Strengthen access to child health care through immunization

Mardochée with her son being vaccinated

Vaccination remains vital for the health of infants, young children and mothers. UNICEF, with support from donors, in support of the Ministry of Public Health and Population (MSPP), supports immunization activities across the country. Thanks to a donation from Japan, UNICEF is strengthening routine immunization activities in public hospitals and health centers to keep children healthy.

Croix-des-Bouquets, October 1, 2018 – This is the usual affluence in the health center of Croix-des-Bouquets. Dozens of women with their children wait patiently for their turn in the service that concerns them. It is still early, but doctors and nurses are already at their posts in the services. Things are starting to come alive.

Some equipment of the Cold chain

The room for vaccination is a little cramped, about thirty mothers are struggling with their children. Mardochée B., aged 20 and mother of two boys, is one of them. She came to vaccinate the youngest of them, Steve, barely a year old. The boy is already very robust for his age, and his mother has all the trouble in the world to contain his movements. Vaccination stations are staffed by nurses, auxiliaries and community-based general health workers (CHWs).

“The health worker told me that the vaccination will protect my child from diseases, so I took him. This will keep him healthy. My eldest son has already received all the vaccines, “she says. Mardochée is also sensitized on hygiene, nutrition and other practices to protect the child’s health against bad practices. The health center raises awareness on these issues.

Families who attend the Health Center are very vulnerable as Mardochée, she does not work. The vaccination service within the center is free because it is subsidized. When the vaccine is available, they come with their children. Some children also receive vitamin A supplementation.

Deal with the demand

Mothers waiting for their turn

People come from every corner of the commune of Croix-des-Bouquets, one of the largest in terms of area, to benefit from free health care, including vaccination. By day, there are between 40 to 50 women who come to be vaccinated and their children. Vaccination is from Monday to Friday, children from 0 to 11 months and from 12 to 59 months are vaccinated. The vaccines offered are: pentavalent (DTP-hib-HEB), polio, BCG, measles vaccine.

Dr. Faubert Aurelus, head of the health center, details the services offered to the population: pediatric consultation, prenatal consultation, family planning, general consultation, among others.

The hospital received, as part of Japan’s funding, a solar refrigerator for the storage of vaccines and other cold chain equipment. For the manager, it will help to better preserve vaccines because the energy problem will no longer be. “This is an important step, because with the former, there are variations in temperature that may deteriorate the quality of vaccines,” he says.

Reaching children in localities

Health workers assigned to the health center promote vaccination in the communities and carry out community vaccination posts in the most remote localities. Altidor Grevi, is one of them, he works in four localities of the commune of Croix-des-Bouquets. Sometimes he must walk for hours to reach these communities.

“I am doing gathering work with people in the communities and I am vaccinating. I’m weighing children also. Thanks to vaccination, measles has virtually disappeared in the localities where I work, “he explains.

Strengthen routine immunization

This routine immunization program, funded by the Japanese people, covers all ten departments, with a focus on the 70 very difficult to access communes. The RED approach (Reach every district)is the adopted reinforcement strategy. This project is in line with SDG 3, which aims to ensure a healthy life and promote the well-being of all at all ages.

“The main objective is the reduction of childhood morbidity and mortality due to vaccine-preventable diseases. We also want to increase vaccination coverage against measles and rubella from

Routine vaccination

51.9% to 90% with coverage of at least 80% at the communal level. Thanks to this generous donation from Japan, many more children will have access to routine immunization, “said UNICEF Representative in Haiti Maria Luisa Fornara.

Bringing ACAT into isolated localities

 

The Wash facilitator talking twit some members of the ACAT Committee

With funding from the Japanese people, UNICEF is conducting open defecation fight’ activities in various hard to reach communities. In the locality of Lauranette, commune of Cerca-la-Source, in the Centre’ department, the population has practically eliminated open defecation. This represents a considerable progress, as in the past, cholera was wreaking havoc in the area. The inhabitants are now very satisfied with the results and thank the Japanese people for their valuable contribution.

