Richard J. Gelting

Water, Sanitation and Hygiene in Haiti: Past, Present, and Future

Haiti has the lowest rates of access to improved water and sanitation infrastructure in the western hemisphere. This situation was likely exacerbated by the earthquake in 2010 and also contributed to the rapid spread of the cholera epidemic that started later that same year. This report examines the history of the water, sanitation, and hygiene (WASH) sector in Haiti, considering some factors that have influenced WASH conditions in the country. We then discuss the situation sine the earthquake and subsequent cholera epidemic, and the responses to those events. Finally, drawing on Haitis National Plan of Action for the Elimination of Cholera in Haiti 2013–2022, we suggest some actions that could help bring about long-term WASH improvements for the future. Because the current WASH situation has evolved over decades of limited attention and resources, it will take a long-term, sustained effort to improve the situation.

A community demand-driven approach toward sustainable water and sanitation infrastructure development

In September 2001, Cooperative Assistance and Relief Everywhere, Peru Country Office (CARE Peru), obtained funding from the United States Agency for International Development (USAID) to implement community-supported, condominial water and sanitation interventions in Manuel Cardozo Dávila, a settlement in Iquitos, Peru. With technical support from the Centers for Disease Control and Prevention (CDC), CARE Perus Urban Environmental Health Models (Modelos Urbanos de Salud Ambiental [MUSA]) project built on previous work from implementing the Protocol for Assessing Community Excellence in Environmental Health in this same community. The project led to the municipal water supply distribution system being extended 1.3 kilometers into the Southern zone of Iquitos, where it connected to the condominial water system. Altogether, 1030 households were connected to the water supply system after the installation of a condominial water and sewerage system in Cardozo. Diarrheal disease decreased by 37% for children less than 5 years of age from 2003 to 2004. This paper illustrates the strategy used by CARE Peru in conjunction with the Cardozo community to assure that the local demand for improved water and sanitation was met.

Awareness, adoption and implementation of the water safety plan methodology: insights from five Latin American and Caribbean experiences

Considerable effort has been made worldwide to disseminate information and provide technical assistance to encourage the adoption and implementation of the water safety plan (WSP) methodology. Described since the third edition of the World Health Organization (WHO) Guidelines for Drinking-water Quality, a WSP provides guidance for water utilities to ensure the delivery of safe drinking water and protect health. Attention is now being given to understand the success of efforts to advance adoption of the WSP methodology in the Latin America and Caribbean (LAC) region. More specifically, there is interest in knowing how early adopters developed strategies to implement the WSP methodology and what challenges exist for further implementation. To better understand adoption and implementation trends, key informants from five LAC countries were interviewed and case studies were developed to reveal the diversity of WSP approaches applied in the region. Results indicate that WSP implementation is more widespread than previously reported. Respondents affirmed that the WHO Guidelines for Drinking-water Quality are routinely used as a model for country-level drinking-water regulations, which has led to uptake of the WSP methodology. Interview respondents also revealed innovative national strategic approaches for WSP implementation.

Applying a New Framework for Public Health Systems Recovery following Emergencies and Disasters: The Example of Haiti following a Major Earthquake and Cholera Outbreak

Abstract. Emergencies can often directly impact health systems of an affected region or country, especially in resource-constrained areas. Health system recovery following an emergency is a complex and dynamic process. Health system recovery efforts have often been structured around the World Health Organization’s health systems building blocks as demonstrated by the Post-Disaster Needs Assessment. Although this structure is valuable and well known, it can overlook the intricacies of public health systems. We retrospectively examine public health systems recovery, a subset of the larger health system, following the 2010 Haiti earthquake and cholera outbreak, through the lens of the 10 essential public health services. This framework illustrates the comprehensive nature of and helps categorize the activities necessary for a well-functioning public health system and can complement other assessments. Outlining the features of a public health system for recovery in structured manner can also help lay the foundation for sustainable long-term development leading to a more robust and resilient health system.