This time last year, I was in Haiti working with a sister city program and reporting to the ONE Blog. One of the most meaningful experiences I had there was when I met with the mountain community Savanèt, located near Jacmel. I had run into Jackson Jean-Batiste, the chair of their community committee Komité Relèvman Savanè, on a hike the day before, and he had asked me to meet with his organization. I was interested in learning about the earthquake- and food-related challenges they faced, so I did.

At the meeting, I was careful to let them know that I was not going to do anything for their community directly, and, although I would take what I learned to Washington, I would not be lobbying for their community, or even for Haiti, but for people around the world who also depended on land and faced similar challenges.

Interestingly, they were more than okay with that and grateful that I wasn’t there to make promises I wouldn’t keep. Many foreigners had passed through Savanèt doing post-earthquake surveys and promising to replace tents with houses. But none had returned.

As an agriculture policy wonk, I talked about food and food production. When I asked what they typically eat, all of Savanèt all shouted in unison, “DU RIZ!!” Rice. The community doesn’t eat many fruits or vegetables, but they do grow and eat bananas, which the women sell in the city from time to time. With women selling bananas and the men working odd construction jobs, the community doesn’t have money to buy fruits and vegetables.

So, what about home gardens? I knew that Helen Keller International (HKI) has had a lot of success in Africa and Asia with homestead gardens. In Savanèt, one woman named Lucilia Darent said she had had a garden when her husband died but now she was too old to work in it and her three grown daughters didn’t know how to garden and had no interest. Violette Charlemagne, the co-chair of Komité Relèvman Savanèt, said they would love to grow gardens but that they needed know-how and water.

The community received rainfall only six months per year. But with the famed Bassin Bleu (a waterfall that is definitely worth the visit if you’re in the area) up the hill, they thought they should be able to irrigate from the stream that fed the basin, but weren’t sure how to go about doing that or where they would get the money to do so. I asked what they thought about catching rain, and, again, the same questions in response: how do we do it and where do we get the materials? With barely enough money to buy rice and little engineering knowledge, Savanèt and other Haitian communities, need a hand-up from programs like Feed the Future.

But Feed the Future hasn’t yet completed a strategic plan for Haiti, so it’s impossible to tell whether it will help communities like Savanèt. Meanwhile, US food aid and cheap imports continue to pour into Haiti, undermining local farmers in the fertile Artibonite river basin in central Haiti. The residents in Savanèt can’t help their countrymen in a campaign to “Buy Haiti.” They have to buy the cheapest rice available, which is often supplied by heavily-subsidized US rice farmers.

This has been going on for some time, ever since the Clinton Administration pressured Haiti into lowering their rice tariffs from 15 percent to 3 percent. But in a Foreign Relations Committee hearing in March 2011, the former President admitted that he had made a mistake in pressuring Haiti into reducing tariffs on food imported from the United States

When will US foreign policy align with the needs of the world’s poorest? The US Farm Bill presents an opportunity to reform food aid, and you better believe ONE will be keeping an eye on it.

Here’s an interesting point to consider: Although Japan’s earthquake last week was a whopping two magnitudes larger than Haiti’s (approximately 100 times more intense), there were very few injuries or deaths reported in the capital city or anywhere else affected by flood waters. Thanks to strict building codes, land use regulations, and enforcement, Japan was able to keep the death toll down to just a fraction of the casualties from Haiti’s quake last year.

Poor countries simply can’t afford to develop and enforce the kind of complex regulations — like building earthquake-proof buildings — that were set by Japan’s government, and because enforcement agents (when they do exist in poor countries) are paid so little, they are particularly prone to corruption.

Charles Kenny from the Center for Global Development argues that because earthquakes are rare and unpredictable, retrofitting existing buildings and investing in expensive construction techniques might not actually be money well spent in places where preventable disease and malnutrition kill widely and reliably. He points out in a piece for Foreign Policy magazine that there are “a range of interventions that cost less than $2 per healthy year of life saved in the developing world,” meanwhile the costs of retrofitting public buildings in Istanbul was estimated to be around $280,000 per building.

