(2021-08) Humanitarian Action for Children 2021 (Revision 1, August 2021): Haiti

2021 Revision 1 (August 2021) www.unicef.org/appeals/haiti UNICEF Haiti/2021/Rouzier Humanitarian Action for Children A woman affected by the 14 August earthquake receives emergency supplies in Torbeck, near Les Cayes, Haiti. Haiti HIGHLIGHTS IN NEED The 7.2 magnitude earthquake which struck Haiti on 14 August has further exacerbated an already challenging humanitarian situation shaped by persistent political instability, socioeconomic crisis and rising food insecurity and malnutrition, gang-related insecurity and internal displacement, the COVID-19 pandemic, as well as the Haitian-Dominican migration situation. In response, UNICEF Haiti is supporting the Government and humanitarian partners to ensure the continuity of basic services, including water, sanitation and hygiene (WASH), education, health, nutrition, child protection and social protection services, while facilitating disaster risk reduction, emergency preparedness, and interventions to address violence against children as well as gender-based violence and prevention of sexual exploitation and abuse. UNICEF is requesting US$122.2 million to meet the humanitarian needs of Haitian children and their families. This includes US$ 73.3 million for the earthquake response and US$48.9 million to cover other humanitarian needs in the country. 4.4 2.1 million million people 1 children 2 2017 2021 TO BE REACHED 1.6 million 800,757 children 5 people 3,4 KEY PLANNED TARGETS 46,598 251,283 children admitted for treatment for severe acute malnutrition children and women accessing health care 2017 2021 FUNDING REQUIREMENTS 692,768 580,100 people accessing a sufficient quantity of safe water children accessing educational services Figures derived from the 2021 Humanitarian Response Plan and August 2021 Haiti earthquake Flash Appeal, which is based on preliminary assessments and subject to change. US$ 122.2 million 2017 2021 HUMANITARIAN SITUATION AND NEEDS Humanitarian needs are rapidly growing in the aftermath of the 7.2 magnitude earthquake that struck southwestern Haiti on 14 August 20216; the three most affected departments include Sud, Grand’Anse, and Nippes. The earthquake's devastating impact was later compounded with heavy rains from tropical depression Grace on 17 August. While assessments are still in progress, official reports indicate more than 2,200 deaths, more than 12,000 people injured, and 130,000 homes destroyed,7 rendering thousands homeless and in urgent need of assistance.8 These disasters come as Haiti continues to reel from the 7 July assassination of President Jovenel Moïse and the escalation of gang violence that has affected 1.5 million people and displaced 19,000 people since June 2021. Despite negotiation of a humanitarian corridor with armed gangs to access the road connecting the capital Port au Prince to the South, access constraints remain a key challenge facing humanitarian partners. The Haitian-Dominican migration dynamic remains a concern due to increased numbers of Haitian returnees along the border over recent years.9 The combined impact of natural hazard-related disasters, persistent political and socioeconomic crisis, gang-related insecurity and internal displacement, as well as COVID-19 is being felt by the most vulnerable. According to the Humanitarian Needs Overview (HNO) 2021 released before the earthquake, an estimated 4.4 million people in Haiti10 were food insecure and an estimated 217,000 children were suffering from global acute malnutrition, an estimated 2.95 million people, including 1.2 million children and 400,000 pregnant women and adolescent girls required emergency health care; the earthquake’s impacts are likely to exacerbate these vulnerabilities.11 SECTOR NEEDS Nutrition 234,891 children are severely undernourished17 Health 3.2 million people need health assistance18 Water, sanitation and hygiene 4.3 million people lack access to basic WASH services19 With health systems in the three hardest-hit departments facing challenges in keeping pace with the exponential widening of health needs, maintaining access to life-saving assistance and the continuation of other essential health services, including maternal and child health, is a critical response priority.12 Access to safe water for consumption, sanitation services and hygiene promotion remains a significant need. With thousands displaced and sleeping in the streets and water and sanitation infrastructure suffering extensive damage, vulnerable populations are becoming increasingly exposed to the risk of waterborne diseases,13 and acute respiratory infections, including COVID-19.14 Education 850,000 children at risk of missing their education20 Over 3 million children have already been unable to attend school for months at a time, due to political and security challenges over the past two years, as well as COVID-19 related lockdowns.15 In earthquake affected areas, preliminary assessments led by the Ministry of Education indicate extensive damage across schools,16 affecting an estimated 100,000 STORY FROM THE FIELD Cherestale Thérèse, 67, is from in Camp Perrin, near Les Cayes. The mother of three and grandmother of five lost almost everything when the earthquake hit Haiti on 14 August. Today, she has come to receive emergency supplies distributed by WFP, IOM and UNICEF. “I'm grateful for the help we received. I just hope it will continue because we've lost everything... Since our house was destroyed, the tarpaulins we received was very helpful,” she said. UNICEF Haiti/2021/ Edler Guillaume