Cerca-la-Source, Haiti.,03 October 2018 – It rained the night before, so taking the road to go to Lauranette (2nd communal section of Losianne), is not a party of pleasure. The ground is very muddy, and the road can easily become a trap for any vehicle, however robust. Reaching this locality in these circumstances is therefore a difficult task, but it does not discourage the World Vision agent, a UNICEF partner for the project ” Strengthening cholera prevention in the Central Department ‘.

A latrine built by the community

“We are conducting hygiene awareness sessions for the community. Before launching the Community Approach to Total Sanitation (ACAT), we organized visits, mobilized and verified that the area is ready before starting the process. In doing so, we invite community members to join us to get involved, “says Zacharie Porpote, WASH facilitator at World Vision for the area.

In collaboration with the population, the facilitators set up an ‘’Action and Monitoring Committee for Sanitation’’ (CASA). Their role is to make a census of toilets in the community. “The committee mobilizes and educates people who do not have toilets to build them. People have been very enthusiastic and dynamic. They started working from day one “he continues.

The enthusiasm of the community was crucial

This enthusiasm is expressed in the person of Mrs. Elula Jean, ASEC (the local authority) of the communal section. She has been a driving force for ACAT’ success, raising awareness and motivating people. “I remind residents, the devastation that cholera has caused in the community before the construction of toilets. I ask them to dig latrines with the means they have, even if these means are derisory. If possible, I support them to feed the workers and I lend them tools, “she explains.

“There has been a lot of improvement when you consider the situation before. But it’s an everyday struggle to make life easier for people. There are many more latrines in the community and since then there is no more cholera, “she continues. Many people have died of cholera in the locality as it takes a long time to get out of the area. Thus the population understood the importance of using toilets and adopting adequate hygiene measures.

“We congratulate the people of Japan and UNICEF for making this contribution in the community. They allow us to protect our lives as well as those of our children. I encourage them to always work in the field because they have helped us a lot. Without this help, we do not know where we would be right now, “she recalls.

A project with many aspects

Water point has been built in the Centre department

These activities, financed by Japan in the Center department and notably in Cerca-la-Source, cover several areas, including the rehabilitation or construction of water supply facilities in 17 communities and peri-urban settlements, including creation and training. water, hygiene and sanitation committees; the implementation of the ACAT approach in 100 rural communities and an appropriate sanitation approach in 20 peri-urban areas; building WASH infrastructure in schools as well as promoting hygiene.

“At UNICEF, we are very pleased with the funding of this project, as it will enable vulnerable families and children to benefit from WASH services in the Central Department. It will save the lives of children and help us fight waterborne diseases, including cholera. Once again, we thank the Japanese people for helping us accomplish our mission, “said Maria Luisa Fornara, UNICEF Representative in Haiti.

Fight drought in remote Southern communities

A water tank at Ti Plaine ( South departement)

The locality of Tiplaine, located in the Southern department, has suffered greatly from drought episodes. Its isolation makes the situation of people living even more difficult in terms of access to drinking water. UNICEF, with a contribution from USAID, together with the Dutch Red Cross, has rehabilitated the water system in the area, including building a catchment, a reservoir, a water system capable of to feed the residents through fountains. All under the supervision of the National Directorate of Drinking Water and Sanitation (DINEPA).

They do not know how to thank the donors, because now it’s a relief for everyone, so much has life changed in the locality. Training for plumbers makes the network sustainable.

Cayes, 17 September 2018- A broad smile cuts the face of Smart Joseph, ASEC (a local authority) of Tiplaine, when she speaks of the water network of the locality.

“Before the installation of the network, the situation was untenable within the area in terms of water. The place where we used to draw water was very unhealthy, there were a lot of rocks, trees were everywhere and it was very difficult for us. For some people, they had to walk more than an hour, back and forth. There were many people who drew water and the flow was very low, “she recalls.

