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(2024) Rapò tematik ACAPS - Ayiti: Enpak konfli a sou timoun ak jèn yo (30 septanm 2024)

(2024) Rapò tematik ACAPS - Ayiti: Enpak konfli a sou timoun ak jèn yo (30 septanm 2024)

Assessment Capacities Project (ACAPS) 2024 8 paj
Rezime — Pwofil tematik ACAPS sa a evalye kijan konfli k ap ogmante ann Ayiti a afekte timoun ak jèn yo, avèk yon konsantrasyon sou Pòtoprens ak Latibonit. Li baze sou yon revizyon done segondè ak twa entèvyou ak ONG ki travay sou timoun, li dokimante yon mwayèn senk timoun ki mouri chak semèn nan premye mwatye 2024, rekritman fòse toupatou (timoun estime a 30-50 pousan manm gang yo), vyolans seksyèl k ap monte, lekòl ki fèmen, ak yon ogmantasyon prèske 20 pousan nan malnitrisyon grav ant janvye ak jiyè 2024, avèk prèske twa milyon timoun ki bezwen èd imanitè ijan.
Dekouve Enpotan
Deskripsyon Konple

ACAPS trase pwofil sitiyasyon timoun ak jèn yo nan mitan konfli ayisyen an k ap entansifye depi asasinay Prezidan Jovenel Moïse an jiyè 2021, yon sitiyasyon ki vin pi grav anpil an mas 2024 lè gang yo atake de pi gwo prizon peyi a, libere plis pase 4 000 prizonye, ansèkle ayewopò a epi fòse Premye minis Ariel Henry kite pouvwa a. Avèk 150-200 gang k ap goumen pou kontwòl ak plis pase 5,1 milyon moun (anviwon 56 pousan popilasyon an) ki ekspoze ak vyolans an 2024, rapò a konsantre sou zòn metwopolitèn Pòtoprens lan ak Latibonit, kote 73 pousan kidnapin yo rapòte te fèt ant avril ak jen 2024. Metodoloji a konbine yon revizyon done segondè ak twa entèvyou ki te fèt an out 2024 ak ONG pwoteksyon timoun, e rapò a siyale gwo twou nan done sou viktim timoun, timoun andikape ak timoun separe oswa ki poukont yo.

Konsta pwoteksyon yo grav: an mwayèn senk timoun te mouri chak semèn nan premye mwatye 2024, anviwon 500 000 timoun ap viv nan katye gang kontwole, e yo estime timoun reprezante 30-50 pousan manm gang yo, kote grangou ak pèt lekòl ap pouse rekritman an. Tifi yo sibi vyolans seksyèl ni kòm viktim vyolans baze sou jan, sitou nan sit moun deplase, ni anndan gwoup ame yo. Deplasman ap agrave risk yo: prèske 600 000 moun te deplase ant mas ak out 2024, twa fwa plis pase menm peryòd la an 2023, e anviwon 30 000 timoun òfelen te anrejistre nan mwa out 2024. Prèske twa milyon nan 4,3 milyon timoun Ayiti yo te bezwen èd imanitè ijan nan mwa jen 2024. Aksè ak edikasyon tonbe nèt, avèk anviwon 900 lekòl fèmen ak anpil lòt k ap sèvi kòm abri pou moun deplase, pandan malnitrisyon grav moute prèske 20 pousan ant janvye ak jiyè pou rive prèske 125 000 timoun, e 40 pousan etablisman ospitalye Pòtoprens yo te fèmen depi me 2024, sa ki vin ogmante vilnerabilite sante timoun yo.

Sije
SekiritePwoteksyon SosyalEdikasyonSante
Jewografi
National, Ouest, Artibonite
Peryod Kouvri
2021 — 2024
Mo Kle
children, youth, child recruitment, gang violence, child protection, gender-based violence, education disruption, malnutrition, orphans, unaccompanied children, displacement, Artibonite, series:acaps-haiti
Antite
ACAPS, UNICEF, BINUH, ACLED, Save the Children, IOM, OCHA, G9, GPèp, Jimmy Chérizier, Gabriel Jean-Pierre, Jovenel Moïse, Ariel Henry, Garry Conille, Multinational Security Support mission, Bwa Kale, USAID
Teks Konple Dokiman an

Teks ki soti nan dokiman orijinal la pou endeksasyon.

