(2020) Humanitarian Action for Children 2020: Haiti

© UNICEF Haiti/2019/Fanfan 2020 Haiti www.unicef.org/appeals/haiti Humanitarian Action for Children Total people in need 4.6 million10 Total children (<18) in need 1.9 million11 Total people to be reached 648,20012 Total children to be reached 366,00013 Haiti continues to face multiple crises, including worsening food insecurity and malnutrition, the Haitian-Dominican migration situation,1 water-borne disease epidemics and high vulnerability to natural disasters. The situation further deteriorated in 2019 due to the unstable and fragile economic, political and social contexts and recurring civil unrest, which culminated in a countrywide shutdown in September that may lead to increasing needs in 2020. An estimated 3.7 million Haitians are food insecure and over 65,500 children under 5 years are affected by acute malnutrition.2 More than 850,000 vulnerable people require access to primary health care, including maternal and child health services.3 With an estimated 202014 programme targets 10,000 Haitians denied entry to and deported from the Dominican Republic every month,4 the Nutrition Haitian-Dominican migration situation remains a concern. Given their legal and social status, 11,000 children aged 6 to 59 months children who have been denied entry or expelled may not be able to access services and are treated for severe acute malnutrition vulnerable to violence and exploitation. The cholera epidemic is on the decline, with no 55,000 children aged 6 to 59 months confirmed cases since February 2019, and an 80 per cent decrease in suspected cases since 2018.5 However, continuous progress is required to maintain zero cases, declare the complete treated for moderate acute malnutrition elimination of cholera and hand cholera prevention and control over to the Government. Health 336,000 children under 5 years Humanitarian strategy Results from 2019 vaccinated against measles In 2020, UNICEF will strengthen national As of 31 August 2019, UNICEF had US$10.7 78,000 pregnant women attending at least capacities to manage acute malnutrition, million available against the US$23.9 million two prenatal visits improve infant and young child feeding and appeal (44 per cent funded).6 In support of WASH prevent micronutrient deficiencies among the Government's Plan for Cholera 450,000 people accessing a sufficient children in Haiti. UNICEF will continue to Elimination, UNICEF supported rapid quantity of safe water for drinking, cooking support the Government's Plan for Cholera response teams and community awarenessand personal hygiene Elimination 2013–2022 through a revised raising, benefiting over 170,000 people, with 200,000 people reached with response strategy focused on surveillance and zero confirmed cases in the country since handwashing behaviour change coordination, water, sanitation and hygiene February 2019. More than 7,000 children and programmes (WASH) prevention and rapid response to nearly 300 teachers benefited from WASH 20,000 people accessing appropriate diarrhoea cases. Humanitarian WASH rehabilitation in schools damaged by the sanitation facilities activities will include the distribution of October 2018 earthquake; over 2,900 children household water treatment products, hygiene received psychosocial support; and some Child protection promotion, water trucking and temporary 8,000 children resumed school in equipped 28,000 child victims and/or children at risk sanitation. Protection assistance will be temporary learning spaces. In response to the receiving case management, mental provided to children suffering from abuse, countrywide shutdown of February health and psychosocial support exploitation and family separation due to 2019,7 8,000 people benefited from water 1,400 unaccompanied and separated natural disasters, insecurity and/or trucking in Cornillon (West) and nearly 860 children accessing family-based care or migration. Schools will be adequately people benefited from water trucking and appropriate alternative services equipped and alternative learning household water treatment. Over 190 solar programmes will target migrant children refrigerators were installed to support the Education returning to Haiti. UNICEF will maintain national cold chain system.8 Nearly 16,600 30,000 children aged 5 to 14 years, contingency agreements with several partners children under 1 year were vaccinated against including children repatriated from the and stocks of pre-positioned supplies to measles in the South. UNICEF covered 90 Dominican Republic, receiving individual respond to humanitarian situations