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Roundtable Discussion

A year after Haiti was hit by a 7.0 earthquake, Charity Navigator led a roundtable discussion among several leaders of charities that provided aid in the wake of the disaster. We asked these non-profit professionals to share their unique perspective with donors.

The Contributors

George C. Greene III , PE, PhD
Founder and CEO
Water Missions International

Ophelia Dahl
Executive Director
Partners In Health
Jeff Nene
Senior Director of Public Relations
Convoy of Hope

Steve Hollingworth
Christoph Gorder
SVP of Global Programs
Angel Aloma
Executive Director
Food For The Poor
Nan Buzard
Senior Director, International Response and Programs
American Red Cross
Charles MacCormack
President and CEO
Save the Children

The Conversation

Charity Navigator: What went right in the overall efforts to help in Haiti? In the case of your organization?

Steve Hollingworth (CARE) :Despite staggering damage to Haiti’s infrastructure and the losses felt by the UN and other agencies, the international community delivered aid soon after the earthquake. Haiti experienced no nutrition crisis. And virtually all displaced people had some form of shelter within weeks. Early on, CARE was able to scale up its response compared to our initial target. Our largely Haitian staff coordinated with local communities to reach more than 300,000 people with food, clean water, temporary shelter and other services. CARE also moved quickly into the construction of transitional shelter, largely in hart-hit sections of Léogâne and Carrefour.

Jeff Nene (Convoy of Hope):

  • Because of Convoy of Hope’s ongoing presence in Haiti, churches, corporations and organizations saw Convoy of Hope as a viable channel through which to give. This enabled Convoy to quickly use our existing infrastructure to provide millions of meals.
  • We saw the success and importance of relationships with the nationals. Through collaboration of nationals working closely with us to get the job done we were able to accomplish our mission.
  • We knew from the beginning that our direction was supposed to be to work with our partners to getting relief supplies distributed. Most of the logistics were sorted out day by day. We found that our efficiency and effectiveness increased, as we became more flexible..
  • We established many new great relationships in the midst of the response which increased our capacity to respond.

Ophelia Dahl (Partners In Health): Overall, the response on the ground in Haiti would not have been possible without the global attention towards Haiti for the days, weeks, and months following the earthquake. The immediate outpouring of support – donations from individuals, foundations, and corporations in the US and around the world, volunteer medical teams, donations of medical equipment and supplies – allowed for responders on the ground to save many more lives than would have been otherwise possible.

The speed at which I saw Partners In Health (PIH), and our sister organization Zanmi Lasante (ZL), respond in the immediate aftermath of the earthquake was incredible. PIH and ZL have been providing comprehensive, community-based healthcare in Haiti for over twenty years, and our experience—our 4,700+ Haitian staff, our established supply chains, our partnership with the Ministry of Health—allowed us to respond quickly and effectively in Port-au-Prince and across the Central Plateau and Artibonite Department, even though we are not a disaster relief organization.

George Greene (Water Missions International): Water Missions International was able to respond with people and equipment within three days because we had a permanent presence in Haiti and already had trained staff on the ground when the earthquake struck. The Water Missions Haiti Country Director had transferred to Haiti four months before the earthquake. His previous experience had been with Water Missions International in Sri Lanka following the tsunami so he had relevant experience with major disasters. We were also able to quickly mobilize other staff from our headquarters in the US, our Honduran Country Program, and our European office to provide additional resources to significantly supplement our Haiti staff.

Our previous partnerships with other organizations who were also responding to this disaster enabled us to immediately begin joint efforts to respond to the disaster. These joint efforts included work on the ground in Haiti as well as logistics cooperation in delivering people and supplies to Haiti. I would also add that I found good cooperation among most of the aid agencies.

Additionally, we were able to bring many volunteers in to our US headquarters to assemble water treatment equipment. Strategic Partners like FedEx also played a key role in moving equipment into Haiti quickly.

Nan Buzard (American Red Cross): The international community responded quickly to the disaster, working hard to get food, water, emergency shelter and health care to more than 1.3 million people left homeless by the earthquake. American Red Cross efforts – as well as those of other Red Cross groups – saved lives and improved the quality of life for hundreds of thousands of Haitians with emergency shelter, food, water, latrines, medical treatment and other supplies. We have responded to emergency needs, adapted to new developments such as the cholera outbreak, and invested in longer-term projects such as building homes and improving water and sanitation services.

Charles MacCormack (Save the Children): The extremely generous and timely response from the U.S. and international donors played a critical role in enabling agencies to provide immediate relief to the hundreds of thousands of children and families affected by the earthquake. Many agencies like Save the Children were already positioned on the ground and, therefore, were able to redirect staff and supplies quickly to respond within hours of the disaster.

Save the Children has worked in Haiti since 1978, primarily in Port-au-Prince and the Central Plateau region, providing health, education, protection and food security programs to vulnerable children. Immediately after the earthquake hit, we brought in additional personnel from all over the world to augment the capacity of our Haitian staff, giving them time to deal with their losses and providing critical emergency response expertise. We also have a program in neighboring Dominican Republic, which allowed us to bring in supplies over land to address the immediate needs of those impacted by the disaster.

While this is the largest and most complex disaster in the Western hemisphere in Save the Children’s 91-year history, our extensive experience in emergency response and development combined with our history on-the-ground has allowed us to provide hundreds of thousands of families in Port-au-Prince, Léogâne, Jacmel, and surrounding areas with food, shelter, water, health and nutrition services, sanitation and livelihoods support as well as protection and educational activities for children.

Christoph Gorder (AmeriCares): Public support and resources were available right away. Despite the logistical challenges, many humanitarian aid organizations responded with a huge outpouring of support. The U.S. military did a great job re-activating the Port-au-Prince airport and sea port so that aid could get in and delivered to the people who needed it most.

