Girl Scout Joanie Estin helps CARE distribute hygiene kits to earthquake survivors outside of Léogâne. Over 90 percent of the buildings there have been destroyed. Photo: Evelyn Hockstein/CARE
Background
The January 12 th
earthquake that devastated Haiti is one of the largest humanitarian disasters in recent years, both in terms of number of people affected and the magnitude of damage. Current estimates are that one in three Haitians are affected (approximately 3 million people living in and around the capital city of Port-au-Prince). The government of
Haiti has confirmed that 112,500 people are dead and another 196,500 are injured. And while the search and rescue phase of the emergency is officially over, more bodies continue to be found as the cleanup of debris continues. Compounding these horrible statistics are the estimated 1 million people who are now displaced because their homes have been destroyed or rendered uninhabitable. Many displaced families are living in
“tent cities” – makeshift communities with minimal privacy or facilities. Still others, approximately 340,000 people, have left Port-au-Prince to take refuge in neighboring cities.
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CARE has worked in Haiti since 1954, and when the earthquake hit, we were on the ground, immediately launching our response to help survivors. Given our resources and experience, CARE is focusing on the areas of Pétionville and Delmas in Port-au-Prince, and the neighboring towns of Carrefour and Léogâne. Despite great personal loss, all of
CARE’s 133 staff members are safe and accounted for and are working round the clock to contribute their expertise to CARE’s response.CARE staff in Haiti includes emergency personnel who were part of the response to the devastating Hurricane Hanna in 2008.
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We have also deployed an experienced emergency team that has allowed us to start providing emergency assistance, while planning for longer-term recovery.
The purpose of this update is to provide more details on CARE’s efforts to date.
Update from Haiti
General Emergency Response

Despite logistical challenges, aid is getting through to the people of Haiti. The humanitarian chain is getting stronger each day – the airport is operating at peak capacity with an average of 120 incoming flights per day, distribution hubs in the
Dominican Republic and Panama have been established, and transfer of supplies is taking place over land and air.

The water and sanitation cluster organized by the United Nations and comprised of leading non-governmental and government organizations is reaching nearly 500,000 people each day with water. The United Nations coordinates “clusters” in all major response sectors (water, food, psychosocial, etc.), where organizations participating in response efforts can coordinate their response in each sector without duplicating efforts or missing coverage.

Health priorities include mobile clinics for first aid, psychosocial support and postoperative care.
CARE’s Response

CARE has experienced calm and orderly distributions of food and non-food items,
While we do not have a women-only policy, our experience has shown that women are disproportionately affected in emergencies and by reaching the women of the most vulnerable households first, we can reach entire families quicker.

CARE has reached more than 78,566 people thus far with the distribution of food, clean water and water purification packets, jerry cans, hygiene kits, mattresses and blankets, clean delivery kits, newborn kits, and the installation of water storage systems.
 A breakdown of CARE’s distributions to date include:
1 CARE’s other programs in Haiti focus on governance, HIV and AIDS, reproductive health, maternal and child health, education, food security, and water and sanitation.
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–
Food distributions to 17,310 individuals in the Delmas neighborhood of Port-au-
Prince;
– 3,000 PUR
®
water purification packets;
–
7,827 hygiene kits, with a special focus on the needs of women (each kit includes: toothbrushes, toothpaste, soap, detergent, shampoo, a comb, towels; safety pins, clothes line, sanitary napkins and toilet paper);
–
5,419 mattresses, with priority given to families of pregnant women and women with children;
–
10,706 blankets;
–
213 clean delivery kits to pregnant women to help them deliver safer in emergency situations (each kit includes plastic sheeting, gloves, a razor and gauze); and
– 122 infant kits (which include diapers, a receiving blanket, layette gown, safety pins, soap and booties.

Five water storage bladders were installed in Léogâne and Pétionville, providing potable water to 7,600 people daily through CARE water tanker deliveries.

We are in the process of acquiring and bringing in more supplies, such as jerry cans, tents, temporary warehouse structures, generators and high-protein biscuits from distribution hubs in Dubai, Karachi and Nairobi. CARE is in discussions to help distribute shelter kits donated by Habitat for Humanity and hope to begin soon. The government of Haiti has prioritized transitional shelter while the reconstruction phase begins, as they are better protection from hurricanes and easy to install. Transitional shelter kits will include items such as corrugated galvanized iron sheets, timber or metal frames for transitional structures and technical support.

CARE has also begun massive food distributions in the Delmas neighborhood of
Port-au-Prince in collaboration with the World Food Program. To date, we have reached 17,310 people with rice, a main staple in Haiti. The distributions will continue for the next 12 days. CARE has also distributed 1,500 high energy biscuits and has received 50 additional tons to distribute.

