A woman holds one of the USAID hygiene kits at a Cholera Treatment Center on Thursday, Oct. 28, in Verrettes in the Artibonite department of Haiti. The center, run by USAID partner International Medical Corps, opened earlier this week. Photo by Kendra Helmer/USAID
Submitted by: Ryan Cherlin
When a Haitian says, Dèyè mòn gen mòn, they mean to say, as you solve one problem there is always another that must also be solved.
Driving through the densely populated city of Port-au-Prince I wondered how many times this old proverb was the subject of conversation this past year.
In the months following the earthquake in early January 2010, Haitians endured the devastating effects of hurricane Tomas, political instability and violence stemming from a presidential election, and a cholera epidemic.
Perhaps more numerous than the aggregate woes that befell this nation are the number of foreign aid workers and spotted NGO sites funded by international donor organizations like USAID. These organizations continue the behemoth task of delivering the humanitarian and development assistance so desperately needed by the Haitian people. Despite some media reports of stagnant progress, one only has to scratch the surface to realize these programs are making a real difference.
I decided to sit down with USAID beneficiaries from Haiti’s famed Cité Soleil, an extremely impoverished and densely populated commune generally regarded as one of the most dangerous areas in the Western Hemisphere. I wanted to get a sense of the impact USAID programs have in an environment seemingly impervious to progress.
Etienne Jean-Gardy and Ernancy Bien-Aime are two youth educators trained by a USAID Leadership Development Program (LDP) led by Management Sciences for Health that sensitizes community members to the importance of family planning and HIV prevention and awareness. Armed with knowledge received in training, they host meetings in local parks, in homes and in schools to disseminate their message in Cité Soleil.
Dr. Shah and LAC Assistant Administrator, Mark Feierstein, were accompanied by U.S. Ambassador Stephen McFarland, USAID Guatemala Director, Kevin Kelly, and USAID staff on a visit to the village of Magdalena la Abundancia (Magdalene of Abundance) in the municipality of Sacapulas of the Quiché Department. The visitors were met by leaders of the ADIES (Sacapulas Association for Integrated Ecological Development), a small-scale producer group that forms part of the network of USAID agriculture value chain alliances that USAID has supported throughout Guatemala with our long-standing implementing partner, the Guatemala Exporters Association (AGEXPORT).
The successful agriculture value chain approach is a key cornerstone of the USAID Guatemala Feed the Future Strategy to reduce food insecurity and poverty. The value chain program enhances food access for rural populations by assisting small-scale agricultural producers to increase their incomes and improve family quality of life.
Administrator Shah with villagers from Magdalena de la Abundancia, Sacapulas Photo Credit: Wende Duflon
Magdalena la Abundancia is similar to thousands of other villages in the highlands of Guatemala in terms of the high poverty (51% of the Guatemalan population lives in poverty or extreme poverty) and high chronic malnutrition rates (nearly half, 43.4% of all children under five years old). It is within this context of scarcity that ADIES was formed and is thriving, thanks to their ability and determination to maximize on assistance received from USAID and AGEXPORT.
The ADIES president Manuel Tum welcomed Administrator Shah and his team to a celebration of their successes. The venue was the small concrete patio outside the simple processing and packing plant built in the middle of a field of export-quality onions. A brightly-colored plastic tarpaulin protected villagers and VIP visitors from the strong high-altitude sun and the floor was covered with the traditional greeting of pine boughs that scent the air as people walk over them. Villagers as young as a few months to 80 years old sat on plastic chairs or stood on the sidelines, many in colorful clothes, typical daily wear of this principally indigenous community.
It was the best of times; it was the worst of times. January 12’s earthquake, epicentered in Port-au-Prince, killed over 200,000 people, but also mobilized one of the largest humanitarian disaster responses in the Western Hemisphere in the last 60 years. As Medical Officer at USAID/Washington, I was part of that response.
Dr. Clydette Powell on the USNS COMFORT in January 2010. Photo Credit: USAID/Global Health
They lay in adjacent incubators – two of Haiti’s newest citizens – one born in Port-au-Prince, the other born on a ship in the harbor. Both premature, weighing in at some three pounds. Catherine was born one day before the earthquake. Barely 24 hours old on January 12, 2010, Catherine and her mom were suddenly homeless. Her mom could not breastfeed, and Catherine became dehydrated and ill. After days of wandering the streets of Haiti’s capital city, Catherine’s mom was found by a medical triage team who sent them both to the US Navy hospital ship, the USNS COMFORT, which had just arrived in the harbor. On board, Isabella Rose, her incubator neighbor, had just been born by C-Section. Her mom had been severely injured during the earthquake, and went into premature labor. Again, another triage team sent Isabella Rose’s mom for emergency obstetrical care on the USNS COMFORT, and Isabella Rose took her first breaths on board a US Navy hospital ship.
