Storm clouds over Haiti

Dr Unnikrishnan PV is a medical doctor who works in humanitarian situations and is ActionAid's Emergencies and Human Security Advisor. He is currently co-ordinating ActionAid's flood response in Haiti.

In Haiti's water-scarred nightmare, hope is dying. Since August, Haiti has born the brunt of four massive storms, killing 800 people and leaving a million homeless. UN relief co-ordinator John Holmes has categorised the devastation as "a major catastrophe" and one of Haiti's biggest disasters.

It is not just lives and homes that have been decimated by ferocious winds and millions of tonnes of water. The UN estimates that 70% of the island's agriculture has been destroyed and much of its infrastructure is now twisted metal and rubble.

Driving from South Eastern Haiti's provincial capital of Jacmel to the coastal town of Marigot to evaluate ActionAid's work, I scarcely saw a place left untouched. Uprooted plantain trees and crops laid waste under mud and water stretched for miles.

Storms are the rule in Haiti. It is forever recovering from one or preparing to face another. But thanks to the consequences of climate change bringing increasingly ferocious and frequent storms, the breathing space Haiti needs to pull itself together each time is decreasing.

More than half of Haiti's 9.5 million people live on less than a dollar a day. In a country where shortages are the norm, and soaring food prices have already led to riots and the April overthrow of a government, this disaster will almost inevitably mean a gathering political storm.

If that happens, nothing, not even the UN peacekeepers who helped bring down armed gangs, stemming the last spiral of violence, may be able to stop the bloodshed.

Rocketing food prices have their roots in the trade policies Haiti was pressurised into adopting in the 1990s. In1994, the tariff on rice imports was drastically lowered from 36% to 3%. Subsequent massive imports of rice from subsidised US farmers crippled local farmers who simply couldn't compete.

With local agriculture crushed, Haiti became wholly dependent on food imports. But most Haitians now cannot afford imported food and repeated disasters have taken a heavy toll on their resilience.

There is an urgent need to step up humanitarian assistance and meet the survival needs of those the storms spared. Disaster preparedness and risk reduction initiatives - acting now to prepare for the storms we know will come - are necessary to break the deadly cycle. This is something neighbouring Cuba has been able to do effectively.

Yet time is running out. Aid agencies have appealed for US$106 million for the next six month's relief and recovery work, but the international response has remained lukewarm.

In the meantime, reports of diarrhoea and contagious skin diseases are pouring in. With pre-existing chronic food shortages, it is crucial to address the nutritional needs of the vulnerable, particularly children, pregnant and breast-feeding women. Many others need mental health and psychosocial support.

To meet these requirements, Haiti needs a caring government, committed donors, vigilant civil society and an active media. These are sadly lacking. Rebuilding the country for the better needs long term commitment. Haiti cannot afford to sit back and wait for the next storm - be it natural or political - to hit.