Humanitarian Access SCORE Report: Haiti. Survey on the Coverage, Operational Reach, and Effectiveness of Humanitarian Aid

Humanitarian Access SCORE Report: Haiti Survey on the Coverage, Operational Reach, and Effectiveness of Humanitarian Aid Humanitarian Access SCORE Report: Haiti Survey on the Coverage, Operational Reach, and Effectiveness of Humanitarian Aid Abby Stoddard, Paul Harvey, Mariana Duque-Diez, Monica Czwarno, Meriah-Jo Breckenridge July 2023 www.humanitarianoutcomes.org www.aidworkersecurity.org SCORE reports Under the CORE research programme, supported by USAID’s Bureau for Humanitarian Assistance (USAID/BHA), Humanitarian Outcomes is studying how aid reaches people in hard-to-access emergency contexts. In partnership with GeoPoll, the project conducts remote telephone surveys of crisis-affected people on their perceptions of the effectiveness of the aid response and the access challenges in their areas. Combined with key informant interviews with humanitarian responders and other contextual research, the survey results help to identify the humanitarian providers and practices that have achieved the greatest presence and coverage in difficult environments. This SCORE report presents findings from a mobile telephone survey of 1,011 people in Haiti, conducted by GeoPoll for Humanitarian Outcomes in May 2023. The survey reached 515 men and 496 women across 10 regions. Humanitarian Outcomes researchers also conducted remote interviews with 21 key informants representing national and international humanitarian organisations working in Haiti, donor government representatives, and external experts. Full survey results and additional information on the SCORE research methodology, including an interactive dashboard of response data, are available at: www.humanitarianoutcomes.org/projects/core ACRONYMS AAP accountability to affected people ACLED Armed Conflict Location & Event Data Project AWSD Aid Worker Security Database CDC Centers for Disease Control and Prevention FTS Financial Tracking Service HNO Humanitarian needs overview HRP Humanitarian response plan IASC Inter-Agency Standing Committee IOM International Organization for Migration MSF Médecins Sans Frontières OCHA UN Office for the Coordination of Humanitarian Affairs SCORE Survey on the Coverage, Operational Reach, and Effectiveness of Humanitarian Aid SISNU The Single Health Information System USAID United States Agency for International Development WASH water, sanitation and hygiene Summary Haiti’s humanitarian crisis has resulted from a political and economic implosion, compounded by natural shocks, but with consequences similar to major armed conflicts – including severe constraints to humanitarian access. The collapse of law and order after the assassination of the president in 2021, and a wave of violence perpetrated by armed criminal gangs, has displaced over 100,000 people from their homes and contributed to the breakdown of basic social services. These developments contributed to a resurgence of cholera on the island, which to date has taken hundreds of lives, many of them children. Although over 100 humanitarian groups are present in Haiti, the threat of violence prevents them from responding in the places and at the level required to meet the needs. A survey of affected people and interviews with humanitarian practitioners in Haiti revealed that: • aid has only reached a small fraction of people who say they need it, mostly in the form of food and household items • according to people surveyed, the aid received mostly did not reach where it was most needed and did not cover priority needs • humanitarian presence and access issues were obscure to many affected people, who lacked information on what aid was available and what was preventing it from getting to where it is needed. A UN-led scale-up of humanitarian assistance began in April 2023, introducing a new collective strategy and joint initiative to expand access – a promising development with the potential to change the trajectory in Haiti. While the political and protection crisis is well beyond the scope of humanitarians to mediate, recent efforts suggest that humanitarian access can be meaningfully improved through assertive negotiation efforts that are backed up by results in the form of aid delivered, and by working closely with the NGO sector – particularly local organisations that have been able to maintain access through active acceptance measures at the community level and the willingness to negotiate with all power holders. Humanitarian organisational presence and people in need in Haiti Nord-Ouest Nord Nord-Est Artibonite Centre Grand’AnsePort-au Prince Ouest Nippes Monte Cristi Dajabón Elías-Piña Independencia Sud Number of organisations People in need 14 Sud-Est Pedernales 20 30 40 52 Data source: OCHA 20231 202,044 1,755,764 1 UN