Dossier on the fight against cholera in Haiti: four items
1. Human Rights Groups Commend UN for Acknowledging Limitations of “Band-Aid” Approach to Haiti Cholera
Press release, May 10, 2012
Thursday, May 10, 2012, Port-au-Prince, Haiti and Boston, USA—Rights groups in Haiti and the United States commend last week’s acknowledgment by United Nations official Nigel Fisher that the current efforts to alleviate cholera in Haiti are “patchwork, band-aid work on a fundamental problem.”
Fisher is the UN Resident and Humanitarian Coordinator for Haiti. In a May 3rd interview with the UN News Centre, he acknowledged, “What we are doing in the short-term … is necessary, but we all agree that the long-term solution is investment in improved drinking water sources and in waste management.”
“Mr. Fisher’s statement is a strong step in the right direction towards a sustainable response to the UN cholera epidemic,” said Brian Concannon Jr., Director of the Institute for Justice & Democracy in Haiti (IJDH) and an attorney on a case filed by 5,000 cholera victims against the UN last November. He added, “Now the UN needs to take responsibility for its harmful actions and actually start installing the comprehensive water and sanitation infrastructure that is the only long-term solution to the cholera epidemic.”
Numerous studies, including a report by the UN’s Independent Panel of Experts, establish that UN peacekeepers introduced cholera into Haiti in October 2010. The epidemic is now the world’s worst. It has killed over 7,200 people and sickened over 530,000. Mr. Fisher warned that the epidemic could infect as many as 200,000 people in 2012 alone. UN agencies estimate the cost of controlling the epidemic by installing comprehensive clean water and sanitation in Haiti at $746 million - $1.1 billion.
“Of course the UN can afford to pay for permanent solutions to cholera,” said Mario Joseph, Director of Bureau des Avocats Internationaux, and the lead attorney on the case against the UN. “If the UN shortened the peacekeeping mission’s mandate by just one year, that would save $800 million. Fewer ‘boots on the ground’ and more wells in the ground would save tens of thousands of lives every decade. That is peace keeping.”
For more information about Haiti’s cholera epidemic and the victims’ fight for justice, see www.ijdh.org.
Brian Concannon Jr., Esq.
Director, Institute for Justice & Democracy in Haiti
666 Dorchester Avenue
Boston, MA, USA 02127
(617) 652-0876
Brian@IJDH.org www.IJDH.org
2. Update from the Institute for Justice and Democracy in Haiti on the cholera epidemic in Haiti:
Justice in the time of cholera
May 8, 2012
Dear Reader,
We are writing to update you about the most important case in all 17 years of our work. In November 2011, the Bureau des Avocats Internationaux (BAI) and the Institute for Justice & Democracy in Haiti (IJDH) filed a case on behalf of 5,000 victims of the cholera that UN soldiers introduced to Haiti through reckless disposal of human waste at the troops’ base. The case aims to permanently control the cholera epidemic that has killed over 7,000 Haitians and sickened 500,000 so far.
We are proud to be part of the solution to Haiti’s cholera. Our case demands that the UN provide the comprehensive clean water and sanitation infrastructure necessary to control the epidemic. Infrastructure is the only long-term solution to cholera. Medical treatment, vaccinations and chlorine tablets save lives right now, but cholera immunity lasts only a few years, while the cholera bacteria will remain in Haiti indefinitely.
This case is ambitious. The water and sanitation infrastructure will not only control cholera, it will reduce all water-borne diseases in Haiti, which kill thousands every year. If successful, the cholera case will save more than 50,000 lives over 10 years, and sharply reduce Haiti’s #1 health problem.
The good news is that we are winning. The UN initially denied responsibility for the cholera, and failed to announce any plans to provide infrastructure or compensation to the victims. But since we filed our complaint in November 2011:
* January: Several UN agencies announced a “call to action” for the provision of the infrastructure that they estimated would cost $750 million to $1.2 billion;
* February: the UN Security Council visited Haiti. Afterwards the UN Missions for the U.S., France and Pakistan informed the Council that the United Nations must respond better to the cholera epidemic;
* March: President Bill Clinton, UN Special Envoy for Haiti, admitted that UN peacekeepers were the “proximate cause” of the cholera epidemic;
* May: Nigel Fischer, UN Humanitarian Coordinator in Haiti, acknowledged that the UN’s current efforts are “patchwork, band-aid work,” and “the long-term solution is investment in improved drinking water sources and in waste management.”
