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Haitian Lives Still to Save

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This is a joint commentary by the presidents of eight leading humanitarian aid organizations operating in Haiti: George Rupp of International Rescue Committee, Charles MacCormack of Save the Children, Nancy A. Aossey of International Medical Corps, Ruth Messinger of American Jewish World Service, Raymond Offenheiser of Oxfam America, Nancy Lindborg of Mercy Corps, Helene Gayle of CARE and Ken Hackett of Catholic Relief Services.

The vision of suited diplomats and officials meeting in a conference hall doesn't exactly send tingles up the spine. But decisions made at the March 31 international donors' conference on Haiti in New York could literally mean the difference between life and death for the people of Haiti.

As media attention fades from the aftermath of the devastating January 12 earthquake, survival still hangs very much in the balance for many of the millions of Haitians affected. Right now, as more than a million people scrape by under tents, tarps, and bed sheets, Haiti's rainy season is about to begin. Within a couple months, hurricane season will follow -- and some weather experts predict it will be a particularly harsh one.

As leaders of major international aid agencies on the ground in Haiti, we call upon international leaders to act boldly in New York. The donors' conference is the best hope to establish the leadership and resources needed to meet Haiti's urgent needs, while tackling the even more complex challenge of getting the devastated nation on track to manage and secure its own development.

We urge international donor governments to agree upon a reconstruction and development strategy that supports Haitian leadership and includes long-term commitments in six key areas. Action on these points will save lives and provide opportunities now and for years to come.

Shelter: An already crowded Port-au-Prince has lost vast swaths of usable land to rubble, while looming seasonal rains and potential hurricanes threaten the basic temporary shelter that aid agencies have already supplied. Planning, land and incentives are needed to encourage voluntary movement to more appropriate, more secure camps and also to allow host families to continue to share their homes with the displaced for the short to medium term. Donors need to make addressing the complexity of both temporary and permanent land and shelter in Port-au-Prince and the rest of the country for those displaced by the earthquake a top priority.

Water and Sanitation: Experts know that water-borne diseases can be killers in a crisis situation and afflict children under five most severely, so water and sanitation have been a major focus of relief efforts. But more needs to be done as bodies still need to be buried and Haiti's parks and fields overflow not just with people but also their excrement. Building a latrine may not be glamorous but it can save lives and we know how to do this. Addressing overall water and sanitation needs in both urban and rural settings will require a long-term, carefully thought out plan implemented by strengthened national and local governments.

Health Care: Health care remains a critical need. Before the earthquake, Haiti suffered the highest mortality rate in the Western hemisphere, and its health systems were already weak. Now the earthquake has plunged the most vulnerable into even far greater peril -- particularly expectant mothers, infants, and under-nourished children. And while emergency crews of doctors arrived to amputate limbs crushed by falling buildings, thousands of amputees now need wound care, prosthetic devices and physical rehabilitation. Short tours by medical teams from the United States will not solve Haiti's medical dilemma; Haiti needs a real medical system that serves its people.

Protection: Protection of women, children and the disabled must be factored into the delivery of aid. History shows that after a major crisis strikes, women and girls are more vulnerable to violence and need to be protected from exploitation, rape and abuse. Their needs -- and the needs of other vulnerable groups, like the elderly and disabled -- are often overlooked or minimized in humanitarian response. Aid must reach these groups. In addition, our agencies will continue working to identify, register and aid separated and orphaned children.

Education: Getting children back to school in the aftermath of an emergency provides an immediate safe place to play and a time to heal. Educating children paves the path to the future and should form a foundation of Haiti's new beginning.

Economic Recovery: Haitians have lost both housing and jobs, and their economy lies in ruins. Between 70 and 80% of Haitians are out of work. Reconstruction projects must ensure local labor opportunities. Jobs and cash-for-work programs are urgently needed in Port au Prince and outside the capital, too, where families hosting displaced relatives and friends are already facing major scarcity and stress. Women and young people -- sometimes an afterthought in economic development programs -- also need urgent help to support themselves and should be included in plans to get the Haitian people back to work.

Outside of Haiti, other changes are needed too. The U.S. Congress should reconsider laws on the books that hurt Haiti's agricultural development and exports. The Obama Administration ought to consider allowing more Haitians to join family in the United States. And all nations owed money by Haiti should move to forgive debt, as many have already done.

This top "to do" list reflects the needs our teams are seeing on the ground. Most news crews have moved on from Haiti, but the work of helping people restart their lives is just beginning. The Haitian people are not passive. They are clearing rubble and tackling their own lengthy "to do" list. Reconstruction needs to be a Haitian-led process that helps brings good governance, transparency and accountability to the people. Through partnering with and supporting Haitian institutions and individuals, the international community can enable the kind of robust response needed to rebound from the earthquake's epic tragedy.

There are many actors involved, willing and anxious to help: Haitian civil society, local and international aid agencies, the Haitian Government, foreign governments, the UN and multinational organizations, the Haitian diaspora, and private investors. The donors' conference could turn out to be an enormous turf battle, or a long series of speeches followed by little action. Or participants could step up and agree on the framework and resources necessary to help the Haitian government and its people forge the way to a more resilient, secure and prosperous future. Let's all hope they do.