Office for the Coordination of Humanitarian Affairs (OCHA). (2023a). Haiti - Operational presence. HDX. Retrieved 1 June from https://data.humdata.org/dataset/haiti-operational-presence; OCHA. (2023b). Haiti: Humanitarian response plan at a glance (April 2023). Humanitarian Needs Overview. April 13 2023. https://reliefweb.int/report/haiti/haiti-humanitarian-response-plan-2023-glance-april-2023-enht The spiralling crisis of violence in Haiti Haiti is again in the grip of a severe humanitarian emergency, caused by a combination of gang violence, governance breakdown, natural disasters, and economic recession. The confluence of factors has deprived the Haitian population of basic services and driven forced migration and food insecurity. A resurgence of cholera has further escalated the crisis. Armed criminal gangs have operated in Haiti since the 1950s, but their impact has surged since 2021. The assassination of President Jovenel Moïse and the devastating August 2021 earthquake triggered political and socio-economic turmoil, accompanied by widespread insecurity. Violence has been concentrated in Port-au-Prince and its metropolitan area throughout 2022 and 2023, with clashes between the G-9 alliance, led by Jimmy Cherizier, and the rival G-Pèp gang alliance, headed by Gabriel Jean Pierre (Ti Gabriel).2 The UN estimates that gangs control 80% of the capital city,3 and the level of violence has been staggering, with 600 killings reported in the month of April alone. While some gang leaders espouse political goals, their actions principally involve illicit economies, some with transnational links. Gang connections with members of some politicians and affluent business interests in Haiti further complicate any international or homegrown efforts to root them out. Lacking any sense of safety and protection, communities have resorted to vigilante measures. The emergence of self-defence groups in various parts of the capital and the Artibonite department has become a complicating factor and a growing concern, as they have contributed to the rising violence.4 As gangs consolidate control over territories and set up roadblocks, people in inaccessible communities can find themselves effectively trapped, no longer able even to travel away from home to access the services they need. Three consecutive years of economic recession and an inflation rate of 48% have added to the misery of the population. Haiti is one of the poorest countries in the world, with nearly 90% of Haitians living below the poverty line, according to the World Bank, and nearly a third in extreme poverty, defined as a per capita income under $2.15 per day.5 Basic public services like health and education have become dependent on aid groups to fund and run. In recent years, many of them, including medical facilities, have been forced to shut down due to deteriorating security conditions.6 Against this grim backdrop, an outbreak of cholera was confirmed in October 2022, after more than three years without any recorded cases.7 The coordinated response to the outbreak was fatally slow, due in part to the fact that high levels of violence limited movements and the ability to quickly identify and treat new cases, leading to a rapid spread across all 10 departments and almost 600 dead as of February 2023.8 2 ACAPS. (2023). Haiti: Humanitarian impact of gang violence (02 June 2023). ACAPS briefing note. https://reliefweb.int/report/haiti/acaps-briefing-note-haiti-humanitarian-impact-gang-violence-02-june-2023 3 InterAction. (2023). Member recommendations for the Haiti humanitarian response. https://reliefweb.int/report/haiti/interaction-member-recommendations-haiti-humanitarian-response 4 According to local media reports, vigilante groups committed at least 164 of 600 reported killings in April alone. (USAID. (2023). Haiti – Complex emergency – Fact sheet #5. Fiscal Year (FY) 2023. https://reliefweb.int/report/haiti/haiti-complex-emergency-fact-sheet-5-fiscal-year-fy-2023 5 World Bank (2023). The World Bank in Haiti. Overview. https://www.worldbank.org/en/country/haiti/overview 6 As evidenced by the closure of the Médecins Sans Frontières (MSF) hospital in Cité Soleil on 28 February 2023. See: https://www.doctorswithoutborders.org/latest/haiti-violent-clashes-force-temporary-closure-msf-hospital-cite-soleil 7 Centers for Disease Control and Prevention (CDC). (2023, 25 January). Cholera in Haiti. https://www.cdc.gov/cholera/haiti/index.html 8 As of 28 February 2023, the Ministry of Health reported 33,661 suspected cholera cases, over 2,439 confirmed cases, and 594 deaths across the country’s ten departments. (UNICEF. (2023). Haiti. Humanitarian situation report #1. January-February 2023). https://www.unicef.org/media/139356/file/Haiti-Humanitarian-SitRep-February-2023.pdf 5 | Humanitarian Access SCORE Report: Haiti The UN estimates there