Within 48 hours of the earthquake, AmeriCares was on the ground assessing the health care needs and securing a warehouse, which allowed us to get medicines and medical supplies in very quickly. AmeriCares first emergency airlift carrying more than $6.7 million in medical assistance arrived on January 17 and our team immediately began distributing the lifesaving aid into the hands of doctors and other health care professionals treating survivors. We coordinated directly with doctors to develop a total needs-based system. Our existing and new donors responded generously to Haiti’s needs and provided us with the financial and medical gift-in-kind resources we needed to restore health and help save lives.

One aspect of the response that was a new area of work for us was working with private hospitals that opened their doors for free to anyone after the earthquake. Normally, we partner with government or nonprofit organizations and health care facilities, but in the case of the first weeks in Haiti everybody who could lend a hand was helping. All medical care was free in the acute phase of the disaster, increasing access and saving lives. To date, AmeriCares has delivered and distributed more than $40 million in medical assistance to a network of 75 hospitals, clinics and community-based organizations throughout Port-au-Prince, its surrounding communities and across the entire country.

Angel Aloma (Food For The Poor): The overwhelming support of the American people was truly humbling. Immediately following Haiti’s January earthquake everyone was eager to help rebuild Haiti. As staff, we were inspired and motivated by this unprecedented generosity to do all we could personally and as an organization to help those suffering in Haiti. Food For The Poor’s relationships in the Dominican Republic and Jamaica helped us obtain and ship lifesaving aid to Haiti. Our contacts at major airlines and shipping companies worked with us to deliver supplies when there were few options available.

Food For The Poor’s 24-year tenure in Haiti facilitated our quick response. As an organization we remain committed to investing in permanent housing and water projects throughout the country. Since the earthquake, Food For The Poor has shipped more than 1,263 containers of aid and has built approximately 1,500 permanent, concrete block two-room homes with sanitation units. Throughout the country, Food For The Poor homes withstood January’s earthquake and Hurricane Tomas.

Mercifully, we lost none of our Food For The Poor-Haiti staff at the office, but there was not one person who had not lost their children, parents, siblings, other relatives or close friends. Our distribution center experienced only minor damage to the exterior façade which did not hinder our distribution process. 

Shortly after the earthquake struck Haiti, I traveled from the Dominican Republic to Haiti with truckloads of food, medical supplies, water, 1,200 gallons of diesel, and a flatbed with 1,000 100lb-bags of cement. I embraced and tried to comfort our Food For The Poor-Haiti staff who had returned to the office just days after the earthquake to start relief efforts. Food For The Poor was blessed to have recently cleared more than 45 containers from the wharf and to have well-stocked distribution centers in Port-au-Prince and Cap-Haitien. We were also granted permission to ship containers to a small port located just north of Port-au-Prince while the main port was under construction.

Food For The Poor’s response was immediate and effective because of our extensive distribution network of more than 2,000 beneficiaries, and well-stocked distribution center in Port-au-Prince. Our staff on the ground in Haiti has been successful in distributing aid to hospitals, schools, orphanages, tent cities, local community organizations and to other partner NGOs. Immediately following the earthquake we saw relief trucks from a variety of international countries in Haiti.

The initial security at Food For The Poor’s complex was provided by 150 military reservists sent by the Jamaica Defense Force. They made the distribution of some of the first hot meals in Port-au-Prince, Haiti a reality. Approximately 15,000 hot meals are cooked and distributed from this one Food For The Poor complex six days a week.

In a March report, Food For The Poor stated it would double this year’s investment in Haiti for both sanitation and water to try to prevent the spread of disease. Pit latrines and sanitation blocks that include both toilets and shower stalls have been built in areas of critical need, and will be a continuing part of our housing projects. The threat of disease that once loomed over the recovery of the country has become a reality.

Providing clean water was critical even before the earthquake, but Jan. 12 made the need for clean water a matter of life or death. Food For The Poor quickly distributed bottled water immediately after the disaster. That immediate action now has shifted to a strategy of providing long-term solutions through water filtration systems. These solar-powered systems  reduce waterborne diseases by removing suspended pathogens. Since the cholera outbreak began, Food For The Poor has installed more than 30 filtration systems. The filtration systems treat up to 10 gallons of water per minute (10,000 gallons per day) and can support a community of up to 3,000 people.  The rugged system can be transported by pick-up truck, and can be operational in four hours.

CN: What really went wrong in the overall efforts to help in Haiti after the earthquake?

Steve Hollingworth (CARE) :The greatest setback has been the recent cholera outbreak. Energy that could be directed at rebuilding Haiti is instead, by necessity, going to combat a deadly disease that health experts now expect to continue spreading in the weeks and months ahead.

Jeff Nene (Convoy of Hope):

  • Interaction coordination did not fully take into consideration the capacities of NVOAD organizations which impeded the ability of said organizations to execute their mission.
  • OCHA (Office for the Coordination for Humanitarian Affairs) reporting systems did not include a comprehensive report on the activities and logistical needs of agencies on the ground.
  • Governmental agencies could have provided more assistance to agencies that they had a previous relationship with to better navigate international protocols to streamline the delivery of containers as they arrived in port.
  • Christian organizations and churches in Haiti were devastated by the earthquake, therefore they were unable to provide immediate assistance in the relief effort. Thus, initially, some manpower had to come from outside the country. 

Ophelia Dahl (Partners In Health): The sheer scale of the disaster—the likes of which had never been experienced by the Haitian people, the Haitian Government, or any of the NGOs in Haiti at the time—made the coordination of the response to the earthquake incredibly challenging. Even knowing how to try to coordinate the response to such a complex, rapidly changing situation proved to be incredibly difficult. Some of the largest and most experienced disaster relief organizations said that the earthquake was one of the more complicated disasters to which they have had to respond. 

In the more long-term recovery, we see a lack of coordination with the Haitian Government. Haiti is faced, once again, with the chronic deprivation of resources that would allow it to provide public services for the Haitian people. The majority of all earthquake recovery funds are not directed to the Haitian Government, but are being routed through a variety of NGOs in Haiti, some of which work in parallel, rather than in cooperation with the public sector, solidifying the system that ensures that Haiti will never develop or decrease its reliance on foreign aid.

