This preliminary final report conveys an update on the closure of activities for each project under the international appeal for cholera in Haiti and the Dominican Republic. Given that projects have all ended at different times, it was appropriate that a preliminary report be issued as of 30 June, with the Appeal’s final report anticipated at the end of July 2016.
A. Situation Analysis
Summary of response
This International Appeal was based on a revised plan of action developed in close coordination with the Coalition to Eliminate Cholera in Haiti and the Dominican Republic (DR) in support of a ten-year Government programme developed by the respective Ministries of Health and Water and Sanitation. Working in partnership with the Haitian (HRCS) and Dominican (DRC) Red Cross Societies, the activities of this Appeal were based upon the Red Cross’ humanitarian role and responsibility to support the effort to eliminate cholera in both countries.
B. Operational strategy and plan
Overall Objective
The goal of this operation was to contribute to the elimination of cholera from Hispaniola during a period of three years (2013 – 2016). The intended overall outcomes of this operation in both countries included:
Reduced risk of infection, and exposure to, cholera through improved access to potable water amongst targetcommunities.
Reduced risk of infection, and exposure to, cholera through improved access to sanitation facilities in schools.
Increased knowledge amongst the target population regarding hygiene and sanitation.
Increased capacity to respond to spikes in cholera cases
Enhanced coordination between all state and non-state actors in the elimination of cholera from Hispaniola.
Enhanced accountability to beneficiaries.
C. Detailed Operational Plan
As per the agreed project action plans within the Cholera appeal, the Partner National Societies (PNS) (German, Japanese and Spanish Red Cross Societies) together with the International Federation of the Red Cross and Red Crescent Societies (IFRC) and HRCS have managed to implement key activities which were focused on: Preparedness anand Response, Water and Sanitation Facilities, Community Engagement and Hygiene Promotion as linked to local Government initiatives.
The German Red Cross focused its activities on improved access to potable water and sanitation facilities in schools and also supported the increase of knowledge on the disease amongst the target population with regard to hygiene promotion. Activities were implemented in the 3eme section des Vases, Arcahaie commune, in the West Department of Haiti.
For the period until 31 December 2015, the GRC Cholera project reached a total of 1,735 persons (1,662 students and 73 teachers) through the construction/rehabilitation of school latrines, and/or the expansion of existing water supply systems for portable drinking water. A total of 10 schools received improved water facilities with the development of 10 functional school committees. Forty-nine committee members were trained to ensure the maintenance and sustainability of the new infrastructure and 63 teachers were trained in Water Sanitation and Hygiene Promotion (WASH) practices. In addition, approximately 65,100 people were reached through door-to-door sensitisations and mass sensitisation events. This figure equates to 12,390 households (HH) met via door to door sessions and is inclusive of the 3150 persons met via 9 large scale sensitisation events (approximately 350 people met per event).
The Spanish Red Cross concentrated its activities based on prevention, community engagement, communication, awareness and response in targeted schools and communities in the communes of Oranger and Dessource in Léogâne. This Cholera project also ended in December 2015, reaching 5,125 persons (approximately 1,025 households) with greater access to potable water through the rehabilitation and/or expansion of existing water supply systems. Eleven water supply systems were repaired and/or extended. Five (5) of these were in schools and 10 functional water committees were created in the targeted communities. In order to reduce the risk of infection through poor sanitation facilities in the targeted communities and schools, 644 students were reached and 5 school committees were created to take the charge of maintenance and to ensure that developed infrastructure remained sustainable.
A total of 4,156 beneficiaries were reached through hygiene promotion activities and 2,371 hygiene kits were distributed. 7,741 beneficiaries benefited from soap distributions, 8,105 from aqua tabs, 10,000 through flyers distribution and 8,172 through mass sensitization messages. In total, 101 HRCS volunteers and community facilitators were trained in Participatory Hygiene and Sanitation Transformation (PHAST).