are currently 5.2 million people in need in Haiti this year, with 4.9 million of those severely food insecure.9 More than 165,000 people that were displaced by gang violence have sought shelter and safety in overcrowded, often squalid makeshift encampments in Port-au-Prince,10 which increases the risk of cholera transmission. Likewise, the flooding caused by heavy rains in June, and other severe climate events anticipated with the coming hurricane season, could add to the numbers of people in need of assistance. The rise in crisis-level needs over the past few years has not been matched by humanitarian contributions, which have been inconsistent, with the average coverage of funding requirements during 2018–2022 not exceeding 30% (Figure 1a). The UN’s decision in April to scale up the response, and the evident willingness of donors to focus more attention on Haiti, has improved the total amount of funding received in 2023 to date, but coverage rates remain low (Figure 1b). Figure 1: Needs and funding a. Number of people in need vs. people targeted (millions) b. Financial requirements (USD$ millions) 6 5 4 3 People in need not targetted People targetted 0.3 0.61.3 2.8 3.0 2.4 2.5 2.0 3.2 800 700 600 500 400 Shortfall Covered 319 188 547 2 1 0.8 1.3 2.42.2 1.3 2.3 1.5 300 200 100 125 115 85 85 172 153 186 173 0 69 7730 41 0 64 2016 2017 2018 2019 2020 2021 2022 2023 Data sources: OCHA 202311 2016 2017 2018 2019 2020 2021 2022 2023 The SCORE survey of 1,011 randomised respondents across Haiti reflected the vast scope of unmet needs among the population, with 90% reporting they needed aid. Equally alarming, only 6% of those who needed aid reported having received any (Figure 2). Figure 2: Answers to “Did you need aid” vs. “Did you receive aid” 1,000 900 800 700 600 500 400 300 200 100 0 954 54 59 Needed aid Received aid 948 Yes No Data from Survey on Coverage, Operational Reach, and Effectiveness (humanitarianoutcomes.org/projects/core) 9 OCHA. (2023b). Haiti: Humanitarian response plan at a glance (April 2023). https://reliefweb.int/report/haiti/haiti-humanitarian-response-plan-2023-glance-april-2023-enht 10 International Organization for Migration (IOM). (2023, 8 June). Gang violence displaces 165,000 in Haiti, hinders aid efforts. https://www.iom.int/news/gang-violence-displaces-165000-haiti-hinders-aid-efforts 11 OCHA. (2023c). Haiti plan de réponse humanitaire 2023. Financial Tracking Service. https://fts.unocha.org/appeals/1121/summary 6 | Humanitarian Access SCORE Report: Haiti A strangled humanitarian response Crime-based insecurity, coupled with the logistical hurdles of fuel shortages, poor road conditions, and mountainous terrain, have prevented most Haitians who need it from reaching – or being reached by – critical aid. Arguably, an effective response was thwarted from the start by the absence of a single, sudden onset event to galvanise attention and action from the international community, such as the massive earthquake in 2010. Instead, the current crisis slowly and inexorably mounted as the institutions of government failed and gangs proliferated and grew in strength, filling the power vacuum. When cholera re-emerged and the Haitian authorities requested international military intervention to help restore order,12 it was undeniable that the situation in Haiti had become a fully-fledged humanitarian emergency. This was punctuated in late 2022 when gangs blockaded the port for two months, which not only prevented much required goods from entering the country but also sparked a major shortage of fuel. Nearly every person interviewed for this report mentioned the fact that the two main roads connecting the capital to rest of the country (north and south) were controlled by gangs creating major impediments to aid. The UN humanitarian coordination body activated a system-wide scale-up on 17 April and,13 by 12 May, the total number of humanitarian organisations operating in Haiti had grown to 110 (including 54 international NGOs and 33 national NGOs) – the highest number over a 7-year period (Figure 3).14 Going by the numbers in the latest humanitarian response plan, the apparent operational presence is on a similar level to other humanitarian emergency contexts reviewed as part of this research programme (Figure 4). Figure 3: Number of aid organisations and total people in need targeted for aid in Haiti 3.5 120Number of partners PIN (millions) targetted 3.2 110 3.0 100 95 80 2.4 2.2 2.5 2.3 2.5 60 40 20 55 1.3 70 61 1.3 75 74 78 1.5 2.0 1.5 1.0 0.5 0 0.0 2016 2017 2018 2019 2020 2021 2022 2023 Source: OCHA 2023 12 Prospects for a non-UN rapid reaction force to stabilise Haiti have been under discussion at the Security Council, but with no member states yet stepping forward, actions have been limited to enacting sanctions on gang leaders. 