George Greene (Water Missions International): The size of the disaster, the extent of the devastation, and the massive number of injuries tended to overwhelm the resources that were available. The lack of air and seaport capacity made it difficult to bring supplies into the country. The poor roads made it difficult to bring in supplies overland from the Dominican Republic. There was also a diesel fuel shortage during the first couple of weeks after the earthquake. This limited the ability of some aid workers to move around.

In the days immediately following the earthquake, relief supplies moved into the country and to the IDP camps relatively quickly. Within a couple of weeks, however, as the Haitian government began to get back on its feet, things slowed down dramatically. In the case of Water Missions, desperately needed water treatment equipment and vehicles were held up in customs, in some cases for months. Vehicles had to be pulled out of service because the government determined that vehicles without license plates would be confiscated, yet the office that issued license plates had been destroyed.

Nan Buzard (American Red Cross): The severe damage to the port and transportation system initially made it difficult to get critically needed relief supplies into Haiti. But the biggest long-term challenge has been getting people out of tents and tarps in camps and into transitional and permanent shelter. The hurdles of identifying appropriate land and resolving questions about land ownership, on top of large amounts of uncleared rubble, have slowed the process of building these shelters. While we are beginning to make some progress on this front, no one is satisfied with the pace of progress. At the one-year mark, there is no question that Haitians and the international community must remain diligent in addressing these issues.

Charles MacCormack (Save the Children): This was an unprecedented emergency as it struck a capital city, effectively taking out the government and the entities and people who would normally provide the immediate response. Many government workers were killed. The UN lost its main building and many staff. Most of Save the Children staff suffered personal losses, including children, and many had nowhere to call home. About 60 percent of the city was destroyed, making movement difficult. This affected coordination and response time in the early days after the quake as people addressed their personal and familial needs. Also, more than 1,000 camps for displaced families formed spontaneously across the city, requiring aid agencies to stretch precious resources to reach them.
In addition, the high cost of working in Haiti created additional challenges. While our reach was great, the cost of doing business, bringing in supplies and providing assistance was extremely high, as were the costs for more transportation to move staff and supplies to serve the additional population.

Christoph Gorder (AmeriCares): The bottle neck at the airport was a huge challenge in the early days. But AmeriCares worked with health care partners and government agencies to prepare for the arrival of our first airlift into Port-au-Prince. Our newly established warehouse was in close proximity to the airport, making it easier to secure the assistance in a safe place while we developed plans to distribute the aid immediately.

Another challenge was the fact that the Haiti’s government was virtually decimated. Hundreds of dedicated, experienced public servants died in the earthquake. That crippled the government’s capacity to accept aid and many relationships with nongovernmental organizations (NGOs) had to be rebuilt from scratch because records were destroyed. AmeriCares leveraged existing relationships with the Ministry of Health (MOH) and local doctors to assess the most urgent health needs. AmeriCares has continued to deliver medical aid that is needed, when it is needed, most recently working with the MOH and our health care partners on the delivery of antibiotics, IV solutions and other critical aid to combat the cholera outbreak.

With the communications infrastructure down in Haiti, AmeriCares was also quick out of the gate with online communications vehicles, including using the web and social media. This gave smaller, local groups an opportunity to find us online easily. Many of these online contacts developed into full fledged partnerships that have allowed AmeriCares to extend its work throughout Haiti.

Angel Aloma (Food For The Poor): Before the earthquake some organizations found the distribution of supplies in Haiti to be challenging. Haiti lacked basic infrastructure before the earthquake. After, rubble blocked roads and trapped countless people. Damaged ports meant that workers had to turn away cargo ships full of emergency relief supplies. Activities at the capital’s airport were almost brought to a halt as supplies remained unclaimed on the tarmac. Another big problem was the lack of security on the roads and in tent cities. All of these factors hindered proper distribution.

I think the American people who once gave so freely have become more cautious as they have heard about how relatively little aid has been delivered to hurting Haitians. There is frustration that so little of the money donated has been used to help the people almost a year later. Cholera spreads easily in the deplorable conditions found in tent cities, in which more than one million earthquake survivors live.

CN: As you monitored your charity’s results in Haiti, did you make changes to your program efforts? In other words, did you terminate or modify any efforts that were having no impact or negative results? If so, please explain the changes and whether you have evidence yet of an improvement in your results.

Steve Hollingworth (CARE) : Yes, we’re constantly analyzing our results and making changes to improve our response. As CARE built transitional shelters in and around Port-au-Prince, we conducted an interim analysis of our plans and those of other organizations coordinated by the UN shelter cluster. The data showed that in Léogâne, just west of the capital, the number of transitional shelters planned exceeded the number of houses destroyed. Therefore, CARE dialed down its transitional shelter plans in Léogâne and ratcheted them up in Carrefour, a Port-au-Prince neighborhood where shelter needs weren’t being met as fast by other humanitarian groups. CARE is playing an active part in this rebuilding and is well on target to have helped 1,500 families move back to their home through the construction of transitional shelters.

CARE also has been providing water and sanitation services in a number of spontaneous settlements. As we monitored these sites, we could see that in a number of the camps, residents were voluntarily returning to their original communities. CARE adjusted by shifting some of our resources to ensure that potable water and sanitation facilities were available in these communities. The results have been favorable, as this shift makes areas outside of Port-au-Prince more attractive and supports the Haitian government’s goal of building back in a more balanced way.

Jeff Nene (Convoy of Hope): As each day passed, we built new relationships with organizations in country. As these increased, our capacity expanded. We modeled distribution in places and made changes in the midst of the response for the sake of safety and efficiency. Once we had developed a safe and efficient model, we handed it off to the local organizations. We then transitioned ourselves into a logistics role by supplying those relationships with product for bulk distribution.

