Briefing by State Department Counselor Cheryl Mills and USAID Administrator Dr. Raj Shah on the Way Forward in Haiti

Tuesday, February 2, 2010
Subject 
On the Way Forward in Haiti

MR. CROWLEY: Good afternoon and welcome to the Department of State. It’s been a couple of weeks since two of our most senior officials working on Haiti policy have visited with you, so we thought we’d start up with kind of a Haiti update briefing with our chief of staff, Counselor Cheryl Mills, and the Administrator of USAID Raj Shah. And then we’ll pick up on other subjects after that.

Cheryl.

MS. MILLS: Thank you so much. Oh look, the waters are even labeled by our agencies. That’s nice.

Good afternoon. I just wanted to start off by – first, by reiterating what I know many of you all know and have been doing a great job of actually bringing to the fore, and that is the United States commitment to the work that’s being done in Haiti not only to the Haitian people and the work that the Haitian Government is doing, but also to the international community and the type of coordination that has been necessary for the large-scale effort that is ongoing in Haiti right now.

I think each day we are seeing improvements not only in the coordination but in the ability for the delivery of the different services and resources that are necessary given the magnitude of this particular tragedy. And so we are hopeful that we continue to see the progress that we’ve been seeing in that regard.

We’ve been working very closely with the Haitian Government. We have continued daily meetings not only with the prime minister but also meetings that have been happening with President Preval to sort through their priorities, listen to them as they are thinking through their forward planning as they look ahead to the next steps. We spent time at a conference in Montreal, actually, last week, where Prime Minister Bellerive spoke a lot about the vision for Haiti and in particular about the need to do decentralization in Haiti and to see Haiti grow outward from Port-au-Prince as opposed to remaining concentrated there, and what that might mean in terms of their thinking for how they see the recovery and building of Haiti in the future.

At that conference there were many countries from around the world, all of whom were pledging to be committed to Haiti, not just today but tomorrow and the next day and the days ahead. Many of them have been long-term partners of Haiti on the ground, and so it was nice to be in a place where so many people who had a great familiarity of not only the Haitian country and culture and government, but also what have been the challenges and the opportunities that are in Haiti. And that’s what I think everybody is anticipating focusing on as we look ahead down the road.

We are anticipating that conference, which will be a donors conference to pledge what resources each country would be willing to put forward to support the building of Haiti, to occur in March. And we are also anticipating that at that time there will have been an assessment that’s been done by the UN that will allow us to make the kinds of judgments and the kinds of commitments that will build a better Haiti, or, as the Haitians have said and Prime Minister Bellerive, a new Haiti for the government and the citizens of that country.

We are very cognizant of the fact that Haiti alone, and certainly not the – with the United States or anyone else alone can actually accomplish the breadth and scope of the task that’s necessary for what needs to be done in Haiti. And so we are really looking forward to critical partnerships around the globe in support of the Government of Haiti and the people of Haiti as they go about defining what their future should look like.

So that’s just a little bit of a broad overview, but happy to answer questions and I’m going to turn it to my colleague who is going to speak in specifics about some of the things ongoing now. Raj.

ADMINISTRATOR SHAH: Thank you. So I’ll just share a few broad thoughts and then provide a sector-by-sector update on where we are with the current unified relief effort.

First, as Cheryl points out, rebuilding Haiti, first and foremost, is a partnership with the Haitian Government and we are fortunate to be working with the Haitian Government across the range of sectors that I’ll describe. In most cases, it is the Government of Haiti, through coordinating systems on the ground, that is providing the specific strategic leadership about what gets done in what neighborhoods and at what pace. And that has been very important to guide the efforts of our collective response efforts but also efforts of other donors and other partners.

Second, the recovery effort – this is now shifting as we’re ramping up the relief effort and we’re trying, in a very focused way, to do things that are sustainable, that are appropriate, and that can contribute to a strong Haitian recovery in terms of the economic recovery and in terms of the recovery of the capacity of public services to sustain services provided to the Haitian population. So when we were talking earlier, our priority and our focus was around saving lives through search-and-rescue, and it has obviously evolved.

