The United Nations Population Fund says that its limited emergency funds for Haiti hurricane relief cannot carry them far beyond the next few months, potentially jeopardizing the health care of more than 13,000 women expected to give birth this year.
With present levels of funding, UNFPA, tasked with addressing reproductive health and family planning, can continue Haiti relief work “with the bare minimum of services for three months, maximum,” according to Marielle Sander Lindstrom, UNFPA’s Haiti representative.
“A lot of these women will have complications and we are concerned we are not able to reach them in time,” Lindstrom explained in a phone call from Port-au-Prince.
“We have some money, but this money will start to run out in the next month, or so,” she told Devex. She estimates the emergency response would need to continue for six months to allow enough time for damaged clinics to be repaired and refurbished.
UNFPA assessments of damaged health clinics in Haiti’s remote southwest region indicate that many can be refurbished and restocked, while others need to be rebuilt. Eleven of the 33 hospitals in the badly hit departments of Grand’Anse, Sud and Nippes were severely damaged as a result of Hurricane Matthew, a Category 4 storm that swept through Haiti Oct. 4.
An emergency flash appeal funding gap of about $86 million for Haiti hurricane relief is placing widespread strain on United Nations agencies’ work, as the organizations and partners struggle to meet the needs of about 800,000 people who require immediate food assistance and to stem the increased risk of cholera spreading.
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UNFPA has not received any funding from a flash appeal of nearly $120 million, but is working with $350,000 it received from the Central Emergency Response Fund to cover its first three months of work. UNFPA had requested $2.7 million from CERF, which so far has released $5 million in emergency funding, as well as an additional $8 million to UNICEF.
“The risk of course is that everyone says, ‘Oh, OK, there has been an emergency appeal, Haiti should be fine for a while, it’s alright.’ We are not at all fine,” Lindstrom said. “We need to reinforce the infrastructure that the government put in place after the earthquake ... but we also need to make sure that other issues are not forgotten and for that we require a longer process.”
The number of reported annual maternal deaths in Haiti has nearly halved from 1990 to 2015, dropping from 1,700 women who died either while pregnant or 42 days within the termination of a pregnancy to 950 deaths last year. But Haiti still has the highest maternal mortality rate in the Western Hemisphere. It’s nearly as dangerous to get pregnant or give birth there as it would be in Burkina Faso, Ethiopia or Yemen.
Already, before the hurricane, about half the population had no access to basic health services and just 36 percent of births took place in a facility.
As of September, UNFPA was already operating with a budget shortfall of $140 million, more than their deficit for the two previous years together.
Lindstrom says she that displaced pregnant women are now more likely to give birth outside of clinics and without the help of a trained professional. UNFPA is planning to deploy mobile health clinics, which would be staffed with midwives. It also announced earlier this month it is sending 252 emergency reproductive health kits to reach 450,000 people.
Lack of funding could impact ongoing work with local authorities to deliver equipment if UNFPA is not able to pay to maintain staff on the ground in communities.
Lindstrom expressed concern that women’s health, and the protection of women and girls, is “not top of mind in the humanitarian response. Rather, it is like bottom of the drawer.” This lack of prioritization could lead to “problems further down the road,” as relief work transitions to the development stage, she said.
“In terms of family planning, for example, if women are using contraception now and their cycle is disrupted, it means that we will have elevated levels of pregnancy and birth at a time when the environment is already stressed, the crops have been destroyed, and I am just concerned that hunger, serious hunger, will be a problem next year,” she said.
It’s also clear, following several interviews UNFPA has conducted with displaced women, that there is an elevated risk of gender-based violence and rape, as women and girls are living outside of the safety of their local homes and communities. A reported 141,493 Haitians remain displaced following the hurricane.
Support from the United Kingdom’s Department for International Development will soon allow UNFPA to post a gender-based violence coordinator for three months in the city of Jérémie, one of the hardest hit by the storm.
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