The Sanitation Crisis in Port-au-Prince

I have been out of touch for the past several weeks. Every day is like a lifetime and at the end we just collapse into bed after a cold shower, and in the morning we sit up and look out at the camp spread before us and the whirlwind begins again. But most of us have managed to hold on to our sanity, tethering our minds to our work. As the weeks go by the city begins to look more familiar, the shattered buildings have become a part of my mindscape and there are moments when I barely notice them. People wind through the traffic jams and the streets are lined with vendors, people who have left the camps during the day to return to their old sites along the street, sitting in front of their crumbled homes selling fried food and soaps. Children run around the camps in packs and their laughter filters through my pillows.

As the weeks drag into months I remain in awe of the ways in which people maintain their dignity, I am amazed by the discipline and kindness of hungry people. I think of how hunger can affect my own mood and wonder if I would be as compassionate and full of humor if I had not eaten for days. Despite the deepest resilience there is an anger brewing, a frustration with the fact that aid is not moving fast enough and as we move into the rainy season tens of thousands of people will be stranded without tents. Haiti has struggled with poverty for centuries but it was not a nation of homeless people. Haiti was a country held together by family and community and very few adults slept on the street. Before January 12 no one would have considered camping in Port au Prince, now over a million people sleep in the streets every night, forced to lay aside their fears as they drift off to sleep in a sea of neighbors and strangers.

For nearly 2 months Nick and I slept behind Matthew 25 House in the middle of a small tent city of some of our dearest friends, volunteers and doctors, adjacent to a camp with about 1400 people sleeping in it. Every night I left my purse next to my bed, and being myself I often left it out there in the morning when I went for coffee. In 2 months I never had a single thing stolen nor felt unsafe in any way. I even became accustomed to the evangelical woman with a megaphone who begins circulating around 4:30 am. I am used to the pace of life here, the easy smiles and the tough stares, the animated arguments and voiceless interchanges, but I will never cease to be impressed with the grace of the Haitian people, even in the face of inexplicable suffering.

Time passes and we have continued with our relief efforts though our strategy is shifting. We will continue to give food and water for the coming month, but we are also beginning to focus on sanitation solutions that could help prevent the spread of disease as the situation in Port au Prince shifts from emergency to recovery. Nick and I began attending the sanitation cluster meetings during our first week in Port au Prince, to get a better sense of the various actors. Just as people never slept in the street before the earthquake, there was no active interest in sanitation in Haiti prior to Jan 12. For centuries Port au Prince’s human wastes have been dumped into the ocean, rivers and fields without treatment. Before there was no question of where our wastes were going, and now the halls of DINEPA (the government direction of portable water and sanitation) are flooded with representatives of all of the world’s big organizations, everyone clamoring to get a handle on the sanitation crisis that has been unveiled by the earthquake.

Prior to the earthquake Haiti had by far the lowest sanitation coverage in the hemisphere and heavy child mortality due to water borne disease. In a city of more than 2 million people, hundreds of thousands never had access to a toilet and were forced to go to the bathroom in plastic bags or in nearby ravines. The sanitation crisis did not come from the earthquake, the earthquake only exacerbated it, as people spilled into the streets so too did their secrets, and when you don’t have a toilet, sanitation is a secret. Now the spotlight of international attention is directed on Haiti and it is impossible to ignore the increasingly dire sanitation crisis. Given that more than half a million people are displaced, there is a need for a minimum of 10,000 toilets to safely serve a population of that size. Two months after the crisis there are less than 3000 toilets in place in the camps and many of those that have been installed may be damaged in the coming rains.

In Petionville the two main squares are now home to over 13,000 people and only 15 portable toilets. Imagine if there are 866 people per toilet and 720 minutes in the day, that would mean that for everyone to use the toilet once a day there would be less than 1 minute per person. Also at the rate the toilets are being used, they need to be emptied every day and there are currently not enough desludging trucks in Port au Prince to service all of the toilets being installed. When the toilets are emptied they are taken to a new site set up by the government which is in the middle of the city dump. To get to the site you pass through piles of burning garbage the size of football fields. Hundreds of people come to the dump every day to scavenge for pieces of metal, and firewood. At the end of the steaming garbage there are 4 pits, dug shortly after the earthquake. The sludge from the toilets is dumped into or near the pits where it is mixed with all kinds of garbage and medical wastes. Now only 1 month after the holes were dug they are full and every day the amount of human wastes coming out of the camps is increasing.

SOIL is a small organization and we do not have the capacity to make an impact in terms of number of toilets, but we are innovative and we are planning on being in Haiti for the long haul. So we have chosen to focus our efforts on piloting ecological technologies and helping as best we can to coordinate between other large agencies to increase the efficiency and cultural appropriateness of service delivery. This week we began a project in collaboration with OXFAM – GB to construct 50 urine diversion toilets, 100 arborloos and construct a pilot composting site for Port au Prince. We will be working on this project for the next 6 months while continuing to move forward with our sanitation work in the north. We hope that our pilot work and our dedicated networking will help to create sustainable sanitation systems in Haiti. We are committed to breaking the cycle of disease that happens when people come in contact with untreated human wastes by rebuilding the nutrient cycle. By recycling human wastes through composting, the pathogens die off and the nutrients can be reused to enhance agriculture and feed people, breaking the disease cycle and closing the nutrient cycle.

With the rainy season just weeks away, organizations focusing on health in the camps have warned of large-scale risk for outbreak of diarrhea due to the high density of the camps, the lack of proper waste management services, and poor sanitation services. The pace of aid is slow and the level of dissatisfaction is understandably growing. Sometimes frustration washes through me and I remember what Rea always says to me “se’m pa janm dekouraje” which translates to “my sister never give up”. If Rea can stand strong and keep fighting, fiercely moving through the dust of the crumbled buildings, then surely we can all find the strength to keep moving forward.

The rain began to fall a few days ago and I could feel the city shudder. As the rubble runs down the main streets and the latrines fill we feel even more committed to our work. I drift off to sleep at night, willing my heart to slow after the madness of the day, before I sleep it returns to the rhythm that reminds me that there is nowhere in the world I would rather be. Many organizations filled with good hearted people will come and go, restricted by security rules and short term contracts, but SOIL will stay and we will do our best to be the glue that holds together all of the incredible souls, Haitian and international, who are working for reconstruction and a sustainable future.

SASHA KRAMER, Ph.D. is an ecologist and human rights advocate and co-founder of Sustainable Organic Integrated Livelihoods (SOIL). She is an Adjunct Professor of International Studies at the University of Miami. She can be reached at: