera, (ii) protection, (iii) drought, food insecurity and acute 2.8 million malnutrition, and (iv) infant mortality. # of people in need (OCHA HRP 2018) • Despite a significant decrease in the number of cases of cholera, 1,148,000 # of children (<18) in need of humanitarian some localized outbreaks have been reported in Artibonite, Centre assistance and West departments. Water, sanitation and hygiene (WASH) 1.5 million assistance and rapid response need to be reinforced and to count on # of people to be reached predictable funding to maintain the positive trend. 615,000 • In preparation for the cyclone season, UNICEF has prepositioned a # of children to be reached
multi-sectorial contingency stock of lifesaving items for 20,000 people and supported emergency preparedness. • UNICEF calls for additional funding to source nutrition supplies to treat up to 17,000 children with acute malnutrition and carry out
essential WASH emergency and resilience work. UNICEF Appeal 2018 • The Haitian-Dominican migration situation continues to be of US$ 30 million concern and requires increased support to scale up child protection. UNICEF’s Response with Partners Funding Status 2018*
UNICEF Sector Funds UNICEF Total Sector Total received Carry- Target Results Target Results* current forward year: Cholera : # of persons reached amount: 720,000 130,130 720,000 130,130 $6.5m by the cordon sanitaire $9,6m Nutrition : # of children 6-59 11,000 4,900 11,000 4,900 months treated for SAM Health : # children under 1 2018 funding and pregnant women requirement: 35,000 25,900 35,000 25,900 $30 million receiving emergency vaccination WASH : # of persons provided 450,000 57,800 896,000 57,800 with safe water** Funding gap Child Protection : # of $13.8 m persons accessing 3,500 3,900 3,500 4,800 preventative social work interventions *Funds available include emergency funding received for 2018 as well as the carry-forward from 2017. Education: # of affected 5-14 **Lack of funding has prevented the CO from undertaking years old children receiving 30,000 22,300 95,000 22,300 learning materials
Situation Overview & Humanitarian Needs • More than one year after Hurricane Matthew made landfall, the humanitarian situation in Haiti remains challenging. The country is still affected by cholera outbreaks, food insecurity, malnutrition, and migration as well as potential hurricane and heavy rains threatening the lives and livelihoods of the population. • Despite a significant reduction in the number of cases of cholera early this year compared to the same period in 2017, some localized outbreaks have been reported in the departments of Artibonite, Centre and West, especially in urban areas. • WASH assistance remains a critical priority as people affected by previous natural disasters remain vulnerable with limited access to water, hygiene and sanitation. Infrastructures and sources of water supply need to be protected and temporary shelters upgraded to address potential displacement during the upcoming cyclonic season. More than 4.8 million people lack access to an improved water source.1 • Despite efforts made by the Government and partners, the food security situation continues to deteriorate in Haiti, a consequence of prolonged drought and the impacts of hurricanes Matthew (2016) and Irma (2017). Of the 1.3 million people in food crisis,2 only 42 per cent were reached by response programs (OCHA, June 2018).3 The National Coordination for Food Security (CNSA) estimates that nearly three million people are classified in stress phase from March to June 2018.4 An estimated 75,900 children under 5 are expected to be affected by acute malnutrition and require curative life-saving interventions.5 • The Haitian-Dominican migration situation continues to be of concern and necessitates the strengthening of border monitoring activities. There are about 737,000 people, including 356,000 children, considered as “trans- border population” in the border area between Haiti and Dominican Republic. In 2018, it is estimated that over 96,000 Haitians might return voluntarily or forcefully from Dominican Republic (Revised HRP, 2018). • As of June 28th, the 2018 Humanitarian Response Plan (HRP) for Haiti is funded at 9%.
Estimated Population in Need of Humanitarian Assistance (Estimates calculated based on initial figures from HRP 2018)
Start of humanitarian response: Total Male Female Total Population in Need 2,800,000 1,428,000 1,372,000
Children (Under 18) 1,148,000 585,480 562,520
Children Under Five 336,000 171,360 164,640
Children 6 to 23 months 152,000 77,520 74,480
Pregnant and lactating women 37,000 - 37,000
Humanitarian Leadership and Coordination • Following hurricane Matthew, Government-led emergency sectoral coordination groups were launched, with UNICEF co-leading WASH, Nutrition, Education Sectors and the sub-sector Child Protection to enable sustained efforts to ensure response and transition to recovery. • UNICEF is a member of the OCHA-led Inter-Sector Coordination Group (ISCG) which promotes coordinated assessments, and provides situation analysis, mapping and information to the Humanitarian Coordination Team (HCT). • In preparation for the cyclone season, UNICEF is prepositioning a multi-sectorial contingency stock covering a population of 20,000 persons, with mainly life-saving items to meet the key needs of children and women in the
1 According to the World Health Organization (WHO) / UNICEF Joint Monitoring Programme Report for Water Supply, Sanitation and Hygiene (2015), 45 per cent of the population do not have access to an improved water source, 19 per cent practice open defecation and 75 per cent do not have access to a hand washing facility with soap. 2 Integrated Food Security Phase Classification Analysis, 2017. 3 Food Security Situation Report, OCHA, 08 June 2018. 4 Food Security Situation Report, OCHA, 08 June 2018. 5 SMART survey, 2017.