Third, every day we are very focused on doing better than we did the day before. And that continual metric we track in quantitative terms, sector by sector.

And finally, I’ll just remind folks – and I enjoy sharing this because it’s an important point – that it is the resilience of the Haitian people that is the primary vehicle through which most relief is provided, and I was reminded of that when I visited and walked through a settlement near the presidential palace. And you walk through that environment, and we would – we pulled up a blanket and saw a 12-volt battery connected to an inverter connected to a power strip charging probably 20 mobile phones. And people are, in fact, using those types of systems to stay connected to get information and to make effective decisions about where to go for food and supplies and for shelter and other forms of support.

In the food sector, we’ve now provided food and two-week rations to more than 800,000 Haitians. The rate of daily service has more than tripled from an initial rate of around 45,000 served a day to now more than 120,000 today. The reason for that significant improvement has been putting in place a fixed distribution system at 16 sites throughout Port-au-Prince. And the U.S. military, together with the World Food Program, the Government of Haiti, and a number of NGO partners, has come together to make that system an effective one.

Our reports from distributions that are done by providing coupons to women who then can come and receive rice, and soon will be able to receive other commodities and even non-food items through the system, has been distributions have been orderly, distributions have been calm, that there has been a sense of hopefulness around them, and that in addition to those fixed-point distributions, we’re all – we’ve also served more than 250,000 people outside of Port-au-Prince in neighboring cities. So that’s an important step forward for the overall relief effort. And we will continue to work towards the target of reaching 2 million people served.

In shelter, our target remains between 240- and 300,000 households and providing them with services and the capacity to provide shelter for themselves, and shelter that would be protective in an event of rains. We believe, through the combined efforts of a number of NGO partners, UN partners, and the Government of Haiti, that we’ve reached approximately 70,000 of those households, especially with plastic sheeting and shelter kits and some training to help support their efforts to build and to maintain a shelter for themselves.

The rate in terms of the rate of the number of the people we’re reaching in that sector has increased significantly in the last 10 days, and we continue to track that, and believe we now have enough materials, plastic sheeting, shelter kits, and NGO capacity to serve up to 260,000 households. So we believe that system is on track.

There are challenges that, of course, remain. Sanitation is one of them, and exploring how we support efforts to remove rubble in a way that allows for effective placement of these shelters and of families is another challenge that we’re working through under the leadership of the Government of Haiti.

In health, we’ve had similar progress. We have worked with the Pan American Health Organization, CDC, and the Government of Haiti through its 43 hospitals to help put in place a disease surveillance system that has now 51 surveillance sites. We will soon be starting vaccination campaigns for DPT, for measles, mumps and rubella, and tetanus toxoid. They’ll be targeted, of course, to different subgroups of the population.

In addition to that, we continue with the trauma service and medical service that’s been provided by the Disaster Medical Assistance Teams and by the USNS Comfort that has been in the theater. We estimate U.S. medical professionals have now seen more – or nearly 25,000 patients; that’s a tremendous achievement. Of course, the needs with such a tragic situation are far in excess of that, but it is an important point. And we are now working collectively with our NGO partners and, in particular, partners of our PEPFAR program and with the CDC to really help transition some of these medical assets that were brought down by the Disaster Medical Teams to NGO partners who can help sustain their ability to serve Haitians, and also make sure those assets get integrated into a sustained and more effective healthcare system for Haiti.

The other focus in the health sector for us will continue to be on post-trauma and post-operative care. And we’re increasing capacity in Haiti primarily by identifying and expanding the capacities at 31 sites that we believe have the capacity to provide post-operative and orthopedic services.

In water, water has remained, I think, a success story; that we have had approximately 2 million liters delivered daily to nearly 160 sites. That has continued to increase steadily week by week, and we have not seen shortages of water in pockets or with settlements.

