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.

New UNICEF Representative visits partners in the Department of Centre

The Representative talking with nurses in the CTDA

Ms. Maria Luisa Fornara, the new UNICEF Representative in Haiti, paid a short visit to the Center Department. She met with several partners in the field of water, hygiene and sanitation and the fight against cholera. The main objective was to understand the different challenges and progresses in these areas. Ms. Fornara had very fruitful discussions with Dr. Jasmin Paul Menahel, a cholera control high ranking officer in the Department of centre for the Ministry of Health (MSPP).

Mirebalais, August 17, 2018- Early in the morning the UNICEF car hits the road. On board, the former and new head of the Emergency section of UNICEF, Gregory Bulit and Antonio Marro. After crossing the traffic, the road in the mountains of the department were offered to the delegation.

Ms. Fornara visited an acute diarrhea treatment center (CTDA) in Mirebalais and could talk with the nurses in charge of the Center. They expressed their determination of every day to provide the necessary care for their compatriots and to save lives.

The UNICEF Representative met with Zanmi Lasante (Partners in Health), a UNICEF partner in the field of water, hygiene and sanitation. The organization deals with the management of the CTDA and it is building, with funding from other donors, a modern CTDA with a larger capacity. The UNICEF Representative also visited the site.

“Zanmi Lasante evolves mainly in the care, per the attributions that we granted by the MSPP. It is necessary to continue by making sanitary cordon around the houses with suspected cases, however there are partners like ACTED, UNICEF and other organizations that make the community care. There is therefore a continuous coordination between us. We must maintain the bridge to give the maximum to the community, “said Dr. Kenia Vissières, program coordinator at Zanmi Lasante.

According to her, visits by senior officials, such as the UNICEF Representative, are always very important to see for themselves the challenges with a view to make their contribution.

A sensitization session in a remote area in the Centre

To see progress in the fight against cholera

Pierre Davidson, technical coordinator of the cholera project at ACTED for the whole country, explains that the visit is important because it can see for itself the evolution of the response.

“It will allow her to understand what the fight against cholera is required. There is certainly a lot of progress, but much remains to be done to eradicate the epidemic across the country. She will also be able to see the commitment of the various actors in the fight against cholera, “he said.

Better understand the rapid response strategy

Ms. Fornara also followed a rapid response team in the field. Composed of members of ACTED and the MSSP, their main task is to fight and contain cholera. These teams deploy rapidly when there are suspected cases, to establish a cordon sanitaire around the home concerned. They are responsible for raising awareness about water, hygiene and sanitation; they decontaminate the houses; they distribute a kit containing soap, tablets for the chlorination of water, salts of oral rehydration.

 

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.

 

 

 

 

 

 

 

 

 

 

Rehabilitating the water network to combat drought

Jacmel’s Tepac and UNICEF staff discussing in front of a reservoir on the capture of the source Domingue

The droughts experienced by several departments of the country have put a strain about people in terms of access to drinking water. Especially in the Southeast department where communities are often far away and live in remote mountains. To facilitate access to water in these areas, UNICEF is undertaking a program of source rehabilitation and water abstraction, in cooperation with the National Directorate for Drinking Water and Sanitation (DINEPA). USAID funding has made it possible to undertake these activities in several departments of the country such as: North-West, South-East, South and Grand’Anse.

Jacmel May 31, 2018- The communes of Jacmel, Valley of Jacmel and Bainet are among the beneficiaries, because several drinking water supply systems (SAEP) and pumps with human motricities (PMH) presented an advanced state of degradation. For example, the drinking water supply system of Domingue, in the communal section of Bas Cap Rouge, 1st section of the municipality of Jacmel has benefited from the rehabilitation work. Now, more than 8,500 people have access to safe drinking water.

The TEPAC, agents of the National Directorate of Drinking Water and Sanitation (DINEPA), represent the spearhead in monitoring the management of drinking water supply systems (SAEP) in remote communities. Together with the local water committees, they put in place a mechanism, which allows the transparent and efficient management of the systems, linking the population to the water management committees.