However, early warning systems (EWS) play a huge role in alerting residents to evacuate — but countries have been slow to understand its value…or pass the message along. Although EWS wasn’t much help in Japan’s case (water was rushing “faster than a jet plane” toward its shores), it could have helped save the lives of more than 225,000 people from 14 countries during the 2004 Boxing Day tsunami.

As a result of the 2004 disaster, UNESCO set up a global tsunami program to help assess tsunami risk and make sure that tsunami-prone coastal communities are prepared. Unfortunately, the program hasn’t made much headway, and UNESCO’s funding is at risk of being cut by government agencies like the UK’s DfID.

More broadly, efforts to reduce disaster risk have been estimated by the World Bank to return 7 to 1 on investment, meaning that for each dollar invested in emergency preparedness, building codes or resilience building in disaster-prone areas, $7 in emergency response is saved.

Disasters can be traumatic and deadly, as can preventable disease. But at least we know that we can spare lives with better planning, strict guidelines and enforcement for construction in earthquake zones, investment in early warning systems, and efforts to bring adequate health systems, vaccines and nutrition to poor countries. As G.I. Joe used to tell us, knowing is half the battle. The other half, for poor countries, seems to be a serious lack of funding…

Watching the news this week, it’s likely you’ll see images of how bad things still are in Haiti one year after the earthquake. You might wonder whether your donation has done any good, and whether there is hope. I can assure you that the answer is yes on both counts.

The money Americans donated provided life-saving relief to hundreds of thousands of Haitians. It gave people food, water, protection against the elements, and vaccinations against deadly diseases. It has also enabled us to keep important hospitals open. And with time, more visible signs of progress are appearing, such as the brightly colored transitional homes that we and our partners are building.

Like all of us, I wish the pace of progress was faster. But I have to keep reminding myself that Haiti was a very poor country before this disaster, and that in many cases, aid groups are not rebuilding Haiti—they are building some of the infrastructure for the first time.

It’s a rollercoaster of emotions every time I go to Haiti. There’s deep sadness, despair, but also pride, joy and, yes, hope. With the incredible generosity of Americans, the strength and determination of the Haitian people and the heroic efforts of aid organizations and governments like ours who are helping, there is hope for the people of Haiti.

-Gail McGovern, President and CEO, American Red Cross

Learn more about American Red Cross work in Haiti by visiting www.redcross.org/haiti.

It was all so surreal. We were detained by Hurricane Tomas on the day we were to leave Haiti. As the storm hit landfall, I could see people scurrying in the dark trying to brace for the onslaught. One of the villagers slit his foot in the frenzy, so my wife Jasmine was left to suture a 10-inch gash with what medical supplies we had left. The owner of the guesthouse didn’t want blood tracked through her place so we had to improvise with a lounge chair and flashlight on the patio while the storm raged behind us.

Had it really been only a week since we arrived? It felt more like a year. Almost as soon as we arrived, word spread through the little town of Carries (just north of Port-Au-Prince), that doctors were in town. Through the course of the week, we must have treated more than a thousand patients in a makeshift clinic that had no running water and only electricity from a generator. All the diseases of poverty were there… malaria, malnutrition, dental disease. Fortunately, cholera had not yet reached the area, but we took precautions by bringing our own water. I personally had to treat dental patients with a flashlight and a battery-operated drill.

On one night, a non-responsive, six-day old baby was released from the hospital in St. Mark (an hour away) untreated. Due to cholera, the hospital was overflowing and patients could only sit on the floor. The mother was brought to us and her baby was treated with antibiotics. The following evening, a dental patient who had a tooth extracted just hours before came to the guesthouse still bleeding. He was in hypovolemic shock due to loss of blood.

Our team immediately put him on an IV drip hung by a coat hanger on the wall while I attempted to find the source of the bleed and suture him closed. What struck me is that incidents like these are a daily occurrence. With no medical facilities in the area, people just die… often from simple, treatable diseases and infections. It was for this reason that Bridges to Haiti — our nonprofit organization — was formed.

Earlier in the year, we attempted to send aid in the form of shoes, clothes and medicine through FedEx. All items were held hostage by customs in Haiti without reason. They wanted us to pay $2,000 in “storage fees” before they would release the boxes. We soon realized that the only way to get aid to Haiti was to hand-deliver it directly to the people. Our team took more than 50 suitcases loaded with medicines, clothing, school supplies and of course, water. We had to purchase most of the medicines and supplies with personal funds.

