Relief organizations need to think long-term, research shows

by Julia Glum

When a magnitude-7.0 earthquake hit Haiti in 2010, the world wanted to help.

People gave blood. Communities organized bake sales. International and nongovernmental organizations visited the area to dig wells and provide access to safe .

But University of Florida researchers say NGOs dropped the ball by not providing the long-term follow-through needed for their assistance projects to be truly effective. In fact, researchers say that routinely happens in NGO assistance projects in other crisis-stricken countries. The study results were published online July 28 by the American Journal of Tropical Medicine and Hygiene.

NGOs need to not only provide initial help to crisis-stricken countries but also to make long-range plans to maintain them, said Glenn Morris, director of UF's Emerging Pathogens Institute.

"You came in and did the easy part: You dug the well," he said. "Then you left before you did the hard part … monitoring it."

In Haiti, monitoring the wells was critical because dirty water can spread cholera. Haiti is still in the middle of what the Centers for Disease Control and Prevention call the intestinal disease's worst recent outbreak in modern public health.

When the UF research team, headed by Jocelyn Widmer, surveyed 345 wells in Haiti two years after the earthquake, they found more than a third of the wells contained fecal bacteria.

"The people who are drinking the water … have a risk of getting sick not just from cholera but from a variety of other diarrheal diseases," Morris said.

The average cost to have a contractor dig a well in Haiti is between $7,000 and $11,000, so NGOs can create them quickly and cheaply and then report it to their backers. But maintenance to keep the water clean costs money, and it's rarely included in budgets.

The study's results show that NGOs' preliminary relief efforts aren't enough, Morris said. Contamination is a constant threat, especially after storms: In the flooding that followed Hurricane Sandy, 51 percent of the wells showed evidence of fecal contamination.

Chlorinators and trained professionals could help keep the water clean, but the researchers found no coordinated strategy for the water sources installed after the earthquake.

"We need to rethink the way we respond to disasters," Morris said. "We need to rethink the approach that basically says you come in, do good deeds for a little while and then you walk off and leave the problems with the people that are still there."

For example, NGOs had built 56 percent of the water points in the study region, but only 25 percent had any evidence of a management strategy. Sixteen percent were non-functional. Although about half reportedly had a "pump keeper," they had no power to repair or run the wells. Instead, Haiti's resource-deficient government faces the maintenance challenge.

While issues with some NGOs' transparency and credibility have been documented in news accounts, Morris said the Haiti situation should serve as a strong reminder that the follow-through problem needs to be addressed.

"It's easy to go in and do for a short period of time," he said. "What's hard is sustainability."

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