1. Gloria Callwood, Ph.D., PI and Director Caribbean Exploratory Research Center & Noreen Michael, Ph.D. University of the Virgin Islands

2.  January 12, 2010, Haiti experienced a 7.0 magnitude earthquake  Epicenter approximately 10 miles SW from the capital, Port-au-Prince  Estimated 316,000 lives lost  245,000 ruined or hopelessly damaged structures estimated produced 200 million cubic yards of rubble  >1.5 million homeless  Hundreds of thousands became “internally displaced persons”  Most governmental buildings and 20 % of Haiti’s civil servants lost

3. Destruction

4. Destruction

5. Damage to Government Palace

7. Habitat International CoalitionHabitat International Coalition 10-8-2012 report  Only 13,198 houses have been repaired and 4,843 permanent homes built.  Of 1.5 Million, 369,000 people still living in displacement camps  80 % of displaced have nowhere to return to because they were renters.  Data from International Organization for Migration, current shortages will leave more than 300,000 without housing.  When evicted from camps, no option but to inhabit substandard housing units.

8. Tent City for Displaced Persons

10. Facilities

11. Human Suffering

13. There is evidence of:  Increased Intimate Partner Violence (IVP) after major disasters  High prevalence of sexual assault, IPV and marital stress around the world where there are displaced populations from natural or human caused disasters  Increased danger to women of rape in refugee situations globally, often necessitating both community safety strategies and increased rape interventions

14.  2008 intimate partner violence (IPV) data from the population based Demographic and Health Survey (DHS) from 10 countries included Haiti Data Report supports that violence against women was a serious problem in Haiti before the 2010 earthquake.  The U S Virgin Islands are in close proximity to Haiti and has a substantial Haitian immigrant population Proximity & existing relationships/links to the Caribbean Diaspora make CERC uniquely situated & relevant to addressing violence against displaced women and girls survivors of the earthquake CERC major research is focused on violence against women

15. CERC wrote a proposal for a supplement to Center grant to fund Haiti Project Awarded two years funding CERC wrote a proposal for a supplement to Center grant to fund Haiti Project Awarded two years funding

17.  1) Design and develop collaborative approaches and measures to protect internally displaced women and adolescent girl survivors of the Haitian Earthquake from violence and abuse.  2) Describe the prevalence of violence and abuse among internally displaced Haitian women and adolescent girls following the Haitian Earthquake.  3) Evaluate the outcomes of a collaborative project designed to protect internally displaced women and adolescent girls from violence and abuse following the Haitian Earthquake.

18.  Participants: Displaced women and girls 12-44 years old living in Port au Prince and surrounding areas  Process, Instruments and Data collection: Focus groups representing women, men, health professionals to assure cultural appropriateness and sensitivity  Haitian staff PI, Coordinator, data Collectors  Culturally appropriate measures reviewed and translated into Haitian and French Creole by Haitians  Audio Computer Assisted Self Interview (ACASI) system used to collect data

19.  Project delays related to: Cholera outbreak Political unrest Carnival  Change of head of state and key players resulted in need to identify and make contact with new governmental appointees who can positively impact improvement of Haitian women’s status

20.  Met with: ◦ Key players in Government ◦ NGOs working on Gender Based Violence ◦ Focus groups  Obtained project approval from Haitian Ethics Committee  Entered into subcontract with Universite´ Jean Price Mars ◦ Hired Haitian research staff ◦ Provided training to staff ◦ Pilot tested use of ACASI system with participants ◦ Tested electronic upload of data ◦ Completed initial survey interviews  Shared information about project with Haitian community at INUFOCAD graduation

21. Preliminary Results

23.  The Adolescent Sample ◦ Number of Adolescents in Sample:78 ◦ Age  Mean Age = 14.2  Median Age = 14 ◦ Education  90% attended school before the earthquake  86% were enrolled in school after the earthquake ◦ Education  42.3% reported a 5 th grade education or below  37.2% reported being in grade 6 th, 7 th or 8 th  16.7% reported being at the high school level

24.  The Adult Sample ◦ Number of Adults in Sample:208 ◦ Age  Mean Age = 28  Median Age = 27[Over 50% in the 20-29 age group] ◦ Education  8 th grade or less 38.2%  Some High School 42.8%  High school graduate or HS equivalence 3.9%  Some trade, community college 1.4%  Completed trade, community college 2.4%  Never attended high school 11.1%

26.  Physical or Emotional Abuse before Earthquake ResponseFrequencyPercent No3950.0 Yes3950.0 Total78100.0  Physical or Emotional Abuse after Earthquake ResponseFrequencyPercent No3848.7 Yes4051.3 Total78100.0 Haiti Survey – Adolescent Questionnaire Results

27. Haiti Survey – Adult Questionnaire Results  Physical or Emotional Abuse before Earthquake ResponseFrequencyPercent No6330.3 Yes14569.7 Total208100.0  Physical or Emotional Abuse after Earthquake ResponseFrequencyPercent No5827.9 Yes15072.1 Total208100.0

28.  Physical Hurt by someone before Earthquake ResponseFrequencyPercent No4253.8 Yes3646.2 Total78100.0  Physical hurt by someone after Earthquake ResponseFrequencyPercent No4353.8 Yes3646.2 Total78100.0 Haiti Survey – Adolescent Questionnaire Results