On the evening of January 12, I had seen the broadcasts of the earthquake’s devastation and the misery it brought to people of a country where I had worked for USAID on numerous short term assignments since 2001. Without hesitation, I volunteered to be part of USAID’s response to this disaster. Being the civilian-military liaison for our Health Office within the Bureau for Global Health, the medical officer in the Infectious Disease Division, and a member of the Haiti Health Team provided the foundation for quick deployment. Invited by the Commanding Officer to serve on the USNS COMFORT, I sailed down with its crew and found myself in several roles, including as neurologist in the Pediatric Intensive Care Unit, when Catherine and Isabella Rose arrived.
Our USAID/Haiti Health team, themselves survivors of the earthquake, and our team on board the COMFORT quickly established communication links. We worked in tandem to triage, transport, and care for the most severely injured. During the course of two months, the ship-based and the land-based teams collaborated in the care of over 1,000 patients. More than 2,000 helicopter flights transported patients and teams between ship and land. Public health priorities and support for the stewardship role of the Haitian Ministry of Health became daily (and nightly) discussions of both the ship and USAID land-based teams. As the relief effort grew, so did the complexities of patient management, the coordination of care, and the optimization of public health disaster relief responses. Yet on a microcosm, there were still the Catherines, the Isabella Roses, and other children—the displaced, the orphans, some likely restaveks—and injured adults, all of whom sought emergency medical care on board the USNS COMFORT.
As I look back to one year ago, representing USAID in the Haiti earthquake response generated in me a renewed sense of patriotism, increased admiration for our USAID/Haiti team, greater esteem for the US Navy, lasting gratitude for my medical and public health skills, and an even deeper respect for the Haitian people. In the worst of times/best of times perspective, Catherine received her angel wings, to use the Navy parlance, but Isabella Rose bloomed. One of Haiti’s newest citizens, she became a symbol of her people’s resilience, and a tiny testimony to the effective collaboration of USAID, the US Navy, and the non-governmental organizations when all things can work together for the good.
USAID Administrator Shah Visits a Local Agricultural Project. Photo Credit: Wende DuFlon/USAID
Administrator Shah packed an enormous amount into his day-and-a-half visit to Guatemala. Dr. Shah and Mark Feierstein, Assistant Administrator for Latin America and the Caribbean (LAC), were hosted by U.S. Ambassador Stephen McFarland and USAID Director Kevin Kelly and USAID staff on an early morning helicopter ride over Guatemala’s mountainous terrain to a village in the municipality of Sacapulas, Quiché to meet with partners in USAID agriculture value chain, food security, and health/nutrition programs. The ride took travelers by six of Guatemala’s 33 volcanoes and past the famous destination spot–Lake Atitlan. At midday they returned to Guatemala City via helicopter for courtesy meeting with Guatemala’s President Alvaro Colom and Foreign Minister Rodas and an all-hands meeting with USAID Guatemala staff.
The Administrator held a press roundtable with Guatemalan journalists and several meetings with U.S. Government (USG) agency staff (USAID, Centers for Disease Control, Peace Corps, and U.S. Embassy sections) on two Presidential Initiatives—Feed the Future and Global Health—as well as the Central America Regional Security Initiative (CARSI). The U.S. Ambassador and USAID Director accompanied Administrator Shah and LAC Assistant Administrator Feierstein throughout the day and evening at a dinner hosted by Ambassador McFarland at his Residence for government and civil society leaders to meet and talk with Administrator Shah to discuss security and justice issues in Guatemala.
The visit was an exceptional opportunity for USG staff to meet Dr. Shah and brief him on why Guatemala is a key player in a region that is critically important to the United States. Guatemala has the largest population and economy in Central America. Sadly, the country has some of the lowest human development indicators in the world, and income distribution is among the most unequal. Guatemala is also the epicenter in Central America of the fight against organized crime and large areas of its territory are under the control of drug trafficking organizations.
Administrator Shah’s trip signifies the long tradition of collaboration and friendship between Guatemala and the United States.
One of the hallmarks of the U.S. Government’s fresh approach to development in Haiti is making better use of innovative private sector ideas to solve tough development challenges.