The water was not drinkable

Not to mention the poor quality of water that was not drinkable and that was a source of illness of any kind for the population, especially children. The water was drawn from the ground. People caught all kinds of illnesses. The children had pimples on the skin and on the scalp as well as waterborne diseases. In the case of women, they faced a serious problem in terms of personal hygiene.

Josette Blanc, one of the beneficiaries and mother of three children, remembers all the difficulties she encountered to be able to draw water that was not even drinkable. “The situation was so critical that we did not know what to do. It was God who sent UNICEF, USAID, the Red Cross and DINEPA otherwise we would all already be dead because the cholera was wreaking havoc “, she admits.

She had serious skin problems because of the water. “Now my skin is healthy and I am cured because of the new water network,” she says.

People are more than satisfied

A Red Cross technician conducting control quality

“With the arrival of UNICEF, the Red Cross, USAID and DINEPA who built this network, the situation has improved considerably, we no longer face the same problems. It’s different, kids are healthier, “she says.

People welcomed the project with open arms, she said. Other areas started work well before them. But their enthusiasm and energy allowed them to finish before the others. People have been trained on water management so that everyone is aware of the importance of drinking water, how to protect themselves from germs, handwashing, and more.

Plumber training that made the difference

As part of the project and sustainability of the works, on the proposal of DINEPA, there have been training sessions for plumbers who manage drinking water supply systems (SAEP) of the various networks of the South. Thirty plumbers took part in the workshop.

The plumber of Ti Plaine, responsible for the system did not hide his satisfaction. He was particularly pleased by the fact that his plumber assistants benefited from the knowledge he gathered during the workshop. “They can take over the system when I’m not there,” he said, emphasizing the unconditional support of the people for the realization of the project.

Keep the network in good condition

Several thousand trees have been planted around the catchment sources to conserve water. Seedlings were distributed as part of the project. There have been trainings to raise awareness about the importance of trees. “Many people went to plant trees,” says Smart Joseph. Indeed, the Dutch Red Cross has also trained on tree planting techniques and provided nurseries which allowed the reforestation of 2 hectares on the perimeter of protection of the source. In total, 1 530 trees, including 1050 fruit trees and 480 foresters were planted by the communities. This will increase the plant cover and protect the newly rehabilitated source.

A Drinking Water Supply and Sanitation Committee (CAEPA) – made up of community members – was set up and trained on these tasks and responsibilities by DINEPA according to the national protocol in order to ensure the management of the system. of water supply. Also at the community level, people living on pipes and fountains in support of CAEPA ensure cleanliness, sensitize people and hunt animals, so that everything is always clean.

“We must be able to sustain the system because it belongs to us,” said one of the leaders.

This project is very important for UNICEF, DINEPA and USAID because it integrates the construction component of water access systems with that of sustainability through the training of stakeholders and the preservation of water resources. These two elements being the guarantee of the continuity of the service of water in the localities synonymous with the eradication of waterborne diseases.

The project aims to respond to the critical water needs of people living in drought areas and at risk of food insecurity and under-nutrition.

 

The EMMUS VI Survey formally launched by the government

The presentation of the EMMUS VI

The new figures from the Mortality, Morbidity and Utilization Survey (EMMUS VI) will allow the government to better define their actions. Public policies will be based on the data from the survey. They will also serve local and international partners in their daily interventions.

Port-au-Prince, August 21, 2018- EMMUS VI was launched in the presence of the main actors and donors of the health sector, the Ministry of Public Health and Population (MSPP), UNICEF, the Embassy Canada, the United States Embassy, the United Nations Population Fund, the World Bank, among others.

Dr. Marie Greta Roy Clément, Minister of Health, recalled that the data presented is the backbone of public health. “Indeed, all your decisions, if they want to be rational and hopeful for the Haitian people, must necessarily be based on statistics of reliable services and news,” she insisted.

The Minister further indicated that with the publication of these results, the diagnosis of the health situation is available which will facilitate better planning and management of our programs and projects in public health. This will bring the country closer to the Sustainable Development Goals (SDGs).