13 Inter-Agency Standing Committee (IASC). (2023). Humanitarian system-wide scale-up activations and deactivations. https://interagencystandingcommittee.org/iasc-humanitarian-system-wide-scale-activations-and-deactivations 14 OCHA. (2023a). Haiti – Operational presence. HDX. Retrieved 1 June from https://data.humdata.org/dataset/haiti-operational-presence 7 | Humanitarian Access SCORE Report: Haiti Figure 4: Number of humanitarian organisations responding in emergency contexts (2023) 250 220 200 180 Other RCM UN NNGOs 150 146135 132 126 110 100 50 0 INGOs 21 Myanmar Afghanistan NE Nigeria CAR Yemen Iraq Haiti Tigray Source: HDX OCHA 2023 3W’s While the apparent increase in humanitarian presence would appear most welcome and appropriate, the numbers may obscure the low level of access and movement these organisations have, as programmes and services have been suspended or shut down since 2022 due to the levels of violence.15 Interviewees described the pre-scale-up period as a low ebb of international assistance, citing a general lack of humanitarian actors and weak coordination. “Everyone had left post-earthquake, and it was just development and state-building that was the main focus, but there’s no state to build at the moment.” The same interviewees acknowledged the renewed efforts but expressed concern that it was proceeding “with not nearly enough presence or funding”. While some humanitarian representatives we interviewed perceived the scale-up to be making a meaningful difference in terms of aid presence on the ground, others were far more restrained in their optimism. On the positive side, the infusion of additional funding and air assets has helped expand reach to some areas that were previously inaccessible, and a revitalised humanitarian coordination system has mobilised joint access efforts and brought in experienced humanitarian staff. The major UN humanitarian agencies, an interviewee noted, “can now get everywhere”. On the other hand, the interviewee said that generally, humanitarian presence across the country “is still low”. The perception of sparse aid presence was clearly reflected in the May 2023 SCORE survey (though it is possible that at that time the public had yet to register the effects of the scale-up that had started just a month earlier). Most Haitians we surveyed (of those who had an opinion – almost a third did not) said that the presence of aid workers in their area had either stayed the same or reduced (Figure 5) and that aid was mostly not reaching where it was most needed (Figure 6). 15 Reuters. (2023, 8 March). Medecins Sans Frontieres shuts Haiti hospital amid gang violence. https://www.reuters.com/world/americas/medecins-sans-frontieres-shuts-haiti-hospital-amid-gang-violence-2023-03-08/ 8 | Humanitarian Access SCORE Report: Haiti Figure 5: Has the presence of aid providers in your area changed in the last year? 40 34% 30 20 17% 12% 10 6% 1% 0 Reduced a lot Reduced Neutral/stayed the same Increased Increased a lot Data from Survey on Coverage, Operational Reach, and Effectiveness (humanitarianoutcomes.org/projects/core) Figure 6: Does aid reach where it is needed most? 40 30 20 10 0 31% 38% 5% 8% 9% Not at all Not really Neutral Mostly yes Yes – very much Data from Survey on Coverage, Operational Reach, and Effectiveness (humanitarianoutcomes.org/projects/core) When asked to name the most present and effective aid providers, a few survey respondents were able to name groups like the Red Cross, World Vision, and the World Food Programme – but by far the most frequent response was “okenn” (none). 9 | Humanitarian Access SCORE Report: Haiti Crime at the scale of war: Prospects for negotiated access Despite an operational environment and security conditions that are routinely described by humanitarians as the worst they have ever experienced, negotiated access is not only taking place in Haiti but growing – and showing some signs of success. The assassination of President Moïse set off a wave of violence that in 2022, the highest incident year on record, claimed more than 650 victims – a 45% increase over the previous year and a seven-fold increase from 2018.16 The UN has called the situation in Haiti a “grave protection crisis”, citing an average of three kidnappings per day in 2022 and at least 807 people killed so far this year.17 UNICEF also notes that schools have been gang targets with shootings, looting, and the abduction of teachers, leading to an indefinite postponement of the start of the school year. Women and girls are at high risk of sexual violence as gangs use rape to terrorise and control populations, much the same way armed groups use rape as a weapon of war in conflict zones. The Single Health Information System (SISNU) recorded 16,470 incidents of gender-based violence in 2022.18 “Virtually every metric of insecurity, from homicide, sexual violence and kidnapping