Haiti has a long challenge ahead when it comes to getting its water infrastructure in repair. Dr Gareth Evans looks at how the nation’s ongoing water programme has developed following the earthquake.
January's earthquake has compounded Haiti's long-standing water problems, making an already seemingly intractable situation far worse. Even before the magnitude 7 quake struck, scarcely more than half of the country's ten million population enjoyed access to clean water, while two-thirds lacked proper sanitation.
One of the most densely populated places on the planet – and arguably the poorest nation in the Western hemisphere – decades of rural to urban migration has "adversely affected the distribution of the water supply", according to the US Army Corps of Engineers' Water Resources Assessment of Haiti report.
That document was written in August 1999, when the island nation's population had still to reach eight million.
The quake effect
Ten years and an extra two million people later – earthquake aside – Haitians are already facing difficult times. Twelve days into 2010, the uphill struggle to provide adequate services suddenly became a whole lot steeper.
Water projects on this sort of a scale are always set to be problematic, but when so much essential infrastructure is swept away in little more than 30 seconds, to say that those difficulties escalate, ranks as an understatement of grotesque proportions.
As the immediacy of the relief operation gives way to the long-term process of rebuilding, the challenge in moving from temporary measures designed to stave off today's dehydration to more lasting solutions for Haiti's collective tomorrow are likely to be very great. The island has a long history of the problem.
Water resources in Haiti
In 1492, when Christopher Columbus first landed on Hispaniola, he recorded a land covered in tall, lush trees. Today, on the Haitian section of the island a legacy of prolonged deforestation means that a mere 2% remains.
The now-bare hillsides clog streams with mud as the rainy season run-off disappears in torrents long before it has any chance of replenishing dwindling groundwater supplies.
Moreover, the resulting excess sedimentation in Lac de Péligre – Haiti's second largest lake – has robbed the country's only major reservoir of around a third of its storage capacity.
It is not as if there is insufficient water to go around. Haiti has an average rainfall of 1,400mm and estimates suggest that only around one tenth of the total available water is actually used, with 90% of this being destined for irrigation.
The root of the problem lies in poor resource management, irregular population density and inadequate – and now severely compromised – supply infrastructure.
Nature also exacerbates Haiti's difficulties. The island's uneven rainfall distribution sees some regions receiving less than 400mm a year, while others are deluged with 3,500mm or more.
Despite these hurdles, before the disaster things were beginning to change and modest progress was being made, particularly with the expansion of water initiatives in rural areas, where even simply establishing locally managed well pumps represents a major leap forward. For the moment at least, such projects are on hold, but they provide some hope for the future.
Water and disease
Inevitably, the endemic lack of clean water and sanitation plays a huge role in the country's dismal health record, high infant mortality and low life expectancy. According to the Pan American Health Organization, excluding fatalities due to flooding, hurricanes and, now, earthquakes, water-borne diseases have been responsible for half of all deaths in Haiti over recent years.
In the crowded poorer areas of the capital, Port-au-Prince, where pathogens constantly re-circulate, dysentery, typhoid and cholera are ever-present threats, something the cramped conditions of makeshift camps have hardly helped. As one nurse, who returned to Haiti as part of the relief effort, described, "water's always been a problem in the city, and it just got a lot worse".
With rudimentary water and sewage lines destroyed in the quake, UNICEF's senior emergency health adviser Robin Nandy warned of the "huge risk of communicable diseases such as diarrhoea and measles, which could cause a large amount of illness, as well as deaths, among women and children in particular". May heralds the coming of the rains, with July the start of the hurricane season.
With the clock ticking, Dr Thierry Causse of the French Red Cross, and others like him working in the field clinics and refugee camps, point to the potential for more deaths amid epidemics of malaria and typhoid, if those at risk cannot be relocated and services improved.
From relief to reconstruction
While the initial relief phase has passed, on 16 April 2010, Haiti's outgoing parliament voted to extend the country's state of emergency for 18 months and approved the formation of a commission co-chaired by former US President Bill Clinton to oversee the reconstruction. Some $5.3bn was pledged for 2010-11 at a UN conference at the end of March, with some estimates suggesting that around $1bn of that will be spent on water.
As lead relief organisation for water and sanitation, UNICEF has already made great strides to bridge the gap between the emergency cover provided by the likes of bottled water and the desalination capacity of US warships and the provision of reliable infrastructure and stable supplies.
Working alongside state-owned water utility DINEPA, 115 distribution points in and around Port-au-Prince have been set up – some of them within the ad hoc settlements that have sprung up, where they have clearly helped cut some of the risk of disease.
There remains much to do. In 1999, the Corps of Engineers' report concluded that the "critical issues are the lack of access to water and sanitation, high population density and high mortality rate, the extensive environmental damage caused by deforestation, and the lack of hydrologic data. The solution to these issues presents significant challenges to the managers of Haiti's water resources".
Since then the island nation's water and wastewater arrangements have been partially transformed, at least in some areas, and many of these central questions have, to some extent, been addressed. Nevertheless, there is no escaping the fact that the situation for the average Haitian is a perilous one and the challenges largely remain the same.
Ayiti pap peri
There is some cause for optimism. If the international reconstruction effort can usher in a comprehensive watershed management plan to evaluate resource use, identify areas of potential competition and facilitate decision making, then the basis of Haitian water use, going forward, could be revolutionised. Part of this would obviously have to be short-term in its scope – stabilising erosion, repairing, replacing and extending vital existing infrastructure and implementing new local supplies – while other aspects could begin to address long-term strategic needs.
The Haitian Creole slogan 'Ayiti pap peri' ('Haiti did not die'), seen on a thousand hastily printed T-shirts, may well be true, but neither is the country off the critical list just yet.