VZCZCXYZ0008
OO RUEHWEB

DE RUEHPU #0114/01 0331438
ZNR UUUUU ZZH
O 021436Z FEB 10
FM AMEMBASSY PORT AU PRINCE
TO RUCNDT/USMISSION USUN NEW YORK IMMEDIATE 0088
RUEHC/SECSTATE WASHDC IMMEDIATE 0297
RUEHGV/USMISSION GENEVA IMMEDIATE
INFO HAITI COLLECTIVE IMMEDIATE
RHMFISS/HQ USSOUTHCOM MIAMI FL IMMEDIATE
RHMFISS/JOINT STAFF WASHINGTON DC IMMEDIATE
RUEHDG/AMEMBASSY SANTO DOMINGO IMMEDIATE
RUEKJCS/SECDEF WASHINGTON DC IMMEDIATE
RUEHPU/AMEMBASSY PORT AU PRINCE

UNCLAS PORT AU PRINCE 000114 
 
AIDAC 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: EAID ECON PGOV PINR PREL PREF HA
SUBJECT: USAID/DART - HAITI NUTRITION UPDATE 
 
REF: PORT A 0096 
 
¶1.  Summary.  USAID Disaster Assistance Response Team (USAID/DART) 
staff caution that disrupted access to food and poor sanitation 
conditions in earthquake-affected areas of Haiti have the potential 
to lead to an increase in acute malnutrition, particularly among 
infants and young children.  USAID/DART staff report that immediate 
nutrition priorities include safe feeding support for infants under 
one year of age who are orphaned or without breastfeeding 
possibilities; preventing moderate and severe nutrition among 
children under five years of age through supplemental feeding; and 
strengthening the integration of nutritional screening and referral 
mechanisms. 
 
 
 
¶2.  USAID in coordination with the Nutrition Cluster, U.N. 
organizations, and implementing partners is rapidly increasing 
response programming to address nutrition concerns among 
earthquake-affected populations.  USAID's Office of U.S. Foreign 
Disaster Assistance (USAID/OFDA) has provided nearly $6 million for 
nutrition interventions in Haiti, to date.  USAID/OFDA has also 
strongly discouraged the use of powdered infant formula as part of 
response efforts due to associated risks of increased infant 
morbidity and mortality in emergency settings.  End summary. 
 
 
 
------------------------------ 
 
INFANT AND YOUNG CHILD FEEDING 
 
------------------------------ 
 
 
 
¶3.  Due to the combined conditions that support an existing demand 
for infant formula in Haiti, including significant numbers of 
orphans, infants who have been separated from their mothers, and 
existing low exclusive breastfeeding rates USAID, in consultation 
with the U.N. Children's Fund (UNICEF) and the Nutrition Cluster, 
identified a need for limited quantities of infant formula as part 
of nutrition response efforts.  However, given the current poor 
sanitation situation in Haiti and associated challenges with 
ensuring a hygienic environment and clean water availability, the 
USAID/DART emphasizes that powdered formula is inappropriate.  The 
Nutrition Cluster recommendation is to provide ready-to-use infant 
formula (RUIF), under controlled distribution and strict 
supervision, in order to minimize the risk of diarrheal disease and 
increased mortality rates among infants and young children. 
 
 
 
¶4.  USAID/DART staff emphasize that years of field-based evidence 
confirm that the use of breast-milk substitute (BMS), particularly 
in emergencies, significantly increases illness and death among 
infants and is therefore strongly discouraged.  However, under 
certain conditions, as is the case in Haiti described above, and 
where specific criteria are met, the purchase and strictly 
controlled use of infant formula in accordance with the 
International Code of Marketing of Breast Milk Substitutes, and 
humanitarian policies and guidelines may be appropriate. 
USAID/DART staff emphasize that general distributions of BMS is 
never appropriate. 
 
 
 
¶5.  At the request of UNICEF and the Nutrition Cluster, USAID/OFDA 
is procuring a limited three-month supply of RUIF for targeted 
distribution to infants under one year of age that are orphaned or 
without breastfeeding possibilities.  The lead sub-cluster 
non-governmental organizations (NGOs), Save the Children/US 
(SC/US), Concern, and Action Contre la Faim (ACF), will distribute 
RUIF to selected orphanages, baby feeding tents, and pediatric 
wards in hospitals with appropriate breastfeeding messaging, 
training, and supervision.  On January 29 and 30, ACF and Concern 
opened the first baby feeding tents in three spontaneous 
settlements in Port-au-Prince.  The next USAID/OFDA shipment of 
32,000 quarts of RUIF is scheduled to arrive in Port-au-Prince on 
February 2. 
 