to the killing of police and migration out of the country – is trending upward.”19 Figure 7: Incidents of violence against civilians in Haiti, 2018 - 2022 700 600 500 400 300 200 100 0 94 200 344 454 657 2018 2019 2020 2021 2022 ACLED, Data export tool, 2023, https://acleddata.com/data-export-tool/ 16 Armed Conflict Location & Event Data Project (ACLED) export tool, Haiti dataset, 2023. https://acleddata.com/ 17 OCHA 2023b. 18 UNFPA. (2023). Addressing gender-based violence in Haiti. ReliefWeb. https://reliefweb.int/report/haiti/addressing-gender-based-violence-haiti-june-2023 19 Muggah, R. (2023). Haiti’s criminal markets: Mapping trends in firearms and drug trafficking. Research and Trend Analysis Branch, United Nations Office on Drugs and Crime (UNODC). https://www.unodc.org/documents/data-and-analysis/toc/Haiti_assessment_UNODC.pdf 10 | Humanitarian Access SCORE Report: Haiti Increasing violence is reflected in attacks against aid workers as well. Ten incidents were recorded in the Aid Worker Security Database (AWSD) in 2022, the highest recorded for any humanitarian context in the region. Most of the perpetrators were criminal actors but the database is only able to identify affiliations to criminal gangs in three incidents since 2020. The rest are either unidentified or unaffiliated criminal actors. Of the violence affecting humanitarians, international NGOs have experienced the largest number of reported major incidents (13 attacks and 25 victims since 2013), followed by UN agencies (11 attacks, 12 victims). National NGOs have experienced two major incidents according to the data, but this doubtless reflects under-reporting. Kidnappings, on an upward trend since 2020, make up most attacks (13), followed by shooting (4 since 2020). In one highly publicised incident in 2021, 12 international aid workers were kidnapped by a criminal group when travelling outside of Port-au-Prince (they were released after two months) – but in general most aid worker victims are Haitian nationals. Figure 8: Attacks affecting aid workers in Haiti, 2013-2022 16 14 12 10 8 6 4 2 Total kidnapped 14 Total wounded Total killed 8 3 2 2 1 1 1 1 1 1 1 1 1 1 1 0 2013 2015 2016 2017 2018 2019 2020 2021 2022 Data source: Aid Worker Security Database (www.aidworkersecurity.org) The insecurity in Haiti is extreme – but not unique among complex emergency contexts in terms of organised crime gangs being the principal driver of threat. Past research has found that while political conflict and crime overlap in many crisis contexts, humanitarians tend to think differently about the latter, “and possess fewer risk management tools for dealing with crime, defaulting to purely protective or deterrent approaches”20. However, the experience of Haiti has underscored that negotiated access is still possible, and that through highly localised programming and painstaking outreach and communication to power holders, some aid activities can be maintained, even amid an anarchic criminal environment. Negotiating for humanitarian access with armed actors who have criminal rather than political objectives is more challenging on its face. Compared to political militias, the power distribution in many criminal gangs is even more fragmented and chaotic, and alliances more tenuous. There would seem to be less compunction against targeting humanitarians as crime gangs are not concerned with political legitimacy, or paying even superficial fealty to rules of war and, after all, aid groups possess valuable resources to plunder. In political conflicts, it is possible to strike deals with opposition forces 20 Stoddard, A., Harvey, P., Czwarno, M., and Breckenridge, M.-J. (2021). Aid Worker Security Report 2021: Crime risks and responses in humanitarian operations. Humanitarian Outcomes. https://www.humanitarianoutcomes.org/AWSR2021 11 | Humanitarian Access SCORE Report: Haiti once they have consolidated control over a territory because they have a political interest in providing for the populations they control, whereas this is usually not seen among organised crime gangs unless they are at the scale of major syndicates and drug cartels. Access negotiations are made even more challenging in the Haiti context because they must take place within dense urbanised settings like Port-au-Prince and Cité Soleil as well as in the more rural provinces. As one NGO representative put it, “When you’re going to Cité Soleil, you must negotiate 34 times, one for each neighbourhood you’re visiting.” Interviewees talked about the need for intense, months-long negotiations to unlock access in some key areas such as critical road routes to the rest of the country from Port-au-Prince and the fact that access always remains fragile and has to be continuously re-negotiated. An important mitigating factor in the Haiti context however is that, unlike in some