I mentioned previously sanitation is more of a challenge, and so we’re making that an increasing priority, and also expanding distribution of chlorine tablets at water distribution sites to prevent disease spread.

Other parts of the relief effort include a jobs program. We now are providing, through the Government of Haiti and in partnership with the Government of Haiti, nearly 5,600 daily jobs. Many of these jobs are around clearing rubble, and clearing rubble in strategic areas per a plan developed through the Government of Haiti. That will be very important, of course, for both creating space to build latrines and also creating sites where people can settle in a more effective and sustainable way, and that’s an important part of our solution. And over time, more of these jobs will also migrate to those areas where people who have left Port-au-Prince and gone to secondary cities will be, so that there are expanded employment opportunities, and over a longer term, of course, transitioning that to private sector employment opportunities will be an increasingly important priority.

So as you can see, sector by sector, we’re trying to make sure we just continue to solve problems and do better every day, do that in partnership with the Government of Haiti, and do that in a way that helps create the basis for sustained and sustainable activity so that the Haitian people have access to services that they need at this – in what continues to be, of course, a tragic emergency response situation.

So, thank you. I’m happy to take questions along with Cheryl.

QUESTION: Can you give us an update, if there is one, on these 10 Americans who are being held or arrested?

MS. MILLS: I don’t think we have any further update. They are obviously continuing to be held and we do know that the court or the judge today is supposed to be looking at their case and making some assessments. We don’t know if that’ll actually be done today or in the next day or two.

QUESTION: Do you know, has there been any contact between the government – between the two governments on this case?

MS. MILLS: I’m not aware of any, but I am certainly aware of the fact that we have reached out to make sure that we had consular affairs services and access to the individuals, so I don’t know if that constitutes that kind of contact.

QUESTION: No, no, no. I mean between the Haitian Government – between the Haitian Government and – not between the detainees, the --

MS. MILLS: Sure, but we also reach out to the government to be able to have access to the detainees, so just to be --

QUESTION: Right, but I --

MS. MILLS: Sorry, lawyer.

QUESTION: Not in terms of --

MS. MILLS: Always worried about the right – saying the right thing there for you.

QUESTION: I’m talking about in terms of their --

MS. MILLS: But we haven’t had any broader conversations about their prosecution or their case or something like that.

QUESTION: Okay.

QUESTION: But in a more general way, Ms. Mills, what does it say to you about the American response and how people are reacting here that this group of Americans did feel compelled to do what apparently they did do?

MS. MILLS: Well, two things. I can’t speak to, obviously, these individuals’ motivations. I can speak to the fact that I think – look, one of the most human instincts out there is to make sure that in any particular instance, we are being thoughtful for how we treat young people and children.

I think that’s one of the reasons why this Department took such a firm stance that we were only going to be paroling in individuals who already were in process for an adoption, and making sure that they already had been adjudicated to be orphans, because in any other instance, you truly don’t know whether or not you were separating a family or not. And I think one of the things that is uniquely important in these kinds of situations, given the vulnerability of children, is that we actually are all, as an international community, focused on that particular goal.

I appreciate that obviously, in this instance, individuals were making their own assessments about how they best could participate in that, but I think the real bottom line has to always be that we are ultimately seeking to maintain families, and children with their families when there are families who are present, and separating them does not ultimately serve the larger objectives that we have, which is ensuring that in the end, orphans who are genuinely orphaned, that are in a process and have been adjudicated to be, end up with families who are seeking them.

QUESTION: Can you spell out just for the record what the process typically is for someone who wanted to adopt a child from Haiti?

MS. MILLS: Sure.

QUESTION: Especially because it’s my understanding that this particular church group wasn’t listed as an official adoption agency with the State Department. What should people be doing?

MS. MILLS: Two things. One, just if you want the actual specific step by step, we’ve put that on our website, www.state.gov, so that you can also have that for your own reference. But as a general matter, the process actually begins with two separate sides, right, the – someone in the United States gets reviewed and determined to be actually eligible to adopt a child, and there’s typically a background process that one goes through. And to the extent there’s an international adoption, there’s a process that you also go through associated with the State Department and others.