“There is still a long way to go, we must hasten the pace, trot or even gallop if we want to present a satisfactory record of our health actions by 2030,” she said. Dr. Roy Clément also emphasized the efforts to equip the health system with qualified human resources, particularly in the field of community health. Thus, the system has been enriched by: 1,200 community health workers, 270 general nursing assistants, 270 health officers.

UNICEF contributed to EMMUS VI

Ms Maria Luisa Fornara during her speech

UNICEF, along with other partners, provided technical and financial support for the survey. “UNICEF is proud to have accompanied the MSSP in the production of this important survey, and wishes to recall that this support is a continuation of the previous EMMUS,” said Maria Luisa Fornara, UNICEF Representative in Haiti.

Ms. Fornara praised the leadership of the MSPP in this survey. “This survey will enable us to better direct our actions, alongside the government and in collaboration with our partners and donors, to reach the most vulnerable children and families in the most remote areas of the country,” he said. she emphasized, while renewing UNICEF’s commitment alongside the MSPP.

A fundamental inquiry

The Sixth Survey Mortality, Morbidity and Utilization in Haiti 2016-2017 (EMMUS-VI) is a representative sample survey at the national level. The main objective of the 2016-2017 EMMUS-VI is to provide updated estimates of basic demographic and health indicators.

During the 2016-2017 EMMUS-VI, data were collected on fertility levels, fertility preferences, knowledge and use of family planning methods, breastfeeding practices, and mortality. children, infant and maternal health, possession and use of mosquito nets, nutritional status of mother and child.

Launch of the 2018 ‘’Punch Operation against Cholera’’

The representatives of the local collectivities during the launching

                      

 In 2017, the operation punch allowed a breakthrough in the fight against cholera in the West department. On Monday, August 7, the Ministry of Public Health and Population (MSPP) and the National Directorate of Drinking Water and Sanitation (DINEPA) launched the 2018 ‘’Punch Operation’’. The main partners in the fight against the disease were there, including UNICEF and the representatives of local and regional authorities in the West.

Port-au-Prince, 22 August, 2018- With the launch of the ‘’punch operation’’, the main partners want to strengthen the fight in the department of the West. There has been significant progress in the fight, as evidenced by the numbers that have never been so low.

The administrator of the Western Health Directorate (DSO), Mr. Maliou Etienne, welcomed the participants’ presence during the workshop. “I want to remind you that the fight to eliminate, to eradicate cholera is not only the business of the MSPP but also it involves the participation of all. Everyone must contribute to the fight, “he said, officially launching the workshop.

Mr. Paul Chrystian Namphy, coordinator of cholera control at DINEPA, emphasized the important elements of the strategy to eliminate cholera: medical care, community response, epidemiological surveillance, awareness, drinking water and sanitation, involvement of local elected officials.

“These elements are essential, we must provide the population with access to water and sanitation. We must support the population in a real revolution of behavior change, promotion of awareness and hygiene, “he continued.

 

Mrs. Maria Luisa Fornara, UNICEF Haiti Representative during his speech

UNICEF a key player in the fight against cholera

In the fight against cholera, UNICEF has been with the Haitian government from the first moments. The organization supports the fight against the disease at several echelons, including the aspect of support for coordination and response at national, departmental and communal levels. Thus, the organization is the leader of the WASH sector and ensures a constant presence in the health sector to reinforce the links and the cohesion between the activities Wash and health.

“The punch operation has this strength to rally all the actors concerned by this common goal of eliminating cholera. UNICEF is delighted with the involvement of everyone, especially local and regional authorities in this major operation, “said Mrs. Maria Luisa Fornara, UNICEF Representative in Haiti.

The elimination of cholera: more than ever a truth

The latest figures against the disease show that it is possible to eliminate it. At the 30th week of this year, only 31 suspected cases were recorded for the whole country. In general, 818,874 suspected cases of cholera have been reported from 2010 to 28 July 2018; in 2017, the number of suspect cases reported amounted to 13,681 for the whole country; and from January to July of the current year there are only 2,874 cases across the country.