Read more about this story here Cherestale Thérèse, 67, receives essential emergency supplies in a joinWFP-IOM-UNICEF distribution in Camp Perrin, near Les Cayes. HUMANITARIAN STRATEGY UNICEF works with partners to ensure the continuity of essential health, nutrition, WASH, education and child protection services, and strengthen disaster risk reduction and emergency preparedness through various modalities including cash transfers. Following the 14 August earthquake, greater attention will be placed on providing immediate life-saving assistance and recovery support to affected people, while strengthening support to the Internally Displaced Persons (IDPs) crisis in the metropolitan area. UNICEF is supporting continued access to essential health care services, including immunization and maternal and child health, as well as prevention and treatment of acute malnutrition. In areas affected by the earthquake, UNICEF is working to provide essential medicines, medical supplies and equipment and nutritional commodities, and supporting the resumption of health care services on damaged or destroyed health centers, as well as strengthening health supply chain management. WASH interventions aim to ensure access to sufficient safe drinking water for vulnerable communities, provide emergency latrines, and hygiene services, including critical hygiene supplies, hand washing facilities, and COVID-19 prevention. The earthquake response is focused on the rehabilitation/upgrade of damaged WASH facilities together with hygiene promotion and awareness raising in health centers and schools to prevent the risks of spread of infectious diseases including cholera, diarrhoeal diseases, malaria and COVID-19. In response to school closures, UNICEF will promote a safe return to school through provision of school supplies for school reopening and access to distance learning programmes where needed. In earthquake affected areas, UNICEF will prioritize the rapid establishment of temporary learning spaces and rehabilitate schools to provide a protective environment for 100,000 boys and girls while providing mental health and psychosocial support to students and teachers. Protection services will be provided to children exposed to violence, including gender-based violence, exploitation and family separation. UNICEF will also focus on psychosocial support, identification, referral and service provision for vulnerable children, and community and family sensitization on child protection risks and preventative measures. To mitigate the negative socio-economic impacts of humanitarian crises, UNICEF will provide emergency cash transfers to help the most vulnerable families meet their immediate needs. UNICEF supports national authorities and humanitarian partners to strengthen humanitarian coordination and disaster preparedness and response. In collaboration with the Government, UNICEF leads the WASH sector, continues to co-lead in education, nutrition, child protection sub-sector. UNICEF maintains stocks of pre-positioned supplies to respond to humanitarian situations as they arise. Gender equality, Accountability to Affected Populations (AAP) and Protection against Sexual Exploitation and Abuse (PSEA) will be mainstreamed throughout the response. UNICEF will strengthen reporting systems, survivor assistance and capacity building of staff and partners. This appeal is aligned with the revised Core Commitments for Children in Humanitarian Action, which are based on global standards and norms for humanitarian action. 2021 PROGRAMME TARGETS21 Nutrition 46,598 children aged 6 to 59 months with severe acute malnutrition admitted for treatment 62,730 primary caregivers of children aged 0 to 23 months receiving infant and young child feeding counselling 67,310 children aged 6 to 59 months with moderate acute malnutrition admitted for treatment 176,118 children 6-59 months screened for acute malnutrition Health 251,283 children and women accessing primary health care in UNICEF-supported facilities 35,000 children under 1 year vaccinated against measles 37,000 pregnant women who attended at least two prenatal visits 3,000 healthcare facility staff and community health workers trained in infection prevention and control (IPC) and provided with personal protective equipment (PPE) Water, sanitation and hygiene 692,768 people accessing a sufficient quantity of safe water for drinking, cooking and personal hygiene22 692,768 people reached with handwashing behaviour change programmes 278,563 people accessing and using adequate sanitation facilities 690,368 people reached with improved capacity to face a shock through disaster preparedness activities Child protection, GBViE and PSEA23 57,900 children and caregivers accessing mental health and psychosocial support 1,552,507 people with access to safe channels to report sexual exploitation and abuse24 2,650 unaccompanied and separated children reunified with their primary caregiver or provided with family-based care/alternative care services 40,000 women, girls and boys accessing gender-based violence risk mitigation, prevention or response interventions Education 580,100 children accessing formal or non-formal education, including early learning 580,100 children receiving individual learning materials 100,000 school-aged children in earthquake-affected vulnerable households reached with humanitarian cash transfers for education25 Social protection and cash transfers 20,000 households reached with humanitarian cash transfers across sectors26 Cholera 95 per cent of cholera suspected cases (including 'other acute diarrhoea' cases) identified