Similarly, on the other side, what is happening is countries usually are making a determination that a child is indeed eligible to be adopted. In the particular instance of the protocols that we and Prime Minister Bellerive, on behalf of Haiti, agreed to – we actually agreed to make sure that given that there were children who had actually been adjudicated by a court in Haiti to be orphans, or had already been identified in the process as having been orphans, or children who properly should be united with their American families – anyone who didn’t meet that strict requirement, given the circumstances of the situation in Haiti today, probably were not children who should be removed at this time, but instead, best efforts should be made to unite them with their families.

Obviously, as this process goes on, there will be no doubt children who are legitimate orphans. The Government of Haiti will make that adjudication and assessment of them, and that is the time at which children would become available for adoption and then the normal processes that we have on this side would work.

QUESTION: Dr. Shah, you mentioned, if I got this correctly, with shelter that 70,000 of the households have been reached with plastic sheeting and so on. And you said we now have enough materials and NGO capacity in the country to serve 260,000; is that right? So what’s sort of the gap there between the 70,000 and the 260?

ADMINISTRATOR SHAH: Well, it’s just how many we reach a day. So every day, we’re reaching more and more households. I think 10 days ago, the total reached was under 10,000, and so you had a very quick ramp-up in the last 10 days. And that’s – we track the total number served and the rate at which we’re serving. So that’s basically it.

The other parts of that that make this challenging, of course, are finding sites that are appropriate for families to build these shelters. And often, that comes down to rubble, and rubble being removed. This is still – especially a lot of the homes that collapsed are in very dense, urban neighborhoods and there’s a lot of rubble, a lot of structures that need to be removed in order to create space. The jobs program is helping to do that, and the Government of Haiti is directing that effort around prioritizing where and how that rubble is removed. And people are even exploring, together with the Army Corps of Engineers, alternative uses for that rubble. Can it be recycled and reused in different contexts? It probably can. So those things are underway, but they do create a bottleneck on – the rate at which we can scale up shelter.

QUESTION: And I mean, there was – initially had been a request by the Government of Haiti for 200,000 tents. So this is not actually tents, right? It’s sort of --

ADMINISTRATOR SHAH: Some of these have been tents. The Government of Haiti has actually asked for both tents and plastic sheeting in its shelter strategy. They are deeply involved. My understanding is the senior government representatives are in the shelter cluster, which is the group of NGOs and UN partners and us and the government that meet every morning to identify priorities. And so this is being done at that direction.

For a variety of reasons, plastic sheeting can sometimes be more durable and more effective in terms of protecting families against rain. They can be easier to clean, which is very important from an infectious disease prevention perspective. And they can provide more room and more flexibility for families as they put these together. So there are a variety of reasons why different strategies are different – are appropriate in different contexts.

QUESTION: Do you have a better handle on the demographics of this disaster? We get various numbers going around, but do we know it’s going to be two million people needing full food aid for a year? Do you have a better handle on that now?

ADMINISTRATOR SHAH: Well, the original estimates, you recall, were as high as four million. We were doing a lot of planning around four million. I think that number has probably come down to around two million, which continues to be the planning metric that we use in defining, for instance, how much food assistance we should be providing, how we’re working with the World Food Program to size the response over the course of the next year.

That said, that’s a very rough and inaccurate overall estimate. And the reality is on the ground every morning, these teams are getting together and saying, “How many people did we reach yesterday? How can we do that better? What are the areas of need?” And through NGO networks and through the Government of Haiti, we’re able to reach more and more people in different parts of the country, and even in parts outside of Port-au-Prince. So people have been migrating outside of Port-au-Prince to secondary cities. They’re receiving a greater degree of support as well. So it’s probably less accurate to say there’s one fixed number that works for – across every sector.

