Haiti has long had a sanitation problem, being one of a very small number of countries where sanitation worsened over the last twenty five years.  Port au Prince, its largest city, has no central sewage system and is unlikely to ever have one.  There are other models for sewage management but implementing them without good governance, the rule of law, and a well-informed public is, as with anything else, challenging.  However, there are champions for improving sanitation both within and outside the Haitian government. The full NPR article by Rebecca Hersher follows. 

Haiti's infant mortality rate remains the highest in the western hemisphere.  This is due in part to a lack of accessible health care facilities with sufficient staffing, training, and equipment.  With funding from Every Mother Counts, Midwives for Haiti have been training skilled birth atttendants (midwives) to asist mothers during delivery.  Ideally, every Haitian mother could deliver in a facility staffed by health care professionals available to them twenty four hours a day.  That's isn't the reality for most Haitian mothers, making the work of skilled birth attendents critical for them and their babies.  Take a look at the full Washington Post photo essay to learn more. 

Linked and copied below is a BBC article about yet another effort by the Haitian government to re-create a military force. The reasons given are job creation, disaster response, and border patrol.  Costa Rica also does not have a military and is able to patrol its borders and respond to disasters through civilian institutions.  In addition, Costa Rica creates jobs by encouraging investment.  Given the sordid history of the Haitian military, donors would much prefer that Haiti continues to focus on strengthening the national police force.  Recreating the military could very well result in more instability and uncertainty - as was the case in the past. 

Doctors Without Borders, also known by its French acronym MSF, has released a report on sexual violence in Haiti. Gender-Based Violence (GBV) is a human rights and a public health issue as it can cause mental trauma, unwanted pregnancies, and transmission of HIV and sexually transmitted infections.  Stigma remains intense in Haiti due to lack of access to justice and survivor-centered health care.  In 2015, MSF opened a clinic in Port-au-Prince that specializes in providing health and psychological support to GBV survivors.  Take a look at the report (available in English and French with summary below), and if you would like to support MSF, you can do so here. 

A World Bank study recommends that Haiti and its donors focus less on building hospitals and more on preventative and primary care.  Haiti spends less than 5 percent of its budget on health care meaning that it must prioritize. The best run hospitals have long been managed by or co-managed with non-governmental organizations.  Public hospitals are in need of serious reform. Ninety pecent of operating budgets for hospitals are for payroll with an over-emphasis on administration.  Decentralization could potentially empower health facilities by allowing staff to make their own budgetary and human resource decisions.  The full article by Miami Herald journalist Jacqueline Charles follows. 

The U.S State Department has released the 2017 Trafficking in Persons (TIP) reports.  The Haiti Country Narrative (copied below) notes that while Haiit does not meet minimum standards for preventing and responding to TIP, it is making significant efforts to improve.  This included strengthening its interministerial anti-trafficking commision, working more closely with international organizations, improving investigations and prosecutions and obtaining convinctions under the 2014 antri-trafficking law.  In short, progress is being made although much more remains to be done. 

Individuals and groups give more than $70 million in donations every year to hundreds of orphanages in Haiti.  However, these orphanages vary wildly in terms of accountability - some are well-managed while others abuse and exploit children.  Children in orphanages should have their rights respected and opportunities for a better future.  It is important to remember though that most childen in Haitian orphanages are not orphans.  They are children from large families that could not afford to take care of them.  If their parents had consistent access to family planning, there would be far less need for orphanages in the first place.  Children's Rights NGO Lumos advises that funding would be better spent on helping Haiti to develop a proper foster care and adoption system.  The full article on this subject by Anastasia Moloney of the Reuters Foundation follows. 

Below is a recent article in the Economist about the current state of Hait's development.  The Canadian government funded the Copenhagen Consensus Center (CCC) think tank to study the impact of different policies in Haiti - what would they cost and what would have the greatest impact? The Haitian government can't do everything at once and the intent is to help it prioritize.  Interventions that come out on top include fortifying wheat flour with micrconutrients and reforming the electrical system.  Learn more at the CCC website which includes a PPT presentation on the top ten proposed interventions.  

As the UN Peackeeping Mission in Haiti (MINUSTAH) winds down, it leaves a mixed legacy - less insecurit and better police along with an ongoing cholera epidemic and a number of Haitian women who became pregnant by U.N peacekeepers. Reuters journalist Makini Brice notes in her article below that while the United Nations has a "zero tolerance" policy on sexual exploitation and abuse, peacekeepers move on while their children grow up without any support. Haitian lawyers intend to file law suits although the timing is unclear.  The United Nations has a long track record of promising but under-delivering on accountability in peace-keeping operations - how these women are treated will be an indicator of whether anything has changed. 

The current administration has granted undocumented Haitians in the United States an additional six months of Temporary Protected Status (TPS), protecting them from deportation...at least for now.  The Department of Homeland Security has warned that this may be the final six months of TPS and Haitians should prepare for return.  It is difficult to imagine how Haiti can absorb 60,000 returnees at this point in time - especially those who would be returning to the hurricane affected Grande Anse.  Due in large part to Hurricane Matthew, the economy is expected to contract ths year.  Additional information follows in a Miami Herald article by Jacqueline Charles below.