6

Case Study: Post-Earthquake Recovery in Haiti

The earthquake that struck Haiti on January 12, 2010, resulted in 222,570 deaths, 300,572 people injured, and approximately 2.3 million people displaced (Figure 6-1).1 The earthquake damaged or destroyed 60 percent of government buildings and caused major disruptions in communication systems. More than two years later, in August 2012, it was estimated that approximately 369,000 displaced people remained in 541 camps.

In response to the earthquake, concerned global citizens used Web 2.0 technologies to create an online, interactive map that harnessed short message service (SMS) to locate disaster victims, coordinate relief supplies, and guide search-and-rescue teams. The Haiti Crisis Map was built using the Ushahidi platform, an open source mapping system developed during the December 2007 Kenyan elections as a means for laypersons to use SMS and e-mail to record and report post-election violence. The map made use of the collective, local intelligence of Haitian SMS, e-mails, blogs, and Facebook and Twitter posts to continually display and update the status of trapped persons, medical emergencies, food supplies, water, and shelter.

But verification of the validity of these reports or the responses by NGOs and disaster relief workers was limited. This lack of validation points to the

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1 The introduction to this chapter is drawn from a background paper prepared for the workshop by Ryan Shelby, Christine Mirzayan Science & Technology Policy Fellow and J. Herbert Hollomon Fellow at the National Academy of Engineering.



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6 Case Study: Post-Earthquake Recovery in Haiti T he earthquake that struck Haiti on January 12, 2010, resulted in 222,570 deaths, 300,572 people injured, and approximately 2.3 mil- lion people displaced (Figure 6-1).1 The earthquake damaged or destroyed 60 percent of government buildings and caused major disrup- tions in communication systems. More than two years later, in August 2012, it was estimated that approximately 369,000 displaced people remained in 541 camps. In response to the earthquake, concerned global citizens used Web 2.0 technologies to create an online, interactive map that harnessed short mes- sage service (SMS) to locate disaster victims, coordinate relief supplies, and guide search-and-rescue teams. The Haiti Crisis Map was built using the Ushahidi platform, an open source mapping system developed during the December 2007 Kenyan elections as a means for laypersons to use SMS and e-mail to record and report post-election violence. The map made use of the collective, local intelligence of Haitian SMS, e-mails, blogs, and Facebook and Twitter posts to continually display and update the status of trapped persons, medical emergencies, food supplies, water, and shelter. But verification of the validity of these reports or the responses by NGOs and disaster relief workers was limited. This lack of validation points to the 1  The introduction to this chapter is drawn from a background paper prepared for the workshop by Ryan Shelby, Christine Mirzayan Science & Technology Policy Fellow and J. Herbert Hollomon Fellow at the National Academy of Engineering. 47

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48 HARNESSING OPERATIONAL SYSTEMS ENGINEERING FIGURE 6-1  On January 12, 2010, an earthquake struck near Port-au-Prince in Haiti. SOURCE: CIA World Factbook. need for a decision support system to rapidly identify inaccurate informa- tion, detect early warning signs of conflict or disease outbreak, and maintain the security of information and the privacy of people reporting it. In October 2010 a lightning-fast and virulent outbreak of cholera swept through the earthquake-ravaged country, killing more than 7,000 Haitians and sickening more than 530,000 despite the presence of the large number of NGOs. In response, the Haitian government established the National Sentinel Site Surveillance (NSSS) system at 51 sites to help decision makers allocate resources and identify effective public health interventions. It also established the Internally Displaced Persons Surveillance System (IDPSS) to facilitate the monitoring of communicable diseases identified in temporary clinics serving displaced people. It is not known whether the hundreds of NGOs operating in Haiti are integrated into these systems, nor whether there is a common disease sur- veillance system among the NGOs. Reports indicate that medical responses have been delayed by communication difficulties among NGO partners and by limitations of IDPSS data due to lack of reliable information about the population in camps.