QUESTION: I have a question about the whole decentralization issue. And I understand there’s a bit of a difference of opinion on the ground in Haiti about the wisdom of moving people out of the city into tent – sort of tent cities, as it were, or letting them build their tents and their temporary accommodation right where they are. Where does the U.S. stand on this? And what – if we are assisting in moves to establish temporary tent cities, what’s to prevent those from becoming permanent and sort of township-style developments outside of town?

ADMINISTRATOR SHAH: First, let me clarify the point. I think there’s a distinction between decentralization, which has been a concept that the president and the prime minister and other senior leaders in Haiti have promoted publicly and privately in a variety of different contexts, including supporting transport for more than 200,000 people from Port-au-Prince to other cities throughout the country. That’s a very different construct and a concept than the question of how you deal with settlements in and around Port-au-Prince.

So we’re following the Government of Haiti’s lead on the decentralization point.

On settlements in and around Port-au-Prince, we’re also following the government’s lead, which has been to support – there are somewhere between 600 and 700 identified settlements. Some are larger, some are smaller. And in all cases the priority is what’s the best shelter strategy in that environment, how do you address sanitation, water, and food distribution needs in that environment, and how do you protect against potential public health risks? And those are all things we’re working on with the Government of Haiti on a case-by-case basis as they go through that. There’s a shelter cluster that addresses these things and actually has just grown to include 20 experts from around the world that have gone down to help the Government of Haiti make – implement the strategic decisions that they are laying out. I don’t know if, Cheryl, you want to add to that.

MS. MILLS: No, I agree, the clarification that Administrator Shah just laid out is an important one. There were discussions around decentralization at the conference in Montreal, but with respect to thinking about how, in the future, their urban areas are growing or not growing and where they are going in terms of their long-term planning, not with respect to the tent issue.

QUESTION: Okay. But just for my information, would those – these tent cities that are being established or may be established outside of town, are those going – are they temporary? Is the idea that the people who are there would eventually migrate back to their old neighborhoods? Or what’s the sort of medium-term thinking?

ADMINISTRATOR SHAH: Well, they’re working through that. I wouldn’t use the term “tent cities” as a long-term part of the strategy that – as we’ve sort of heard it from the Government of Haiti. It’s been much more around dealing with temporary shelter needs for a population that’s displaced, making sure they’re protected against health, have access to water and food. And then the Government of Haiti is thinking through and leading the process of identifying where and how would you build back communities and housing that meets certain code for anti-seismic construction. There are a whole range of things they are then thinking about that are on a slightly longer-term horizon. So I wouldn’t use the phrase “long-term tent cities.” I don’t think that’s part of the strategic concept.

MS. MILLS: Yes.

QUESTION: I had a couple questions. The first one would be about the capacity of the Haitian Government right now. Understandably, in the days after the quake, they were scattered and they weren’t able to stand up for themselves. Is there an assessment on the U.S. Government’s part of the percentage of the government that’s able to function now? Are there certain sectors of the government that are able to function? Is, for example, customs not functioning? Can you give us a kind of a sense of that?

MS. MILLS: See, we don’t have a formal assessment, if you will, but I think we are increasingly seeing more and more of the government functioning. In the beginning, obviously, we were functioning primarily with the president and the prime minister. Increasingly, their ministers are now actually taking leadership responsibilities. And Administrator Shah can speak to that in terms of the planning efforts that are underway in the various clusters and sectors. So they are, every day, having more and more of their ministers assuming more and more responsibilities associated with not only the relief but also anticipating the recovery. I don’t know if you want to --

ADMINISTRATOR SHAH: Yeah. I would just add, we’ve all seen the photographs of ministries that were destroyed in the earthquake and the capacity that was lost. I mean, people lost family members, and the tragedy they’ve been through is tremendous. So the fact that civil servants and political leadership, ministers, the president and prime minister are so actively involved now in guiding strategic decisions sector by sector is a pretty strong testament to their commitment and their leadership. And I think whether it’s identifying the rubble removal priorities, directing the jobs programs implementation, or any number of other things, we are doing this in active and direct response to guidance from planners and ministers in the Government of Haiti now.