So when one third of Haiti’s bank branches were destroyed in the earthquake a year ago, we looked for ways to overcome one of the primary obstacles to economic growth in the country: poor access to affordable financial services. But instead of building more banks or installing ATMs, the U.S. Agency for International Development partnered with the Bill and Melinda Gates Foundation to set up a $10 million incentive fund to jump start the provision of banking services to Haitians through their mobile phones.
Maarten Boute, CEO of Digicel Haiti (left), is joined at the podium by Scotia Bank’s Maxime Charles. Photo Credit: Kendra Helmer/USAID
In the short term, the Haitian Mobile Money Initiative will enable Haitians, 40% of whom own a mobile phone, to communicate, send, receive and store money on their devices.
The Government of Haiti and the private sector have enthusiastically embraced the mobile money initiative. The Central Bank of Haiti has already issued new directives on mobile banking. And yesterday, USAID and the Gates Foundation awarded Digicel $2.5 million for being the first telecommunications company to develop a competitive mobile money service in Haiti.
The project has already significantly increased the number of Haitians with access to banking services, and it has the potential to provide universal access thanks to the increasing penetration of cell phones in the country. By helping Haiti leapfrog the limits of the physical infrastructure of banking, mobile banking is putting financial power literally into Haitian hands.
With 2011 on the horizon, USAID looks at back at its accomplishments in 2010. Among them:
Supported the game-changing CAPRISA study, which in July provided the first ever proof of concept that a vaginal microbicide could safely and effectively reduce the risk of heterosexual transmission of HIV from men to vulnerable women. Science Magazinerecently named the CAPRISA study one of the top ten breakthroughs of 2010.
Piloted a groundbreaking mobile banking technology to increase Haitians’ access to much-needed financial resources following January’s devastating earthquake.
Provided shelter, food and medical supplies for the more than 20 million people affected by the floods in Pakistan this summer.
Assumed leadership of Feed the Future, the U.S. government’s signature food security initiative, in December. USAID quickly established the Bureau for Food Security committed to addressing chronic hunger.
Announced the first recipients of Development Innovation Ventures (DIV) funds that will, among other outcomes, improve rural solar access and produce affordable, fuel-cell powered bicycles. The DIV promotes innovative and scalable solutions to core development challenges.
Launched a country-based strategic planning approach, with 20 Country Development Cooperation Strategies (CDCS) already underway. The CDCS will help the agency make evidenced-based decisions, prioritize investments, and hold itself accountable for results.
Josette Colin discusses how her earthquake-damaged home was made habitable again by USAID/OFDA-funded Pan American Development Foundation teams in the Simmond-Pele neighborhood in Port-au-Prince, Haiti, on Dec. 16, 2010. Photo is from Kendra Helmer/USAID.
Posted by Rajiv Shah on Friday, December 10th 2010
Today, in honor of International Human Rights Day and the Universal Declaration of Human Rights, U.S. Embassies and USAID missions around the world are opening their doors to civil society; to the Russian journalists who bravely report on corruption and abuse in the face of grave danger; to the Egyptian human rights activists who fight every day for justice; to the Kenyan political activists who recently helped shepherd a peaceful vote on a Constitutional referendum.
In 1994, USAID became the world’s first donor agency to establish democracy, human rights, and governance as core development objectives. Since then, USAID has become the leading development agency on these issues. With over 400 experts worldwide, USAID manages and programs the vast majority of the U.S. Government’s total budget—over three billion dollars this year alone—devoted to these issues.
These investments are critical to our national security and to reflect our national character, making the word safer and more equitable. That’s why the Obama Administration has laid out an ambitious democracy, human rights, and governance agenda for USAID. We are engaged in a renewed focus to help our partners deliver for their citizens.
In Colombia, USAID created an early warning system to help prevent human rights violations by illegal armed actors, paramilitaries, leftist guerrillas, and drug mafias.
In Indonesia, USAID worked across 9 provinces with nearly 600 local nongovernmental organizations to increase citizen participation in local governance and social service provision.
Across Asia, USAID helped uphold rights to access for at-risk populations, including transgender communities and men who have sex with men, to HIV/AIDS prevention, care, and treatment, as well as building regional and in-country capacities to respond.
In Egypt, USAID is supporting disability advocates to organize and lead the development of policies and programs targeting the inclusion of people with disabilities, impacting over 15,000 Egyptians with disabilities at both the local and national levels.
And in the Democratic Republic of Congo, USAID and its partners helped provide medical services, fight impunity, and promote community awareness of and response to sexual and gender-based violence for more than 100,000 survivors of rape.