The Japanese Red Cross (JRC) in conjunction with the IFRC through the Cholera Hygiene Promotion will continue to implement activities in the Communes of Colombier (Section 1) and the Commune of Savanette (Section 2) in Haiti’s Centre department until December of 2016. The team utilized the IFRC’s Community-Based Health and First Aid (CBHFA) approach supported by the Epidemic Volunteer Control (ECV) manual and toolkit. Thus far, 162,0791 beneficiaries have been reached through hygiene promotion activities. Of this figure, 12,212 beneficiaries were reached through soap distributions, 17,151 beneficiaries with aqua tabs and 14,313 beneficiaries through mass sensitization messages. 4,166 flyers were distributed to communities, 496 community training tools (or manuals) in support of increasing the knowledge base of the volunteers and communities on issues related to the diseases. In total, 411 HRCS volunteers and community facilitators were trained in ECV and 493 of them were trained in CBHFA.
Additionally, the JRC and the IFRC has maintained the focus on the fight against cholera in the Communes of Bas Plateau in Haiti’s Centre department (Saut-d’Eau, Mirebalais, Boucan Carré, Lascahobas, Belladère and Savanette) through the Cholera Response project.
This project will end as of on 30 June 2016. Response activities have been marked by trainings and community responses in the areas of Lascahobas, Savanette and Belladère where confirmed cholera cases/outbreaks were identified, particularly in the locality of Pouly, a town in the Commune of Lascahobas. In order to prevent further outbreaks, household decontaminations took place and volunteers sought to provided community sensitization sessions to students before the end of the school year. School activities included (inter alia) hand washing sessions and information on the use of Oral Rehydration Salts (ORS). The increase in cholera cases in this region was attributed to the commencement of the rainy season and it is linked also to the mango harvest.
In the Dominican Republic, the National Society’s project ended in September 2015. DRC continued its support to the Ministry of Health and the Ministry in charge of Prisons, as linked to their objective to coordinate and develop prevention strategies that reduced the number of cholera outbreaks in local prisons. 7 prisons benefited from hygiene promotion activities involving the distribution of information, education and communication (IEC) materials and with training on water and waste management.
The DRC Cholera project also distributed a total of 5,000 hygiene kits inclusive of soap and chlorine drops at public events together with IEC materials. A total of 2,500 families and 50 schools were reached through the repair and/or expansion of 30 water systems in the targeted communities. 200 latrines were constructed in communities that lacked adequate sanitation systems.
4,578 houses and 1,511 latrines/toilets in the area of Bavaro, 72 houses in the area of San Cristobal and 14 in Monseñor Nouel were reached with home disinfection. A total of 200 families in the province of Monseñor Nouel and Bonao benefitted from 8 tube wells and a community cistern. The communities of Bavaro and Roman benefitted from the distribution of Health, Water and Sanitation products including chlorine drops, oral rehydration salts, soaps, bladders, cutlasses, axes, and machetes. First Aid Kits were also made available to the communities. Also in the province of Monseñor Nouel, 10 pool tests, 2 disinfection backpacks, 10 complete outfits for disinfection and one drum of chlorine was provided.
In view of the closure of the Cholera Appeal, a consultant was engaged to conduct a final evaluation of the emergency Cholera Appeal. The evaluation targeted a representative sample of project staff, beneficiaries and communities. Interviews took place in the following areas. In Haiti: Arcahaie, Section communale Dessource and Oranger, Léogâne in the West department, Lower Central department: Saut-d’Eau, Mirebalais, Boucan Carré, Lascahobas, Belladère, Colombier and Savanette. In the DR: La Altagracia, Azua, San Cristobal, Santo Domingo, Dajabón, Puerto Plata and Monseñor Nouel.
The purpose of the evaluation was to assess the effectiveness, efficiency, outcomes and impact of project activities as well as to evaluate the relevance and appropriateness of the appeal in terms of population needs, project sustainability, effectiveness of implementation and efficiency. In addition, the evaluation looked at the cooperation and coordination modality of the appeal, given that it was implemented by the JRC, IFRC, SRC, DRCS and the GRC with financial support from the Singapore, Italian and Japanese Red Cross Societies.
A final evaluation report will be shared with all partners at the end of June 2016.
In addition, more detailed information on overall achievements and lessons learned will be reported in the final report of the operation.