QUESTION: And can I have – my second question, real quick, was just looking forward. When it comes to the local economy and rebuilding that, I was curious if there is a plan or an idea about providing loans for local businesses, loan guarantees for banks to get that rolling again and boost employment – local employment there.

MS. MILLS: I mean, I think all of those, obviously, are going to be things that are going to be examined very closely because you ultimately want to build an economy that can actually be sustainable, and we want to create the best opportunity to do that in an effective fashion. That is certainly something that had already been anticipated prior to the earthquake, and there had been a number of investors who had traveled down to a large-scale conference and thinking about how they could invest and how the local businesses actually could be a larger part of the investment to kind of spur economic growth. That has to clearly be a central element of the planning that gets done over the long haul. It’s something certainly President Preval has been very focused on. And I anticipate as they come forward with what their plan for long-term development is, that that will be a central part of it.

QUESTION: Can I ask about the – more about the jobs program? Dr. Shah, you mentioned that 5,600 through U.S. participation were working right now. You didn’t mention a goal. Is that something that’s going to grow a lot more? I know a lot of UNDP is involved, other private organizations, but I’m wondering about the U.S. program working with the government. And also if there’s some plan or hope that this – expanding these programs kind of gets the private sector going instead of food aid, but getting people cash so they can go to the private markets that are up and running.

ADMINISTRATOR SHAH: Well, you’re absolutely right, and let me start with the private markets piece because I would just reiterate that in every sector, the single most important relief strategy has been the private market. Food markets have been operating throughout, are now very robust. We’re seeing people buying a range of food items and cooking and charcoal is moving in markets. So that’s just in food that – it’s absolutely true in water. And water, we supported – we now have a convoy of 200 trucks that go back and forth between Santo Domingo and Port-au-Prince. But a lot of what they bring is then distributed through private markets and through NGOs. But private markets have been a huge part of the successful effort to get water to where water is needed, because there have been local water companies that do that and had the capacity to do that very quickly after the disaster.

In that same vein, in every area that we work in, we are, together with the government, planning what is the right strategy to make sure that we’re providing food to those populations in need, but doing that in a way that is cognizant of the government’s own aspirations to have a strong and vibrant agriculture sector. And there’s been an active discussion about that and people are tracking market prices to understand the impacts of the relief effort on private markets. So I think that’s a very important point. I’m glad you raised it.

On the jobs program, that is, again, directed by the government and in concert with UNDP, which is also – and I think you made reference to – also launching various programs. The way these programs work, of course, at the government’s direction is they – it’s local mayors or local political leaders identify priorities in their areas. They work through their own mechanisms or with partner NGOs to identify what needs to get done, and on a day-to-day basis they go out and hire people, pay a minimum wage, and then provide that employment opportunity and also get important public works done. I think as that – that is also a part of a transition strategy, of course, to a private sector based employment strategy, but I think that will take some time.

QUESTION: So just the 5,600, is there some goal for –

ADMINISTRATOR SHAH: Well, we’re trying – our goal is more every day under the direction and capacity of the government. That’s true across every sector. And so just a few days ago, that number was 2,800 and it’s now 5,600. We anticipate it will grow significantly through February.

QUESTION: Can you update us on how many Haitian orphans are still waiting to come back to the U.S., how many are in the pipeline? And then can you address these 10 Americans or missionaries, whatever they were – is there any concern that this has put a long-term damper on the relationship between the U.S. and Haiti with adoptions? Will this have a long-term effect?

MS. MILLS: So there’s about 575 children who have already been processed through. I don’t have a good number, but I can actually have P.J. get back to you with what at least we would anticipate. I would imagine that there’s still at least another hundred children that would actually be – assuming that they get their paperwork in order – would be in the pipeline. But there might be more than that, and we certainly can get back to you on that.