1 Any comments or questions? Please contact us at info@acaps.orgThematic profile 30 September 2024 OVERVIEW Since the assassination of President Jovenel Moïse in July 2021, conflict in Haiti has intensified, and armed gangs have taken control of large parts of the country. The situation worsened in March 2024 when gangs attacked the country’s two largest prisons, the National Penitentiary in Port-au-Prince (PAP) and the Croix-des-Bouquets civil prison, freeing over 4,000 inmates. In the same month, they also besieged the airport and forced Prime Minister Ariel Henry into exile (TNH 26/06/2024; ACLED 06/03/2024; InSight Crime 27/05/2024). The escalating violence has aggravated the already dire conditions of poverty and political instability facing civilians. ACLED estimates that over 5.1 million people (around 56% of the population), including children, will continue to be exposed to violence throughout 2024 (ACLED 07/08/2024) . The area most affected by violence and insecurity is the capital city, the Metropolitan Area of Port-au-Prince (including communes in Carrefour, Cité Soleil, Delmas, Pétion-Ville, PAP, and Tabarre), where the population has decreased significantly because of massive displacement towards other areas of the country (Flowminder Foundation 03/05/2024). In March 2024 alone, 300,000 people (more than 10% of its pre-March population of 2,980,000) left the city because of insecurity (MT accessed 16/09/2024; Mercy Corps 27/08/2024). Artibonite department is also among the most affected areas; between April–June, at least 312 (73%) of the 428 reported kidnappings countrywide occurred in the department (BINUH 30/06/2024). While exact figures on the number of children affected by violence are not available, the recent developments in the country have significantly affected the protection, shelter, education, and physical and mental health needs of civilians, including children. Increased food insecurity and malnutrition, a cholera outbreak, and the current hurricane season compound this situation. In June 2024, nearly three million children (out of a total of 4.3 million children countrywide) were in urgent need of humanitarian aid (WCP accessed 20/09/2024; UNICEF 15/06/2023). KEY MESSAGES • The increasing conflict in Haiti poses severe protection risks for children, with an average of five children killed per week in the first half of 2024. They face violence from several perpetrators, including armed gangs and self-defence brigades (armed civilians aiming to protect people from these gangs) (AJ 28/03/2024; ICG 03/07/2023). • Children are at high risk of forced recruitment into armed gangs, sexual abuse, and other protection threats. Women and girls are at particularly high risk of gender-based violence (GBV), especially in IDP communities. • Education access is limited because many schools are serving as IDP centres. At the same time, insecurity is preventing many children from going to school. • There is limited information on unaccompanied and separated children, but the increase in internal and cross-border displacement is separating children from their families. • Severe acute malnutrition among children increased by almost 20% between January– July 2024, with nearly 125,000 Haitian children facing severe acute malnutrition in July. • Increased malnutrition, violence, and poor WASH and health access, which has resulted in decreased vaccination rates, heighten children’s vulnerability to injury and waterborne, vector-borne, gastrointestinal, and other diseases. Children have limited healthcare access, with 40% of inpatient facilities in PAP closed since May 2024 because of insecurity. About this report Aim: the report aims to provide an overview of the humanitarian needs and risks children are facing given the escalating violence in Haiti. While mainly covering the escalation of conflict in 2024 and its impact on children, the report also provides contextual information. It covers the situation across the country, with a particular focus on Port- au-Prince (Ouest department) and Artibonite, where the conflict has been most severe. Methodology: the report is based on a secondary data review. This is complemented by three key informant interviews conducted in August 2024 with NGOs focused on children’s needs and protection at the national and regional levels. HAITI Impact of conflict on children and youth Thematic report | 30 September 2024 2 RECENT DEVELOPMENTS • Until 23 September 2024, the country remained in a state of emergency, which was declared on 17 July in PAP and extended on 4 September to cover the entire country (US DOS accessed 27/09/2024; BBC 05/09/2024; Jamaica Observer 21/08/2024; Reuters 05/09/2024; ACLED 12/08/2024) . In 2024 alone, the country has declared two states of emergency: one in February, which lasted until