We weren’t there to change Haiti, but Haiti certainly changed us. The six-day old baby we treated survived, as did the bleeding patient. Cholera finally reached Carries two days after we departed. Fortunately, we left enough medicine to treat up to 1,200 patients. Did we make a difference? Maybe not for the country, but for that village, and for those people, we made a difference that day.

-Arnel Eugenio, ONE member, California

Many of our partners have responded to the difficult challenges in Haiti. Here are some highlights of some of these efforts.

International Medical Corps: Just 22 hours after the earthquake, the International Medical Corps was on the ground, delivering life-saving medical care to Haitians. And when cholera broke out nine months after the quake, their medical workers were dispatched, treating thousands of patients and educating more than 11,000 people on cholera prevention. Read more about their work on their website.

American Red Cross: The American Red Cross has committed more than $3.3 million to combat the cholera outbreak. By using a massive public awareness campaign with the use of text messages, radio broadcasts, special advertisements and sound trucks, the Red Cross is attempting to share with a large as possible number of people about prevention techniques. Here is a video that shows volunteers who personally teach the Haitians about basic hygiene practices as well as prevention and response tips for cholera.

American Jewish World Service: The American Jewish World Service is providing its grantee Movimiento Social-Cultural de los Trabajadores Haitianos (MOSCTHA), with emergency funding to launch an educational campaign around cholera prevention. In additional to distributing educational material, MOSCTHA has provided potable water, water treatment systems, hygiene products and cleaning supplies to empower Haitian communities to take control of their health. Read MOSCTHA’s blog or follow MOSCTHA on Twitter to find out more about the great work it has done in combating cholera and empowering Haitians.

CARE: CARE has responded to the cholera outbreak in the hardest-hit areas of Aribonite and the North West. CARE’s cholera prevention campaign on local radio stations has reached over 85,000 Haitians. CARE’s notes from the field describe the work CARE has done to alleviate the suffering of the people of Haiti.

Catholic Relief Services: In addition to responding to the cholera outbreak, Catholic Relief Services recently completed construction of hundreds of temporary shelters for families that were left homeless after the January earthquake. Here is an article about the work CRS has done in building temporary shelters in Haiti.

Islamic Relief: Islamic Relief’s main focus in Haiti is to provide shelter, camp management support, water and sanitation as well as to ensure that people have access to food and basic needs through cash-for-work programs. Islamic Relief has employed over 450 Haitians in its “Cash for Work” program. Here is a blog entry about Islamic Relief’s work in Haiti.

Partners in Health: Partners in Health has been working in Haiti for over 20 years and provides health care for the poor. Here is an excellent video which shows what it is like fighting the cholera epidemic on the ground.

Save the Children: Save the Children is currently training young people to recognize the early symptoms and the prevention of cholera in Haiti. Eleven-year-old Wawins was the first case of cholera at one of Save the Children’s cholera treatment units in Port-au-Prince. After recognizing that he had the symptoms of cholera, he went to a cholera treatment center and returned home completely healthy three days later. Here is a diary of a Save the Children aid worker in Haiti.

Screenshot of the site — pretty cool, right?

That’s why we’re really excited about Water.org’s latest project, my.Water.org. It’s an interactive online resource that allows people to see firsthand how water projects unfold in the real world, particularly in Haiti. You can choose a community and get weekly field reports — in the form of photos, videos and updates — from local certified partners as they deliver water solutions to the villagers.

In the Haitian village of Logalit, for example, you can find out how many households there are (60), how many of those households have latrines (46) and how many minutes it takes them to get to the nearest water source (up to 30!). You can even take a look at a photo of a villager grinding millet that reporter Kiki took just a couple of days ago.

If you have a moment, sign up for my.Water.org and play around on the website. It’s easy to use and you can even use your Facebook account to log in. And let us know what you think of the site in the comments below.