A situation that was serious

The old tank

In Bas-Cap-Rouge, the situation was very difficult because the too low flow of the catchment source could not supply the entire network. People had difficulty getting water. “The locality has faced a serious problem of drought; the source has dried up. The population had no choice but to fetch water from the riverbed, “explains Anel Colin, TEPAC for the commune of Jacmel.

The SAEP faced serious technical problems with the water, the water supply line was cut off, there were several leaks on the distribution line. A lot of water loss was noticed. There were 12 fountains that were not working.

“Before, people used to draw water from the river. Most people who used to bathe in the river, defecated on the ground. This was a public health problem, and people who were drinking water were getting sick, not to mention cholera, “he says.

Fleurant Louissaint, secretary of the Committee for Provision of Drinking Water and Sanitation (CAEPA), explains the vital importance of the network and the changes in the lives of the inhabitants. He remembers the difficult period of drought when the river beds were dry, the trees were dying, the cattle heads were dying, it was really a disaster.

“In the past, people had to walk several miles to find the water, now it is no longer the case. Residents are happy with this improvement, it has improved the living conditions of people. Capture is a worthwhile initiative, “he says, adding that he wants state support for reforestation around the area’s water sources.

Manage the distribution of water

A young boy collecting water

DINEPA, UNICEF, Solidarités International, with funding from USAID, have undertaken work that has practically changed the lives of the population by facilitating access to water. Anel Colin, said to be satisfied at this level because it brings a big change in the community.

He deplores the cutting of the trees that were in the source of the river, which results in a decrease of the source.

To ensure the effective management and maintenance of the system, CAEPA has been formed with community members to ensure the continuity and sustainability of the water service. “The committee in concert with the people are developing a distribution schedule. My role is to collect the grievances of the population and find solutions to the problems, “he recalls.

Ensuring Sustainable Development Goals

SDG 6 states that we must “ensure access for all to water and sanitation and ensure sustainable management of water resources”.

Hamidou Maiga, UNICEF WASH Officer, emphasizes the importance of meeting this SDG. “Our mandate at UNICEF is to protect the lives of children and adolescents. Drinking water means less risk of getting sick. We stand alongside DINEPA in the implementation of public policies regarding access to water and sanitation, “he adds.

 

 

Community involvement at the heart of access to drinking water

A local resident drawing water

In remote areas of the country, access to safe drinking water can be a major challenge, considering the relief configuration and the availability of natural water sources. UNICEF, with funding from USAID, is implementing source capture and drinking water projects. Often community involvement is essential for the success of these projects. The locality of La Vallette, in the South-East department is a striking example.

Jacmel, 31st May 2018- As part of the fight against drought that hit several departments of the country including the Southeast, UNICEF in collaboration with USAID undertook work of rehabilitation of water sources in several localities. The La Valette source in the Montagne section La Voûte, 6th section of the town of Jacmel, is one of the beneficiaries.

Alma Oplan, the keen eye, the straight and decided step is the coordinator of Casec Section La Montagne. He was one of the great artisans, at the community level of the rehabilitation of the source of La Montagne. “As a development agent, our role is to work for the benefit of our communal section for the well-being of the community,” he says.

Problems that were recurrent

The rugged terrain has favored soil erosion in the area; the increase in the population has led to overexploitation of the system; natural disasters such as hurricanes (the earthquake, cyclones Emilie and Katrina and Hurricane Matthew …) have accelerated the degradation of structures. Regarding the catchment: there were cracks on the superstructure, the hatch was damaged, the nearby environment degraded. So, the rest of the network could not be powered.

The lack of ownership of the source by the community has led to a lack of monitoring of the works. People did not take care of the old catchment and threw filth, there was no cleanliness. “The situation was very difficult because people were drawing water, close to where the animals were drinking,” he says.

The community was involved

A water pump in a locality of South-East

Community members saw the need to repair the water source, so they made the request to the National Directorate of Drinking Water and Sanitation (DINEPA). USAID provided funding to UNICEF for the project. Solidarités International was chosen as the project manager.

