Almost two years after the devastating 7.0 earthquake destroyed much of Port-au-Prince, full recovery appears to be years away. Thousands of people continue to live in makeshift shelters and tents, rubble from dilapidated buildings still line some streets and a cholera epidemic has claimed well over 6,000 lives.

According to data from the World Bank, in 2010 there were almost 10 million people living in Haiti after the earthquake claimed an estimated 300,000 lives. As of July 2011, the CIA World Factbook estimates that there are 9,917,932 people living in Haiti.

Longstanding economic and political instability in Haiti has made access to healthcare even harder than it was before the earthquake. The $2 a day that many people live on in Haiti couldn’t stretch to cover medical costs, so a trip to a healthcare facility was either abandoned after a first visit, or not even considered.

The United Nations’ presence was evident in Haiti before the earthquake, but the U.N., along with Haiti’s government, was unable to react effectively at the time due to how the institution was affected by the quake. The large amount of newly homeless and injured — as well as the dead, whose bodies were scattered about — presented new challenges that would be piled on top of all those that already existed. Despite all the precautions in place to ensure health concerns were of utmost importance, a cholera epidemic broke out and spread to almost every part of the country. According to Haiti’s ministry of health, the first cases of cholera were identified in October 2010. Since then, over 450,000 Haitians have fallen ill, and the death toll has skyrocketed to more than 6,000.

Doctors Without Borders/Médecins Sans Frontières (MSF), an international medical humanitarian organization that was already present in Haiti before the quake, was one of the first to respond, providing medical care, shelter and water. Between then and this past summer, MSF has taken the lead role in treating cholera patients. In the space of that time, MSF has treated more than 140,000 patients, or about 40 percent of the reported cases.

Based on information reported on its web page, MSF notes that international organizations involved in healthcare, water provision, and sanitation services are retreating from the fight against cholera in Haiti at a time when treatment needs are urgent.

Yann Libessart, communication advisor for Doctors Without Borders, says that “donors and the new government are now focusing on rebuilding the economy, investing in education and creating jobs, which were already needs before the earthquake.”

Libessart said that as a result, several non-governmental organization (NGO) projects have stopped, including water distribution for cholera treatment centers. But the immediate needs of Haitian are still largely uncovered.

“Half a million persons are homeless in Port-au-Prince, 50 percent of the total population has no access to clean water, and 80 percent has no sanitation facilities, which creates a perfect ground for cholera to spread,” Libessart said.

Although these objectives are fair, numerous Haitians still have nowhere to live safely, no access to water and sanitation facilities, and limited access to healthcare.

Libessart says that many won’t survive until the economy gets better. In the meantime, it is crucial that local and international NGOs continue to receive funds to cover the gaps.

Doctors Without Borders could not provide any recent consolidated numbers about mental trauma and the Haitian people, but said that since October 2010, the number of patients treated for mental health disorders that were directly related to the earthquake has been continuously decreasing. The majority of patients are now victims of criminal violence or sexual assault, and seriously injured patients that need help to deal with the fallout from an accident, such as amputation.

There are more cases of addiction to alcohol and drugs than before the quake.

Solidarity remains the best coping mechanism.

Erica James Caple, an associate professor of anthropology at the Massachusetts Institute of Technology said in her book Democratic Insecurities: Violence, Trauma, and Intervention in Haiti that the deep level of personal, political and social insecurity strangles and maims people in Haiti. She adds that the traumatic stress that Haitians endure is continuous, a cycle that ceases to end.

Paul Farmer writes in Haiti After the Earthquake that Haiti needs help standing on its own over a period of time. Band-Aid recovery hasn’t worked in the past and will do nothing now.