April, and this recent one in July, which was extended in September and remains active (OCHA 24/04/2024; AJ 08/03/2024). • On 18 September, the Government established an electoral council comprising journalists, activists, representatives of farmers, religious communities and unions, and government officials. This council aims to develop the legal framework to hold elections in 2026 (Reuters 19/09/2024; AJ 19/09/2024). Democratic elections can be a step forward for Haiti, which has been without elections since 2016, but they can also generate tension and clashes between different groups interested in gaining political control of the country. This also implies a risk of increasing humanitarian needs for civilians, including children. • Around 600 Kenyan police officers have been deployed in Haiti between June–July 2024 under a Multinational Security Support (MSS) mission to address gang violence (Africanews 16/07/2024). On 12 September, Jamaican soldiers were deployed to Haiti to back up the Kenyan police (AP 12/09/2024; ABC 12/09/2024). Since July, the Kenyan police have concentrated on crucial defence duties, including the protection of key infrastructure, such as airports and oil terminals (FEWS NET 31/07/2024). • Starting in April 2024, gang violence appeared to decrease, until ransom kidnappings and attacks on civilians surged in July as armed gangs sought to reinforce their resources and strengthen their capacity to challenge the MSS mission (ACLED 12/08/2024). As a result, forced child recruitment into armed gangs has increased significantly (BINUH 30/06/2024). • On 5 July, Jimmy ‘Barbecue’ Chérizier, leader of Fòs Revolisyonè G9 an Fanmi e Alye (G9 gang), publicly announced intending to lay down arms to facilitate national dialogue. On 25 July, he signed a peace treaty with the Government (EFE 06/07/2024; Kenyans 26/07/2024). There is little information about the implementations of this treaty; until 21 September, violence persisted, with reports indicating that armed gangs continued to block roads, burn homes and police stations, loot businesses, and commit acts of murder and kidnapping (DW 21/09/2024). • Appointed Prime Minister Ariel Henry left the country on 11 March and formally resigned on 25 April because armed groups threatened him and blocked his return to the country. Gary Conille, a former senior UN official, was appointed to replace Henry on 3 June (Brookings 12/07/2024; BBC 26/04/2024). Further information on Haiti’s political and contextual information is available in ACAPS’ Haiti: Criminal Gang Violence in Port-au-Prince . TERMINOLOGY Armed gangs are criminal groups that primarily seek to control urban areas. They are estimated to dominate 60% of PAP (AJ 13/03/2024). The most prominent is the G9 gang, a federation of nine powerful gangs in the city led by Jimmy ‘Barbecue’ Chérizier, a former police officer. G9 has previously been linked to past politicians as enforcers and supporters of certain governments. Their main rival is GPèp, another gang federation headed by Gabriel Jean-Pierre, mononymously known as ‘Gabriel’. Another notable group is the 5 Seconds gang. These armed gangs engage in extortion, kidnappings for ransom, and the seizure of buildings and public services (such as electricity and water), for which they demand payment for access (AJ 13/03/2024; InSight Crime 21/03/2023).  Self-defence brigades are armed civilians who aim to fill the security void left by a lack of police in some areas of the country and neighbourhoods of PAP. They have been responsible for some mob killings – the violent act of a group of people executing or attacking an individual under the pretext of administering justice – against suspected gang members (AJ 28/03/2024; ICG 03/07/2023) . Unaccompanied children are children who have been separated from both parents and other relatives and are not under the care of an adult legally or traditionally responsible for them (ICRC 01/2004). Separated children are children separated from both parents or their previous legal or customary primary caregiver but not necessarily from other relatives, meaning they are not necessarily unaccompanied (ICRC 01/2004). Orphans include any child under the age of 18 who has lost one or both parents to death. (STC 2007). Thematic report | 30 September 2024 3 CONTEXT Haiti has experienced a series of unstable governments that has strengthened the control of armed gangs over the country. It is estimated that between 150–200 armed gangs dispute territorial and social control in Haiti (UN 04/04/2024; AJ 13/03/2024). The situation has been particularly severe in PAP, Artibonite, and the southwestern communities of Carrefour and Gressier, where gangs exert significant control and influence (HT 26/08/2024; Le Monde 26/08/2024) . Political instability deepened in 2016 when