The combined efforts of all the partners involved in this fight bring Haiti closer and closer to the goal of elimination. It is important to be extra vigilant during the rainy season.

Even if the figures are encouraging “we cannot yet claim victory, because the cholera is still there” warned Mr. Paul Christian Namphy.

 

 

 

 

 

 

 

 

 

 

Eliminating Cholera from Haiti – The last mile is the most difficult

Michel Ange supervising the a rapid response team at Carrefour

Port-au-Prince, April 2018: “It could be one of the most important activities happening in Haiti now,” states Michel Ange, team leader of one of the 58 rapid response teams working relentlessly to eliminate cholera in Haiti. “We are saving lives, educating the local population around hygiene practices, and helping to eradicate a killer bacterium.”

In 2017, for the first time since cholera was introduced to Haiti in 2010, the epidemic was under control and the highest suspected cases were concentrated in three out of the ten Departments: West (31%), Artibonite (29%) and Centre (19%). 2018 began with the lowest numbers recorded, 995 cases between January 1st and March 31st  compared to 4,248 cases for the same period last year (source: DELR/MSPP).  This evolution is largely due to a strategy that combines reinforced local coordination, surveillance, solid rapid response, and enhanced prevention through water chlorination and intensified hygiene awareness. With the support of UNICEF, the Ministry of Health launched this “alert-response” strategy in 2014, resulting in the activation of rapid response teams that are staffed with agents of the Ministry of Health response teams and Non-Governmental Organizations (NGO). It required three years of close monitoring and technical support to reach a satisfactory level of performance, and now the results speak for themselves. Due to the availability of funding, all rapid response teams were activated in 2017, resulting in an unprecedented response rate of 95 percent to all suspected cases.

“We are good at what we do. You can see that in how the number of cases has dropped in the last year,” states Michel Ange. She is not showing off but simply stating a fact. Never has the chance to eliminate cholera been so close, yet the way there was hard. “It was an uphill battle but organizations like Solidarity International and UNICEF didn’t give up at all.”

UNICEF and the Ministry of Health continue to support a network of response teams nationwide. Four NGOs, are working hand in hand with the 13 teams from the Ministry of Health, called EMIRA (in French, Equipe Mobile d’Intervention Rapide), to deliver a complete package of activities: visiting affected households and an average of 12 houses living in a 50m perimeter around the patient’s house and establishing a “cordon sanitaire” to avoid the disease from spreading in the community. The teams provide oral prophylaxis to the patients and their families, disinfect homes, and distribute oral rehydration salt, soap and water chlorination tablets. They also secure water sources by establishing emergency water chlorination points or support DINEPA (National Directorate for Drinking Water and Sanitation) to chlorinate the water systems in affected areas when needed.

A rapid response team is distributing supplies to fight against cholera

These NGO teams are composed 100 percent with skilled Haitian professionals who have been trained to investigate and respond to suspected cases of cholera and other types of acute diarrhea, which directly benefit children as diarrhea remains one the main causes of child morbidity in Haiti.

Fund predictability also allowed for the improvement of complementary health and hygiene promotion activities and community mobilization, activities, crucial to ensure quick outbreak control. In addition to the work of response teams, UNICEF’s NGO partners deployed community engagement teams which reinforced the rapid response by conducting hygiene awareness interventions in schools, churches, places or events gathering people in affected areas, and food hygiene sensitization in public market places.

In the metropolitan region of Port-au-Prince, rapid response agents like Michel Ange have contributed to respond to approximately 5,000 suspected cholera cases in 2017, and to sensitize over 360,000 people in affected neighborhoods. It is a labor of passion and love. “Haiti is my home, my country, and I love it with all my heart. Of course, it is a difficult place, but with the help of organizations like Solidarités International and UNICEF, we are learning techniques to address our problems, to take over,” says Michel Ange with a smile. “My children will grow up in a stronger Haiti, a better Haiti than the one I had…we will all help each other to learn and grow together.”

