Tuesday, October 11, 2016

Haiti-Early Assessment of Hurricane Damage

Overflowing river in Gros Morne caused by run-off from deforestation.
Five days after Hurricane Matthew smashed the south coast of Haiti and cut a swath through the southern peninsula, we can begin to assess the extent of the physical destruction and the scope of the human tragedy caused by the category 4 storm. In this early stage as foreign NGO damage assessment and needs teams reach the affected areas, it will be important to coordinate relief efforts through the Haitian Government and its agencies (The Haitian Red Cross, Ministries of Health and Agriculture, Haitian Civil Protection Department) to avoid the chaos and resentment that occurred after the 2010 earthquake.

I am relieved to report that the Artibinite Department, and specifically the Medicine For Peace programs in Gros Morne did not suffer extensive damage. MFP health workers and our colleagues are safe. The Alma Mater Hospital and its dispensaries are intact, although roads are washed out and fear of mudslides prevent attending to patients in the rural dispensaries. Thankfully, the feared destruction of homes and municipal facilities in the town of Gros Morne, as occurred during the 2008 hurricanes Gustav and Hanna, did not materialized.

The Departments of Sud, Grand Anse, and Nippes in south west Haiti were not as fortunate. One hundred and forty-five miles-an-hour winds, torrential rains and swelling seas flooded towns, knocked out communications, and destroyed homes in its path. More than a million people were affected, 62,000 people were evacuated, and 750,000 Haitians are now in need of assistance.  Aerial reconnaissance revealed major destruction of the key cities of Jeremie, Les Cayes, and Port Salut, and on the ground assessment teams report 70% of the homes uninhabitable. The rising death toll, an all too frequent phenomenon in Haiti, is now approaching 800.

The state of children. The school cycle has been interrupted with approximately 200 schools flooded, destroyed, or used as shelters. The Government  announced reopening of the schools on October 10, which seemed unlikely for the nearly 100,000 affected students. Return to school is critical in order for children to participate in the national school lunch program, an important source of nutrition for Haitian children. An additional two thousand children were evacuated from orphanages.

Food and water availability. A number of U.N. (e.g. World Food Program) and Governmental Agencies have begun the delivery and distribution of life sustaining food to the affected areas. Approximately 50 metric tons (primarily rice, pulses-beans, peas, lentils, and oil) is in the process of being distributed. One ton of food will only sustain 400 individuals for a week, which speaks to the urgency of needs assessments, transport and distribution of additional desperately needed food.

Potable water is also critical, and Government teams and their NGO partners are attempting to stock strategic water stations. A number of water trucks have arrived in the affected area, and large water bladders have been supplied to a number of key hospitals. Water purification systems, chlorine tablets and water testing kits are being delivered to Haiti by foreign NGO’s.

Communication. The bridge between Post-au-Prince and the south (on National Route 2) collapsed immediately during the storm isolating the south from the rest of the country for a number of days. A temporary bridge has been constructed. Most of the major roads were not accessible during the storm but travel between the major cities in the south (e.g. Les Caye and Jeremie, Anse-de-Veau and Baderes) is now possible. Telephone service was unavailable in the affected area during the storm but Digicel now reports service   gradually being restored and now 30% of the south west is being covered.

Public health.  There were conflicting reports on the damage to health facilities but it now appears that the major hospitals in Jeremie, and other populations centers are at least partially operating.

The major threats after the storm are a surge in water-born infections and an increased incidence of mosquito transmitted diseases. Flooding, overflow of sewage and contamination of drinking water threatens to increase the case load of cholera, already endemic in the country. Last year, 27,000 cases were reported in Haiti, one of the highest incidence rates in the world. The center of the cholera epidemic was in the Artibinite department, considerably north of the hurricane's path. Nevertheless, officials are alarmed because there have been 30 new cases of cholera reported in the affected areas in the few days following the hurricane. More alarming are 10 new cases reported in Gonaives, a city out of the storm’s path, perhaps signaling a country-wide explosion in cholera cases. Haitian authorities are on alert and are heightening cholera prevention and containment measures.

Stagnant water after flooding breeds mosquitoes, and public health officials have been alerted to implement measures to control mosquito populations to prevent a spike in cases of malaria, dengue fever, chikungunya, and zika.

In summary, we are in an early stage of damage assessment, but emergency needs (e.g. food, water, and shelter) are already being addressed. Assessment in the field by teams that include logisticians, public health officers, sanitation and water experts, engineers, and epidemiologists are assisting the Haitian Government and its humanitarian partners to develop a strategic plan to avoid preventable deaths in this critical period in the aftermath the storm.

This summary was compiled from information obtained in conversations with MFP health workers and colleagues in the field,  and  reports from Haiti Ministry of Health, U.N. Children's Fund, the U.N. Office of Coordination of Humanitarian Affairs, World Food Program, Agency France-Presse, Humanity Road, USAID,MAP International, and Doctors Without Borders.