Survivalism

Latrines Join Food, Water on Haiti's Crisis List

January 30, 2010

AP - Relief officials are scrambling to confront a sanitation crisis that could spread malaria, cholera and other deadly diseases throughout the chaotic camps packed with hundreds of thousands of Haitian earthquake survivors.

Shortages of food, clean water, adequate shelter and latrines are creating a potential spawning ground for epidemics in a country with an estimated 1 million people made homeless by the Jan. 12 quake.

On Saturday, a single portable toilet served about 2,000 people in a sprawling camp across a street from the collapsed National Palace, forcing most to use a gutter that runs next to an area where vendors cook food and mothers struggle to bathe their children.

"We wash the vegetables first from water brought in by trucks, but a lot of times the water isn't clean," said Marie Marthe, 45, cooking a large pot of collard greens, carrots and goat as flies gathered on her daughter's diaper. "We don't have any choice."

Survivors have erected flimsy shelters of cloth, cardboard or plastic in nearly every open space left in the capital.

Women wait until night to bathe out of buckets, shielding their bodies behind damaged cars and trucks. Water is recycled - used first for brushing teeth, then for washing food, then for bathing.

"My 1-year-old has had diarrhea for a week now, probably because of the water," said Bernadel Perkington, 40. "When the earthquake happened I had 500 gourdes (about 15 U.S. dollars), which I was using for clean water for her. The money for that ran out yesterday."

The crowding and puddles of filthy water that breed mosquitoes have begun to spread diseases such as dengue and malaria, which were already endemic in Haiti. Some hospitals report that half the children they treat have malaria, though the rainy season - the peak time for mosquitoes - won't start until April.

Tight quarters also expose people to cholera, dysentery, tetanus and other diseases.

Dr. Louise Ivers, Haiti clinical director for Partners in Health, said she fears "a mass outbreak of measles, which would really be potentially devastating for a camp where there are 10,000 people living." Her organization has operated in Haiti for more than two decades and has about 4,000 medical workers in the country.

The U.N., Oxfam and other aid organizations have started to dig latrines for 20,000 people, said Silvia Gaya, UNICEF's coordinator for water and sanitation, even if that's a small fraction of the 700,000 people that officials said were living in the camps last week.

"In some parks, there is no physical space" even to dig latrines, Gaya said.

Dr. Jon Andrus, deputy director of Pan American Health Organization, said nearly three dozen organizations were joining the U.N.-led effort to build latrines and handle solid waste disposal.

Authorities also plan to build more permanent resettlement camps with plumbing and sewage, while PAHO is working with Haiti's government to chlorinate water in collapsible tanks.

Efforts to treat the injured suffered a setback, however, as the U.S. military said it had halted flights on Wednesday that had been carrying earthquake victims to the United States for emergency medical care, apparently due to a dispute between the states and federal government over who will pay.

"We can't fly anyone without an accepting hospital on the other end," said Capt. Kevin Aandahl, spokesman for U.S. Transportation Command.

But a Miami doctor involved in the relief effort said he had hospitals ready and waiting - and accused the U.S. government of endangering the Haitians' lives.

"We have 100 critically ill patients who will die in the next day or two if we don't Medevac them," said Dr. Barth Green, chairman of the University of Miami's Global Institute for Community Health and Development.

On a cot at a temporary field hospital at Haiti's international airport, 5-year-old Betina Joseph lay in a slate blue party dress, trying with waning energy to shoo a fly buzzing around her face.

Doctors said Saturday tetanus had developed in a small leg wound suffered in the quake.

"If we can't save her by getting her out right away, we won't save her," said Dr. David Pitcher, one of 34 surgeons staffing the University of Miami-run field hospital. Pitcher said two men had just died of tetanus at the hospital, which performs as many as 40 surgeries a day.

Joseph's mother, Denise Exima, 28, caressed her daughter's corn rows, apparently unaware that getting her out could mean life or death.

