Hurricane Matthew made landfall on the island nation just over one week ago as a Category 4 storm killing more than a-thousand people and destroying already-weak infrastructure schools, homes and churches where people were taking shelter. Now, the spread of cholera is the fear. The World Health Organization is sending a million doses of cholera vaccine to the region. But with roads decimated the going will be tough to get that and any other aid including clean water to the people who need it. And those are just the start of the challenges.

Joining us to discuss are Ophelia Dahl (@PIH) co-founder and executive director of Boston-based Partners In Health, which been operating hospitals and clinics in Haiti for nearly three decades and Marie St. Fleur (@BTWIC) former democratic state rep. and the first Haitian-American to hold public office in Massachusetts.

St. Fleur says, "Things [in Haiti right now] are rough. I think that I'm but I want folks to remember because...the hope is to recognize that it's really the southwestern part of the country that's been hit." She explains that roads are down and cholera is a continued challenge facing the population. The conditions, partially accumulated damage from past disasters, have been difficult for humanitarian aid to make a significant impact on the resilience of the nation.

Dahl explains, "It's very hard to when there is weak infrastructure to get through roads and and that sort of thing...I think there's a lot of people who are who are really coordinating the efforts and trying to get to these hardest-hit most remote most rural areas." Prevention and treatment together can be effective in long term recovery. She says, "There's a part of this that's natural. The path of the hurricane or the epicenter of the earthquake... The other part that's not natural is really what is the damage that gets done after after the hurricane hits. That's because of of weak infrastructure and this is a place in which time and and real international development and patience has to be invested in order to really help haiti build in many places much much stronger."

The organizational need in places like Haiti is crucial to their redevelopment. St. Fleur says, "It's being dealt with in a limited way not as effectively I think with the large internationals they have to take a look - a fresh eye - about how it is that they accomplish that and whether or not how we are defining disaster relief and recovery, and what is the excuse that is used when money is provided men is not it doesn't shift over to recovery."