areas of nutrition, health, WASH, education and protection. UNICEF supported capacity strengthening on emergency planning and response in the most vulnerable departments (Artibonite, Grande Anse, Nord, Nord Ouest, Sud, Sud Est).
Humanitarian Strategy • UNICEF launched its 2018 Humanitarian Action for Children (HAC) for Haiti on 31 January 2018,6 which laid out UNICEF’s planned humanitarian response throughout the country for 2018, in line with the Humanitarian Response Plan (HRP) 2017-2018. UNICEF is appealing for US$30 million to meet the immediate needs of children and their families affected by ongoing humanitarian crises in Haiti in 2018. Interventions are based on an integrated approach to address emergency needs in water and sanitation, education, protection, nutrition and health. • Particular attention is being paid to sustaining the cholera response to achieve the current level of control through the implementation of the Cholera Elimination Plan, which covers daily surveillance and coordination; rapid response in communities; hygiene awareness-raising activities; and engagement with local authorities and communities. • Access to water and sanitation is facilitated through the rehabilitation and chlorination of water supply systems, the construction of sanitary blocks, hygiene promotion, and the distribution of WASH supplies. • UNICEF provides emergency vaccination and cold chain systems strengthening. • UNICEF is the lead UN agency for the treatment of acute malnutrition, infant and young child feeding and the prevention of micronutrient deficiencies. • Addressing the needs arising from unregulated migration flows between Haiti and the Dominican Republic remains a priority. UNICEF supports the Institut pour le Bien Etre Social et de la Recherche (IBESR) in its capacity as the national child protection agency, to ensure the continuity of child protections services at critical border points. • UNICEF continues to maintain and pre-positions contingency supplies for humanitarian response.
Summary Analysis of Programme Response
Cholera7 • Despite a significant reduction in the number of cases of cholera in early 2018 compared to the same period in 2017, some localized outbreaks have been reported in the departments of Artibonite, Centre and West, especially in urban areas. In March 2018, a cholera vaccination campaign reached 60,000 people in the town of Saint Michel de l’Attalaye in Artibonite department. • The declining epidemiological trend has stabilized at transmission rates never observed since 2010. 2,688 suspected cases have been reported since January 2018, while 7,626 suspected cases were reported during the same period in 20178. The incidence rate of 0.021% reached from January to June 2018 (to be compared to 0.063% in 2017) remains below the 2018 target of 0.1% and points to a strong control of the disease. • The alert-response strategy, which was possible to undertake thanks to predictable funding since Matthew and throughout 2017, has enabled the activation of a total of 55 teams in addition to the 13 teams operated by the Ministry of Health and increased awareness and community engagement to better control localized outbreaks. WASH • In January 2018, with support from UNICEF, the National Directorate of Safe Water and Sanitation (DINEPA) established a WASH mobile team which conducted emergency chlorination of water supply sources in the Centre and Ouest departments. Chlorination agents have been identified within communities, trained and paid to ensure daily chlorination of drinking water supply systems. Families have received Aquatabs to treat water at home. • UNICEF calls for urgent funding to improve access to safe water in vulnerable areas. As the country braces for the coming cyclone season, sector wide contingency stocks have been established to meet the needs of 80,000 people for emergency supplies of drinking water and 90,000 people for hygiene products. However, emergency
6 UNICEF Haiti – Humanitarian Action for Children 2018
sanitation stocks currently cover only 1,000 people, against a planned figure of 595,000 people potentially affected 9- out of which 300,000 would need WASH support. Emergency preparedness of the DINEPA and partners has fallen behind which could cause difficulties should the country face a major hurricane.
Nutrition • In the absence of a domestic budget for nutrition, UNICEF provides critical support to the identification and treatment of acute malnutrition, infant and young child feeding and the prevention of micronutrient deficiencies. At least 10,200 children have been treated for Severe Acute malnutrition (SAM) / Moderate Acute Malnutrition (MAM), and 26,000 children have received micronutrient powder. • 13,000 cartons of ready-to-use-therapeutic food (RUTF) are required to meet the target of 17,000 children treated for acute malnutrition. In preparation for the cyclone season, UNICEF has pre-positioned essential nutrition supplies including 1,400 cartons of RUTF in the South region.