civil conflicts, aid organisations are not targeted for political reasons, and forging acceptance among communities, including those under gang control, is possible. The violence creating so much suffering in Haiti is borne of state failure and institutional breakdown rather than military conflict over control, so preventing aid from reaching populations is not pursued as a strategem. Many organisations that have been working in Haiti for a long time continue to do good work, in small remits without bunkerising or subjecting staff to any unacceptable risks. Organisations are still able to use visibility strategies (visible brands on vehicles and premises for example). Because gang members and their families live in the areas they control, that have personal and organisational incentives to allow some aid programming, which may make them amenable to negotiation. Medical services in particular are desired, despite the facilities often being the site of incidents, simply because gang members incur heavy casualties in the fighting. A staff member of a medical NGO accustomed to working in major conflict settings said that, at the beginning of 2023 in Haiti, they were “treating more gunshot wounds than anywhere else in the world”. Another NGO interviewee remarked that when they were working “We can always go in an ambulance. Usually, gangs do not oppose our presence if there is a medical situation.” 12 | Humanitarian Access SCORE Report: Haiti The information gap Information in emergencies and communication with affected people has long been recognised as vital for effective humanitarian response. This means not only that relief organisations are informed about the real-time needs and conditions of affected communities, but also that affected communities have the necessary information about available aid, safety measures, and recovery strategies. As such it is a core component in ensuring accountability to affected people (AAP). This appears to be lacking in the Haiti response, as affirmed by interviewees, and evidenced by a pattern of responses in our survey. The proportion of people responding “I don’t know” to questions about their understanding of the aid response and the obstacles to access were markedly higher than in other challenging contexts surveyed for this research programme (Figure 9). The closest comparator was in Tigray, surveyed at the height of the conflict, where a militarily-imposed communications blackout prevented people from accessing phone and internet services for long stretches. Figure 9: Percentages of survey respondents answering “I don’t know” a. What are the main obstacles to receiving aid? b. How has aid presence changed? 50 40 30 20 10 26%24% 43% 10% 7%9% 42% 16% 35 30 25 20 15 10 5 12% 13% 30% 5% 9% 16% 10% 0 Myanmar Afghanistan CAR Haiti Iraq NE Nigeria Tigray Yemen 0 Afghanistan CAR Haiti Iraq Myanmar 2% NE Nigeria Tigray Yemen Data from Survey on Coverage, Operational Reach, and Effectiveness (humanitarianoutcomes.org/projects/core) 13 | Humanitarian Access SCORE Report: Haiti Promising developments and practices Before it became a Level-3 emergency, Haiti exhibited the common features of a long-running neglected emergency, including the phenomenon of ‘access inertia’, where an under-capacitated response maintains low-scale operations within agencies’ comfort zones. The scale-up has galvanised the response effort and enhanced coordination – an essential step towards extending the reach of humanitarian aid. In addition, donor investments in air assets have allowed for movement of health and WASH supplies to regions affected by cholera. Interviewees saw substantial improvements in coordination and leadership of the humanitarian response over the last six months. An especially important development has been the establishment of the Humanitarian Access Working Group, which brings together the UN agencies and representatives of the NGOs working in the country to tackle access constraints and expand the reach of aid. The strategy, developed in May 2023, takes an area-based coordination approach, whereby agencies with a strong presence in a particular area play a key role in joint negotiations with gang leaders and community members. According to UN officials, this has allowed deliveries in previously inaccessible areas of Port-au-Prince and Cité Soleil. In addition, the UN has recently established another office for coordination and negotiations in Artibonite. A crucial focus of the strategy is to reopen the roads, allowing people and aid to get in and out. And, in the words of a UN representative, the point is not to “get access for its own sake” but always delivering aid immediately upon getting agreement – taking maximum advantage of the opportunity and reinforcing the tangible value of the negotiation. AAP and communication with crisis-affected communities