Haiti entered a political vacuum resulting from allegations of fraud against prime minister candidate Jovenel Moïse. His election sparked mass protests, and he was assassinated in 2021. Since then, two prime ministers have led the country: Ariel Henry and Gary Conille (CFR accessed 27/09/2024; ICG 23/05/2024). While democratic elections are anticipated in 2026, the current political instability and lack of coordinated authority have empowered armed gangs, severely affecting the safety, health, and development of children and creating a long-term impact on their future. Map 1. Reference map of Port Au Prince and Artibonite in Haiti Source: ACAPS using HT 26/08/2024 Displacement The increasing control of armed gangs has resulted in heightened insecurity and violence, which has been the main driver of displacement. Between March–August 2024, the violence displaced nearly 600,000 people (including children), which is three times higher than the same period in 2023 (OCHA 26/08/2024). The population of PAP has been decreasing as people leave because of the concentration of gangs in the city. In June 2024, around 80% of IDPs were residing with host families, and 20% were sheltering across more than 110 IDP sites, many of which were in schools (USAID 06/09/2024). Cross-border displacement to the Dominican Republic, the US, and other countries is also increasing. This displacement is separating families; in many cases, this includes the separation of children from their parents (KII 08/08/2024; VOA 05/04/2024; Le Monde 10/03/2024). There have been reports of the deportation and forced return of unaccompanied minors to Haiti, exposing them to human trafficking, sexual abuse, and other protection risks. Deported and repatriated children usually lack support networks when they arrive, besides facing violence, child recruitment, educational disruption, and psychological trauma (Al Momento 30/08/2024; El País 28/08/2024; BBC 29/08/2023; USCRI 06/06/2024) . Limitations/information gaps There are discrepancies in the exact mortality rate in Haiti. According to the UN, there were more than 4,700 homicide victims across the country in 2023, while an independent survey reported more than 2,300 violent deaths in Cité Soleil alone in the same year. ACLED recorded 1,980 reported fatalities countrywide in 2023 (MSF 07/03/2024; ACLED 17/01/2024). The figures are likely even higher, with insecurity limiting the gathering of information in the country. It is also uncertain how many of the fatalities were children. 2024 figures also vary depending on the source. Between 1 April and 30 June 2024, BINUH documented 1,379 victims of killing and injury, as well as 428 victims of kidnapping. Men represented 77% of victims of killing, injury and kidnapping, women 20%, and children 3% (BINUH 30/06/2024). There are no disaggregated figures of the kidnapping and injury of children in Artibonite, PAP, and countrywide. There is little to no information on children with disabilities and little information on separated and unaccompanied children. Thematic report | 30 September 2024 4 PROTECTION IMPACTS ON CHILDREN AND YOUTH Violence An estimated 500,000 children in Haiti are living in neighbourhoods under the control of armed groups, putting them at higher risk of violence and child recruitment (UNICEF 04/06/2024). Children are at risk of violence from diverse perpetrators, including armed gangs and so- called self-defence brigades, mostly in neighbourhoods of PAP (KII 01/08/2024; HL 03/04/2024). Between January–June 2024, an average of five children died from the violence per week. Many were killed or injured by stray bullets, but others were targeted because of their suspected support for rival gangs or perception as police informants (STC 13/08/2024). Gangs are also increasingly recruiting children to participate in criminal activities (BINUH 30/06/2024 and 11/03/2024) . The actual number of child casualties is expected to be significantly higher because of the underreporting of casualties. It is uncertain how many cases of kidnapping countrywide involve children. Minors who leave armed gangs or are suspected of belonging to them face other significant protection risks, such as torture, degrading treatment, and stigma. Children face a high risk of killing, kidnapping, or torture, particularly in territories with the presence of armed gangs or self-defence brigades (KII 08/08/2024). Forced recruitment The exact number is unknown, but between 30–50% of children in Haiti are involved with armed groups (KII 08/08/2024; UNICEF 04/06/2024). Humanitarian responders suggest that the recruitment of minors to armed gangs is increasing after the deployment of the Kenyan and Jamaican MSS troops (KII 08/08/2024). Armed gangs recruit children to reinforce their ranks and solidify their role and