29.  Physical Hurt by someone before Earthquake ResponseFrequencyPercent No7234.6 Yes13665.4 Total208100.0  Physical hurt by someone after Earthquake ResponseFrequencyPercent No7536.1 Yes13363.9 Total208100.0 Haiti Survey – Adult Questionnaire Results

30.  Sexual Abuse before Earthquake ResponseFrequencyPercent No6178.2 Yes1721.8 Total78100.0  Sexual Abuse after Earthquake ResponseFrequencyPercent No6178.2 Yes1721.8 Total78100.0 Haiti Survey – Adolescent Questionnaire Results

31.  Sexual Abuse before Earthquake ResponseFrequencyPercent No10651.0 Yes10249.0 Total208100.0  Sexual Abuse after Earthquake ResponseFrequencyPercent No10349.5 Yes10550.5 Total208100.0 Haiti Survey – Adult Questionnaire Results

32.  Haiti Survey – Adolescent Questionnaire Results

33.  Haiti Survey – Adult Questionnaire Results

34.  Haiti Survey – Adolescent Questionnaire Results

35.  Haiti Survey – Adult Questionnaire Results

36.  Haiti Survey – Adolescent Questionnaire Results

37.  Haiti Survey – Adult Questionnaire Results

38. Sexual Victimization Physical Victimization Psychological/Emotional Victimization

39.  Haiti Survey – Adolescent Questionnaire Results

41.  Haiti Survey – Adult Questionnaire Results Mean = 45.11 SD = 19.4 Reliability = r =.957 N = 131

42.  Haiti Survey – Adult Questionnaire Results

44. *Helpfulness – Resource rated as “Good, Very Good or Excellent” ResourceUsageHelpfulness* Parent or Guardian 31.9%73.9% Legal Assistance (P or G) 26.4%63.2% Teacher or Head Master26.4% 68.4% Fellow Student or Friend26.4% 73.7% Mental Health Professional 25.0%61.1% Church 40.3%72.4% ER or Clinic 23.6%64.7% Primary Care MD or Nurse 34.7%84.0% Internet6.9%60.0% Note: Care should be taken in interpreting results. Number of respondents ranged from a low of 5 to a high of 29.

45. R ESOURCE U SAGE H ELPFULNESS * Workplace, School, Supervisor, Instructor 16.8%25.0% Co-worker or Co-student 22.6%34.9% Mental Health professional 20.5%35.9% Church, Priest, Voodoo Priest 18.9%41.7% Alcohol/Drug treatment program 10.6%25.0% Legal Assistance 17.9%35.3% Restraining Order 14.3%40.7% ER or Clinic 19.5%54.1% Primary Care Doctor or Nurse 18.9%55.6% Community Health Worker 12.1%60.9% Crisis Hotline 18.9%47.2% Domestic Violence (DV) Advocate 16.3%38.7% DV Support Group 14.7%42.9% DV Shelter 15.3%41.4% Police 18.4%42.9% DLS, BS, NGOs 15.3%69.0% Community Organization or NGO 5.8%45.5% Internet12.1%60.9% *Helpfulness – Resource rated as “Good, Very Good or Excellent”

47.  Health care providers can positively intervene with women and girls at risk for or victims of violence by routinely assessing for violence, and providing appropriate interventions, referrals, and safety messages

48.  Development of safety training modules to be delivered to percentage of participating women and girls  Collaboration with KOFAVIV (NGO) to deliver training  Resurvey of participants receiving training to evaluate effectiveness of training in keeping participants safe

49.  Michelle J. Hindin; Sunita Kishor; Donna L. Ansara (2008) Intimate Partner Violence among Couples in 10 DHS Countries: Predictors and Health Outcomes. DHS Analytical survey # 18. Calverton, MD, USA. Macro International, Inc.  International Rescue Committee Report (2011) http://www.rescue.org/sites/default/files/resource- file/IRC_Report_HaitiAnniversary.pdf  Habitat International Coalition: reprint of10-8-2012 report Haiti-Housing: Organizations launch “lasting solutions” campaign for displaced people. AlterPresseAlterPresse

50. Haiti Project Team  Doris W. Campbell, PhD, ARNP, FAAN 1 ; Desiree Bertrand, MSN, RN 1 ; Tessa Liburd 1, Kimbalee Dawson, MA 1 ; Lorna W Sutton, MPA 1 ; Noreen Michael, PhD ₁ Jacquelyn C. Campbell, PhD, RN, FAAN 2 ; Phyllis W Sharps, PhD, RN, FAAN 2 ; Nancy Glass, PhD, RN, FAAN 2, Elizabeth Sloand, PhD, RN 2 ; Betty Dennis, PhD, RN 3 ; Cheryl Killion, PhD, RN, FAAN 4 ; Faye Gary, PhD, RN, FAAN 4 ; Hossein Yarandi, PhD 5 ; Annie Lewis-O’Connor, PhD 6 ◦ Affiliations 1 University of the Virgin Islands; 2 Johns Hopkins University; 3 North Carolina Central University; 4 Case Western Reserve University; 5 Wayne State University; 6 Brigham and Womens Hospital Haitian Collaborators:  Nicole Muller-Cesar, MSW, Project Director; Jean Fanélise, MSA, HSA, MD, PhD., Project Coordinator  Haitian Nationals and residents of Port au Prince who shared their insights. Funded by NIH NIMHD to the University of the Virgin Islands School of Nursing Grant # P20 MD002286