MCC photo/Paul Shetler Fast

Flooding from Hurricane Matthew in October 2016 contaminated this drinking water in parts of Port-au-Prince, Haiti, increasing the cases of cholera in the country. To help prevent the spread of cholera, MCC is working with communities in the mountains northeast of Port-au-Prince to build latrines so that human waste isn't washed into the Artibonite River, one of the major sources of water in the country.

Hurricane Matthew hit the rural community of Wopisa-Gabriyèl hard in early October 2016 and led MCC to respond to sanitation needs identified by community leaders.

“There was a lot of damage to this community in the storm,” says Previl Pierre, a local leader and community monitor in MCC’s environmental education program. “Many goats and cows died, and whole gardens were lost.” 

But beyond the damage to animals and crops was the increased risk of cholera caused by the intense rains washing cholera-infected human waste into the streams and rivers that are used for bathing and drinking.

Community leader and educator Previl Pierre.MCC photo/Ted Oswald

The threat of cholera

Cholera, a bacterial disease that causes severe vomiting and diarrhea, was introduced to Haiti in 2010 when the contaminated waste of United Nations peacekeepers was discharged from improperly built latrines into Haiti’s main waterway, the Artibonite River. Cholera spread like wildfire through the country, killing more than 10,000 people. People in the Artibonite were especially affected.

Elius Pierre contracted cholera recently: “I wanted to die it was so painful. I am still not the same person I was before. I used to be strong and now I can barely eat. I spent 11 days in the hospital. I truly thought I was dead.” MCC photo/Ted Oswald

In Wopisa-Gabriyèl, a community wedged among several mountains in the Artibonite region, a small creek feeds into a larger river. The absence of latrines means the 1,500 residents practice open defecation, dramatically increasing the risk of cholera exposure.

“When it rains, everything runs down into the water and contaminates the springs. It infects our drinking water, our gardens and our food,” said Roseline Pierre-Louis, a community health worker. 

Roseline Pierre-Louis, a community health worker. MCC photo/Ted Oswald

Once contracted, cholera can kill quickly if treatment isn’t received, but reaching care is very difficult from this remote community. The quickest route to medical care requires descending a waterfall on foot.

“There is no road, so people must walk to the hospital on foot or be carried,” Roseline says. To reach the nearest medical facility takes three hours on foot and up to six hours if one is sick. Sometimes people have to be carried by others on makeshift stretchers or mattresses.

The shortest route to reach medical assistance from Wopisa requires descending this waterfall.MCC photo/Ted Oswald

A solution out of reach

The community has long known of a relatively low-cost solution to protect its water source and its health: the installation of latrines. For subsistence farmers, though, the materials to build latrines are too expensive.

After the hurricane, MCC met with people in Wopisa-Gabriyèl to discuss how it might provide assistance and partner with the community in addressing their needs. Because of the risks from waterborne diseases including cholera, the community identified latrine construction as its most pressing need.

“We can’t drink our water safely. We can’t care for our children. We can’t protect our families,” says Previl. The community saw better sanitation as a necessary building block for both short- and long-term recovery and for improving their community.  

The frame of the first latrine in the community.MCC photo/Ted Oswald

A partnership to save lives

Even though a community may say latrines are their highest priority, being able to build them is complicated. In Haiti the government has withheld approval of almost all new latrine projects by nongovernmental organizations because too many weren’t executed well. Latrines built without community input and with poor design have led to increased disease and a waste of resources in communities that can become dependent on outside assistance. 

"When we sat down with community leaders and talked about what latrine design and implementation should look like, community members were thoughtful and clear about their needs,” says Paul Shetler Fast, an MCC Haiti representative.

“They made a point to tell us that they did not want the kind of latrines that they have seen built in other communities—ones which they described as nicer than their churches, schools and houses. They said that these latrines were not respectful and did not have community buy-in.”

Because MCC planned, designed and implemented this project in partnership with local people, the government officials approved it.

We can’t drink our water safely. We can’t care for our children. We can’t protect our families”

MCC provides the block, cement, tin and nails -- supplies for the simple, solid latrines -- and a local expert builder to direct the construction. Then community members transport the materials and form neighborhood work groups to complete the labor and construction. In total, this project will construct 450 latrines that will meet the needs of 90 percent of the residents.

Desinord Petide said seven people in his house will benefit from the latrine he helped build. "I am proud to build this toilet," he said. "The first in the community!" 

A larger benefit

The benefits of this project will extend beyond just Wopisa-Gabriyèl. Because the community rests at the source of a spring, downstream communities will be protected.

The first phase of building 250 latrines is nearing completion, and the second phase, with an additional 200 latrines is already underway. As part of our hurricane response, MCC will be working with other remote communities at high risk for cholera by building a total of 630 latrines serving more than 5,000 people over the next four months. 

Rebecca Shetler Fast is an MCC Haiti representative with her husband Paul Shetler Fast. Ted Oswald is a former policy analyst for MCC Haiti.

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