Today, the situation invokes optimism but the fight is not over. To avoid a resurgence of the epidemic, an effective set-up must be maintained to ensure surveillance, prevention and response until the last case is gone; this requires steady and predictable funding.

Haiti: Institutional death due to Cholera, Epidemiological Week 7 (February 2018):

A CHANCE TO LIVE FOR HAITIAN CHILDREN.

Together, we can give each child more than a day, more than a month, more than survival.

Did you know that every year in Haiti, 9600 children die at birth? Although impressive and unacceptable, this figure is still marginal on a global scale. Indeed, according to a new report on neonatal mortality published today by UNICEF and available here, there are 7,000 newborns in the world who die every day.

“We know that the vast majority of these babies can be saved by providing affordable, quality health care for every mother and newborn. Small gestures from each of us would help ensure the first steps of these newborns in life. Says Henrietta H. Fore Executive Director of UNICEF.

In Haiti, at the maternity Isaie Jeanty near Cité-Soleil, a rather difficult area of the capital Port-au-Prince, this little miracle occurs every day. For Liliane Jean-Charles, a young mother living in the area of Canapé Vert, this second universal experience of childbirth went very well for her.

Children

Liliane Jean-Charles, a young mother living in the area of Canapé Vert, this second universal experience of childbirth went very well for her. She loves children.

“There was pain, but the doctors took very good care of me during the delivery says Liliane. Despite the rather limited technical resources of this maternity, Liliane really felt that there was a pair of safe hands to accommodate her baby at birth and in the minutes that followed. “They showed a lot of patients waiting for the baby to show up,” says Liliale, already standing next to her bed, just minutes after giving birth.

His baby named Christopher is his second: “I love children because it’s a gift from God. It’s a gift that embellishes the house. Because without children, there are no flowers in the house.”

Thanks to the care of MIJ medical staff, Liliane Jean-Charles and her little Christopher will be able to return home quickly.

For the year 2017, 3340 childbirths were performed at the Maternity Isaie Jeanty of Port-au-Prince. UNICEF is contributing in his way to this challenge by strengthening the technical and logistical capacities of the maternity ward by distributing various equipment, accessories and materials such as gynecological tables, medical instruments and products.

Together, we can give each child more than a day, more than a month, more than survival.

#EveryChildALIVE

For more informations https://www.unicef.org/french/every-child-alive/

Editorial of Marc Vincent, UNICEF Haiti Representative

Young children, waiting outside, during an inauguration of a school

The 2017 is about to come to an end, it has been a year rich in intervention for UNICEF Haiti. We have supported the actions of the Government of Haiti and reinforcing its capacities in the areas that have been linked to survival and development of the children. Our actions are guided by our mandate which is the wellbeing of all the children.

It is the principle of equity that guides us to allow the most vulnerable children and families and those living in the most remote places to benefit from a life-saving humanitarian intervention. UNICEF has been on all fronts this year 2017.

Among other actions:

-The certification of foster families is part of one of the alternatives to placement of children in institutions. We also proceeded to the Certification of ” Schools Friend of Hygiene” with partners. Children will be able to evolve in a healthier environment.

– UNICEF has also contributed to strengthening the health system by providing technical support to the MSPP and developing community health systems by training community health workers and strengthening the network of health workers. These agents will help save lives.

– From January to September, more than 32,000 children aged 6 to 24 months and 22,000 pregnant and lactating women received several micronutrients to improve their diet and fight iron deficiency anemia.

In addition, we continued with our interventions in the departments affected by Matthew:

  • UNICEF enabled access to safe water to more than 640,000 people since the passage of Hurricane Matthew.
  • 120 schools damaged by Hurricane Matthew have been rehabilitated, which facilitated the return to class for over 30,000 students. More than 10,000 items of school furniture were provided in 139 schools, and 27,000 children received psychosocial support.
  • In 2017, a total of 10,628 children under five with severe acute malnutrition and 7,381 children with moderate acute malnutrition were treated. More than 32,000 children 6-24 months of age, and 22,725 pregnant and lactating women received micronutrients.