Ophelia Dahl (Partners In Health): Partners In Health and Zanmi Lasante did modify some of our efforts in the months following the earthquake. We now operate 15 clinics and hospitals in the Central Plateau and Artibonite Department of Haiti, but prior to the earthquake did not have a presence in Port-au-Prince.

At the request of the administration of the badly damaged and understaffed General Hospital in Port-au-Prince—l’Hopital de l’Université d’Etat d’Haiti (HUEH), PIH/ZL coordinated more than a dozen relief NGOs’ medical relief efforts at the hospital in the weeks following the earthquake. In the six months following the earthquake, we continued to support the hospital by organizing teams of clinical specialists to meet the evolving needs of patients. As patient needs changed, Haitian staff returned to work, and departments were repaired and became functional, PIH/ZL returned the responsibilities back to the hospital administration and only served to fill specific staff, equipment, or program shortages.

We have stopped sending volunteer surgical teams to Haiti. The PIH/ZL model is centered on training and building local medical and support staff, but the sheer magnitude of patient need required us to bolster ZL’s medical team with clinical staff from abroad. Now that patient needs have shifted away from emergency orthopedic and surgical care, and as we build partnerships to grow long-term local rehab programs, we no longer rely on medical volunteers.

PIH/ZL continues to operate in Port-au-Prince at clinics within three spontaneous settlements. Residents of these settlements can access free comprehensive primary care and social support services—including maternal and child health, reproductive health care, HIV testing, and malnutrition screening and treatment—and patients needing further care are referred into our pre-existing health network.

George Greene (Water Missions International): No, we did not make changes as a result of the Haiti disaster.  We respond to disasters with the same equipment that we use in community development projects. As we place equipment in response to the disaster we place it where it is most needed, but we also keep in mind that we will transition the equipment into sustainable community development work as the work moves from disaster response to recovery and development. This approach has worked well for us in past disasters and it is working well in Haiti. We have already begun the process of transitioning equipment placed in response to the earthquake into permanent community development projects.

About 85% of the water treatment equipment placed in communities immediately after the earthquake has now been transitioned into long term community development programs in those communities. These programs are designed to ensure that the communities will be able to independently operate and maintain the equipment on a sustainable basis.

Many of the water treatment systems that were set up in IDP camps and other emergency centers are still being used in those locations because the people are still dependent on them.

Nan Buzard (American Red Cross): The American Red Cross carefully monitors and evaluates its work, and our programs have provided important benefits to many of Haiti’s earthquake survivors. However, in major disaster responses like this one, it is important to develop and follow a relief and recovery plan – and know when to be flexible in order to adapt to changing conditions and emerging needs. In Haiti, the American Red Cross extended the relief phase of its operations long after it would have ended in other contexts, based on the situation. As a result, it kept the doors open for the largest public hospital in Port-au-Prince as well as the only critical care and trauma hospital in Haiti. The American Red Cross has also allocated $14 million to respond to the cholera outbreak.

Charles MacCormack (Save the Children): At the onset of the disaster, Save the Children developed a strong plan based on our prior work in the areas of health, education and livelihoods. Haiti was in the midst of a simmering emergency before this crisis—with only half of children in school and 80 percent of the population living in extreme poverty. Because the quake exacerbated issues facing children and families, we developed a five- year strategy, the first phase focusing on alleviating the suffering of those affected by the disaster and the second on building back a better Haiti.

Consolidating our geographic coverage has been our biggest modification. We believe focusing on comprehensive programs in specific areas will give us greater impact in the long run. For example, many of the displaced who now live in tents receive better services than they ever had before, including water, sanitation and health services.

It also is extremely important to offer services that show individuals hope of a sustainable future; one that includes a livelihood, access to health care and the opportunity for their children to attend school. By linking program interventions together, we can encourage people and give them the confidence to leave the tented camps. Strengthening the capacity of Haitians and their institutions — governmental and nongovernmental alike — will also enable Haiti’s people to play a more active role in managing their own future.

Christoph Gorder (AmeriCares): AmeriCares started out with a strategy to partner with large established NGOs operating in Port-au-Prince. AmeriCares has been delivering medical assistance to Haiti since 1984 and had established partnerships in place before the earthquake. As the magnitude of the earthquake unfolded we found we could be more agile and have a greater impact by working with small Haitian-based health care groups both in Port-au-Prince and in other parts of the country, including Jérémie, Léogâne and Cap-Haïtien. Our work continues today with partnerships with local hospitals and clinics, Haitian grassroots organizations and international aid organizations treating the people of Haiti.
We were constantly asking for feedback from doctors, hospital administrators and other public health professionals so we could modify our medical assistance and deliver the medicines and supplies they most needed at any given time. We modified actual material aid based on their feedback.

AmeriCares implemented a strategy where we combined donated medicines and supplies with small cash grants to maximize impact. Our results have shown a dramatic increase in access to health care and medicines for communities hosting displaced rural earthquake survivors.

Angel Aloma (Food For The Poor): Food For The Poor’s response was immediate and effective because of our extensive distribution network of more than 2,000 beneficiaries, and well-stocked distribution center in Port-au-Prince. Our staff on the ground in Haiti has successfully distributed aid to hospitals, schools, orphanages, tent cities, local community organizations and to other partner NGOs.

We increased our fundraising and matched those efforts with an increase in shipment and construction. We were blessed to have had a full warehouse with approximately 48 cleared containers ready to be distributed after the earthquake. Food For The Poor formed leadership groups in the tent cities who partnered with us to distribute goods in the most efficient manner. In some tent cities, the leadership preferred community cooking efforts rather than distribution of dried rations. The large number of completed water projects throughout the country helped dramatically immediately following the earthquake when resources were scarce.   
Since Haiti’s cholera outbreak, Food For The Poor has shipped and airlifted containers of critically needed supplies such as medicines, hygiene kits, rehydration fluids, and blankets. Rains and severe flooding associated with Hurricane Tomas facilitated the spread of the quick-killing disease.  With thousands infected, the situation continues to act as a reminder of the importance of access to clean water and to moving earthquake survivors into permanent housing. Food For The Poor remains committed to investing in sanitation and water projects throughout the country.

