Wellington 11 February 2010. - A month on from the devastating Haitian earthquake the relief operation has moved into high gear, but the spread of disease is proving to be a very real risk.

The devastating 7.0 magnitude earthquake struck the capital Port-au-Prince and surrounds almost a month ago. More than 200,000 were killed and 300,000 injured, with 3 million people - half of them children - affected over all.

UNICEF NZ Executive Director, Dennis McKinlay, says that initial relief efforts were hampered by the huge level of infrastructure damage, including to the port and airport, UN and government offices, and water, sanitation and communications.

"There was a real bottleneck as relief supplies had to be flown into the capital's small airport or travel by road from the neighbouring Dominican Republic. But the international community really rose to the challenge and aid materials are now flowing freely and distribution to survivors has improved hugely."

Mr McKinlay says that more than 1.1m survivors are estimated to be homeless, with some 700,000 people living on the streets of Port-au-Prince under makeshift shelters or in temporary settlements.

"The overcrowded conditions combined with lack of running water and sanitation facilities, and the approaching rainy season, are contributing to an increased risk of water-borne diseases such as diarrhoea and cholera. We are hearing increasing reports of displaced children with diarrhoea, which can be a fatal disease especially for the very young.

"UNICEF and partners are providing drinking water to more than 900,000 people daily through water tankering and water treatment at some 300 sites across the capital and surrounding cities. In the longer term, the focus will shift to restoring and improving piped water supplies.

"A lack of latrines and pressure on existing facilities is exacerbating health issues further. Pit latrines and portable toilets are helping to fill the gap though, and steps are being taken to provide thousands more toilets to meet the huge need."

Mr McKinlay says that Haitian children are also at risk from killer childhood diseases like measles, which could spread like wildfire in part because of low existing levels of immunization coverage.

"UNICEF is working with the World Health Organisation and others to immunize 500,000 children under seven against measles, rubella, diphtheria, tetanus and whooping cough. UNICEF is providing technical guidance, supplies such as vaccines and cold chain equipment, and supporting operational costs.

"There have already been several reports of suspected measles cases that are being investigated by the Government. It's vital for children that we stamp out these killer diseases before they get a chance to get a foothold."

UNICEF has also been addressing child nutrition needs and working to keep children safe from abuse and exploitation. A priority has been establishing 'safe spaces' for lost and unaccompanied children, tracing family members, visiting orphanages and providing essential supplies, and supporting government efforts against child trafficking.

Education is another enormous challenge facing Haiti's children, with most schools remaining closed and up to 2.9 million primary school-aged children affected. Some 90 per cent of schools in the West were destroyed or severely damaged by the quake, while even undamaged schools that are open are reporting a lack of students because of parental fears for their safety.

"UNICEF has been providing temporary learning spaces, school-in-a-box kits and recreation kits for displaced children, with plans to expand help further. It is absolutely essential for children to return to school to not only continue their education, but also to get back a sense of normality and recover faster from the trauma they have experienced.

"New Zealanders have shown incredible generosity, with around half a million dollars being donated to UNICEF NZ alone. Their support is helping to ensure that children receive the life-saving care that they desperately need.

"The international community now faces the challenge of using the unprecedented commitment, support and funding for Haiti to build back a better place than was there before the earthquake. With education, for example, we can't limit help to repairing damaged schools. We need to improve them and aim to get every child into the classroom.

"UNICEF has been in Haiti since 1949 and we will be there for the long-term to make a difference for children and their families."

People can donate to UNICEF NZ's Haiti Emergency Appeal on 0800-800-194 or online at www.unicef.org.nz