Children in Haiti are a chorus of more than four million voices, nearly half of the country’s total population.

Each one of these voices speaks for a child whose life has been forever altered by the January 2010 earthquake and the cholera, hurricane, and civil unrest emergencies that further complicated humanitarian response.

This chorus of voices shares common hopes and aspirations and calls out in unison for education, for an end to hunger and malnutrition, for protection from physical and emotional threats, and for a healthy life with equitable access to safe water, sanitation, healthcare, and livelihoods.

Unfortunately, this remains a tenuous dream for most of Haiti’s children even 12 months after the earthquake.

In this Caribbean nation of more than 9 million, one in every 12 children dies before their fifth birthday, one in every 16 never reaches their first birthday, and one in four is chronically malnourished leading to irreversible impacts on their cognitive development and opportunities later in life.

The plight of women is as daunting, with one in 37 chances for a mother to die needlessly during childbirth and three quarters of deliveries taking place without a skilled birthing attendant.

These indicators painted a bleak picture for children and women even before the January 2010 earthquake focused attention on this disadvantaged country. But with the cholera outbreak, killing more than 3,500 people and infecting more than 150,000, this picture has become even more complicated.

UNICEF was among the first organizations to respond; 72 cholera treatment centers and units were established, and medical supplies, water purification tablets, and soap among other supplies are being distributed with the help of partners on the ground as mass public awareness campaigns are empowering Haitians to protect themselves.

Today, 380,000 children continue to live in displaced persons camps, facing heightened risks of gender-based violence, trafficking, and abuse. Too many children are still exploited as unpaid domestic workers and deprived of their most basic rights.

UNICEF is helping strengthen Haiti’s child protection agency and police forces to prevent child trafficking at the boarders.

While the scope of the phenomenon has always been hard to define, there are strong fears that an increased number of children have fallen victim to child trafficking since the earthquake.

I am proud of the progress that has been made to date in helping Haiti recover from the earthquake. There are 720,000 children being supported in 2,000 schools, almost 100,000 children are able to play and interact in 369 child-friendly spaces.

Almost 2 million children have been vaccinated against life-threatening diseases.

At the height of the emergency 1.2 million people were supported in accessing clean water by UNICEF and WASH Cluster partners.

And I am proud that today, thanks in part to UNICEF and its partners working in support of the Government of Haiti, a surge in malnutrition has been avoided and children are being helped to recover from the trauma of the earthquake.

But there is fear and near certainty that without continued commitment and a focus on building sustainable solutions gains made will be lost, and the determination and dedication of international and national agencies and individuals and Haitians themselves will receive less and less support.

I have experienced first­hand the dedicated efforts of UNICEF national committees, of international and national partners, and, particularly, of staff working every day to improve access to services, to help protect children from falling into exploitation.

I have seen the wonders our partners are doing in our child-friendly spaces to bring back children from the trauma they have suffered by providing a protective and nurturing environment.

And I have also never ceased to be amazed at how quickly we were able to bring children back to school, starting with the establishment of 225 temporary learning spaces through the distribution of more than 1,600 tents, and the construction soon after of 90 semi-permanent schools, so children could go to school, many for the first time, and realize their right to education.

We owe what success we have achieved on behalf of children to our partners and to the many countries and individuals that have responded so generously in the aftermath of the earthquake and the cholera outbreak.

But Haiti’s children need and deserve more.

Too many continue to live on the edge of survival. Too many remain trapped in displacement camps, too many voices remain unheard, and too many children remain unable to access even the most basic services.

In a country where two thirds of the population lives on less than two dollars a day, putting equity at the forefront of our humanitarian efforts is a special challenge, and one made even more unique in the aftermath of the earthquake.

Equity for the children of Haiti will be a guiding principle for us as we focus energies on those children, particularly in remote areas, who have the least and for whom humanitarian efforts will have the greatest and most lasting impact.

There is a Haitian saying that I always keep in mind ― timoun se riches (children are treasures).

Every day I renew my hope that the global wave of solidarity for Haiti’s children will not recede, that these treasures and an entire generation will not be lost through a failure to nurture and protect the future that children represent.

The children of Haiti are counting on our help to beat the incredible odds weighing against their survival and development. We owe it to them to deliver on our promise, and keeping that promise will be the core of UNICEF’s efforts in Haiti in 2011 and in the years to come.

By Franoise Gruloos-Ackermans

Franoise Gruloos-Ackermans is UNICEF representative in Haiti. ― Ed.