as they per cent of the country's therapeutic nutrition learning materials arise. UNICEF will support the Government to commodity needs, reaching over 18,300 strengthen humanitarian coordination and children under 5 years suffering from acute Cholera disaster preparedness and response, focusing malnutrition. Over 34,000 children received 115,300 people reached by the cordon on mainstreaming climate change learning materials. Lack of funding hampered sanitaire provided by the rapid response adaptation. To enhance efforts to prevent the delivery of protection services for children teams sexual exploitation and abuse, UNICEF will affected by migration, as well as community strengthen systems for reporting, as well as management of acute malnutrition, WASH survivor assistance, accountability to affected shield activities9 and education. populations and capacity building of staff and partners, focusing on emergency preparedness. Sector 2019 targets Sector results UNICEF 2019 targets UNICEF results 6,500 8,526 6,500 8,526 13,000 9,876 13,000 9,870 35,000 37,000 16,568 5,580 NUTRITIONi Children aged 6 to 59 months treated for severe acute malnutrition Children aged 6 to 59 months treated for moderate acute malnutrition HEALTH Children under 1 year vaccinated against measlesii Pregnant women who attended at least two prenatal visitsiii CHOLERA People reached by the cordon sanitaire provided by the rapid response teams Suspected cholera cases identified and responded to within 48 hours with a complete WASH package WATER, SANITATION AND HYGIENEvi People accessing a sufficient quantity of safe water for drinking, cooking and personal hygiene People reached with handwashing behaviour change programmes People accessing appropriate sanitation facilities CHILD PROTECTION Unaccompanied and separated children accessing family-based care or appropriate alternative services Child victims and/or children at risk receiving case management, mental health and psychosocial support People in four at-risk communities reached with key messages on child protectionviii EDUCATIONx Children aged 5 to 14 years, including children repatriated from the Dominican Republic, receiving individual learning materials Children aged 5 to 14 years accessing formal education through rehabilitation and/or equipping of schools 333,000iv 170,175v 333,000 170,175 95% 92% 95% 92% 525,000 17,839 350,000 16,339 225,000 60,000 8,983 8,983 150,000 40,000 7,483 7,483 1,800 298 800 0vii 7,125 2,918 3,300 2,918 10,000 8,012 5,000 7,549ix 87,300 36,818 30,000 34,601 11,520 13,942 5,000 7,929 * Results are through 31 August 2019 unless otherwise noted. i Pending the finalization of the 2020 Humanitarian Response Plan (HRP)/Humanitarian Needs Overview (HNO), the nutrition sector target is the same as the UNICEF target as UNICEF is the only agency providing assistance on acute malnutrition and micronutrient deficiencies. While the original HRP/UNICEF target for severe acute malnutrition treatment represented 50 per cent of the expected caseload, overachievement reflects the growing caseload due to the negative impact of the socio-economic crisis on poor households, and the worsening food insecurity and nutritional status of children. ii Vaccinations include measles and rubella, polio, Bacillus Calmette-Guérin, diphtheria, tetanus and pertussis, poliomyelitis and haemophilus influenza. iii This covers institutional visits only as mobile clinics have stopped since the end of 2017 (Hurricane Matthew). iv The sector targets for cholera are the same as the UNICEF targets as UNICEF is the lead agency on the cholera rapid response in support of the Government. v The underperformance on the cholera cordon sanitaire indicator is due to an 80 per cent decrease in the number of suspected cases requiring a rapid response. vi WASH interventions focused on preparedness as the need for response due to natural disasters was much less than the original planning targets. vii Since there were no large-scale natural disasters in Haiti in 2019, the need for robust emergency assistance for unaccompanied and separated children has been limited. Though civil society actors continue to report arbitrary expulsions at the border, underfunding has continued to limit UNICEF's protection services for unaccompanied and separated children at the border. Funding from the European Union is in the pipeline to support activities at the border, including care for unaccompanied children. viii This indicator corresponds to the 2019 HRP indicator "At-risk departments reached with key messaging on child protection." ix The overachievement