Gonaïves - Five weeks after a series of hurricanes struck Haiti, people in the city of Gonaïves are still deprived of essential services. Since early October, families have been evicted from schools and churches where they had sought refuge after the storms destroyed their homes.

With no alternative housing offered, we estimate that about 10,000 people - out of a total population of 200,000 - are living on roofs, in tents or in fragile shacks made of wood debris and bed sheets. Other families are crammed into abandoned buildings by the dozens, or staying temporarily with relatives in overcrowded conditions that increase the risk of poor sanitation and domestic violence. In addition to this, electricity and running water have yet to be re-established.

While it has not rained in more than ten days, many roads are still flooded. Mud is one metre deep in some parts of the city, making it extremely difficult to get around.

"It's as if a cyclone passed through here just a couple of days ago," said Vikki Stienen, Project Coordinator for Médecins Sans Frontières (MSF) in Gonaïves. "The coordination of relief efforts is extremely chaotic."

"Usually, after natural disasters, MSF can reduce it activities after the first month," Stienen continued. "Here, it's the opposite: we've had to reinforce our teams and our intervention."

So far, in Gonaïves, MSF has distributed 3,000 family kits (including plastic sheeting, soaps, jerry cans) and is distributing 2,000 more starting today. Moreover, MSF is planning to distribute another 5,000 kits to cover the needs of as many people as possible in the city. Besides, MSF is producing 1 million liters of drinkable water per day and still distributing the largest part of it.

MSF sees also an increase in the number of malnourished children admitted in its hospital. MSF reopened the hospital in Gonaïves only 10 days ago and seven severely malnourished children have already been admitted. We expect this number to grow as people will hear about the hospital. Haitians face chronic food crises and nutritional deficits to begin with. The recent hurricanes destroyed crops and killed significant numbers of livestock, making people all the more vulnerable.

International food aid reaching the community is clearly insufficient in quantity, unsuitable for the nutritional needs of young children, and it is being distributed in a way that excludes single women with children. There is still no clear strategy to identify the needs, nor implement a proper nutritional response.

Despite the significant presence of international organizations - with plenty of experts and publications to show for it - the people of Gonaïves have yet to see much benefit. Hurricane season ends in late November. If another one were to strike the region with more heavy rains, inhabitants here would once again pay a heavy price.

MSF urges international organizations and the Haitian government to immediately re-examine their emergency aid response, and to prioritize housing and nutritional support for the youngest of the flood victims.