legitimacy within communities. They offer children enlisted as soldiers work and social recognition and often distribute food or cash to their communities to gain validation and legitimacy (GITOC 24/07/2024). There is no disaggregated information on how many of the recruited children are boys or girls, but the impact of recruitment is gendered. Boys are used as fighters more frequently than girls. Some girls and boys are used as key informants, collecting information from the national police, Kenyan army, Jamaican army, and other armed groups. They are also assigned various small tasks and duties, such as buying groceries (KII 01/08/2024; KII 08/08/2024). At the same time, there are testimonies and reports of girls joining armed groups to avoid sexual violence but who nonetheless face sexual assault upon integration into the armed groups (KII 08/08/2024). Child recruitment contributes to a cycle of violence in the country, and there is a risk that many affected children may grow up to become combatants and perpetuate further violence. Separated, unaccompanied, and orphaned children The violence has resulted in many children becoming separated, unaccompanied, or orphaned and dependent on aid organisations. These children are highly exposed to protection risks, such as forced recruitment, forced labour, and sexual and psychological abuse (UNICEF 02/07/2024). As of August 2024, there were approximately 30,000 orphaned children registered in Haiti, some of whom had lost both parents while others had only one parent who could not take care of them (Heartline Haiti 10/08/2024; Lumos 09/10/2017). In 2023, there were 750 orphanages in Haiti, over 500 of which were in PAP alone. The exact number of orphans in PAP and Artibonite is unknown (AP 12/06/2023; Ashley et al. 13/11/2019). There is little information on separated and unaccompanied children in Haiti, their needs, and the impact of conflict in their lives. According to local organisations, most unaccompanied children tend to be on the borders of Haiti. Being alone makes them more vulnerable to forced recruitment from armed gangs and sexual violence (KII 08/08/2024). Unaccompanied and separated children are often displaced in situations with little access to services, such as education, healthcare, nutrition, and safe spaces (UNICEF 02/07/2024). Detention By the end of June 2023, the Centre for the Rehabilitation of Minors in Conflict with the Law, located in the commune of Delmas (part of the Metropolitan Area of Port-au-Prince), became the only functional detention centre in the capital after gang attacks on the National Penitentiary in PAP and the Croix-des Bouquets prison in early March 2024. Since then, new inmates arrested in the capital have been held in this centre. By June, it had reached four times its capacity, with 230 inmates sharing a space built to accommodate only 60 minors. Currently, there are adults (men and women) detained with minors (boys and girls) in the same compound (BINUH 30/06/2024). These overcrowded conditions increase protection risks, particularly for boys and girls, whom adults in detention are likely to attack or harass. There is also an increased risk of sexual violence. Thematic report | 30 September 2024 5 Gender-based violence Sexual violence is often used as a weapon of war, mainly as a tactic to instil fear and seize social and territorial control (UNFPA 26/06/2024). Around 1.2 million women and girls need protection from GBV (UNFPA 28/03/2024). Since June 2024, different international and regional NGOs have expressed concerns about increasing cases of sexual violence against women and girls in several neighbourhoods and IDP sites in PAP. Groups of armed men often attack women and girls as they travel on foot or by public transport to get to work or school. There have been cases of children as young as three years old being raped in their homes or IDP sites (BINUH 30/06/2024). The consequences for children can be severe, including unwanted pregnancies, sexually transmitted infections, and mental health issues, such as depression and anxiety. Girls are frequently forced to drop out of school, resulting in social exclusion and limiting their future opportunities (STC accessed 13/09/2024; IRC 22/08/2023). From January–May 2024, 839 (over 20%) of the 3,949 survivors of reported GBV incidents across the country were minors (796 girls and 43 boys) (Protection Cluster/MCFDF 25/07/2024). Between April–June, humanitarian organisations reported receiving an average of 40 rape survivors (not only children) per day in PAP alone (BINUH 30/06/2024). Most GBV survivors are IDPs (43% living in the community and 18% in displacement sites). Between January–May, 66% of the cases were perpetrated by armed gang members and 45% by someone in the same household (Protection Cluster/MCFDF 