IOM Haiti’s Health Team works to bridge critical gaps in public health and psychosocial support, while supporting vulnerable individuals in camps and communities and responding to the cholera epidemic through a range of initiatives. This effort is achieved through direct service delivery and the creation of synergies with other IOM programs, particularly within IOM's role as CCCM Lead Agency. The Health unit work closely with other IOM units - i.e. CCCM; Camp Management Operations; Non-Food Items (NFIs); Water, Sanitation, and Hygiene (WASH); and Shelter - to provide health perspectives and key responses to these programs.
IOM’s Health team has been playing a significant role in cholera prevention, treatment and response following the outbreak in October 2010. In collaboration with the Ministry of Public Health and Population, IOM has established over 365 Oral Rehydration Posts in highly vulnerable camps, communities and at key border crossing points. Over 2300 community cholera brigadiers have been trained by IOM in rapid response, early recognition and treatment, community sensitization and awareness and referral, to ensure that populations at risk are provided first line community care in line with national strategies. Other elements of response include facilitating transport of cholera patients, providing personal protective equipment, NFI cholera items to hospitals, health facilities and other partners such as NGO’s/INGO’s and agencies, as well as contributing to interagency mapping efforts.
In 2013, IOM continues to support cholera response in 73 camps, 13 communal sections in Artibonite and Sud-Est Departments and established additional 57 ORP’s , and reinforce rapid emergency response capacities to investigate reported cases, distribute cholera kits, transport suspected cholera patients, and reinforce capacities of MSPP staff at the departmental level to strengthen their response capacities. IOM works closely with MSPP to integrate cholera response into primary health care.
From 2011 to 2017, IOM provided continued support in cholera response to 128 camps, 141 communal sections and communities in Artibonite, Sud-Est,Sud-Ouest,Nord-Ouest and Nord-Est Departments and established additional 394 ORP’s , and reinforce rapid emergency response capacities to investigate reported cases, distribute cholera kits, transport suspected cholera patients, and reinforce capacities of MSPP staff at the departmental level to strengthen their response capacities. IOM works closely with MSPP to integrate cholera response into primary health care.
Water & Sanitation
IOM’s WASH team works closely with the GOH / Direction National de l’eau portable et l’assainissement (DINEPA), to carry out activities in both IDP camps and neighbourhoods. In addition to covering critical gaps in water and sanitation provision in camps, IOM the supports household-level water treatment, hygiene promotion and sensitization in rural communities of Upper Artibonite Region.
In 2012‐2013, following the initial collaboration between the Center for Disease Control (CDC) and IOM on a field study of household drinking water use in the Department of Artibonite, IOM developed a three‐phased pilot project based on a “social marketing and commercial” scheme, to sell a liquid chlorine household water and treatment storage (HWTS) product called Aquajif. The objective of the project involves reducing mortality rate due to waterborne diseases in Artibonite department, by improving access to potable water through AquaJif treatment. The product is produced incountry by a CDC identified company called La Perle S.A. and distributed to the most vulnerable communities in the Artibonite department.
In the two previous phases of the project, IOM worked on creating demand and developing a distribution network throughout Artibonite department by identifying wholesalers and retailers. Aquajif sellers included businesses, community‐based organizations, MSPP dispensaries, and private individuals.
Phase III which was implemented from 1 March 2016 to 31 October 2016, addressed challenges identified in this existing distribution and supply network and implemented an exit strategy to ensure the sustainability of the project.
As such, Phase III activities included emphasizing and facilitating direct communication procedures between distribution networks and manufacturer. IOM also focused on training in sales management and marketing strategies to support the network wholesalers, retailers, dispensaries and CBOs/NGOs.
A total of 86 CBOs/NGOs had been trained in AquaJif Business plan, after the training sessions, IOM field team enrolled a total of 31 wholesalers and 223 distributors, and thus became actively involved in commercialization of AquaJif. The 31 Wholesalers included, 26 private sectors (84%), 3 health centers (10%) and 2 Communities based Organization (6%) While the 223 distributors included 68 private sectors, 70 health centers and 85 Communities based Organization.
