Across the country, government and humanitarian agency teams are carrying out public education campaigns, handing out millions of chlorination tablets, powder, liquid, and staffing cholera treatment centers.
UN General Secretary Ban Ki-moon has called for $164 million to fight Haiti’s cholera epidemic.
Humanitarian agencies are attempting to get more and better water to the country’s 1,300 refugee camps and to the areas of the country where people mostly rely on river water.
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In the capital, DINEPA and its UN and “non-governmental organization” (NGO)  partners are mobilizing a fleet of 32 “desludging” trucks that will concentrate on the camps and cholera treatment centers. A new excreta dump site – with a special clay-lined pit for excreta – is being build by DINEPA and its partners north of the capital.
But even if cholera is beaten into submission, or eradicated, another waterborne disease could easily sweep through Haiti if more long-term work isn’t done.
Pre-January 12 Reforms
For over a decade, state and non-state actors worked on various plans to reform the water and sanitation sector in Haiti. In 2009, the parliament finally voted a law establishing the new national water agency DINEPA (the Direction Nationale de l’Eau Potable et de l’Assainissement).
The agency, which is part of the Ministry of Public Transportation and Public Works (MTPTC), is charged with assuring safe water and sanitation for all Haitians, in urban and rural areas by developing services, establishing rules and regulations, and regulating all actors – private, public, regional and even small local water committees.
“The structure is like a chain that starts into the capital and reaches out to all regions,” Pierre-Yves Rochat, who is responsible for DINEPA’s rural programs, told Haiti Grassroots Watch.
Prior to the earthquake DINEPA was busy setting up the regional structures, applying for and obtaining grants and loans from the Inter-American Development Bank (IDB) and other funders, and was planning the harmonization and improvement of water and sanitation.
Reconstruction, Cholera and the new National Strategy
The January 12 earthquake interrupted the building of that chain, obviously.
Water and sanitation were built into the post-earthquake National Action Plan, which calls for upping the access to potable water to 60 percent in the capital and 73 percent in the rest of the country, and for assuring sanitation systems for 58 percent of the population in the capital and for half the rest of the country. The cost was US$160 million.
But because of the cholera outbreak, DINEPA’s plans have gone beyond that.
DINEPA’s newly released National Strategy for the Fight Against Cholera (French) offers a 14-month roadmap of how to deal with the current emergency and how get the country on the path to a more coordinated, more effective, and more far-reaching water and sanitation sector.
According to the UN Office of the Special Envoy, foreign donors – and all of the money is grants, not loans – have committed US$ 273,899,618, much of which is already being disbursed. (That figure includes some pre-January 12 projects.)
The strategy has three phases – emergency, post-emergency, and development, and includes plans to:
- assure that 6.5 million people have access to a network of affordable water treatment products like chlorine pills,
- assure all of the country’s existing 600-700 urban and rural water systems are being systematically and correctly chlorinated,
- construct 150 wells and rehabilitate 500 more,
- test water in all the country’s wells and set up regular chlorination, if necessary,
- establish regulations for the vendors of “reverse osmosis” drinking water, and establish a system for the regular treatment of that water
- carry out a campaign to obligate families living in cholera-affected areas to build latrines (about 500,000) with the assistance of the government
- establish at least four “excreta management centers” – outside the capital and three other large cities, and eventually build ten – one per department
“The strategy for today is also a strategy for tomorrow,” Rochat explained. “We have to work very hard and be very ambitious because the cholera attacking the country is a sign that things cannot stay the way they are.”
accord where they agree to only carry out projects that fit within national strategies and plans.
“We have a lot of NGOs in the water sector. We had a lot before the 12th, now we have even more… Everyone needs to work together in the same strategy, the same approach, and follow DINEPA,” he said. “That is the objective of the protocol, so that everyone follows the rules.”
DINEPA also plays a leadership role in the Water and Sanitation (WASH) Cluster, which is a mechanism that brings together state, multilateral and humanitarian agencies. [See previous HGW article on clusters.] In contrast to some of the other clusters (Shelter, Camp Coordination), WASH meetings are chaired or co-chaired by the state actor (DINEPA), held almost uniquely in French, and publish all or most documents in French.
In addition to proving leadership and guiding principles to NGOs, DINEPA will oversee and regulate the private sector also. For, even though according to the Haitian Constitution (Article 36.5), springs, rivers and streams “are part of the public domain of the State,” Rochat explained that DINEPA alone cannot assure all Haitians water or sanitation.
“We have a very active water and sanitation private sector, and we’re lucky because the public sector couldn’t provide the necessary services,” Rochat noted.
But allowing the private or semi-private (NGO) businesses to provide life-and-death services is risky business.
“Water is a public good. When you start to tie the private sector to the public sector, you are getting into dangerous territory,” Dr. Maxi Raymondville, who works at the Mirebalais Cholera Treatment Center, told Haiti Grassroots Watch. “What we need is a strong state, and even a code of ethics from the state, to orient them so that they coordinate their work.”
Rochat thinks DINEPA is up to the job.
“DINEPA will develop the rules that all actors must follow. If someone doesn’t want to follow those rules, they need to find another business,” he said.
On December 7 DINEPA took a step forward by issuing a directive requiring all water trucks in the capital to chlorinate water, and – with NGO assistance – the tanks will be regularly checked. (Once the water truck chlorination directive and monitoring is working the capital, it will be rolled out in other cities.)
Another directive still in the works has to do with excreta – where to dump it, how to protect employees, how to clean the trucks, etc.
For now the documents are “directives,” not rules or laws with fines attached for non-compliance.
“We don’t have what is called a ‘constraint.’ It is something we will need to put into place but we need to have a way of enforcing it yet,” Rochat said.
The objective of all the reforms is for water and sanitation structures across the country to become “autonomous, including financially,” Rochat said.
“People will need to pay for all of the services, whether for water or sanitation, but they will pay what they can afford. We have a principle of equity. The price needs to be just,” he concluded.
The direction and directives from DINEPA include risks and dangers. But they also offer positive signs. But will the new agency be able to coordinate the private, public, local, national, international and donor sectors with the end-users – the Haitian people – and assure them affordable and safe water and sanitation services?
Can the often weak and inefficient, and sometimes corrupt, public administration really regulate the private sector in the public interest?
Can the NGOs be brought into line, and made to follow a national strategy?
Time, and the numbers of cholera deaths, will be the judge.
1. The term is a bit of a misnomer, since it defines using a negative, and because many of the larger NGOs receive a good deal, if not most, of their financing from government sources.