In terms of concern, actually, no, and I’ll tell you why. We’ve had very good relations with the leadership of the Haitian Government and, in particular, had sat down and talked through the careful parameters we were placing on those children that we would allow to have humanitarian parole into the United States. And I think that gave them a lot of confidence that we were taking very seriously the need to ensure that only children who were already in process were actually going to be paroled out of the country and that we were not seeking to have any other children paroled out of the country at this time, that this is really the time for UNICEF and a lot of the other NGOs who are working on the ground there to actually ensure that they were placing children with families or identifying families that might be more extended families in the instance where children had been separated from more immediate families. And so that process has continued apace and I actually feel very good about the careful parameters that we’ve placed on the orphans that we would parole in.

QUESTION: And based on what you know now – it’s been several days since these Americans were detained – is there any better sense of whether there was malice in their actions?

MS. MILLS: I don’t have any information with respect to malice in their actions. I mean, I’m reading the same reports about why they say they did things that you are.

Yes.

QUESTION: Do you all have a date for the March conference?

MS. MILLS: We do not. I anticipate that we likely will have a date by the end of this week, though. We are having a series of conference calls with the other partners in the actual conference and so we should have a date.

QUESTION: And the venue is the UN?

MS. MILLS: The venue will be the UN, yes.

QUESTION: A question, please, to you both. It was a United Nations comment today about how the situation in Haiti was potentially a volatile security situation, particularly in the aftermath of an attack or attempt to take control of a food convoy. You spoke of how orderly things were. What’s the contrast here and how do you resolve that?

ADMINISTRATOR SHAH: Well, I think you have to recognize there are three or four different distribution systems for food. One is we consign food and commodities to NGOs that go out across the country and many have longstanding relationships and histories serving different parts of the population. The other is this fixed point distribution system that has been stood up over the last few days and has really significantly increased the capacity to meet population needs with two-week rations. And then there are a variety of other systems through other partners and through the private sector.

We are getting reports every day across all 16 fixed point distribution sites and across the full range of partners that we work with around safety and security, and we have not seen a consistent trend or disorder – there have been isolated incidents where order has been challenged in one form or another, but across the board, especially at these 16 sites where it’s women that are getting ration coupons and coming in and picking up food and then leaving, it’s been remarkably effective and it has been orderly.

We obviously continue to work on this and think about it. The Haitian National Police, MINUSTAH, and our Department of Defense are all working as a team to provide security to food convoys and at these sites, and that’s obviously very helpful.

But it’s been orderly. We had people that were just out at 12 of them today, and they were calling in and telling me about it, and it sounds like a big step forward. And I think it’s just a point to note about the Haitian population and their commitment and resolve and resilience in this.

QUESTION: Do you – we’ve seen some of the – say, the medical workers who were early to arrive. You know, a number of them are now leaving. Is there any concern that now that sort of the very initial phase is sort of ending, that folks are leaving before – while there’s still all this tremendous need on the ground?

ADMINISTRATOR SHAH: Well, I would say and I would encourage as a message that we are in an emergency relief situation and we will continue to be in an emergency relief situation for many weeks to come. I think the people who recognize this more than anybody are the people who’ve gone to Haiti and are doing this work. And when I was just there recently and had the chance to visit with – whether they were a Spanish medical team or medical teams from the U.S., I think they appreciate that.

That said, many of these teams go in and have a two-week window for their own sustainability and then cycle out and others come in and replace them. There’s also, every day that goes by, more Haitian capacity, medical providers that can step in and provide services in the hospitals they used to work at, et cetera. And so this is a normal transition, but we wouldn’t expect nor would it be appropriate for there to be a large-scale exit of, say, medical or health volunteers.

In fact, kind of the opposite is happening. We’re doing, I think, a better job of saying, okay, we need Creole-speaking nurses in these parts of the country for these functions, we need to target our assistance to prosthetics and post-operative care and post-trauma care, because the needs will evolve and change a little bit. And we need the system to evolve and change to meet those needs.

MR. CROWLEY: Thank you.

MS. MILLS: Thank you.

U.S. Department of State, Washington, DC