Green told The Associated Press that not even the U.S. Navy hospital ship Comfort, anchored off Port-au-Prince, can provide the respirator care - three to four weeks of it - that would enable Joseph to survive. The hospital ship Comfort is so crammed with patients that U.S. military officials are trying to organize a location on land where they can recover.

U.S. Ambassador to Haiti Kenneth Merten said about 435 earthquake victims had been evacuated until the flights stopped. He said the problem should be fixed.

"I'm sure the Department of Defense wants to do the right thing as do we," he said Saturday. "Look, everybody is here working on the ground trying to do the right thing for as many people as possible."

Food distribution was becoming more organized. The World Food Program on Saturday began handing out coupons that women - and women only - can turn in for food at 16 sites in the capital starting Sunday.

The coupons entitle each family to 25 kilograms (55 pounds) of rice. The idea is to ensure a dependable supply for families and prevent young men from forcing their way to the front or stealing food from weaker people in line, a common occurrence after the quake.

U.N. officials say they are still far short of reaching all 2 million quake victims estimated to need food aid.

Scenes of Survival and Death in Desperate Haiti

January 29, 2010

AP - They are the latest scenes of survival and of death in Haiti's deadliest disaster - a looter shot dead for breaking into an appliance store and crowds erecting new houses on shaky ground.

More than two weeks have passed since an earthquake destroyed much of Haiti's capital and left a vacuum of power over who should rebuild the country.

In a snapshot of the growing desperation, a private security guard fatally shot a looter who joined with others in breaking into a damaged appliance store in the commercial district Friday. As young scavengers carted away ovens, refrigerators and an air conditioner, an Associated Press journalist watched as the guard arrived firing an automatic pistol.

About a dozen soldiers from the U.S. Army's 82nd Airborne Division rushed to calm the situation but it was too late. The looter lay dead, face-down at the bottom of the stairs, splattered in blood.

Other Haitians are trying to focus on getting on with life, but the mood is grim everywhere.

"The situation is only getting worse," said Josielle Noel, 46, who was among dozens of people pooling their labor to start rebuilding in the concrete slum of Canape Vert, an area devastated by the quake.

Noel's house partially collapsed in the Jan. 12 earthquake. Two more small aftershocks shook parts of the capital Friday, although new damage is hard to spot in a landscape of buildings cracked, partially collapsed or flattened.

Tired of waiting for government help, the families lugged heavy bundles of wood and tin up steep hillsides to start rebuilding new homes on top of old ones.

Few tents have been supplied to the quake's survivors, rubble remains and signs begging for help in English - not Haitian Creole - dot nearly every street corner in Port-au-Prince.

It could take weeks to get the 200,000 tents needed for Haiti's homeless, said Marie-Laurence Jocelyn Lassegue, the culture and communications minister. Haiti now has fewer than 5,000 donated tents and coordinating the aid operation remains a problem.

"I have 44 years' worth of memories in this house," said Noel Marie Jose, 44, whose family was reinforcing crumbling walls with tin and wood in Canape Vert.

Houses on their side of a mountain were nearly all destroyed while dwellings on the other side remained intact.

"I got married here. I met my husband here. My mother braided my hair there, where these walls used to stand," Jose said. "Even if it's unsafe, I can't imagine leaving. Even if the government helps, it will come too late. This is how it is in Haiti."

Surrounding her, concrete homes were either crushed or had toppled down a hill. Jose and other families said they were worried both about the coming rainy season and fear they may lose their plots after demolitions because they either lack clear title or the government does not want them to rebuild on land it considers unsafe.

Reconstruction, resettlement and land titles are all priorities of the government of President Rene Preval - but so far in name only.

The government has been nearly paralyzed by the quake - its own infrastructure, including the National Palace, was destroyed - and so far it has been limited to appeals for foreign aid and meetings with foreign donors that have yet to produce detailed plans for the emergencies it confronts.

