Managing water, sanitation and hygiene in Port-au-Prince: how do we get out of the emergency phase?
Managing access to water and sanitation is one of the most complex tasks for urban institutions. These challenges are particularly complex in a city destroyed by an earthquake. The international community’s operations were extremely effective in supplying the population with water in the first days following the earthquake. However, the response also revealed a lack of preparation and tools to manage excreta in urban emergency situations and the chronic difficulty of ending the emergency phase.
The context before the earthquake
The water and sanitation sector in Haiti in general and in urban zones in particular was in a very poor state before the earthquake of 12 January 2010, despite the efforts of the recently created DINEPA, the new regulatory authority with a mandate to reform and harmonise the sector. In Port-au-Prince, less than 30% of the population were supplied by the municipal water service and less than 50% had access to toilets. The network of the Centrale Autonome Métropolitaine d’Eau Potable (CAMEP - Autonomous Metropolitan Station for Potable Water) was too small in relation to the increase in population (which had gone up from 300 000 to 2 300 000 inhabitants in a few decades), was outdated and had not been properly maintained.
The private water sector grew in Port-au-Prince to fill these gaps, but was not subject to control due to lack of means. The inhabitants of Port-au-Prince drank water which was treated by inverse osmosis which they bought at the hundreds of kiosks all over the city, either in little bags (for immediate consumption), or in 22 litre bottles. Water was also supplied by tanker to neighbourhoods which were not connected to the network. However, this private solution did not cover all the gaps in the CAMEP’s metropolitan network.
As for toilets, households which had them used bayakous (people who traditionally empty toilets) when they were able to pay for the service. The bayakous are a stigmatised population amongst which the consumption of alcohol is the usual means of managing the smell and psychological impact of this kind of work. The toilets were emptied at night, and their contents deposited some way away, in the streets or the ravines, which only “displaces” the problem. The bayakous are subject to a great deal of violence within communities. Their life expectancy was lower than average, and this problem was compounded by the fact that people emptied all kinds of solid objects into their toilets, including sharp objects which injured the bayakous and often caused mortal infections because of the contact with excrement.
The management of solid waste in Port-au-Prince consisted of moving refuse from one place and putting in a ravine or a rubbish dump. A small amount was emptied into the Truitier dump, which was run by the SMCRS , on the outskirts of the city. The health risks were all the more extreme as this dump was also used as an outlet for sewage from septic tanks.
The creation of the DINEPA  in 2009 was a significant move forward in a country which was emerging from a decade of troubles, was building its governance and preparing elections. The sharing of responsibilities and power relations between the CAMEP and the DINEPA was one of the major challenges of the reform. This was the context on the morning of 12 January 2010.
A major disaster and a response which is looking for its bearings
Apart from the major destruction to buildings, the earthquake also destroyed kilometers of piping and meters cubed of storage space in neighbourhoods. For the million people still living in tents or under tarpaulin, and for the few lucky ones who have been given a temporary shelter or who have built one themselves, the challenges in relation to water are considerable.
It is difficult to get a clear picture of the methods used to gain access to water in IDP sites as there are a variety of sources available. Generally, it seems that the supply methods which existed before the earthquake have continued, including the buying and consumption of water treated by inverse osmosis. The DINEPA very rapidly took over the coordination of humanitarian aid in the WASH sector and during the first 6 months it was responsible for a third of deliveries by truck in IDP camps, the remaining two thirds having been provided directly by humanitarian agencies via soft reservoirs known as “bladders” filled with chlorinated water. Only a third of the population use the water from the “bladders” as drinking water. People do not trust the quality of the water supplied and are not used to drinking water of this kind. Thus, the water from the bladders is used to cover most needs for washing, doing the dishes and doing housework.
The sanitation of excreta in the urban context of Port-au-Prince was a real headache for the international community and took a long time to be put in place. In the end, classic pit latrines were built where it was possible to dig pits (which was far from being the case everywhere) and portable toilets emptied on a daily basis by private companies, were also set up. According to the CDC  , the rate of use of the toilets was 190 people per toilet in June 2010. At the same time, some displaced people continue to use the toilets in their destroyed homes or those available near their site, but how many exactly is not known.
In the acute emergency phase, the supply of chlorinated water by truck was completely appropriate. But the effectiveness of the international aid community could have been improved if it had listened to the local population very early on. Communication about hygiene could have been more adapted to the Haitian context such as the consumption of water treated by inverse osmosis. This treatment does not leave any aftertaste, as opposed to chlorine. This local characteristic was not properly taken into account in the hygiene promotion strategy.
Options such as reinforcing the population’s capacity to treat water at home (which in numerous cases is a way of supporting spontaneous post-disaster resilience strategies, which are themselves based on existing practices from before the earthquake ), only emerged quite late on in the process. The cholera epidemic appears to have led to an exponential increase in the practice of treating water at home. This should be supported and will need to be taken into account in current and future strategies.
 Société Métropolitaine pour la Collecte des Résidus Solides.
 The framework law which instituted the reform of the potable water sector was voted in by the Parliament in January 2009. It came into force with the promulgation of the law in the Official Journal, “Le Moniteur”, of 25 March 2009.
 CDC, Access to Water, Sanitation and Hygiene In IDP Settlements in Port-au-Prince, Haiti, Results of a Household Survey (conducted in June 2010), Draft August 4, 2010, [Not For Distribution].