Haiti Two Years Later - All This, And Cholera Too

It's been two years since the devastating earthquake in Haiti. At least one quarter million people were killed outright, another million were made homeless, and one of the largest humanitarian crises in modern history ensued.

After two years of massive relief efforts on the part of the U.S., the UN, and others, reconstruction is moving at a snail's pace. Only half of the earthquake rubble has been removed, half a million people are still living under tarps and tents, and less than half of the promised relief funds have actually been disbursed (which probably says something about the risk of public corruption traditional business practices in Haiti).

The cherry on top of this towering heap of tragedy is that thousands of Haitians have died of a cholera outbreak. Incredible as it may seem, especially if you are familiar with Haiti, cholera is A BRAND NEW DISEASE there. It was perhaps the only form of misery that Haitians had not already experienced. And it appears that the disease was inadvertently brought to the Island of Hispaneola by the UN itself.
 
ABC News: UN Soliders Brought Deadly Superbug to Americas:

Compelling new scientific evidence suggests United Nations peacekeepers have carried a virulent strain of cholera -- a super bug -- into the Western Hemisphere for the first time.

The vicious form of cholera has already killed 7,000 people in Haiti, where it surfaced in a remote village in October 2010. Leading researchers from Harvard Medical School and elsewhere told ABC News that, despite UN denials, there is now a mountain of evidence suggesting the strain originated in Nepal, and was carried to Haiti by Nepalese soldiers who came to Haiti to serve as UN peacekeepers after the earthquake that ravaged the country on Jan. 12, 2010 -- two years ago today. Haiti had never seen a case of cholera until the arrival of the peacekeepers, who allegedly failed to maintain sanitary conditions at their base.

"What scares me is that the strain from South Asia has been recognized as more virulent, more capable of causing severe disease, and more transmissible," said John Mekalanos, who chairs the Department of Microbiology and Immunobiology at Harvard Medical School. "These strains are nasty. So far there has been no secondary outbreak. But Haiti now represents a foothold for a particularly dangerous variety of this deadly disease."

More than 500,000 Haitians have been infected, and Mekalanos said a handful of victims who contracted cholera in Haiti have now turned up in Venezuela, the Dominican Republic, and in Boston, Miami and New York, but only in isolated cases.

How cholera landed in Haiti has been a politically charged topic for more than a year now, with the United Nations repeatedly refusing to acknowledge any role in the outbreak despite mounting evidence that international peacekeepers were the most likely culprits. The UN has already faced hostility from Haitians who believe peacekeeping troops have abused local residents without consequence. They now face legal action from relatives of victims who have petitioned the UN for restitution. And the cholera charge could further hamper the UN's ability to work effectively there, two years after the country was hobbled by the earthquake.

-- snip --

"The scientific debate on the origin of cholera in Haiti existed, but it has been resolved by the accumulation of evidence that unfortunately leave no doubt about the implication of the Nepalese contingent of the UN peacekeeping mission in Haiti," said French epidemiologist Renaud Piarroux, whose research on the outbreak was published by a U.S. Centers for Disease Control journal.

-- snip --

Louise C. Ivers, an infectious disease specialist and professor of global health and social medicine at Harvard Medical School ... witnessed firsthand the destruction it caused as hundreds of villagers started dying from an unfamiliar malady.

"It was overwhelming," she said. "There were no reported cases in Haiti before 2010, ever. Really people had no idea what was happening. To hear the fear and the suspicions and the lack of understanding about how this was happening is very, very sad. The outbreak put a huge stress on what was already a very fragile health system. I'm afraid it will be a problem for the foreseeable future."

She said what has made Haiti so vulnerable was a lack of latrines and clean potable water. She said there have been small outbreaks in the Dominican Republic, but nothing on the scale of what hit Haiti because conditions are more modern and sanitary.

-- snip --

Mekalanos said ... "Cholera is a disease of the impoverished ... When the standards of living are already at the lowest levels, cholera is a killer of historic proportions. If it spreads to other parts of the world, in those kinds of settings, I fear there will be a very high rate of death." 

Relief and development organizations ought to take something like a Hippocratic Oath to do no harm.