Our case has a high profile in the press, which puts additional pressure on the UN to respond justly to the epidemic. Here are some highlights:
* An award-winning film about our case recently premiered at New York City’s Tribeca Film Festival. Baseball in the Time of Cholera features our fight for justice and the personal impact of the cholera epidemic on a 14-year-old baseball player whose childhood abruptly ends.
* The New York Times ran a front-page story confirming the UN’s responsibility in bringing cholera to Haiti and exposing the UN's failure to respond accordingly.
* The Economist ran a scathing piece calling on the U.N. to accept responsibility for its wrongdoing in Haiti.
Tell the UN to live up to its mission and be a force for justice in Haiti. Keep us fighting - Donate Now!
You can read more about the case and learn about how to get involved on the cholera accountability page on our website.
Mesi anpil,
Brian Concannon, Esq.
Executive Director, IJDH
www.ijdh.org
3. Haiti unprepared in the face of resurgent cholera
Press release from Doctors without Borders, May 9, 2012
PORT-AU-PRINCE, MAY 9, 2012—Cholera cases are on the rise in Haiti following the onset of the rainy season, and the country is not adequately prepared to combat the deadly disease, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.
While Haiti’s Ministry of Health and Populations claims to be in control of the situation, health facilities in many regions of the country remain incapable of responding to the seasonal fluctuations of the cholera epidemic. The surveillance system, which is supposed to monitor the situation and raise the alarm, is still dysfunctional, MSF said. The number of people treated by MSF alone in the capital, Port-au-Prince, has quadrupled in less than a month, reaching 1,600 cases in April. The organization has increased treatment capacity in the city and in the town of Léogâne, and is preparing to open additional treatment sites in the country. Nearly 200,000 cholera cases were reported during the rainy season last year, between May and October.
“Too little has been done in terms of prevention to think that cholera would not surge again in 2012,” said Gaëtan Drossart, MSF head of mission in Haiti. “It is concerning that the health authorities are not better prepared and that they cling to reassuring messages that bear no resemblance to reality. There are many meetings going on between the government, the United Nations and their humanitarian partners, but there are few concrete solutions,” he said.
An MSF study in the Artibonite region, where approximately 20 percent of cholera cases have been reported, has revealed a clear reduction of cholera prevention measures since 2011. More than half of the organizations working in the region last year are now gone. Additionally, health centers are short of drugs and some staff have not been paid since January.
“Rain is just one of the risk factors for contamination. But as soon as the rains end, cholera subsides, and funding stops until the next rainy season, instead of money being channeled towards cholera prevention activities. As a consequence, people are still highly vulnerable when cholera comes back,” said Maya Allan, MSF epidemiologist.
The majority of Haitians do not have access to latrines, and obtaining clean water is a daily challenge. Of the half-million survivors of the January, 2010 earthquake who continue to live in camps, less than one third are provided with clean drinking water and only one percent recently received soap, according to a April 2012 investigation by Haiti’s National Directorate of Water Supply and Sanitation.
“Hygiene advice is of little use if people are unable to put it into practice,” said Drossart. ”People urgently need the means to protect themselves against cholera.”
While the cholera vaccination being used in some parts of Haiti can help control the disease, it is not a foolproof solution. The vaccine provides immunity for approximately three years and is estimated to be only 70 percent effective. Only major improvements of Haiti’s water and sanitation systems will provide durable solutions to the epidemic, but that will take time.
“The priority today is to save lives,” said Drossart. “All health actors in Haiti need to start working towards this goal immediately.”
Since cholera emerged in Haiti in October 2010, 535,000 people have been infected and more than 7,000 people have died, according to the Ministry of Health and Populations. To date, MSF has treated more than 170,000 people, or 33 percent of total cases, across the country.
4. Help alleviate the Haitian cholera crisis: Message from the Honorable John Conyers, Jr.
Date: 5/7/2012
Dear Colleague:
Please join me in supporting efforts to address the cholera epidemic in Haiti by signing a letter to U.N. Ambassador Susan Rice urging UN authorities to play a central role in addressing the crisis.