¶6.  As part of the Haiti response, USAID/OFDA has actively worked 
to discourage the donation, transport, and/or use of powdered 
infant formula to prevent increases in diarrhea related morbidity 
and mortality among infants and young children.  USAID/OFDA 
participated in the Joint Statement on Infant Feeding in 
Emergencies (IFE) released by UNICEF, the U.N. World Health 
Organization (WHO), and the Government of Haiti (GoH) Ministry of 
Health.  In addition, USAID/OFDA disseminated the Guidance Cable on 
Breast Milk Substitutes in Emergencies.  USAID/OFDA has also 
seconded a nutritionist to the Nutrition Cluster to act as the IFE 
focal point. 
 
 
 
---------------------------------- 
 
MALNUTRTION PREVENTION PROGRAMMING 
 
---------------------------------- 
 
 
 
¶7.  The baseline nutritional status in Haiti is poor, with 
pre-earthquake acute malnutrition levels between 4.3 and 9 percent. 
USAID/DART staff caution that disruptions to food access and poor 
sanitation conditions in earthquake-affected areas of Haiti have 
the potential to result in a rapid deterioration in nutrition 
status among infant and young children, particularly for those 
newly orphaned or separated from parents. 
 
 
 
¶8.  As a preventive measure to mitigate an escalation of 
malnutrition among vulnerable children in affected areas, UNICEF, 
the U.N. World Food Program (WFP), and partners plan to conduct a 
blanket distribution of supplementary plumpy rations to 200,000 
children under 3 years of age for a three-week period.  WFP has 
procured 105 metric tons (MT) of supplementary plumpy to support 
the feeding program.  The International Medical Corps is scheduled 
to begin distributions in orphanages and hospitals on February 2. 
Planning for blanket supplementary feeding at displacement sites 
remains ongoing as the Nutrition Cluster seeks to resolve security 
concerns, establish a registration system, and identify 
implementing partners. 
 
 
 
-------------------------------------------- 
 
MALNUTRITON SCREENING AND TREATMENT REFFERAL 
 
-------------------------------------------- 
 
 
 
¶9.  USAID/DART staff note that mobile clinics are reporting cases 
of malnutrition, including three mobile clinic sites in Carrefour, 
Gressier, and Port-au-Prince visited by USAID/DART staff on January 
¶29.  Screening for malnutrition as part of mobile clinic operations 
is critical to ensuring early detection and treatment.  The number 
of identified cases remains limited to date but USAID/DART staff 
note an absence of comprehensive data.  Once malnutrition cases are 
identified through mobile health clinics and health facilities, 
referrals to alternate facilities capable of receiving and treating 
cases remains ad-hoc.  USAID/DART staff emphasize the need to 
establish a standardized screening and referral process for 
malnutrition cases in order to ensure early detection and 
treatment.  USAID/DART staff report that stabilization centers for 
severe acute malnutrition have been established and that the 
Nutrition Cluster has compiled and disseminated a list of NGOs with 
the capacity to receive and treat severe malnutrition cases and 
provide nutritional care units. 
 
 
 
¶10.  On January 30, USAID/DART and UNICEF staff conducted 
assessments of the two therapeutic feeding centers (TFC) operating 
in Port-au-Prince.  USAID/DART staff reported that although the 
Saint-Damien Hospital in the Tabarre neighborhood continued to 
 
receive severe acute malnutrition (SAM) cases, the facility lacked 
the required therapeutic supplies to adhere to treatment protocols. 
In response, the assessment team arranged for UNICEF to supply the 
hospital with the appropriate F-75 and F-100 therapeutic milk.  The 
TFC at the University Hospital in Port-au-Prince began operations 
on January 30.  The TFC, operated by the NGO Concern, admitted 
eight severely malnourished children on the first day and is now 
fully operational.  The NGO Concern also opened two infant feeding 
tents in spontaneous settlements in Port-au-Prince on January 30 
using USAID/OFDA-supplied nutritional commodities. 
 
 
 
---------- 
 
CONCLUSION 
 
---------- 
 
 
 
¶11.  USAID/DART staff identify safe feeding for infants and young 
children and supplementary feeding for children under five years of 
age as immediate priorities to prevent moderate and severe 
malnutrition.  In addition, USAID/DART staff highlight the need for 
the integration of nutritional screening and referral of 
malnutrition cases identified through mobile health clinics and 
health facilities.  USAID/DART staff continue to monitor nutrition 
conditions on the ground and coordinate with USAID/Haiti, the 
Nutrition Cluster, the U.N., and relief organization partners to 
address the nutrition concerns of earthquake-affected populations. 
 
 
 
¶12.  To date, USAID/OFDA has provided nearly $6 million for 
nutrition interventions in Haiti, including more than $1 million to 
SC/US and $4.5 million to UNICEF to support nutrition commodities 
and treatment programs, as well as public messaging and education 
outreach on infant and young children feeding practices. 
 
 
 
 
 
MINIMIZE CONSIDERED 
MERTEN