Haiti: the limits of the “Aid System”
Jean-Marc Biquet and Catrin Schulte-Hillen
The present article looks at the 2010 aid efforts in Haiti, a year in which 2 events resulted in massive humanitarian crisis. The first, the January 2010 earthquake, triggered overwhelming mobilization of aid: hundreds of actors poured into the country, deploying large scale emergency assistance. The second event, a cholera epidemic, started in October and received much media attention, but met with an overstretched aid community.
The now traditional UN coordinated efforts aimed to organize aid mobilization for both crises.
In the article MSF exposes an analytic review of the 2010 aid reality in Haiti as well reflections that emerge from the experience: despite the undeniable effort invested in the coordination of aid, the current “aid system” does not seem to have improved emergency assistance; worse, the system itself appears to generate “roadblocks” for an effective response. Various reasons can be evoked for this, notably the much advocated shift to early recovery, while actual immediate needs of the affected population are far from being addressed.
The cholera epidemic in Haiti started in October 2010 and is likely to continue presenting a health threat for the Haitian people for some time to come. So far there have been two peaks in the epidemic: Oct-Dec 2010 and March-May 2011. A total of 513,997 cholera cases have been registered, with 6,908 deaths . The epidemic continues to deserve full attention and effective management. Still, it is important to look back at the first year of aid to the Haitian population: the earthquake response starting January 2010 and the initial 3-months emergency of the response to the cholera epidemic which started in October 2010. These two events were followed by a massive mobilisation for aid.
Already before the earthquake, a large part of the population was practically excluded from health services : few were available, and there were many obstacles to accessing them.
For several decades, Haiti has been de facto dependant on development and emergency aid. Health services were and still are a patchwork of private for-profit and non-profit initiatives. There is some public service tissue running through them, but nothing that would ensure basic health services to the population at large or provide a basis for emergency response.
 OCHA figures November 2011.
 Source: PAHO declares that 40% of the population do not have access to basic health services. An MSF report from 2005 “Les soins de santé de base hors de portée pour la population rurale d’Haïti : exclusion et appauvrissement des vulnérables” demonstrates that even when physically available, access is further handicapped by financial barriers (forfeit or cost coverage) and discourages 30-66% of the people from seeking treatment. Estimates are as high as 80% exclusion.