Its first priority is moving people from areas prone to more quakes and landslides into tent cities that have sanitation and security but have yet to be built. Preval held dozens of meetings with potential outside contractors to discuss debris removal, sanitation and other long-term needs.

Albert Ramdin, assistant secretary of the Organization of American States, has offered help in creating a new Haitian land registry - a process that could take months if not years because countless government records were destroyed in the quake.

Haitians ardently defend their property rights. If a family has occupied land for more than 10 years, they gain ownership rights even without a deed. For some families, small homes have been passed down through generations. Few Haitians have insurance, and the loss of what few assets they have has crippled countless families.

Many have tired of living in tents improvised from tarps, sheets and bedspreads, opting to rebuild their homes rather than find new plots.

Lassegue, the communications minister, said such rebuilding won't be tolerated - and the government wants to develop and implement a comprehensive reconstruction plan that might feature building codes, an anomaly in this impoverished nation.

"We've been sleeping outside but the rains will come soon," said Merilus Lovis, 27, taking wooden planks and erecting them for walls inside the foundation of his former home, where his wife and daughter died. "I'm scared of the floods on this hillside but I don't think that God would let such bad things happen twice."

Paul Louis, a 45-year-old porter, has started a business buying wood from scavengers and selling it on the street. He purchased a cracked and worn 1-by-8-foot board for about $2 and was selling it Friday for $3.

"People are afraid to build with concrete now," Louis said.

In another neighborhood, people dug through destroyed homes to salvage materials. Women did the wash amid the ruins.

"I have stayed, but I lost my home," said Thomas Brutus, who lives perched precariously on a debris-strewn hillside in a shack made from the remains of destroyed homes. "So I made this little house, even though I know it's dangerous. We have been here for 14 days and have received no help."

Many residents say they're staying because they grow vegetables on their small plots. Thousands of others have swarmed to improvised tent camps, where Elisabeth Byrs, an official of the U.N.'s humanitarian coordination office, said there is a "major concern" about sanitation.

About 200,000 people are in need of post-surgery follow-up treatment and an unknown number have untreated injuries, she said.

A Glance at Haiti Developments 18 Days after Quake

January 30, 2010

The Associated Press - A look at the latest from Haiti on Saturday, 18 days after a 7.0-magnitude earthquake devastated the capital, Port-au-Prince, and left an estimated 200,000 dead throughout the country:

SANITATION

Relief officials are scrambling to confront a sanitation crisis that could spread malaria, cholera and other diseases throughout chaotic camps packed with hundreds of thousands of survivors. Shortages of food, clean water, adequate shelter and latrines are creating a potential spawning ground for epidemics in a country with an estimated 1 million homeless.

EVACUATION

The U.S. military has halted flights carrying victims to the United States because of an apparent dispute over where seriously injured patients should be taken for treatment.

It was unclear exactly what prompted the decision to suspend the flights, or when it would end. Military officials said some U.S. states were refusing to take patients, though they wouldn't say which states.

AIRPORTS

The U.S. military is assessing Haitian airports to which it can divert military traffic to allow Port-au-Prince's congested international airport to return to its civilian functions, said U.S. Army Corps of Engineers Col. Rick Kaiser.

Port-au-Prince's Toussaint Louverture International Airport is being strained by international relief efforts, with more than 160 flights a day landing at one point.

RUBBLE

The rubble from destroyed buildings in Port-au-Prince could easily fill to the limit five football stadiums the size of New Orleans' Superdome.

U.S. Army Corps of Engineers Col. Rick Kaiser said Haiti's government could put the rubble to good use - perhaps building an artificial reef to augment fishing or using it as landfill to reinforce Haiti's many eroded mountains and ravines, thus preventing mudslides.

PORT

After temporary repairs by the U.S. Army Corps of Engineers, Port-au-Prince's earthquake-damaged port now can handle some 2 1/2 times the number of containers it was dealing with before the disaster.

The port's northern pier collapsed entirely under water in the earthquake, and the partially collapsed southern pier received further damage from aftershocks.