25/07/2024). The number of sexual abuse cases is likely higher given the underreporting of GBV cases, mainly out of fear of being revictimised and stigmatised and the lack of an effective justice system (KII 08/08/2024; UNFPA 26/06/2024) . Access to health services after sexual violence is scarce in Haiti. According to the GBV Cluster, from January–February, only 3% of rape cases (including adults and minors) were treated within 72 hours of the incident because of access constraints, a lack of medicine, and inadequate resources to support case management and referrals (OCHA 25/03/2024). There are many challenges for survivors, including the insecurity in the country blocking access to safe spaces, the inadequacy or absence of care facilities, and the lack of trained staff. Some survivors do not press charges for fear of reprisal. Legal services are expensive, and there are no resources to support the courts (Protection Cluster/MCFDF 25/07/2024). SECONDARY IMPACTS Education By June 2024, approximately 156,000 students had already lost a substantial portion of their academic year because of school closures and violence. Some of these children have experienced education disruptions on several occasions – such as in 2020 because of the COVID-19 pandemic and in 2022, when gang-related violence blocked education access for 500,000 children (UNICEF 06/05/2022). Many schools in the capital city remain either closed or inaccessible because of gang violence (UNICEF 06/05/2022). By 11 September 2024, at least 919 schools in Artibonite and western departments had been closed since January. Many schools also serve as IDP sites, while others are under the control of gangs as coordination bases or housing (UN 11/09/2024; OCHA 27/08/2024; EI 26/04/2024) . Even when education is available in some areas of the country, children struggle to focus and concentrate because of trauma and a lack of sleep from sleepless nights punctuated by gunfire (AP 12/05/2024). The new school year was delayed from September, and is expected to start on 1 October. By 14 September, humanitarian responders and the Haitian authorities were still trying to find a relocation site for IDPs, as around 30 schools in PAP were being used as IDP shelters (OCHA 14/09/2024 and 27/08/2024). If the Government is unable to relocate IDPs and violence persists, it is likely that education in PAP will continue to be disrupted for many children (VBI 17/09/2024). Those that will be able to attend school are expected to face overcrowded classroom conditions, with some classes expected to double the number of students to 80 (STC 26/09/2024). There are some online courses available for children unable to attend school, but these are only accessible to those who can afford Wi-Fi and a generator. Most Haitians spend a lot of time in the dark without electricity because of chronic power outages (AP 12/05/2024). Disruptions to education also prevent children’s access to school feeding programmes implemented under the Government’s national school feeding policy and strategy (WFP 15/03/2024) . WFP, the largest implementer of this programme, was providing school meals to 420,000 children across Haiti until 29 January 2024 (WFP 29/01/2024 and 02/04/2024; MENFP 01/2016) . The exact impact of increased insecurity since March on this programme is unclear, although WFP reported providing 163,500 children with school meals that month, representing a reduction from January that may be attributable to the increased insecurity (WFP 16/04/2024). It is likely that access to meals has drastically decreased because of the school closures resulting from insecurity, leaving children without reliable sources of nutrition. Thematic report | 30 September 2024 6 Education is often a coping mechanism for children to escape violence, meaning school closures further constrain their ability to cope. The lack of education is expected to have a long-term impact not only on children but also on the country’s development and economic growth (KII 01/08/2024; UNICEF 06/05/2022). It has also forced some children to start working to support their families, with an increase in cases of forced child labour being observed countrywide at a rate of 13% (PI 19/08/2024). Other children have been forced to join armed gangs, as was the case in 2022 when violence also increased (UNICEF 06/05/2022). Mental health and psychosocial needs The effects of war on children are both physical and psychological, with trauma from conflict often having long-lasting consequences. Children and adolescents have reported feeling unsafe in shelters and experiencing anxiety and fear because of violence, threats, and attacks from armed groups. They are also increasingly worried about robberies, kidnappings, and disappearances linked to human trafficking (KII 08/08/2024; PI 