Haiti earthquake: one year on

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This month marked one year since the earthquake hit Haiti on 12 January 2010. At the WHO 128th Executive Board Meeting's special presentation on Haiti, the WHO Director-General reminded the participants of how the response to the earthquake tested to the limit the capacities of the Organization and of its partners, including donors and all stakeholders. The earthquake claimed more than 200 000 lives, injured many thousands, and devastated the country's infrastructure. It also reduced to rubble the Ministry of Public Health and Population (MSPP), killing more than 200 staff members in the building, and destroyed or seriously damaged 30 hospitals in the three most affected regions. The Health Cluster began operating three days after the earthquake. It includes more than 400 NGOs and institutions and is coordinated by the MSPP, with technical and managerial support from WHO, through its Regional Office for the Americas, the Pan American Health Organization (PAHO). Coordination, however challenging, was one of the successful aspects of the response: it allowed for rapid identification of gaps, fast and efficient deployment of resources, and swift resumption of critical public health programmes. Some of the most prominent achievements in health include: the establishment of an early warning and response surveillance system for prompt detection and response to epidemic-prone diseases, the distribution of quality medicines, vaccines and medical supplies to provide basic health care to tens of thousands of people and treat many more for cholera, the implementation in June 2010 of a system to provide free health care for children under five, the free obstetric care programme expanded the range of services provided to pregnant women in 2010 and, the development and maintenance of a database of health facilities. In October, a cholera outbreak in the north of the country spread quickly to all 10 departments. As of mid-January 2011, 188 967 cases and 3838 related deaths had been reported by the MSPP. Extensive support from all health partners has helped lower the overall case fatality rate to 1.1 %. However, in rural areas, where people live far from health centres and thus are more at risk of dying before reaching them due to lack of transport, many cases go unreported and deaths unregistered. The graph below illustrates the funding requested and received for both the earthquake response and the cholera response as of 18 January 2011. Most of the funding was received in the third quarter of 2010. However many challenges remain for the international community. Particularly, improving the determinants of health is prominently important: 40% of the population has no access to health services (same as pre-earthquake figure) and more than 50% has no access to clean water. Many partners are beginning to leave, creating new concerns about the hand over of essential activities and local capacities to replace the exiting staff. WHO/PAHO has a long-term commitment to Haiti and will continue to help coordinate recovery efforts, provide technical cooperation and strengthen national leadership. It will engage, with all willing partners, to promote the improvement of health determinants in the country.