At USAID, we cherish the fundamental liberties contained in the Universal Declaration of Human Rights and we promote democratic institutions to fulfill these rights for every global citizen.
Every day, we are dedicated to making USAID the leader on advancing democracy, human rights, and governance globally. Today on this day, with our friends, with our allies, and especially with human rights activists around the world, we support and honor the global efforts to expand human rights for all.
Nancy Lindborg is the Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance. Photo Credit: USAID
Responding to disasters is never easy, and the cholera outbreak in Haiti is no exception. The six-week-old outbreak has claimed the lives of more than 2,000 Haitians and infected 80,000 others. Sadly, this illness will likely continue to spread for many months to come, and cholera will be present in Haiti for years.
Six weeks after joining USAID, I traveled to Haiti as part of the U.S. response to the cholera outbreak. I saw the worst of it: sick women and children, massive dehydration, and widespread fear.
I also saw signs of hope and reasons for the American people to be proud of our response to the outbreak. The Haitian Government is leading the charge against cholera, and the U.S. Government is coordinating with the international community to deliver life-saving supplies, train Haitian medical staff, and monitor the outbreak.
United States government assistance to the cholera outbreak has been a swift, coordinated multi-agency effort. We have collectively provided more than $21.5 million in assistance for the cholera outbreak in Haiti to date. As cholera continues to spread, the U.S. Government is focusing on both the prevention of and treatment for the disease.
On the prevention side, USAID is supporting a nationwide messaging campaign to promote better hygiene practices and increase public awareness of prevention and treatment of the disease. We are also training almost 7,500 community health workers and hygiene promoters across all 10 departments in Haiti.
To further assist the Government of Haiti’s cholera prevention programs, USAID has already delivered or scheduled the delivery of much-needed cholera prevention supplies. These include:
30 metric tons of chlorine, which will provide nationwide treatment of Haiti’s water utilities for three months
15 million aquatabs, enough to help 750,000 people
Nearly 63,000 family hygiene kits, to benefit 345,000 people
As the numbers of cholera patients increases, we are also increasing our cholera treatment activities. U.S. government funding has established 27 cholera treatment facilities, and we are working to bring an additional 37 facilities online as soon as possible.
To further increase treatment capacity, USAID delivered 25 cholera treatment kits to Port-au-Prince last week. These kits include items such as medical supplies, gloves, soap, and intravenous fluid, and the kits will help treat 10,000 moderate and severe cholera patients. These cholera kits are being placed at critical sites in underserved and remote, rural areas in each of Haiti’s 10 departments.
USAID is also providing supplies to aid in the treatment of cholera. The following supplies are already in country or planned for staggered arrival through the month of January:
5.3 million ORS sachets, which will benefit an estimated 530,000 people
600,000 liters of ringer’s lactate, which will benefit 75,000 patients
2,000 cholera beds
NGOs, donors, and other members of the international community are also mobilizing to help curb the spread of this epidemic. Tragically, it will be nearly impossible to fully stop the course of this epidemic. The earthquake exacerbated Haiti’s weak sanitation systems and health infrastructure, making it particularly susceptible to disease outbreaks. Cholera is also a new disease for Haitians, so their immune system is more vulnerable than those populations where cholera is endemic.
Our goal is first to ensure every Haitian receives information about how to prevent infection and how to recognize the early symptoms of cholera. Secondly, we are determined to reduce both fatalities and the number of severe cases that require hospitalization. We’re already seeing progress. Early in the outbreak, about 9 percent of hospitalized cholera cases were fatal. In the latest reports from Haiti’s Ministry of Health, that figure is down to 3.5 percent.
To say 2010 was a challenging year for Haiti would be a brash understatement. An earthquake, hurricane, and disease outbreak would test the mettle of any population, but Haitians are confronting these challenges head on, and they’re doing it with unprecedented resolve and tenacity.
USAID’s Development Credit Authority recently surpassed a $2 billion milestone of private sector credit mobilized in developing countries. USAID uses partial loan guarantees to encourage local banks to invest locally in sectors ranging from health to clean energy to infrastructure.
Workers sort rubble in Port-au-Prince, Haiti, on August 6, 2010. Photo source: Kendra Helmer/USAID
The two billionth dollar was made available from a new partnership with two banks in Haiti for small and medium businesses. Since Haiti’s devastating earthquake, established businesses lost most, if not all, of their property and equipment. Without these assets, small and medium enterprises no longer have the collateral needed to obtain loans to rebuild their businesses. The DCA guarantee will substitute as collateral for borrowers, enabling two local banks to lend up to $20 million of their funds to help businesses rebuild.