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