The Government of Haiti has established an emergency response center at the National Palace with representation from UN agencies and bilateral organizations. The Haitian government, humanitarian community and aid agencies have responded quickly, over thirty cholera treatment centers are operational nationwide. Officials warn that the outbreak will continue to spread and the infection and death toll will continue to rise dramatically. In the last week, there have been reports of civil unrest and anti-UN demonstrations across Haiti. The UN has responded that the demonstrations are politically motivated as Haiti faces elections on November 28. Civil unrest has hampered the latest cholera response efforts by restricting the distribution of necessary health supplies and delaying healthcare worker training and health promotion campaigns.

I know that infographics are all the rage these days (I just posted a piece on “The true true size of Africa” yesterday, remember?), but I couldn’t help but share another awesome graphic, “Pakistan vs. Haiti: Which got more money?” from GOOD magazine. The beautifully designed chart compares donations from countries and organizations around the world after both natural disasters, and the results aren’t pretty.

According to GOOD, Haiti got twice the amount of aid than Pakistan did, about $3.3 billion versus $1.5 billion. It’s also surprising to see that the average American donated almost triple the amount to Haiti per person than they did to Pakistan. Eesh!

But then again, Haiti’s earthquake happened in January of this year, while Pakistan’s flood happened eight months later. So, the time frame of this comparison may not be totally accurate. Maybe donors need a bit of time — and some nudging from advocacy groups — to get their act together.

Take a look at the big version of the chart, and be on the lookout for more infographics like this one on GOOD’s website.

Over the past year, Haiti has dealt with a devastating earthquake, an outbreak of cholera — and now the country is grappling with a new challenge: Hurricane Tomas.

The hurricane is forecast to pass between Haiti and Cuba tomorrow, with winds of at least 74 mph, and is expected to dump 5 to 10 inches of rain across the island. Although it is not expected to regain its Category 2 hurricane status from the past weekend, the Haiti government is cautious.

According to the Christian Science Monitor, the hurricane could have a devastating effect on the 1.3 million people living in Haiti’s precarious tent cities. Fearing the spread of cholera and people’s safety, “the Haitian government has told citizens to evacuate their tent shelters and find secure housing.”

An outbreak of cholera has been documented in the area surrounding the lower Artibonite region of Haiti by the staff of PIH’s sister organization, Zanmi Lasante, which works with the Haitian Ministry of Health and other partners.

Cholera is a disease of poverty—and was one of the earliest documented public health problems. Cholera epidemics are caused by a lack of access to safe, clean water.

While Haiti has not had a documented case of cholera since the 1960s, the conditions in the lower Artibonite placed the region at high-risk for epidemics of cholera and other water-borne diseases even before the earthquake of January 12, 2010. We believe secure and free access to clean water is a basic human right that should be delivered through the public sector and that the international community’s failure to assist the government of Haiti in developing a safe water supply has been violation of this basic right.

The earthquake resulted in the displacement of 1.7 million Haitians. As of March 2010, an estimated 300,000 additional Haitians had fled Port au Prince to the Artibonite. As there are no “camps” in the region, these displaced persons are “home hosted”—joining poor relatives in already overcrowded conditions, without water security or adequate sanitation. The dispersal of displaced people makes it difficult to provide centralized services.

Thousands of people are being given basic education, soap and oral rehydration salts in their communities by community health workers, and those already ill are being referred to Zanmi Lasante/Ministry of Health facilities in the Artibonite and Central departments. There is a sense from our team in the field that the outreach is working and patients are arriving at medical facilities at earlier, less severe stages of the disease and ill patients are being treated in facilities. Partners In Health and Zanmi Lasante with other partners are working in the camps and are helping to design the contingency plan for Port au Prince.

The key to stopping the cholera epidemic in Haiti is to provide water security for the people of the Artibonite urgently and in the long term. To meet the urgent need for water security, Partners In Health/Zanmi Lasante is partnering with numerous organizations to determine the source of the outbreak, obtain water trucks for distribution and hundreds of community health workers and social workers are engaged in community outreach and education projects.

For the future of Haiti, we will continue to be engaged in community-based water projects and we will also continue to advocate for money pledged for the reconstruction of Haiti be used to strengthen the public infrastructure of the country, including prioritizing the development of a reliable and safe public water supply to provide real water security as a basic right for the people of Haiti.

- Joia Mukherjee, chief medical officer, PIH