CN: What role should charities play in such a disaster?

Steve Hollingworth (CARE): An international aid organization such as CARE, with a strong presence on the ground and many years experience in relief efforts, can play a vital role in delivering aid to people hit by disasters. With damage of this magnitude in a national capital, it would be nearly impossible for any national government – let alone one in the hemisphere’s poorest country --- to handle the response by itself. This is why non-state organizations such as humanitarian groups are a major part of the solution. We at CARE have been working in Haiti since 1954. So we were able to mobilize a staff mainly comprised of Haitians as well as a complementary network of volunteers.

Jeff Nene (Convoy of Hope):

  • Charity organizations have a lot to offer in coordination by way of logistics and commodity distribution. Shelter operations, medical services and all areas of response and recovery are what charities are designed to do.
  • Charities tend to have local relationships in place, which in times of response are crucial to making things happen on the ground. There is a trust factor a charity can use to benefit the people they are there to help. Charities strengths are in the realm of their local relationships in their community. People-to-people is an efficient response process. 
  • Charities should also provide the fuel (donations) to keep the relief engine running. 

Ophelia Dahl (Partners In Health): It depends on the scope of the organization. Many experienced and nimble disaster relief organizations exist in the world, and their expertise was critical in saving lives in the immediate aftermath of the earthquake. Nonprofit organizations should leverage their resources to contribute to relief efforts in the most helpful way possible—responding to local needs, in coordination with the government of the location they want to assist. Organizations without local connection or disaster relief experience hinder relief efforts, instead of assisting

George Greene (Water Missions International): Charities should first and foremost respond to the physical needs of the people. This should be done in a way that respects the customs of the community and the dignity of the individual. At the same time, Christian charities have an opportunity to bring hope that stems from our faith with the disaster victims.

Additionally, charities should work together more closely. All too often there is a competitive atmosphere that is not constructive.

Nan Buzard (American Red Cross): Non-profit organizations have been a critical part of efforts to provide relief and rebuild Haiti. Each organization has a specific mandate to meet needs, and it is important that this is clearly understood within each organization and by the international community. For example, around the world, the Red Cross supplements community, local, and national authorities in preparing for and responding to disasters and alleviating suffering. However, with an estimated $12 billion needed to rebuild Haiti, the needs are beyond the capacity of the Red Cross or any single institution to fix, and requires the collective efforts of governments and humanitarian groups around the world. Haitians must drive the effort to rebuild their country with the support of these charities. That is the only way these efforts will be sustainable.

Charles MacCormack (Save the Children): Collaboration, coordination and partnership among charities are essential to any emergency response. As an example, by working closely together, charities in Haiti have improved the country’s health care and have helped people prepare for future challenges. While it is truly unfortunate that an outbreak of cholera has occurred, the fact that it has taken this long for it to spread to Port-au-Prince is testimony to the vigilance and combined efforts among NGOs to stave off a health crisis. And the fact that there are more NGOs on the ground allows the cholera response to gear up faster.

As for Save the Children, we have coordinated with Haitian authorities, the international community, local and international organizations and communities to reach hundreds of thousands of children and families with lifesaving and life-sustaining assistance. In addition, we have played an important role in the United Nations cluster system by participating actively in the protection, health, water and sanitation, and logistics clusters, and  co-leading the education cluster.

Christoph Gorder (AmeriCares): AmeriCares focused its response early on to address health care needs. Our work continues to meet the most urgent health care needs throughout the country. Charities should support the local government and existing organizations as much as possible and focus on the work they do best. Assessing the needs is an essential component, so charity organizations can work together, coordinate and complement each other’s responses. International charities can raise awareness and public support that are not always accessible to local groups, but if we are to ever create a sustainable model; all organizations (governmental, nongovernmental, charities and local organizations) need to work in concert – sharing expertise, experiences and best practices.

Angel Aloma (Food For The Poor): It is essential that donors entrust established and reputable charitable organizations to respond to disasters. If an organization has not been able to overcome in-country challenges prior to a disaster of this magnitude it is very unlikely that the charity will have the know how to do so afterwards, despite their ability to collect donations.

There should be as much collaboration as possible so that organizations do not duplicate efforts. In one instance Food For The Poor gave the Red Cross a water filtration unit to install because they had the access to the land near the water. Charities should continue to follow their missions efficiently and not try to be everything for everyone.


CN: How did this disaster differ from others where your charity has provided aid?

Steve Hollingworth (CARE): In terms of scale and impact, the Jan. 12 earthquake was the largest and most devastating we had responded to since the 2004 Indian Ocean Tsunami. And in many ways, the relief and rebuilding phases are even harder in Haiti. Few disasters in history have crippled an urban center – the capital no less – like the earthquake in Haiti. The tsunami completely devastated parts of the Indonesian coast, but it didn’t level Jakarta. Port-au-Prince, on the other hand, lay in ruins, as did the very government ministries that would normally work with the international community in coordinating disaster response.

Jeff Nene (Convoy of Hope):

  • The size and scope was different due to conditions in Haiti, which caused this disaster to be far reaching in its impact. Existing infrastructure problems were compounded which made it difficult to move people and supplies.
  • The close proximity of the disaster made it possible for donors and workers to observe the relief effort first hand. 

Ophelia Dahl (Partners In Health): While PIH is not a disaster relief organization, we have responded to disaster before. In September 2008, a series of tropical storms hit Haiti, causing massive flooding and damage in the Central Plateau & Artibonite Department. While short, PIH/ZL had some forewarning about the storms and was able to prepare in limited ways, and our teams of doctors, nurses, community health workers, and staff were able to fan out among the communities we serve.