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CASE STUDY: POST-EARTHQUAKE RECOVERY IN HAITI 49 Finally, gender-based violence has been a continuing problem since the earthquake. In a 2011 survey of “households” in four camps near Port-au- Prince, 14 percent of respondents reported that one or more members of their household had been victimized by either rape or unwanted touching or both since the earthquake. More than 10,000 people were sexually assaulted in the six weeks after the earthquake, and over the next three months 24 percent of all arrests by the Haitian National Police involved sexual violence. There is no systematic collection or management of data on gender- based violence in Haiti, so it is difficult to quantify the occurrence of such violence. Under the dictatorships of François and Jean-Claude Duvalier, gender-based violence was commonly used as a tool of repression. A 2006 report found that approximately 35,000 females and an additional 13,000 restaveks, children working as unpaid domestic servants, experienced sexual assault between February 2004 and December 2005. PERSISTENT CHALLENGES Robert Perito, director of the USIP Security Sector Governance Center, pro- vided a detailed and vivid view of the situation in Haiti. The tent camps in Port-au-Prince are an example of what he called the “Haiti Syndrome,” char- acterized by chronic disease, poverty, and insecurity exacerbated by a crisis. The January 2010 earthquake not only destroyed 190,000 housing units but was followed by a number of aftershocks that caused people to move out of whatever structures were still standing and into any open space available. Golf courses, public parks, even highway medians filled with tents. Three years later, more than 500 tent camps remain in the Port-au-Prince area. These camps pose serious hardships for those still living in them, with no electricity, no sewers, no roads, and no amenities, according to Perito. However, he pointed out that before the earthquake some 300,000–400,000 people lived in the slum at the center of Port-au-Prince, Cité Soleil, which the Economist at the time described as “having little if any electricity, no sewers, no shops, no form of employment and no police.” People came to Cité Soleil from the countryside, and when the agricultural sector in Haiti failed during the 1990s they came in large numbers. After the earthquake, the international community flooded into Haiti and, among other things, created tent camps that, ironically, were a major improvement in living standards for the residents of Cité Soleil. The camps had new tents, free food, bottled water, and in many cases world-class medi- cal care thanks to the legions of doctors who flew to Haiti. The quality of life

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50 HARNESSING OPERATIONAL SYSTEMS ENGINEERING in the camps during the first year was such that it actually encouraged people who lived in or were displaced to the countryside to come live in them. Residents of the camps who had resources could either rebuild their homes or find new places to rent and move on. Others were resettled to loca- tions far from the city where there are no jobs and few amenities. In many cases, however, people left their names on the camp registers in the hope that they would be resettled in a better house or receive some other benefit. Many of those who remain in the camps are what Perito called “a residual hard-core population” who do not have the resources to rent elsewhere and have not been able to participate in a resettlement program. A comprehensive government-led effort is needed to resettle the city’s homeless, Perito said. But it would require urban planning and resolution of the problem of missing land registration titles. No more than 15 percent of the land in Haiti is registered, and resettlement efforts have been hampered by the fact that nobody knows who owns the land. If someone clears a piece of land, squatters often arrive. If someone builds on a piece of land, people often show up with forged documents claiming they own the land. The current government program is to clear six areas in the capital city, mostly former parks and open spaces. To provide people with an incentive to leave the camps, the government has been offering to pay their rent for a year. The government also has been sending armed forces to clear the camps. But with few provisions for resettlement, people forced out of camps often just move to other camps. Further complicating the post-earthquake recovery is the cholera epi- demic, which began a year after the earthquake. Cholera was not seen in Haiti until 2011, and it appears to have arrived with a group of UN peacekeeping troops from Nepal, although the United Nations has not admitted responsi- bility for introducing the disease into the country. Controlling the spread of cholera has been hampered by Haiti’s lack of basic infrastructure. Cities have no water systems or sewer systems; Haitians use streams and other untreated water sources for their drinking water, for bathing, for laundry, and for other bodily functions, often in the same place. Tent camp populations are especially vulnerable because of a lack of clean water, adequate latrines, and medical care. Cholera is a waterborne disease, and spreads during the heavy rains of the hurricane season. The response of the international community to the cholera outbreak has been inadequate, Perito said. The International Organization for Migra- tion announced that it had distributed 10,000 cholera kits, which contain