Health • UNICEF has supported the immunization of 26,000 children aged 1 to 6 against the diphtheria epidemic in the department of South. • UNICEF supported the installation of 45 cold chain systems and immunization activities reached 70 of 140 selected communes. According to the Ministry of Health data,10 immunization coverage for children under one has reached 76 per cent completeness. Since January 2018, 62.8 per cent were vaccinated against measles and rubella; 69 per cent received the 3rd dose of OPV and 68 per cent received PENTA3. • The departure of NGOs that supported the emergency response in Southern Haiti has left significant gaps in meeting the needs in health supplies and services in these still vulnerable regions.
Child Protection • In response to the Haiti-Dominican Republic migration situation, UNICEF has mobilized emergency focal points across the country in all 10 departments and is working with Government and civil society to improve the coordinated response and care of children on the move between Haiti and the Dominican Republic. On 12 March 2018, increased hostilities against Haitians, led to a spike in deportations / expulsions as well as spontaneous returns from Dominican Republic in the Pedernales/Anse-a-Pitres area. • UNICEF and partners maintain an ongoing comprehensive approach to case management services to assist children in emergency and non-emergency settings. Since January 2018, a total of 919 boys and 851 girls received psychosocial support; 77 certified foster care families are on stand-by to provide emergency care to separated children while awaiting family tracing and reunification; 25 girls and 2 boys were reunified with their families; to mitigate the risks of family separation in emergencies, 3,915 individuals received information on prevention of separation. • As Haiti enters the cyclone season, pre-existing child protection problems such as family separation, violence and child labour may be exacerbated should a major hurricane strike the country, thus there is need to ensure ongoing child protection programming which can be scaled up to respond to emergencies. Education • While the number of children in need in the South and Grande Anse departments has decreased since 2017, many schools in these locations are still lacking equipment and school material to ensure a proper learning environment. • Together with partners, UNICEF has supported 22,000 children in attending school with adequate materials including backpacks, and approximately 3,700 children were able to learn in classrooms equipped with school desks and benches. • In preparation for the cyclone season, UNICEF supported the Ministry of Education (MoE) developing decentralized contingency plans and carrying out disaster risk reduction activities, such as development of standard operation procedures (SOP) for schools used as shelters, and training of MoE personnel at local level to strengthen their emergency preparedness and response capacity. • Schools are being equipped with supplies and alternative learning programmes to help migrant children returning to Haiti reintegrate into the education system. Communications for Development (C4D), Community Engagement & Accountability
9 National Contingency Plan, 2018. 10 SISNU, 2018 • C4D has been integrated as a cross sectoral element within the framework of the promotion of essential family practices, including hygiene promotion, in line with the cholera response. • A mapping of community-based organizations has been completed to strengthen emergency preparedness for the South region.
Supply and Logistics • By prepositioning over US$200,000 worth of multi-sectoral emergency supplies in five departments (North; Artibonite, South-East; South; Grande Anse), UNICEF has taken steps to ensure timely and appropriate emergency response and mitigating increased costs of transport in case of a major hurricane. • A comprehensive market assessment of locally-sourced supplies and services is underway to secure Long Term Agreements (LTA) with providers vis-à-vis a large number of services including emergency supplies.
Security • The overall security situation remained the same with anti-government demonstrations held sporadically throughout the country. Gun shooting incidents among gang members in slums in Port-au-Price have been on the increase. • On 6 July 2018, the government advertised a sharp hike in fuel prices that triggered days of violent civil unrest. While UN agencies were not directly targeted, activities were hampered due to security restrictions and the ensuing prime ministerial resignation. UNICEF has undertaken some new measures aiming to improve the security of the staff and all UNICEF premises.
Funding • As of June 2018, there is a funding gap of US$13.9 million (46 per cent) against UNICEF Haiti’s 2018 HAC requirements of US$30 million. Funding available includes carry forward from 2017, mainly due to multi-year funding, as well as funding received in 2018 including from Canada, ECHO, OCHA/CERF, UN Haiti Cholera Response Multi-Partner Trust Fund, French National Committee for UNICEF, the Spanish National Committee for UNICEF as well as the World Bank. • In a context of decreased humanitarian funding, UNICEF Global Thematic Humanitarian Funding was instrumental to maintain programmes in child protection, education and nutrition. UNICEF Haiti wishes to express its sincere gratitude to all public and private donors for the contributions received. • UNICEF Haiti used the Emergency Programme Fund (EPF) loans to be able to scale up the cholera response and reimburse the CERF loan.
