1.Context:
A vast earthquake struck Haiti in January, 2010 this killed over 100,000 people and left huge destruction of the healthcare and sanitation infrastructure in the country. The outbreak of cholera in October 2010 adds to the disaster.
In February 2011 the incidence of cholera had begun to decline compared with the high records in November and December 2010(https://reliefweb.int/disaster/ep-2010-000210-hti). The overall decline was mainly attributed to joined efforts of the Red Cross and Red Crescent Movement and several Red Cross Partner Societies including international and National NGO’s which supported the Haitian Red Cross and relevant stakeholder to master the spreading cholera country wide.
This response had the ancillary effect of strengthen the Haitian National Society (HRC) in implementing the planned activities, following the plan of action, monitor and evaluating the project progress as well as ensuring access to affected population and the volunteer pool.
However the reputation of the HRC generally was rather adverse as impartial and not neutral. Especially the remote communities felt left out of the Red Cross program and services. In my point of view the HRC does not always follow the fundamental principles and was not aware of the safer access framework .
2. Event
On arrival I in Port-au Prince I received briefing from the team members and had been presented to the relevant stakeholders, Ministère de la Santé Publique et de la Population (MSPP), national NGO and the National Society. Hereby it was clearly communicated the purpose of my position and responsibility in the project. This helped to establish a two ways communication between myself and the relevant stakeholder, local branch, volunteers and the staff. Even thou we were not aware about the Safer Access Frame work we instinctively applied it using internal and external communication.
During my deployment as cholera project manager in Arcahaie my mission instruction implied the 24/7 service operation of the CTU, management of a mobile hygiene promotion team, setting up local office and strengthen the local branch.
At the project side there were several challenges met as firstly the deployed staff was transferred from the field hospital in Port-au -Prince to Arcahaie which was not welcomed by the community as they wanted Red Cross to deploy local people. This had impacted on the security of delegates as we have been threatened by the community. This situation has been solved through discussion with the local Police, Branch Director, HQ and relevant stakeholder.
Secondly the tension with the national organization that was running the local health center where the Cholera Treatment Unit (CTU) was set up. This was mainly linked to decline number of patients and breach of promise by previous delegate. Here I use external communication by explaining our mandated and due to the fact that I didn’t anything in written from previous delegate difficult for me to follow up on it but any way few issues which were agreed on have been implemented.
As we were also affected by the declining cholera incidence rate and at the same time the village leaders approached us requesting our support in their remote communities. We saw this as good the opportunity to work on contingency plan and exit strategy from the ERU context. After this idea was green lighted by the HQ we worked on the project proposal for community based health and hygiene promotion in remote communities. This kick off extensive negotiations with MSPP and the national health center manager on the best method handling the CTU closure. As none of the partners felt in the position to take over the CTU we agreed to dismantle the CTU and have it on standby in our warehouse to be activated whenever the need arise.
The preparation of the community project started with agreed selection type of community volunteers with village leaders and in cooperation and coordination with MSPP and the local branch Director. 22 volunteers from Delice areas of Bawo Michel, Bazin and Jean Dumas were trained on fundamental principles, community surveillance, health and hygiene as well as data collection. The aim was to enhance the volunteer pool in Arcahaie and strengthen the local Branch access and acceptance in remote area as well as empowering the local communities.
As I am writing this case study I realized that the elements of safer access are often used unconsciously as they are a part of daily live.
Short term
Delegates should be sensitive on assessing the dynamic of the project and of the communities to adjust our actions to meet the needs of the affected population. Plan exit strategy for smooth transfer from ERU into long term and sustainable project.
Long term
It is important to support in the national society in away that enable them to assume self-confidently their responsibility in peacetime and in time of crisis, develop a good volunteer pool who are well trained and committed to national society
3 Lessons learned
Exit strategy from ERU should be always incorporated into ERU deployment.
Delegates should not only focus on the mission instruction but also on the environment, social, cultural and economic situation that can influence the humanitarian action