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CASE STUDY: POST-EARTHQUAKE RECOVERY IN HAITI 51 rehydration salts, Aquatabs,® and chlorine, in 31 camps. But with more than 500 camps in Haiti, the vast majority has not received the kits. The interna- tional community also has been building temporary clinics, distributing soap and bottled water and treating cases that come to their facilities. But these are short-term responses that do not address the basic problems of people living in the camps. According to Perito, Haiti needs a comprehensive plan for health care delivery in both urban and rural areas. But because of a lack of jobs, educa- tion, and health care, people continue to leave the countryside and move into the camps around Port-au-Prince. Finally, Perito looked at the problem of gender-based violence. Many women living in the camps are alone, having lost their families. The camps offer no privacy or physical protection, and the police presence is minimal if it exists at all. Historically, the slums of Port-au-Prince have been a locale for crimes, gangs, kidnapping, and random violence. In 2007 the UN military cracked down on the gangs, arresting their leaders and putting members in prison, but some 800 of these criminals escaped when prison guards aban- doned their posts at the time of the earthquake. Most of them remain at large, living in the camps, where they have resumed their activities. The international community’s response to gender-based violence in Haiti has been inconsistent. Efforts have focused on making the camps safer, counseling women on how to avoid attacks, caring for rape victims, improv- ing lighting, and increasing camp patrols. All of these are useful and help in the short term, Perito said, but they do not solve the basic problem of living in a tent in the camps. Haiti’s homelessness, illness, and gender-based violence result from a failure of governance and a lack of international coordination, Perito con- cluded. After the earthquake, the international community pledged almost $10 billion, and an interim Haitian reconstruction commission was formed. But then Haiti went through another convulsion of political violence, and the elections in November 2010 were disputed. A president finally emerged in March 2011, but there has been a continuing standoff between the presi- dent and the parliament. Faced with this uncertainty, international donors stepped back. As a result, the camps remain a problem, many institutions have pulled out, and donor fatigue is setting in. A long-term systematic solution will require planning, government buy-in, capacity building, inter- national community coordination, and the creation of a development or reconstruction narrative.

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52 HARNESSING OPERATIONAL SYSTEMS ENGINEERING Breakout Group DISCUSSION This breakout group selected as its objective to develop a method to under- stand the underlying reasons why the camps exist. That is, why does home- lessness exist in Haiti? First, said breakout group reporter James Willis Jr., vice president of SPEC Innovations, the group identified several illustrative root causes of homelessness: weak governance and predatory elites as funda- mental drivers, together with limited ownership opportunities and an inad- equate supply of housing, caused in part by the destruction of buildings by earthquakes and hurricanes. The group did not pretend to have exhausted its analysis of the root causes of homelessness, but it agreed that with adequate information, such analysis could support actionable insights. The discussants also emphasized the importance of a holistic approach rather than separating analyses into silos. To build the knowledge necessary for a full analysis, the breakout group suggested using a variety of technical approaches, including qualitative exploratory methods, case studies, simulations, and prototypes. For example, using prototyping to build out a knowledge base would require the construc- tion of small group of houses in a particular location to assess costs and infrastructure needs. The group asserted that the use of such techniques would also require multidisciplinary expertise both during the planning and operational phases to enable application of systems engineering, modeling, and other integrated approaches. Among the challenges to successfully addressing homelessness would be to gain buy-in from the elites that dominate Haiti. Whatever strategy were developed, it would need to benefit the homeless, the population of Haiti as a whole, and the elites. For example, the group wondered whether there is a way to redistribute land through a Homestead Act that could achieve wide- spread acceptance. They worried that land redistribution has great potential for violence—perhaps even greater than the violence now occurring in camps—but that without resolution of land tenure and ownership issues, there would be little incentive to dismantle these camps. Perito reported that many Haitians have a strong entrepreneurial spirit. Pride of ownership is part of this spirit. An emphasis on land ownership could also build on successful development programs that are already under way in Haiti. As part of its consideration of method, the working group looked at what metrics might be needed to measure success. Of particular concern was the issue of data and of long-term access to those data. The working group thought that potential metrics might include available funding, sustain- able economic growth, fewer people in camps, a reduction in disease, and

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CASE STUDY: POST-EARTHQUAKE RECOVERY IN HAITI 53 an increase in home ownership. The data needed to populate these metrics could be derived from information on NGO activities, lists of ongoing proj- ects, and compilations of building activity. The proposed analysis of homelessness could reveal latent capacity in the slums to address the problem. At the same time, though, it could also make more explicit the needs of the people living in the camps and their vulner- ability (especially women and children subject to gender violence). With a better understanding of Haitians’ own goals and priorities, programming can be designed to ensure buy-in to changes in land ownership. The breakout group concluded that the lack of infrastructure and effec- tive governance in Haiti must be addressed to achieve sustainable outcomes in national and international efforts to overcome the persistent challenges in the wake of the 2010 earthquake.

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