and responded to within 48 hours with a complete water, sanitation and hygiene package FUNDING REQUIREMENTS IN 2021 UNICEF has been on the ground delivering life-saving assistance to the most vulnerable, especially children. For this work to continue, UNICEF requires significant resources. In addition to the US$48.8 million appeal made for 2021, UNICEF is requesting an additional US$73.3 million to scale up its humanitarian interventions in response to the earthquake in line with Flash Appeal (August 2021), which outlines funding needs over a 6-month period from August 2021 to February 2022. UNICEF needs additional resources and support to help prevent further degradation of health services, including routine vaccine coverage, which is already low, especially in the earthquake affected areas. Funding is urgently required for UNICEF to be able to cover scaled-up essential emergency WASH and resilience interventions for vulnerable communities; life-saving care to an estimated 46,598 severely malnourished children; as well as emergency education and distance learning programmes for an estimated 580,100 children at risk of dropping out of school. Funding for Child protection services is also urgently needed to respond to the needs of children exposed to violence, including gender-based violence, exploitation and family separation, and to provide cash-based assistance for 20,000 vulnerable families to help them meet their basic needs over the next few months. 6.9% CHILD PROTECTION, GBVIE AND PSEA 8% OTHER* 9.2% NUTRITION 10.8% HEALTH Appeal sector 37.6% EDUCATION US$122.2 million 27.4% WASH Revised 2021 HAC requirement (US$) Nutrition 11,200,000 Health 13,220,040 WASH 33,500,000 Child protection, GBViE and PSEA 8,377,000 Education 46,000,000 Social protection and cash transfers 4,920,000 Cholera 4,000,000 Cluster coordination 1,000,000 Total 122,217,040 *This includes costs from other sectors/interventions : Social protection and cash transfers (4.0%), Cholera (3.3%), Cluster coordination (<1%). Appeal sector Original 2021 HAC requirement (US$) Revised 2021 HAC requirement (US$) Funds available (US$) Funding gap (US$) 2021 funding gap (%) Nutrition 5,200,000 11,200,000 1,020,110 10,179,890 90.9% Health 4,900,000 13,220,040 1,362,904 11,857,136 89.7% WASH 12,000,000 33,500,000 4,326,207 29,173,793 87.1% Child protection, GBViE and PSEA 2,377,000 8,377,000 842,158 7,534,842 89.9% Education 15,000,000 46,000,000 6,713,390 39,286,610 85.4% Social protection and cash transfers 4,920,000 4,920,000 12,500 4,907,500 99.7% Cholera 4,000,000 4,000,000 2,332,671 1,667,329 41.7% 500,000 1,000,000 12,500 987,500 98.8% 48,897,000 122,217,040 16,622,440 105,594,600 86.4% Cluster coordination Total Who to contact for further information: Bruno Maes Representative, Haiti T +50936241777 bmaes@unicef.org Manuel Fontaine Director, Office of Emergency Programmes (EMOPS) T +1 212 326 7163 mfontaine@unicef.org June Kunugi Director, Public Partnership Division (PPD) T +1 212 326 7118 jkunugi@unicef.org ENDNOTES 1. Prior to the 14 August earthquake, the people in need figure of 4.4 million was derived from the 65 priority communes based mainly on the Integrated Food Security Phase Classification (IPC) analysis as per the 'Haiti: Humanitarian Needs Overview – Humanitarian Response Plan 2021’', (Haiti HNO/HRP 2021), UNOCHA. Following the earthquake, the August 2021 Flash Appeal estimated that approximately 650,000 people – 40% of the 1.6 million people living in the affected departments – are in need of emergency humanitarian assistance. The August 2021 Flash Appeal covers the period from August 2021 to February 2022. Indicators and targets were revised and adjusted in order to include additional people to be reached in the three most affected departments. Considering that the previous figures also include these three departments, the methodology was adjusted to include new people reached, avoiding double counting. 2. Ibid. This figure is based on children being 42.5 per cent of the general population, as per demographic data from the 2016-2017 Demographic Health Survey (DHS). 3. The people to be reached figure is derived from the Haiti HNO/HRP 2021. To avoid potential double counting of beneficiaries, this figure includes the following UNICEF targets: the highest coverage programme target for WASH (adults only); the target for essential health care services; the target for psychosocial support services; the target for formal/informal education; and nutrition targets. The remaining people in need will be covered by other humanitarian partners (United Nations agencies, non-governmental organizations, donors) and government institutions. This figure includes 50 per cent women/girls and 50 per cent men/boys, as well as 10 per cent people with disabilities as per demographic data from the 2016-2017 DHS. 4. As per the Inter-Agency Flash appeal (25 August 2021), the UN estimates that at least 650,000 people among the earthquake-affected population are in need of humanitarian assistance assistance; of which 500,000 people are targeted. It is worth noting that prior the earthquake, a proportion of the communities affected were already part of UNICEF's targeted population in its ongoing programs including humanitarian action. The revised 'people to be reached ' figure has been adjusted to avoid potential double counting 5. To avoid potential double counting of beneficiaries, the children to be reached figure includes the target for Education (580,100 children), Nutrition (176,118 children), Child Protection (2,039 children) and social protection (42,500). The remaining people in need targeted by UNICEF, as part of the previous humanitarian situation, was included in the total figures extracting the proportion that corresponds to the three affected departments in order to avoid overlapping population. 