The CARE team in Haiti has begun planning for the longer-term response. The relief phase (present – April 2010) will focus on food and emergency supplies, temporary shelter and access to clean drinking water. The transition phase (March 2010 –
January 2011) will include strengthening health programming, providing economic opportunities, temporary or transitional shelter, distributing school kits and furniture, and raising awareness around prevention of gender-based violence. The rehabilitation phase (January 2011 – 2015) will address communities’ long-term issues such as earthquake-resistant construction and preparedness, rehabilitation of water systems, and reconstruction of schools and health systems.
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Gender Focus

We know that in emergencies like this, women and girls are at increased risk of sexual violence, exploitation and abuse when seeking food and other services.
CARE has deployed a genderbased violence specialist to enhance our ability to address these issues.
CARE staff Dr. Franck Geneus explains, “For the displaced people gathered now, there’s no electricity, there’s no light, so it is completely dark at night. This is a huge opportunity for someone who wants to violate a female. For instance, if you have a lady, a young lady most likely, going by herself without any protection to the latrine, there is a big chance that she is going to be assaulted. That’s why it is very important to organize the camps….In many camps, CARE has committees that are already constituted and in those committees we have pretty tough women. We can provide direct support to organize the camps in a way that will be less risky for women… This is something that has to be available in almost every camp.”
Health Focus

Port-au-Prince lacks sewer infrastructure, and the massive quake ruptured water lines. This creates a perfect formula for the spread of water-borne disease, particularly as those left homeless are forced into close quarters with limited options for sanitation. Reports of increased tetanus, measles and bloody diarrhea have been reported.
Returning Home
By Rick Perera,
CARE Press Officer
I've just returned from one of the most heart- breaking visits of my two weeks here: to meet the family of Dr. Franck
Geneus, CARE's gentle, dedicated health program director. Their homes destroyed, his extended family of 30 is packed into Franck's brother's tiny house and yard – from the littlest niece, to his 94-year-old grandmother.
Franck's father Ovanier, 64, and mother, Marie, 61, sit idly in the yard, restless and frustrated. Hardworking, middle-class Haitians, they've lost not only their home but also their livelihoods: the grocery store on the ground floor run by Marie; upstairs, the private school where Ovanier employed eight teachers and taught 100 pupils.
Franck was born in this house, grew up here, and was married here. He intended to move his young family in when he returned to Haiti, full of hope at the prospect of running CARE's efforts to improve the country's struggling health care system. That was just two weeks before January 12.
Franck points through a huge gash in the facade to a large, wooden cabinet, battered and coated with dust.
"My father and I built that cupboard, ten years ago," he says, his voice trailing off. Funny how such small details can catch the heart of someone whose life has been forever changed by disaster.
And yet Franck is not destroyed, instead plunging into his work: readying CARE's strategy to manage camps for displaced people; address the threat of violence against women and sexual assault; and take on the daunting challenge of meeting the health needs of women and infants.
This unassuming man, just 37, is not only a Haitian. He is first and foremost a healer, deeply devoted to his family, his country, and his people. CARE is so fortunate to have him.
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Maternal mortality is also a concern given the lack of health services and unhygienic conditions. Haiti’s maternal mortality rate is already the highest in the region, at 670 deaths per 100,000 live births and these figures naturally rise under emergency conditions.

As a member of the U N’s health cluster, CARE is helping with a pilot immunization campaign targeting residents of temporary settlement sites. The immunizations include: rubella and diphtheria-tetanus-pertussis vaccines for children under 7; and diphtheria and tetanus for older children and adults. The health cluster is also working on preparing a strategy to provide basic health services in new settlements.

Safe water is crucial for every survivor of quake – but especially for pregnant women, new mothers and small children. We are concerned that women may stop breastfeeding because they do not have enough food or water themselves, posing a huge risk to newborns.
As Dr. Franck Geneus, CARE’s health expert in Haiti explains, “When lactating women are under stress, they often stop producing milk…you have a high risk for the baby to face malnutrition. This is a real risk and something that has to be addressed.”

Of growing concern is the lack of sanitation services. Latrine construction is impeded by the population density, lack of available space and high groundwater in many areas. The first reports of increasing diarrheal disease incidents were received by the
UN water and sanitation cluster on January 26. CARE is participating in this cluster and has years of experience with water and sanitation projects in Haiti. We are in the process of installing 60 latrines in Carrefour. More than 20 assessments have been completed and we estimate a potential population of 40,000 people who are in need of sanitation services in Carrefour and Léogâne.
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