is due to additional awareness-raising activities in urban settings following increased gang violence, which was not included in the HRP and UNICEF targets. x Due to an increase in available funding, notably for the 2018 earthquake response, UNICEF was able to reach more beneficiaries than initially planned. Thus, results exceed targets. Funding requirements In line with the Haiti HRP 2019–2020, UNICEF is requesting US$18.6 million to meet the humanitarian needs of children in Haiti in 2020. Funding is urgently needed to treat the rising number of children suffering from acute malnutrition; maintain support to the Plan for Cholera Elimination; strengthen routine vaccination and antenatal care in the southern departments; conduct essential WASH emergency and resilience work; provide protection and assistance to children being repatriated or expelled from the Dominican Republic and those affected by natural disasters; and strengthen emergency preparedness in all sectors. Sector Nutrition Health Water, sanitation and hygiene Child protection Education Cholera Total 2020 requirements (US$)15 3,000,000 2,200,000 4,400,000 2,986,000 2,000,000 4,000,000 18,586,000 1 Dominican Constitutional Court TC168/13 (2013) indicates that those born in the Dominican Republic between 1929 and 2007 to migrant parents in irregular conditions are no longer considered Dominicans and are at risk of statelessness. This is based on data from the Integrated Food Security Phase Classification (October 2019) and the Haiti Mortality, Morbidity and Utilization Survey (2016–2017). This figure is provisional and subject to change upon finalization of the inter-agency needs and planning documents. Office for the Coordination of Humanitarian Affairs, ‘Haiti: 2020 Humanitarian Response Plan’ (draft), OCHA, 2019; and Office for the Coordination of Humanitarian Affairs, 'Haiti: 2020 Humanitarian Needs Overview' (draft), OCHA, 2019. 4 Office for the Protection of Civilians/Haiti Protection Group, ‘National Protection Strategy’, November 2018. 5 Government of Haiti Ministry of Health cholera bulletins, 2018–2019. 6 Available funds include US$7.5 million received against the 2019 appeal and US$3.1 million carried forward from the previous year. 7 From 7 to 15 February, the country was in a general shutdown due to demonstrations, resulting in the closure of shops, markets, schools and health centres, and the suspension of social services. 8 As part of the Cold Chain Equipments Optimized Platform Project, with the financial support of Gavi, the Vaccine Alliance and the World Bank, 721 solar refrigerators will be installed by 2020. The process started in 2017. From January through August 2019, 193 solar refrigerators were installed, bringing the total number installed to 384 (53 per cent). 9 WASH ‘shield’ activities complement the ‘sword’ (rapid response) through the chlorination of water supply systems, emptying and safe disposal of septic tanks, hygiene promotion activities and the distribution of household water treatment supplies. 10 This figure is provisional and subject to change upon finalization of the inter-agency needs and planning documents. ‘Haiti: 2020 Humanitarian Response Plan' (draft) and 'Haiti: 2020 Humanitarian Needs Overview' (draft). 11 Ibid. 12 This includes the total children to be reached (366,000 - see endnote #13), plus 57.5 per cent of the WASH target (adult population of 258,800) and 30 per cent of the health target for pregnant women (23,400). Fifty-one per cent of people to be reached are women/girls (330,582) and 49 per cent are men/boys (317,618); and 15 per cent are people with disabilities (97,230). 13 This includes the largest coverage target for children under 5 years (health: 336,000) and the education target for children aged 5 to 14 years (30,000) to avoid double counting. The number of children to be reached includes 50 per cent girls and 50 per cent boys (183,000 each); and 15 per cent are children with disabilities (54,900). 14 Programme targets are provisional and subject to change upon finalization of the inter-agency planning documents. 15 Figures are provisional estimates. Financial requirements are subject to change upon finalization of the inter-agency appeals/planning documents. 2 3 Who to contact for further information: Maria Luisa Fornara Representative, Haiti Tel: +509 3757 4437 Email: mlfornara@unicef.org Manuel Fontaine Director, Office of Emergency Programmes (EMOPS) Tel: +1 212 326 7163 Email: mfontaine@unicef.org Carla Haddad Mardini Director, Public Partnership Division (PPD) Tel: +1 212 326 7160 Email: chaddadmardini@unicef.org