Due to climate change, cyclones are becoming more and more devastating. Strengthening awareness of risk and disaster management is a priority. We held consultations with young people in the South and Grand’Anse, the two departments most affected by Hurricane Matthew. Awareness also goes through our youth and adolescents.

2017 is leaving and 2018 is already knocking on the door. There will be new challenges, because the important thing is to capitalize on the good results recorded but also to correct those who deserve to be. Nevertheless, the goals will remain the same, creating an environment that allows Haitian children to develop their full potential.

We must strengthen the fight against cholera, victory is at hand, we can eliminate cholera.

I send a special greeting to all the children of Haiti, to our partners, and I wish you all a happy holiday.

 

Marc Vincent

Representative

ACAT in Nirva a model of continuity

The ACAT committe with partners Zanmi Lasante and UNICEF

The locality of Nirva (Department of Centre) is one of the first to be declared “End of open defecation” (ODF). Since the committee “Community Approach to Total Sanitation (ACAT) is doing everything possible, between hygiene awareness and home visit, to allow the community to continue on this good start. Cholera has virtually disappeared in this community.

“ACAT has had a major impact in the community. Before, cholera was wreaking havoc. Community members came together to solve the problem by helping people build toilets so that it does not happen again, “says Wilfrid Moise, chair of Nirva’s ACAT committee, who is satisfied with the current situation.

The locality has 150 families, there were only 66 latrines. As part of the ACAT, people have built nearly 42 latrines. Nirva is part of the communal section of Grand Boucan.

André Aimable, a member of the community, still remembers the difficult times the population had to go through, concerning the spread of cholera. “The ACAT is an extremely important experience for us, because before the parents had a lot of sadness. When their children had cholera, by taking them to the treatment center, they did not know if the children would come back alive, “he recalls.

DINEPA, UNICEF and Zanmi Lasante came to them, raising awareness about the importance of latrines and promoting hygiene. They decided to take part in the program.

Difficulties to accept the project

A Latrine with the tipitap

Initially it was not easy, as members of the population expected to receive material or financial assistance to build the latrines. This was even more difficult, as at the same time other organizations were building free latrines. The committee members showed patience and pedagogy to convince people to agree to build the latrines themselves.

“We had to explain to them that they will be the big beneficiaries of these latrines. Because it will be a considerable gain for the health of their children and for them too. We all need these latrines and we are witnessing the ravages of cholera, we have to get together to get there, “says Casséus Mercidieu, another member of the committee.

To dig the holes of the latrines, it needed willpower and courage. The committee members gathered at the end of the day by helping the people of the community. There was a snowball effect and everyone wanted a toilet. The toilets are built with the means of the edge, either in straws, in cloths, and rarely in concrete.

The community was declared “End of Open Defecation” (ODF) in February 2015 and there is a big testimonial party. “Since then we have never had a case of cholera in our community,” says Casseus, satisfied.

A coalition of all partners for monitoring

Jean Montas, Community WASH Officer, within Nirva, is responsible for hygiene awareness. He admits that he has no free time because he must make regular visits to the homes to make sure that certain hygiene rules are respected. For example, if the latrines are clean, if the openings are covered, if the tipitap (sort of gallon for washing hands) are in good working condition. Hygiene awareness is raised in schools, in churches, and in all places of assembly. Jean Montas puts the emphasis on the measures to be applied to avoid catching cholera.

He wonders when he can take a vacation. “But we belong to the locality, we must help people, it is the mission that I gave myself,” he says.

UNICEF supports Zanmi Lasante, implementation partner in Central Plateau. It is executed with the support of the National Directorate of Drinking Water and Sanitation (DINEPA) and the Ministry of Public Health and Population.