19/08/2024). Children who have survived sexual abuse and family separation are also in need of psychosocial support (UNFPA 26/06/2024). Many children have been exposed to the violence, and it has become normalised in their lives, causing trauma, agitation, and the belief that violence is acceptable. This pattern is likely to perpetuate generational violence (KII 08/08/2024; AP 12/05/2024). There is a shortage of humanitarian aid for mental health and psychosocial support to address the current needs of communities (KII 08/08/2024). The lack of health workers prevents children from accessing proper care and causes further mental health issues and trauma; in September alone, OCHA registered 3,493 newly displaced children (including 2,264 girls) in need of psychological support (OCHA 14/09/2024). AGGRAVATING FACTORS Food insecurity and malnutrition Map 2. Projected mapping of food insecurity from October 2024 to January 2025 Source: FEWS NET (31/07/2024) Thematic report | 30 September 2024 7 In March 2024, 50% of the population (around five million people) faced Crisis (IPC Phase 3) or worse acute food insecurity levels. 1.6 million of these faced Emergency (IPC Phase 4) levels (WFP 26/08/2024; IPC 22/03/2024). Almost 125,000 children experienced severe acute malnutrition in July, a 20%  increase compared with the start of the year (FAO 11/09/2024). The areas facing the highest food insecurity are also the same ones more affected by violence, such as Artibonite Valley, rural Grand’Anse, La Gonave, the transverse part of Ouest department, and some neighbourhoods of Cité Soleil, Croix-des-Bouquets, and PAP (IPC 22/03/2024). According to testimonies, many people are able to eat only once a day (PI 19/08/2024) . Food insecurity increases children’s vulnerability to diseases and hampers their ability to learn as they struggle to stay awake and alert. This issue affects both their physical and psychological health, as well as their overall development (Gallegos et al. 26/08/2021). Since February, increasing insecurity has constrained the delivery of aid, particularly food. This has significantly increased communities’ vulnerability to food insecurity and malnutrition, affecting not only urban but also rural areas that have also come to host IDPs (FAO 10/09/2024). Some farmers have had to abandon their land, especially in Artibonite, because of escalating violence. This has reduced agricultural production and the distribution of goods, in particular, supplies to markets (USAID 06/09/2024; FEWS NET 31/07/2024). Health Healthcare access, particularly in PAP, remains extremely limited. Many hospitals have closed or reduced their operations because of medicine and staff shortages (UNFPA 26/06/2024). According to the Ministry of Health, 40% of facilities providing beds for patient care in PAP, including the country’s main university hospital, have closed since May 2024 because of insecurity and looting by armed gangs (UN 01/07/2024). Organisations have been delivering some vaccines, but insecurity across the country prevents children from accessing vaccination and other health services (UNICEF 27/08/2024). This can increase the risk of vaccine-preventable diseases, such as measles, whooping cough, diphtheria, tetanus, Haemophilus influenzae type b, and hepatitis B. The lack of access to antenatal care and safe delivery facilities raises the risk of maternal complications and increases neonatal mortality. According to UNFPA, the closure of hospitals and health facilities has left approximately 3,000 pregnant women in the capital city without maternal health services, while over 84,000 pregnant women nationwide are unable to access secure health services. This situation endangers both women and their babies. Many are at risk of complications and need emergency obstetric care, including Caesarean sections that can only be performed in health facilities (UN 28/06/2024U; UNFPA 28/03/2024). Living in conflict also affects infant feeding because stress and poor nutrition can affect a mother’s capacity to breastfeed. Around 26,800 pregnant and breastfeeding women face acute malnutrition across the country (IPC 08/03/2024). Haiti has been dealing with a resurgence of cholera since October 2022. Between January– July 2024, the country reported over 2,670 cases of the disease and 13 related deaths (WHO 15/08/2024) . In August 2024, there were over 88,000 suspected cases of cholera countrywide. Since October 2022, when the country declared the current cholera outbreak, there have been over 86,600 suspected cases, 4,800 confirmed cases, and 1,300 deaths, mostly in Grand’Anse, Nippes, Ouest, and Sud-Est departments (UNICEF 27/08/2024). Children who experience malnutrition are usually more vulnerable to illness as their immune systems may be weaker. In the first month of the cholera