The cholera outbreak began in October 2010, ten months after Haiti’s tragic earthquake, and “has become one of the largest cholera epidemics in modern history” according to the Pan-American Health Organization. To date, at least 7,200 Haitians have died from the disease and more than 530,000 people have been infected.
As cholera was brought to Haiti due to the actions of the UN, it is imperative for the UN to now act decisively to control the cholera epidemic. UN authorities should work with Haiti’s government and the international community to confront and, ultimately, eliminate this deadly disease from Haiti and the rest of the island of Hispaniola. A failure to act will not only lead to countless more deaths: it will undermine the crucial effort to reconstruct Haiti and will pose a permanent public health threat to the populations of neighboring nations.
If you have any questions or would like to sign the letter, please contact Michael Darner in my office at michael.darner@mail.house.govor 3-3834.
Sincerely,
John Conyers, Jr.
Member of Congress
May XX, 2012
Dear Ambassador Rice,
We are writing to express our deep concern regarding the ongoing cholera epidemic in Haiti and to ask you to strongly encourage the United Nations to take a leadership role in addressing this catastrophic public health crisis. The outbreak began in October 2010, ten months after Haiti’s tragic earthquake, and “has become one of the largest cholera epidemics in modern history” according to the Pan-American Health Organization. To date, at least 7,200 Haitians have died fromthe disease and more than 530,000 people have been infected. So as to ensure that this devastating disease is brought under control, we call on you to urge UN authorities to support efficient treatment and prevention of the epidemic and to help Haiti acquire adequate water and sanitation infrastructure.
As acknowledged by the UN’s Special Envoy to Haiti, former President Bill Clinton, UN troops introduced the cholera bacterium “into the waterways of Haiti, into the bodies of Haitians” and, as such, were the “proximate cause” of the epidemic. We welcome your statement in March to the Security Council calling on the United Nationsto “redouble its efforts to prevent any further incidents of this kind and to ensure that those responsible are held accountable.”
As cholera was brought to Haiti due to the actions of the UN, we believe that it is imperative for the UN to now act decisively to control the cholera epidemic. UN authorities should work with Haiti’s government and the international community to confront and, ultimately, eliminate this deadly disease from Haiti and the rest of the island of Hispaniola. A failure to act will not only lead to countless more deaths: it will undermine the crucial effort to reconstruct Haiti and will pose a permanent public health threat to the populations of neighboring nations.
According to the Pan-American Health Organization (PAHO), Haiti is one of the most underserved countries in the world in terms of water and sanitation infrastructure. These infrastructural weaknesses have made Haiti particularly susceptible to water-borne disease. Cholera had not been present in Haiti for over a century prior to October 2010, making Haitians ‘immunologically naïve’ and even more vulnerable to the disease.
The U.S. Centers for Disease Control and Prevention (CDC), has done a remarkable job in partnership with the Haitian government in distributing treatment supplies, providing treatment training, and establishing a national cholera surveillance system. The CDC estimates that cholera will likely persist in Haiti absent the development of water and sanitation systems, the cost of which has been estimated at $800 million to $1.1 billion.
On January 12 of this year, the presidents of Haiti and the Dominican Republic, joined by UN agencies PAHO, World Health Organization and UNICEF and the U.S. CDC, appealed to donor countries to honor pledges and provide funds for water and sanitation infrastructure. However, there has been little response to this appeal from the international community. Moreover, with the onset of the rainy season, the number of deaths from cholera is rising once again.
Accordingly, we call upon you to urge UN authorities to play a central role in addressing the cholera crisis. First, by helping ensure that resources are in place to provide adequate treatment and prevention of the disease in the short term. Secondly, by taking the lead in helping Haiti and the rest of the island of Hispaniola acquire the necessary funding to develop the water and sanitation infrastructure needed to effectively control the cholera epidemic.
Finally, we ask that you encourage UN authorities and all donor governments involved in the effort to fight cholera to intensify their cooperation with the Haitian state and people through capacity-building and the active inclusion of government representatives in decision-making and through the regular consultation of civil society actors.
Sincerely,
(signed)
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