6. The southern departments of Grand'Anse, Nippes and Sud were the worst hit. 7. 59 health facilities have been affected according to the 14 August Haiti earthquake Flash Appeal. 8. According to the 14 August Flash Appeal, more than 610,000 people in the three most affected departments with acute humanitarian needs prior to the earthquake. Of these, 350,000 suffer from extreme and catastrophic levels of needs. 9. According to the IOM Bi-monthly Situation Report no. 40, an estimated 59,500 total cross border movements observed border crossings were reported from in July 2021. 10. This represents nearly 46 per cent of the population (DHS 2016-2017). 11. While assessments were still on-going at the time of writing, UNICEF estimates that 17,891 additional children are likely to be affected by acute malnutrition in the earthquake affected areas. 12. Based on the estimated population in the three departments, more than 18,600 women are expected to give birth in the next six months and 28,000 are currently pregnant. Among those women, around 2,800 will likely require caesarean sections or experience complications, with potentially deadly consequences if access to emergency obstetric care is not made available (14 August Haiti earthquake Flash Appeal, 2021). 13. The cholera epidemic is now coming to an end, with no cases confirmed since February 2019. However, prevention, surveillance and alert response efforts must be maintained, particularly in earthquake-hit communities, to keep the number of cases at zero and officially declare the end of the epidemic by 2022. 14. As of mid-August 2021, Haiti reports more than 20,500 cumulative COVID-19 cases and more than 570 deaths. However, limited testing and treatment capacities is likely leading to underreporting. As of 20 August, 24,000 vaccine doses have been administered in Haiti, resulting in only 0.2 per cent of the population being partially immunized. 15. Haiti HNO/HRP 2021. Although all schools reopened by mid-August 2020 with biosafety protocols, due to the deterioration of the political climate and socio-economic conditions, growing insecurity and the rise of gang-related activities, a significant number of children are at risk of falling behind on their learning and dropping out of school altogether, with estimates of 500,000 potential dropouts. 16. According to the Flash Appeal, reports from the three most affected departments cite destruction or severe damages in 308 schools. 17. Haiti HNO/HRP 2021 and August 2021 Flash Appeal. 18. Ibid. This corresponds to approximately 23% of the Haitian population. Although the whole of the territory is affected, the majority (65%) of the needs will be concentrated in three departments: West (1,208,810 people), Artibonite (459,231 people) and North (265,205 people). In addition, the August 2021 Flash Appeal targets 225,000 people, including 28,000 pregnant women and 1,200 people with disabilities. 19. According to the Haiti HNO/HRP 2021, this figure includes 1,885,000 people affected by the food crisis (IPC 3 and 4); 1,425,000 people living in municipalities vulnerable to disasters that do not have WASH contingency plans; 231,000 people living in a household where one of the members is affected by a water-borne disease; 226,000 people living in a household in which one of the children under 5 is affected by malnutrition; 40,000 people affected by a hydrometeorological hazard (drought or flood); 15,000 people displaced as a result of internal conflict. In addition, the August 2021 Flash Appeal targets 500,000 people. 20. Haiti HNO/HRP 2021. In addition, the August 2021 Flash Appeal targets 100,000 boys and girls at risk of missing out on their education. 21. Communication for development, including accountability to affected populations, is integrated into sectoral responses and interventions. 22. In addition to supporting continued access to safe water for people affected by natural disasters, planned activities will focus on community awareness and mobilization and prevention activities, with the engagement of community and religious leaders, influencers, youth and women's groups to raise awareness on handwashing among vulnerable communities. 23. Due to space constraints, the following acronyms appear in the appeal: GBViE (gender-based violence in emergencies); PSEA (prevention of sexual exploitation and abuse); C4D (communication for development); and AAP (accountability to affected populations). 24. This represents 80% of the people to be reached. 25. These cash transfers will support the most vulnerable households with school-aged children to cater for expenses for return to school including school supplies, uniforms, and other related costs. 26. In line with the national social protection and promotion policy, these multipurpose unconditional cash transfer include four monthly cycles of cash distribution worth US$82 (70 per cent of the monthly improved food basket value per household, as calculated by the Government). The targeting of beneficiary households is based on a set of criteria including school enrolment of the children, the family's economic vulnerability and the situation of women in the households for the empowerment purpose. For the forthcoming conditional cash transfer in education, a 3-tier targeting was set (geographic, schooling and economic situation of the households).