outbreak, children under the age of 14 accounted for almost half of the 1,700 suspected cases (UNICEF 24/10/2022). The risk of cholera and waterborne diseases increases between August and mid-November, when the country is expected to experience light to moderate rain (FEWS NET 04/09/2024; ClimeChart accessed 10/09/2024) . Hurricane and exposure to climate hazards The country’s exposure to environmental hazards aggravates the situation, with more than 96% of the population exposed to natural hazard-related shocks. Some communities are still recovering from previous shocks, such as the magnitude-7.2 earthquake that hit in 2021 (Dawn 13/09/2023). In September 2024, the country experienced rainfall deficits between 5–60% of the average in northern and southern Haiti, which is likely to affect crops and vegetation (FEWS NET 19/09/2024). Haiti is poorly prepared for and lacks effective mitigation strategies for extreme weather events. Having already experienced heavy rainfall in the early months of 2024, the country is at heightened risk during the current hurricane season, which extends through November in the Caribbean. In October, the country is forecast to experience around 17–25 weather- related events (including four to seven hurricanes) (FAO 10/09/2024; IRI accessed 27/08/2024). The current insecurity and instability make displaced people, including children, more vulnerable to the effects of climate hazards (STC 20/06/2024). Exposure to climate events can have a negative impact on children’s health. Hurricanes and other extreme weather events can lead to physical injuries or increase the incidence of diseases, such as diarrhoea, dengue fever, and malaria. Extreme events usually affect crops and cattle, reducing household incomes and frequently causing food prices to rise. This often affects household food security and children’s nutritional intake (ODID 01/06/2023). Thematic report | 30 September 2024 8 Poverty Haiti remains the poorest country in Latin America and the Caribbean and among the poorest in the world (WB accessed 27/09/2024). People are highly reliant on remittances for food (PI 19/08/2024) . Haiti’s deep poverty facilitates convincing children to take up arms or work as informants or armed group members (The Guardian 23/08/2024). RESPONSE CAPACITY AND ACCESS CONSTRAINTS • Numerous checkpoints set up by heavily armed gangs along National Roads 1, 2, and 3 constrain access in PAP and Artibonite (BINUH 30/06/2024). This limits the humanitarian response to civilians, including children. • There are many challenges that constrain access to children recruited by armed gangs. Armed groups usually do not allow humanitarian assistance, mostly in Artibonite and some areas of PAP (KII 08/08/2024). That said, some humanitarian responders have been able to negotiate with various gangs for access to children and to sensitise them about violence prevention and recruitment (KII 01/08/2024). • Radio is the primary source of news, with numerous regional and privately owned stations available. The sponsorship of private entities, however, can be detrimental to the objectivity of information, as their interests can influence news. At the same time, journalists face threats and other challenges to information gathering in all areas of the country (BINUH 30/06/2024; BBC 21/05/2024; VOA 05/04/2024). • Judicial personnel have faced intimidation and attacks, impeding their ability to perform their duties and compromising their neutrality. Between April–June, at least five judges and lawyers were killed or injured in Artibonite and Nord departments (BINUH 30/06/2024). Insufficient security for judicial personnel hinders the documentation of child protection processes and restricts access to information. • Professionals and highly skilled workers have started to leave the country because of insecurity and a lack of opportunities. This represents a challenge for humanitarian organisations that need to recruit staff. In the Nord-Est department, there are not enough health workers, and hospitals are closing because of the lack of staff (KII 08/08/2024). In 2023, there were at least 40 incidents of violence against healthcare staff and facilities, and 30 health workers were kidnapped (Insecurity insight 02/09/2024). • There are over 157 humanitarian organisations countrywide, many of these are present simultaneously in several departments, 104 are present in Ouest department, and 39 in Artibonite. By 2 September, only 35% of the OCHA humanitarian response plan for Haiti was funded, meaning USD 437 million was still needed to cover all the humanitarian needs of the targeted people (OCHA 02/09/2024 and 09/09/2024; OCHA 27/07/2024). UNICEF also reported a funding gap of over USD  182 million to respond to different children’s needs, including protection (UNICEF 27/08/2024).