has also been taken up by the Humanitarian Access Working Group, acknowledging the gap in this area and the need to significantly build up efforts, including by recruiting staff for dedicated information management officer roles. One agency has created a dedicated budget line for community engagement that includes projects such as training on humanitarian principles for civil society actors and members of armed groups, community level monitors, and expanded communication and advocacy activities. In addition to the high-level efforts coordinated by the UN, national and local NGOs, as well as international NGOs that have worked in Haiti for a long time, have managed to gain and maintain access and provide aid amid the insecurity and violence, albeit at a small scale, by: • negotiating directly with gangs and with community interlocutors, focusing on building community acceptance and the need for long-term engagement to build trust and relationships • using a highly localised programming approach, hiring all staff from the immediate vicinity • stressing the need for clear and unambiguous advocacy around humanitarian space and principles. Humanitarian practitioners in Haiti emphasised the importance of constant outreach, communication, and negotiation to make programming possible, and the need to be flexible and responsive to the local power structures. As one said, some groups are very organised, and a single channel of communication with the leader is possible, but others are more fragmented, with many points of engagement. They described some urban areas where they have to negotiate “street by street”. Interviewees noted that organisations had “really invested in building relationships at a local level” and that there was a “back to basics” focus on strategies to develop acceptance within communities. As well as negotiating directly with gangs, agencies were engaging with a range of community interlocutors, including religious figures, teachers, and business leaders. Donors saw “lots of ingenuity and creativity” from aid agencies in building acceptance and community relationships. 14 | Humanitarian Access SCORE Report: Haiti There are also some signs of revived government capacity for disaster management through the Haitian Civil Protection Agency, which has received capacity support from UN agencies, has played a role in recent earthquake and flood responses, and is starting to engage with aid actors on how to respond to displacement caused by violence in Port-au-Prince. Local actors were described by interviewees as “doing incredible work” in the face of increasingly challenging conditions. In doing so they face risks from more than just the criminal gangs; some organisations have been accused of being complicit with the criminals by virtue of trying to work in gang-controlled areas. It was seen as vital for international actors to protect and defend civil society space and to champion the work of these local organisations. Weaknesses Prior to the scale-up, Haiti was a neglected crisis in which extreme levels of violence and human misery failed to trigger a commensurate response by the international aid sector, and accountability to affected people was sorely lacking. These issues are beginning to be addressed, particularly with the inception of a new access strategy and revived cluster coordination, but much work remains to be done. Although the current crisis is yet another example of humanitarian action insufficiently replacing political action for peacebuilding and good governance, it also reveals that, when a slowly worsening crisis fails to resonate as an emergency internationally, the humanitarian machinery falls into disrepair and stagnation. The principal weaknesses observed in this study were as follows. • Lack of communication with affected people: While the deficit is now acknowledged, major public outreach is needed to communicate the aid situation alongside the campaigns to educate gang members, with at least as much emphasis. • High turnover and inappropriate profile of staff: Now that Haiti has appropriately been raised to a Level-3 emergency, all aid groups should seek to attract and deploy humanitarian professionals experienced in highly challenging environments (such as major conflict settings), and skilled in negotiation. • A lopsided approach to access and acceptance: Agencies showed a lack of engagement with the government, even as their engagement with gang leadership increased. Efforts need to continue to engage with the state on its responsibilities for law, order, and protection even if the state actors’ capacities or willingness to fulfil those responsibilities are currently still limited. Finally, there is the problem of the ‘hopelessness’ perception. The crisis in Haiti continues to be relatively neglected in terms of international attention, but any media coverage it gets tends to focus on the rampant gang violence, often overlooking the fact that aid agencies are still managing to operate despite formidable challenges. Interviewees saw a need for more effective advocacy and communications, both about the scale of need and the aid work that was taking place, refuting the narrative of Haiti as a ‘lost cause’. 