When he talks about the realization of this project, a broad smile illuminates the face of Oplan. “People have taken ownership of the project from the beginning. They participated by giving and bringing construction materials to the site; sand, rocks, blocks, among others “, he says.

Alma Oplan was one of the driving forces behind the mobilization. He sensitized the inhabitants on the importance of the rehabilitation of the spring. He contributed to the food of the workers. He said he was satisfied with the result, although he thinks there may be some improvement.

The bulk of the work consisted of: the rehabilitation, the capture through the clogging of the leak and the cleaning of the environment close to the system; the repair of the internal and external water tightness of the tank; partial rehabilitation of masonry and plumbing; clogging and protection of pipelines at the catchment level; the construction of a retaining wall for the protection of the structure.

Per Jacques Touchard Adia, WASH specialist at UNICEF, the rehabilitation of the source will change the life of the population. Because the impact in their life is real and palpable. “It’s a big difference for the people of La Montagne, because before it was difficult to find drinking water. The population had water in quantity but which was not drinkable. The catchment and reservoir were contaminated with coliforms. UNICEF, in support of the Haitian government, has allowed these remote communities to access water. It will save the lives of children. We thank USAID for its important support to the realization of this project’’, he concludes.

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):

Eliminate cholera in Haiti by the rapid response teams

UNICEF Haiti works with its partners such Solidarités International to support the rapid response strategy of the Ministry of Public Health and Population in order to eliminate cholera with its rapid response teams. This is the story of Michel-Ange

Camille Lacourt in Haiti believes donations can help.

Here in Haiti, more than 4.8 million people do not have access to a source of drinking water. 4.8 million people, that’s 36% of the population, a statistic that Camille Lacourt wants to change by its humanitarian implication. Landed on the island of Hispaniola on February 19 for a five-day stay, the five-time World Swimming Champion was able to see with his own eyes the tremendous work done on the ground by UNICEF and its various partners.

“We see that there is a lot of work and that it works quickly” says the French celebrity, sponsor of the Nuit de l’Eau. This presence in Haiti of Camille Lacourt was aimed at seeing and witnessing UNICEF’s action on the ground and seeing how the funds collected by the Nuit de l’Eau are used.

Camille Lacourt, parrain de la nuit de l’eau, visite l’école de Trianon à Mirebalais. Cette école est “Hygiene friendly school” soutenue par l’UNICEF.
Des enfants se lavent les mains et peuvent accéder à des toilettes séparées grâce au soutien de l’UNICEF.

“All donations are useful. There has been a lot of work done but there is still a lot left. Haiti is not just earthquakes and hurricanes. Do not help only at these times but a little bit all the time, ” explains Camille.

In the department of the Center, Camille was able to see everything that was done and all the difficulties encountered to bring the drinking water from the sources to the populations. At La Chapelle he visited a water system damaged by Hurricane Irma. Thanks to the many donations, this supply system has been rehabilitated and many water points are now cleaned up. In total, 910,000 people now have access to a drinking water point.

Also in the Center, he was able to meet the students of the National School of Trianon in Mirebalais, one of the 152 “friendly schools of hygiene”. There, with UNICEF support, children can wash their hands and can access separate toilets. These programs were partly funded by public generosity at the 2017 Nuit de l’Eau.

“For us when we are lucky to come on the field, we see that the work has really been done and is being done. That’s the message I’m trying to convey: donations, it’s useful, it’s really helpful” says Camille Lecours

Accompagné du médecin Karine Sévère, responsable du CTC de Port au Prince, Camille Lacourt, parrain de la nuit de l’eau, visite les installations et les malades atteints de cholera ou de diarrhée aïgues.

Finally in Port-au-Prince in the West Department, accompanied by the doctor Karine Sévère, doctor in charge, he visited the “Centre de Traitement du Choléra et de Diarrhée Aigüe Gheskio” and a water chlorination point in the Bristou district in Petionville.

“It’s very far from what we know but yes I relativize a lot saying that I was very lucky to be able to do my sport in pools filled with water and that here there is not enough, so that gives me even more desire to talk about that “added Camille Lacourt.