The earthquake happened so instantly, with such an immediate loss of life. No one was prepared for this scale of disaster. However, our 4,700+ Haitian staff reacted just as quickly, mobilizing both in Port-au-Prince and across our sites in rural Haiti to care for survivors. While the types of injuries, and level of devastation, were far more severe, it was evident that our ability to respond was again rooted in our long-term work in the communities we serve.

George Greene (Water Missions International): One of the biggest differences about this disaster was the lack of any Haitian government presence in the first weeks after the disaster. The already weak Haitian government was decimated by the earthquake. Many Haitian government officials lost their lives and many of the government buildings were destroyed along with the records contained in those buildings. As noted above, the absence of the government in the early days allowed quick response. As the government began to get itself reorganized, the ability to respond quickly was hindered.

Also, as noted above, the presence of an established office and staff before the earthquake enabled Water Missions to respond more quickly than we might have been able to, if we had not had a pre-earthquake presence.

Nan Buzard (American Red Cross): Every day, the American Red Cross responds to disasters down the street, across the country and around the world. In each disaster, we work with authorities, provide technical support, and make hard choices about how to best respond. But Haiti has been one of the most challenging international disasters we have ever responded to, and we have mounted the largest single country response in our history. The response to such a devastating earthquake was a monumental task made all the more difficult by the fact that it was an urban disaster that destroyed much of the transportation systems and other infrastructure of the capital city of Port-au-Prince, and affected large parts of the government that otherwise would have taken a much larger role in leading and coordinating the relief and recovery effort. Another notable difference is the increased interest and engagement of the American people, including more than 3 million who made $10 text donations to the Red Cross – and who are eager to learn how their donations are making a difference.

Charles MacCormack (Save the Children): The humanitarian response to the earthquake in Haiti represents the most challenging and complex emergency effort Save the Children has ever undertaken.  Haiti’s people faced enormous challenges before this emergency. In fact, the disaster highlighted the challenges this country, the poorest in the Western Hemisphere, has been facing for decades. The earthquake not only turned lives upside down, it also demolished the infrastructure of the capital and decimated the country’s human resources. For instance, the government lost 25-30 percent of its staff. Hundreds of thousands of citizens were displaced. All of these factors made an already challenging situation daunting.

In addition, Save the Children’s Haitian staff, most of whom suffered personal loss during the quake, had been working under the most taxing conditions. Given the needs of children and families, Save the Children scaled up operations rapidly, creating stress on the agency’s financial, operational and human resource systems.

Despite these difficulties, we have still been able to meet the needs of more than 870,000 children and adults. We are grateful to the generous contributions from across the globe that have allowed us to address the short-term needs while also maintaining focus on helping Haitians build back a better Haiti.

Christoph Gorder (AmeriCares): Haiti was a country that was very vulnerable before the earthquake struck; it is prone to natural disasters. Buildings were already fragile, the sanitation system was practically nonexistent, access to clean water was a challenge and Haiti had never seen an earthquake of this magnitude. Haiti is also complicated by endemic poverty and chronic diseases, including tuberculosis and HIV. Further exacerbating the situation, cholera was introduced and has spread throughout the country.

In Chile, where an earthquake struck in February 2010, buildings were designed specifically to withstand earthquakes and very few buildings collapsed. The loss of life in the Chile earthquake was less than in Haiti, but they too lost more than 20 hospitals in the disaster. The earthquake in Haiti struck the heart of the capital city, Port-au-Prince, a densely populated area during rush hour at the end of the day, when most people were on their way from work and school (the earthquake struck around 5:00 PM EST).

Geographically, Haiti is in close proximity to the U.S. and the earthquake occurred in real-time.There is also a large Haiti Diaspora in the U.S., making the outpouring of support and response instantaneous. During the Southeast Asia tsunami, charity organizations were also inundated with good will because of the sheer magnitude of the disaster.  The tsunami impacted a large geographic area, including multiple countries, destroying health care infrastructure and killing many health care workers in India, Sri Lanka and Indonesia.

With the tsunami and also Hurricane Katrina, the capital cities were not affected and the central governments were intact. In Haiti, there was uncertainty in the first hours whether the president had survived, as the residence was destroyed and hundreds, if not thousands, of officials died.

Angel Aloma (Food For The Poor): Recovery in Haiti will take between 15 and 20 years. This disaster did not discriminate based on race, religion or affluence. Government buildings, homes, churches and one’s sense of normalcy collapsed in minutes. We have found this disaster created a lot of discussion among organizations but more than 10 months later the people continue to suffer. An overwhelming amount of monetary donations have not been distributed and there does not seem to be a cohesive long-term plan.  Currently Food For The Poor’s building of permanent homes in Haiti is limited only by the nonprofit’s funding. For $3,200, Food For The Poor can build a sturdy home with sanitation that a family will call home for generations. There is a definite need for permanent homes in Haiti. We have seen in other countries how temporary shelters eventually become permanent homes for destitute families who lack resources. Food For The Poor has built safe, permanent homes throughout Haiti for more than 20 years. Food For The Poor’s homes withstood the earthquake well. A permanent solution is to provide those who have been displaced by the earthquake and those who have no option but to live in swamps and slums a home, with access to clean water and sanitation. This plan requires the support of the international community.

CN: What has been learned from this disaster?

Steve Hollingworth (CARE): This disaster, coupled with the floods in Pakistan just months later, have taught CARE and other relief organizations that we must have separate strategies and systems for responding to mega-disasters, the kind that normally come just a few times a decade. Few aid groups were prepared, for instance, to deal with the chaos and devastation the earthquake brought to their own staffs. Thus the need for an entirely different system for supporting staff and moving in relief workers from outside the country to help when a mega-disaster hits.

Jeff Nene (Convoy of Hope):

  • Relationships are everything.
  • We need to continually adjust our response expectations and be able to properly communicate them to our donors and supporters.