Post Matthew Activities
The Health section provide sensitization session in affected department .To carry out this activity, IOM has mobilized MSPP agents to provide education, family awareness on hygiene, methods of cholera prevention. A total of 110 913 received keys messages, out of them 36 888 in Grand Anse and 72 025 in the South. 58% of these beneficiaries in the South are women compared to 51% in Grand Anse. Health section also produced an audio spot message in collaboration with La Perle, MSPP and IOM and broadcasted at community radio stations. This message encourages the use of hygiene measures and prevention against cholera and also the promotion of the use of a water treatment product at home "AquaJIF".
Based on the population of the two departments and the coverage of the radio stations, it is estimated that approximately 657,988 people listen to the keys messages.
Health section provided training to medical staff after Hurican Mathew, In South OIM has trained 26 medical staff through two training sessions, 30 staff have been trained in the department of Grand Anse. In addition to formal training sessions, our teams regularly monitor training to strengthen the response to cholera.
IOM Health section provide medical and non-medical items to health facilities to enhance their response capabilities during outbreaks. To ensure the availability of medical and non-medical equipment, our field teams regularly monitor the stock at the management sites and in collaboration with the MSPP and the peripheral drug depot all gaps are covered. IOM ensures that medical and non-medical equipment is available for the benefit of the sick. A Total of 18 222 bottles of Aquajif and 4811 buckets with tap have been distributed in South department and a total of 20 007 bottles of Aquajif and 5090 buckets with tap in Grand Anse.
Assisted Referral for Vulnerable Persons
Those who remain in IDP camps are often the most vulnerable and ongoing health costs/incidents can be significant barriers to successful return. In addition, the ongoing effects of displacement and the prospect and process of return can have significant impacts on the mental health and psychosocial well being of individuals and communities, and should be addressed in all steps of the return process, from community mobilization, to individual assistance and reintegration support. The main objective of this component of return assistance is to identify and address health and psychosocial issues BEFORE & AFTER return, in order to facilitate returns of vulnerable families, assist those with problems to prevent health incidents or costs after return, and prevent return/reintegration failure which could result in a return to camps.
IOM prioritizes those IDP camps receiving return and resettlement assistance, providing support to the most vulnerable, including:
- People living with disabilities (physical, sensorial, mental, intellectual)
- Pregnant, postpartum and lactating women
- Individuals and families with ongoing distress or mental health problems
- Infants and children under 5
- Elderly persons
- People with chronic or disabling illnesses including HIV/AIDS and Tuberculosis,
- Acutely unwell patients
- Direct health and psychosocial assistance to 11,181 during returns/resettlement;
- Tailored assistance packages to 8,245 individuals and Enrollment of 2,611 vulnerable individuals in a Health Insurance program.
Preventive Public Health Information and Education
IOM has trained over 70 community health agents in camps and communities who returned to their neighborhoods to act as focal points on a range of important community health issues including health promotion, cholera and other infectious disease awareness such as TB/HIV, maternal and child health, and information on accessing health care. In 2011 these community focal points have conducted over 35,000 home visits, registered 1,414 pregnant women, and have identified over 300 suspected TB cases which were referred for screening, diagnosis and treatment.
Supporting the Ministry of Health in Priority Public Health Areas
IOM works closely with the Ministry of Health (MSPP) to assist in addressing critical public health gaps in a range of areas including mapping of camps and health facilities, developing and implementing strategies to address infectious diseases such as cholera and tuberculosis amongst displaced populations, building transitional shelters in government hospitals and health facilities as well as distributing health information to displaced populations.
Mainstreaming Health Considerations in Camp Management
IOM’s health unit ensures health considerations are taken into account in shelter and camp management operations, through efforts which include training coordination of condom distribution focal points in camps, allocating transitional shelter support for vulnerable patients as well as hospitals and health facilities, and ensuring actions such as site planning and service provision consider health, psychosocial and physical vulnerability factors. IOM’s health and shelter units worked together to build transitional wards and shelters for patients and hospitals across Port au Prince including HUEH General Hospital, Mars and Klein and Buedet Psychiatric Hospitals, and the destroyed TB Sanatorium in Carrefour Feuille.