15 | Humanitarian Access SCORE Report: Haiti Conclusion There are promising signs that the UN-led effort to scale up the humanitarian response is producing a better response and expanding access – but challenges remain. Agencies are stretched thin, funding against Haiti’s requirements is low, and maintaining sustained international policy attention on Haiti amidst huge competition from other crises is daunting. Importantly, however, the experience of Haiti has shown that negotiation is possible, even with highly fragmented criminal gang leadership amid high levels of general violence, and humanitarian access can be achieved by aid organisations willing to take on the difficult work and donors willing to support them and share the risks. This fact necessarily challenges the mindset that looks at the Haiti context and sees only chaos and hopelessness. As one interviewee said, “Operationally this is the most challenging environment I have worked in, with the worst general conditions, but it is absolutely possible to get access to work almost anywhere.” 16 | Humanitarian Access SCORE Report: Haiti References ACAPS. (2023). Haiti: Humanitarian impact of gang violence (02 June 2023). ACAPS briefing note. https://reliefweb.int/report/haiti/acaps-briefing-note-haiti-humanitarian-impact-gang-violence-02-june-2023 Armed Conflict Location & Event Data Project. (2023). Data export tool, Haiti dataset. Retrieved June 2023 from https://acleddata.com/data-export-tool Centers for Disease Control and Prevention (CDC). (2023, 25 January). Cholera in Haiti. https://www.cdc.gov/cholera/haiti/index.html Humanitarian Outcomes. (2023). Coverage, operational reach, and effectiveness. https://www.humanitarianoutcomes.org/projects/core InterAction. (2023). Member recommendations for the Haiti humanitarian response. https://reliefweb.int/report/haiti/interaction-member-recommendations-haiti-humanitarian-response Inter-Agency Standing Committee (IASC). (2023). Humanitarian system-wide scale-up activations and deactivations. https://interagencystandingcommittee.org/iasc-humanitarian-system-wide-scale-activations-and-deactivations International Organization for Migration (IOM). (2023, 8 June). Gang violence displaces 165,000 in Haiti, hinders aid efforts. https://www.iom.int/news/gang-violence-displaces-165000-haiti-hinders-aid-efforts Médecins Sans Frontières (MSF). (2023, 8 March). Haiti: Violent clashes force temporary closure of MSF hospital in Cité Soleil. https://www.doctorswithoutborders.org/latest/haiti-violent-clashes-force-temporary-closure-msf hospital-cite-soleil Muggah, R. (2023). Haiti’s criminal markets: Mapping trends in firearms and drug trafficking. Research and Trend Analysis Branch, United Nations Office on Drugs and Crime (UNODC). https://www.unodc.org/documents/data-and-analysis/toc/Haiti_assessment_UNODC.pdf Reuters. (2023, 8 March). Medecins Sans Frontieres shuts Haiti hospital amid gang violence. https://www.reuters. com/world/americas/medecins-sans-frontieres-shuts-haiti-hospital-amid-gang-violence-2023-03-08/ Stoddard, A., Harvey, P., Czwarno, M., and Breckenridge, M.-J. (2021). Aid Worker Security Report 2021: Crime risks and responses in humanitarian operations. Humanitarian Outcomes. https://www.humanitarianoutcomes.org/AWSR2021 UN Office for the Coordination of Humanitarian Affairs (OCHA). (2023a). Haiti - Operational presence. HDX. Retrieved 1 June from https://data.humdata.org/dataset/haiti-operational-presence OCHA. (2023b). Haiti: Humanitarian response plan at a glance (April 2023). https://reliefweb.int/report/haiti/haiti-humanitarian-response-plan-2023-glance-april-2023-enht OCHA. (2023c). Haiti plan de réponse humanitaire 2023. Financial Tracking Service. https://fts.unocha.org/appeals/1121/summary UNFPA. (2023). Addressing gender-based violence in Haiti. ReliefWeb. https://reliefweb.int/report/haiti/addressing-gender-based-violence-haiti-june-2023 UNICEF. (2023). Haiti. Humanitarian situation report #1. January-February 2023). https://www.unicef.org/media/139356/file/Haiti-Humanitarian-SitRep-February-2023.pdf USAID. (2023). Haiti – Complex emergency – Fact sheet #5. Fiscal Year (FY) 2023. https://reliefweb.int/report/haiti/haiti-complex-emergency-fact-sheet-5-fiscal-year-fy-2023 World Bank (2023). The World Bank in Haiti. Overview. https://www.worldbank.org/en/country/haiti/overview 17 | Humanitarian Access SCORE Report: Haiti Cover photo by Heather Suggitt on Unsplash Humanitarian Access SCORE Report: Haiti