Funding Requirements (as defined in Humanitarian Appeal of 22/08/2018 for a period of 12 months) Funds available Funding gap Appeal Sector Requirements Funds Received Carry-Over $ % Current Year Cholera 11,750,000 46 006 1 963 889 9 740 105 83% Nutrition 2,550,000 745 983 1 572 462 231 555 9% Health 7,000,000 1 895 619 781 337 4 323 044 62% Water, sanitation and 4,200,000 3 674 564 3 525 185 0 0% hygiene Child protection 3,500,000 86 006 826 627 2 587 367 74% Education 1,000,000 46 007 937 260 16 733 2% Total 30,000,000 6,494,185 9,606,759 13,899,056 46%
Next SitRep: December 2018
UNICEF Haiti: www.unicef.org/infobycountry/haiti.html UNICEF Haiti Facebook: www.facebook.com/UNICEFhaiti UNICEF Haiti timounyo!, La voix des enfants d’Haiti: http://timounyo.com/ UNICEF Haiti : La lutte contre le choléra et les maladies diarrhéiques : http://timounyo.com/%20cholera/ UNICEF Haiti Humanitarian Action for Children Appeal: http://www.unicef.org/appeals/index.html
Who to Raoul de Torcy Jin Iwata UNICEF Haiti UNICEF Haiti contact for Deputy Representative, Resource Mobilization and Report further OiC Representative Specialist Tel: + (509) 31 70 8541 Tel: + (509) 4859 7065 information: [email protected] [email protected] Email: [email protected]
Annex A
SUMMARY OF PROGRAMME RESULTS
Sector Response UNICEF and IPs (Revised HRP 2018) Change Change Overall 2018 Total since last 2018 Total since last
needs Target Results* report* Target Results* report* ▲▼ ▲▼ CHOLERA # of persons reached by the cordon sanitaire 130,130 130,130 - 720,000 720,000 provided by the rapid (1) (1) response teams % of all cholera cases identified are responded to within 48hrs with a - 90% 88% 90% 88% complete WASH package # of persons reached by the oral cholera vaccine 60,000 60,000 - 1,300,000 1,247,451 (OVC) campaign in (3) (3) selected department (2) WATER, SANITATION &
HYGIENE # of persons provided with safe water for 1,200,000 450,000 57,813 896,144 57,813 drinking, cooking and personal hygiene use # of persons sensitized to hygiene behaviour 800,000 200,000 0 547,822 0 including handwashing related risks # of persons having access to safe sanitation including alternative 100,000 40,000 0 69,664 0 sustainable sanitation strategies HEALTH # of cold chain systems 45 45 installed # of children under 5 25,994 who receive emergency - 35,000 35,000 25,994 (4) vaccinations # of pregnant women who receive at least 2 12,200 12,200 prenatal visits both - 37,000 37,000 (5) (5) institutional and mobile clinics NUTRITION # of children 6-59 25,200 11,000 4,900 11,000 4,900 months treated for SAM # of children 6-59 months treated for 50,700 8,000 5,352 8,000 5,352 MAM # of children 6-23 months receiving 152,900 38,000 26,640 38,000 26,640 micronutrients powders CHILD PROTECTION # of unaccompanied and separated children assisted with interim - 3,500 27 4,000 27 care and family reunification support # of persons accessing preventative social work - 3,500 3,915 3,500 4,813 interventions to prevent family separation # of children accessing recreational and - 30,000 1,770 30,000 1,770 psychosocial support activities EDUCATION
# of affected 5-14 years old children receiving 142,000 30,000 22,346 95,000 22,346 learning materials to access education # of affected 5-14 years old children accessing 142,000 5,000 3,747 30,000 3,747 education through equipping of schools (1) No change since last report has been reflected since this is the first Sitrep in 2018. (2) The summary of results reflects UNICEF (HAC) and sector (HRP) targets for 2018 and progress achieved on 1 Jan-30 June 2018 period unless otherwise noted. (3) The initial target was based on a caseload of 27,000 new cases in 2018. However, due to strengthened response and awareness-raising interventions, 2,688 suspected cholera cases have been reported to date. With 88% of suspected cases reached by rapid responses, the target being 55 persons per case covered, the total is 130,130. But due to an imprecise clinical diagnosis, rapid responses teams answered 5,208 of acute diarrhea cases. (4) Only UNICEF with partners performs community rapid responses. Results are provisional, according to the July campaign report, pending official confirmation by the Ministry of Health, Immunization directorate. In 2018, only one campaign was conducted in St Michel de l ‘Attalaye. (5) Diphtheria outbreak campaign in South Department. (6) # of institutional visits only as mobile clinics have stopped since end 2017.