Ophelia Dahl (Partners In Health): The earthquake in Haiti has brought increased global attention to something that we have has known for a long time: the poor are the most susceptible to acute and chronic disasters. In a country like Haiti, a country that has never had the resources to provide for its citizens, the poor remain vulnerable to a variety of disasters: hurricanes and earthquakes, hunger and dirty water. We need to support the Government of Haiti, strengthening public services and addresses the root causes of chronic disaster: poverty and disease.

The consequences of poverty and poor public health are devastating, as the recent outbreak of cholera has made even more evident. I hope the world has learned that partnering with and bolstering the public sector in Haiti, and other poor countries around the world, is the way to effect long-term change and prevent further disaster.

George Greene (Water Missions International): We have learned about the importance of being prepared ahead of time so that when a disaster strikes we will be in a position to quickly implement a pre-existing response plan. At the same time we know that, despite the best planning, there will always be unexpected circumstances that arise and there will be confusion due to communications difficulties and constantly changing conditions. We must plan well but we must also be prepared to be flexible as the need arises.

Three factors are key to be able to respond immediately and to be able to sustain the response: 1) Trained personnel and equipment that can be rapidly deployed; 2) Pre-existing agreements and plans with Strategic Partners to facilitate logistics and on the ground deployment; and 3) A good PR plan to ensure effective communications with donors.

Nan Buzard (American Red Cross): This earthquake brought to light or reinforced a number of issues that should inform our future work as a humanitarian community. In the early days, with limited airspace, some of us believe too much time was devoted to search and rescue operations at the expense of other relief interventions. This is a very sensitive and hotly debated topic and we need to have better criteria for prioritizing our work and more clarity about how these important decisions are made. The United Nations cluster system, which has been so important in coordinating, standardizing and filling in gaps for humanitarian aid, has nevertheless struggled to include the many local Haitian NGOs by primarily communicating in English, and holding the cluster meetings in high-security places with limited access. The earthquake emphasized the great usefulness of technology – from the use of geo-mapping information systems offering environmental and social modeling to the use of mobile phones in all phases of the response. Haitian mobile service provider Voila was able to help track population movements after the earthquake; send SMS messages to displaced Haitians to help with early warning for later disasters; and mobilize people to receive vaccinations and even cash. The earthquake also reinforced important lessons. Local communities must have basic disaster response skills like first aid and light search and rescue (the American Red Cross is currently working on this in dozens of countries).

Charles MacCormack (Save the Children): All the responding NGOs faced extensive scale-ups in staffing, and it can be difficult absorbing people into a changing structure and new culture. From an operations standpoint, the complexity of logistics and the supply chain cannot be underestimated. Many of the necessary supplies were not available in Haitian markets and had to be imported, which is extremely costly. The disaster also demonstrated the importance of ensuring plastic tarps, nonfood items, and systems for water and sanitation are pre-positioned in places that are emergency prone.

In addition to the challenges on the frontline, there were also many obstacles to overcome in the “backroom..”  For many NGOS, finance and human resources staff initially struggled to keep pace with the rapid scale-up of programs, which sometimes caused delays in getting reports to donors.

Christoph Gorder (AmeriCares): It is critical to be able to get aid in early. Specifically, assistance that meets the most pressing needs after a disaster of this magnitude: medicines, housing, food, proper sanitation and clean water.  It is essential organizations work together to ensure these basic but lifesaving steps be taken first to ensure more lives are saved in those critical first hours after a disaster strikes.

Also, the ability to prepare is essential. In addition to delivering medical assistance on an ongoing basis to meet the health needs throughout the country, AmeriCares pre-positions emergency supplies in our warehouse so we can mobilize quickly and respond to urgent needs, such as the current cholera outbreak. Preparedness is the key to saving lives early on.

Angel Aloma (Food For The Poor): There is a direct correlation between media attention focused on a disaster and how involved and informed the public becomes as a result. Before making donations, donors should research the organization’s responsiveness to confirm that a long-term, cohesive approach is possible and will be appropriately handled. The country of Haiti is completely lacking basic infrastructure such as roads, electricity, and water and sanitation systems. For example, Chile was able to recover faster immediately following their earthquake in part because the country had an infrastructure and government regulations that required stronger building.   

CN: What’s next in Haiti?

Steve Hollingworth (CARE): I think we’ll continue to see cooperation between international health officials and the Haitian government to minimize the magnitude of a serious cholera outbreak. But the challenge is great, as Haitians have very limited immunity from and experience with a disease not seen in the country’s recent history. That said, I think the new year, with renewed energy from the international community and the people of Haiti, can be one of great progress in building a better Haiti.

Jeff Nene (Convoy of Hope):

  • We are continuing to invest in the future of Haiti through the children. Currently, we are working to triple our pre-earthquake activities of providing nutritious food, clean and safe water and health education to thousands of Haitian children each school day.
  • Our organization is continuing to increase capacity in the area of our local nutrition program.

Ophelia Dahl (Partners In Health): The earthquake displaced 1.5 million people. In a country of 9 million people, the impact of so many displaced residents will continue to affect Haiti’s recovery for years to come. The most critical piece of the recovery will be to provide adequate and dignified housing for those who lost everything—the Government of Haiti will need massive resources to do so.

Partners In Health/Zanmi Lasante will continue to work in partnership with the Ministry of Health of Haiti to strengthen services at the 15 hospitals and clinics in which we operate. We will continue to train and hire local medical professionals, expand the medical services available, and provide social services for the communities we serve. PIH will also continue to advocate for the international financial support of the Government of Haiti, and that pledges made for earthquake recovery are indeed disbursed and spent accordingly.

