Haitians Face Dire Choice: Find Clean Water, or Risk Their Lives Trying

How accessing water during unstable political and economic times becomes an impossible task

Partners In Health
Partners In Health
5 min readMar 21, 2019

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Children head to the nearest natural spring to gather water for their households in rural Boucan Carré, Haiti. Photo by Cecille Joan Avila / Partners In Health

Haiti’s decades-long water crisis has heightened over the last six months of political unrest, becoming ever more critical. During a 10-day countrywide lockdown in February, protestors blocked streets throughout the capital of Port-au-Prince in response to the ongoing fuel crisis, devaluing national currency and increasing food costs. Most of the country’s local markets were closed; transportation everywhere halted.

Yet, life still goes on; families need to eat, drink clean water, and find help for their sick. The day-to-day reality is that, throughout rural communities and many neighborhoods in the capital, residents don’t have running water inside their homes. Their local water spring has been contaminated for years, as Haiti lacks a formal sewage disposal system. Their only access to safe, clean water can be a two-mile walk away, and their choice then can be to buy water at a kiosk or collect it at public spouts appropriately dosed with chlorine.

Their last resort is the nearby Artibonite River and its tributaries, which have been the main source for spreading one of modern history’s largest and longest cholera outbreaks.

Where can people get clean water when political unrest arrives at their doorsteps and shuts down their communities? For millions of Haitians, this — or a similarly tragic scenario — plays out every single day. On World Water Day, we must continue to focus on clean water access in Haiti, until we find a solution to this inexcusable situation.

According to UNICEF, roughly half of Haiti’s rural populations have no access to clean water. This means that in moments of crisis, as we have seen over the last year, families are forced to secure water from unsafe sources, including contaminated rivers and streams. Since October 2010, more than 1 million Haitians have contracted cholera and more than 10,000 have died. These are official numbers from the Haitian Ministry of Health; we will never know the real number of those who fell ill and died from cholera in small communities, where the cause of death is often unrecorded.

The family member of a patient fills a bottle with clean water at the PIH-supported cholera treatment center in Mirebalais. Photo by Aliesha J. Porcena / Partners In Health

Zanmi Lasante, Partners In Health’s sister organization in Haiti, has been working in the field of water, sanitation, and hygiene for more than three decades. Over the past 10 years, activities to expand access to water and sanitation throughout communities of the Central Plateau and the lower Artibonite have taken on new meaning with cholera’s entrance on the scene. Since the cholera outbreak in October 2010, PIH has kept 10 cholera treatment centers open and staffed — 24 hours a day, seven days a week.

As in the recent political crisis, Zanmi Lasante staff do whatever it takes to keep the cholera treatment centers open for anyone who needs medical assistance.

At the height of the cholera outbreak in 2011, nonprofits and multinational organizations opened hundreds of treatment centers, but just as quickly shuttered their doors as the next global crisis emerged in the news. Many organizations and donors left Haiti altogether.

Yet the water, sanitation, and cholera crises in Haiti remain. While PIH is staying put, the reality is that improving water access — from the smallest community in our areas of programming, through the capital of Port-au-Prince — will take billions of dollars.

Everyday life for Haitians is already enough of a struggle, having to fight for the right to clean water, among other basics. People shouldn’t also have to fight nationwide shutdowns due to political instability and the economic effects of a fuel crisis that began in July 2018.

PIH has been advocating for Haitians’ right to clean water on the world stage since the development of Wòch nan Soley: The Denial of the Right to Water in Haiti in 2002, a movement that PIH co-founder Dr. Paul Farmer and Zanmi Lasante leadership supported to ensure HIV and TB patients had access to clean water. That sentiment still drives us today as we work to ensure the same rights for families and, in so doing, prevent deaths from cholera or other diarrheal diseases.

Currently, Zanmi Lasante is working with partners to conduct social diagnoses of communities to better understand where needs lie in the areas of water, sanitation, and hygiene. This type of analysis is necessary for ensuring that communities understand the role of the implementing partner, as well as the responsibilities of local government and the community.

Rose Marie Renati (center), a Zanmi Lasante health agent, teaches children at an orphanage outside Mirebalais about the importance of washing their hands with soap and water. The activity was part of a cholera vaccination campaign in November 2017. Photo by Cecille Joan Avila / Partners In Health

Today, we are working in 22 schools in the Central Plateau, ensuring more than 5,000 children have access to safe, clean toilets and potable water. Meanwhile, hygiene education and promotion allows children to better understand why handwashing with soap is not only important, but lifesaving.

When a school has a toilet and access to clean water, a girl has a much higher chance of continuing her studies once she begins menstruating. We are working with communities to openly discuss menstruation so that it’s no longer a taboo subject, and to ensure that girls feel comfortable in their surroundings.

We also are expanding water and sanitation programs into 85 new communities between Lascahobas and Mirebalais, providing technical support in the construction of household toilets. In the last 6 months alone, families have built 1,200 new household toilets, and another 1,100 will be completed soon.

A few thousand household toilets may not seem like much, but they provide huge health benefits through disease prevention. Following seven years of work, there are now 10,000 families who are no longer forced to defecate openly. Additionally, we are working with several local health centers to improve their access to water and sanitation, so patients have safe spaces to relieve themselves.

All these efforts march us toward the goal of universal access to clean water and sanitation in the Central Plateau and lower Artibonite. But when will all Haitians have access to clean water without risking their lives? While we work each day toward that goal, we must continue to find creative solutions to clean water access so that our most vulnerable families can focus on staying safe, and not worry about where they will find their next glass of clean water.

Elizabeth Campa is the senior health and policy advisor for Zanmi Lasante and is currently completing an MMSc in global health at Harvard Medical School. She is ZL’s chief contact in Haiti for USAID, World Bank, and UNICEF. She has worked for 19 years within the water, sanitation, and hygiene field, beginning as a Peace Corps Volunteer in Morocco and with emergency response in the Democratic Republic of Congo, Iraq, Sudan, and Afghanistan. She currently advises in this area in Haiti.

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Partners In Health
Partners In Health

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