Listen to people about the future of their livelihoods – that could be the best advice for the teams in Haiti responding to the earthquake disaster. As the emergency phase of the relief operation drew to a close, the Active Learning Network for Accountability and Performance in Humanitarian Action (ALNAP), published a report outlining 28 lessons learned over 30 years of earthquake responses.

One clear finding is that the risks of disease from dead bodies in the street is often overstated. People are more at risk of trauma and shock from what is around them, than from cholera and other diseases.

With about 170,000 bodies counted and expectations that the death toll could reach 200,000, about 1.1 million people were left without homes. Approximately half of all structures in Port-au-Prince are believed to have collapsed in the 12 January earthquake that measured 7 on the moment magnitude scale.

By late January the International Organization for Migration (IOM) estimated that there were 370,000 people living in more than 300 makeshift settlements under improvised shelter with no access to water supplies. IOM was distributing 52,000 tarpaulins and more than 9,000 family tents (http://www.iom.int/jahia/jsp/index.jsp) .

Do not overstate the risk of disease

Only three out of 600 geophysical disasters led to disease epidemics, according to ALNAP research published in the Emerging Infectious Diseases Journal. The real risk posed by dead bodies after natural disasters is mental illness caused by shock and grief. The report (p. 11) states that "outbreaks of communicable disease are rare after natural disasters unless large numbers are displaced from their homes and placed in camps". It warns against wasting money on "imaginary" problems, using an example from the 2004 Tsunami disaster: "Even though there was no confirmed case of cholera in Aceh, an immunisation campaign targeted 160,000 people with preparations for cholera using an expensive two dose oral vaccine".

It is especially important to listen to affected populations about their priorities for livelihood recovery. The ALNAP report (p. 18) cites the example of the earthquake disaster in Bam (Iran) where "interveners gave a low priority to irrigation for orchards, ranking such support lower than shelter, schools and drinking water. The affected population gave water for orchards their highest priority because of the risk of losing their orchard assets".

The report also covers the 1976 Guatemala earthquake that killed 23,000 people and the 2006 Yogyakarta earthquake that left 5,749 dead. Earthquakes are uniquely challenging, with high mortality rates, severe road and infrastructure destruction, debris delaying recovery efforts and the risk of aftershocks.

No lessons applied from previous emergencies

“Every time there is a major evaluation, it states [that] emergency responses did not apply lessons from previous emergencies,” ALNAP head of research and development, Ben Ramalingam, told IRIN. “Decisions we make now in Haiti can influence the way operations go for quite some time.”

He has high hopes that the same mistakes are not being made. Comparing Haiti with the aftermath of the 2004 tsunami, he says: “Now there is much more focus on what can be done better; there is a lot of debate about coordination and quality – this is potentially unique.”

The most important lesson aid agencies must apply is to address emergency relief and longer-term recovery efforts together, ALNAP says. “Recovery is the overriding challenge. Agency planning should not overstate the need for relief, and should quickly move into recovery activities.” Physical recovery is likely to take three to five years in Haiti.

WASH cluster coordination

UNICEF is leading the water, sanitation and hygiene (WASH) relief effort. As of 19 January 2010, the WASH Cluster had established 82 distribution sites for water, and has 180 water trucks with a total capacity to provide water to 180,000 people. Water tanks were being erected across Port-au-Prince. Limited toilet facilities in makeshift settlements were a concern. The Government confirmed that 900 latrine plates were available but said there was a need for more construction materials.

The WASH cluster said it had enough water purification units, but shortages persisted for bladders, distribution units, small water pumps for drinking water and drums for latrines. Towards the end of January the cluster were preparing to begin sanitation and hygiene promotion.

See the latest Reliefweb water and sanitation sector updates for the Haiti earthquake disaster.

Tags: emergencies, latin america & caribbean, on-site sanitation, water distribution, water-related diseases