The largest project that PIH/ZL is undertaking as part of the earthquake response is the construction of a state-of-the-art teaching hospital in Mirebalais, a city about 35 miles north of Port-au-Prince. The hospital will be the largest public hospital outside of Port-au-Prince, with 320 beds, and will include facilities not publicly offered in Haiti, including an ICU and operating theater complex. As the main teaching hospital in Haiti, l’Hopital de l’Université d’Etat d’Haïti (HUEH), was badly damaged in the earthquake, the Mirebalais Hospital will supplement the clinical training for doctors, nurses, and medical staff while other teaching facilities are rebuilt in Port-au-Prince. We expect to open doors at the end of 2011.

George Greene (Water Missions International): Water Missions International is actively involved in response to the current cholera outbreak. Our efforts in the months ahead will focus on transitioning water treatment equipment that was installed in response to the earthquake and the cholera outbreak into sustainable community development projects. This will ultimately result in a larger Water Missions International presence in Haiti. More importantly it will result in more Haitians having sustainable access to safe water. We will also increase our activity in the sanitation sector.

Nan Buzard (American Red Cross): The crisis in Haiti is not over and the recovery process will be long and difficult. Haiti and its people must rebuild their homes, economy, water systems, schools and transportation networks. Sustained recovery requires commitment and effort long after the media spotlight and public attention have faded. Looking forward, getting people now in the camps back into repaired homes or new shelters must be a priority, along with helping transition some of the health, water and sanitation services now provided by non-profits back to Haiti’s government or its private sector.

Charles MacCormack (Save the Children): As of early-November, cholera is a new problem facing the population of  Haiti, which complicates an already precarious situation. Cholera has become a serious epidemic given that densely populated areas with poor sanitation provide the optimal environment for the spread of infectious disease.

Now that an outbreak has occurred despite the best efforts of the Haitian authorities and the international community to prevent it, international aid agencies must support the Haitian government in containing the disease as quickly as possible and getting treatment to those who are affected. Save the Children has mobilized its medical teams to educate children and families on prevention, provide case management and identify, treat and work with partners on serious cases needing referral. The agency has readied health clinics and pre-positioned stocks of lifesaving medicines and supplies like oral rehydration salts. In addition, the organization is working with the United Nations, the government of Haiti and other nongovernmental organizations to address the situation. However the outbreak of cholera clearly shows that without long term investment in water and sanitation in the poorest parts of the country cholera and other preventable diseases will remain an on going problem for the Haitian population, the GOH, and the international community.

Once this crisis is addressed, we can then move forward in building back a better Haiti and get families settled in areas where they can have access to livelihoods, health care and education.

Overall, Haiti post-earthquake presents a new reality. It is an opportunity to take a shattered country, for decades trapped in poverty, and rebuild a nation that stands up and ensures the protection of its children. 

The challenges have been numerous and have made this one of the most difficult emergency responses in Save the Children’s history. Progress is very slow, and it will continue to take a long time to strengthen the institutions and community infrastructure of Haiti. Due to the many challenges of rebuilding including clearing rubble, establishing land tenure and the fact that many people in camps were renting accommodation prior to the earthquake, Save the Children expects the camps to continue to exist for a longer time period than had been estimated. And, while this is not ideal,  we will continue to support families in these camps and work to help them return to permanent shelter as it becomes possible.

There is cause for hope. Children are now back in school. In many camps, pregnant and lactating mothers who have never had access to health facilities are seeing doctors, nurses and midwives. Access to health services has shown many Haitians what better healthcare can provide them. The challenge now will be how these services can be provided as people relocate to locations where they can earn a living. In some cases, but not nearly enough, families have been able to recover their livelihoods and build for their children’s future. This hope must be accompanied by the caveat that it cannot be sustained without the ongoing support and investment by donors. 

As the one-year anniversary of the earthquake approaches, and while Haiti will move further and further out of the news cycle, the needs of the country’s children have remained as pressing as ever. As a global community we have the opportunity and the obligation to support the well-being of the world’s most vulnerable children. Save the Children is committed to Haiti for the long-term, and the commitments we have made to Haiti’s children must be kept.

Christoph Gorder (AmeriCares): With Haiti still in a very fragile state, AmeriCares will continue its work delivering and distributing medicines and medical supplies to our network of health care partners. We have established an office in Port-au-Prince and our warehouse will continue to serve as a critical hub for distributing aid throughout the country.  We are also developing programs to help rebuild the country’s health care system and address the needs of Haiti’s most vulnerable populations, including adolescent girls; mothers and newborns; medications for people living with chronic diseases, such as diabetes; establishing training and education programs for health care workers; and increasing access to health care and medical treatments.

With the upcoming elections in Haiti, it is imperative that the newly elected government get down to the business of reconstruction in Port-au-Prince. It will be essential to keep plans in place (plans sponsored by the current government and its international partners) to encourage and accelerate the depopulation of internally displaced populations (IDP) camps. 

Angel Aloma (Food For The Poor): Food For The Poor continues to raise funds to rebuild Haiti, and ship emergency relief supplies in response to the cholera outbreak. The need for permanent housing and sanitation continues to be critical. With more than 90 percent of schools in the region having been destroyed, Food For The Poor is also committed to educating Haiti’s youth. We cannot afford for another generation to go without an education.

Our staff on the ground in Haiti has been successful in distributing aid to hospitals, schools, orphanages, tent cities, local community organizations and to other partner NGOs. The need for housing in Haiti continues to be critical. More than a million are homeless and living in dangerous circumstances. Food For The Poor homes are permanent, sturdy concrete construction with rebar reinforcements, and strong corrugated zinc roofs. Homes are being built in and around both Port-au-Prince and Cap-Haitien to house those displaced by the earthquake.

Access to clean water is a matter of life and death for the people of Haiti. In Haiti, there are a lot of misconceptions about how cholera is spread. The people are now afraid about food and water supplies.

Food For The Poor has moved quickly to ship and install 30 solar-powered filtration units in Haiti’s affected Artibonite region since the cholera outbreak. Water Missions International, in partnership with Food For The Poor, has helped to install the water filtration units. The filtration systems each can treat up to 10,000 gallons of water per day and reduce waterborne diseases by removing suspended pathogens.

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