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Cholera continues to take lives
Milo Milfort
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Victims sue the UN for bringing the disease into Haiti through blue helmets.

Almost six years after it first appeared in Haiti in October 2010, health authorities are still struggling to contain the spread of the cholera epidemic that has already caused 9,392 deaths and more than 790,000 infected. The challenges are enormous and the victims continue seeking justice and reparation from the United Nations (UN), accused of having introduced the deadly disease into Haiti.

“Cholera is still here. The bacteria are present in the 10 geographical departments in the country. It thrives and grows in filth and dirt,” insists Dr. Jean Donald François, national coordinator of the fight against cholera of the Ministry of Public Health and Population (MSPP). “The Haitian government is still worried.”

Between Jan. 1 and July 19, 2016, the number of people who have died from the disease reached 202, compared to 373 for the entire year 2015.

“Despite numerous efforts by health authorities and their partners in the humanitarian community, cholera remains a major humanitarian concern in Haiti. With more than 16,000 cases reported since the beginning of the year, the island country still has the highest number of reported cases of cholera in the northern hemisphere,” the UN revealed.

With the hurricane season running from June 1 to Nov. 30, various regions of the country have endured heavy rains, an ideal condition for the spread of the disease. In fact, a resurgence of the epidemic is observed in different municipalities every week. This recurrent and persistent situation is evidence of a very complex reality.

“We have made two findings: first, and the most serious, is that people tend to forget the existence of the disease and to ignore the principles of hygiene that we all must adhere to. We have also noticed that after every rainstorm, people forget the principle of hygiene under which one should only drink potable water,” François tells Latinamerica Press.

The outbreaks are caused by the absence of cholera treatment centers in at least 19 municipalities, the repeated floods, and the lack of funding that reduces the number of cholera response teams. What is worse, sanitation and access to potable water remains below world standards in this Caribbean country.

“Half of the Haitian population and more particularly those most vulnerable do not have access to clean drinking water and a healthy environment,” notes the United Nations Children’s Fund (UNICEF).

Currently, Haiti is facing a food crisis that involves more than 3 million Haitians representing one-third of its total population; adding to this number are the arrival of several thousand repatriated Haitians from the Dominican Republic, a political crisis that does not have an end in sight; rampant inflation; devaluation of the gourde, the national currency; and around 61,000 people who are still living in tents more than six years after the January 2010 earthquake.

The plan to combat cholera
A meeting to review the results of the first phase of the National Plan for the Elimination of Cholera in Haiti 2013-2022 was held on July 19 with the participation of the Minister of Public Health and Population, Daphnée Benoit Delsoin, officials of the institution and international bodies such as the Pan American Health Organization (PAHO), the World Health Organization (WHO) and UNICEF.

“Basically, we are satisfied with what has been accomplished since October 2010. While we still have some deaths at times, we no longer live in the times in which we recorded 20 or 40 deaths per day,” said François. According to the evaluation report prepared by those responsible to carry out the plan, the non-realization of all the planned activities for lack of funds, the outdated nature of the awareness messages designed at the beginning, the non-respect for the principles of hygiene by the general population are, among others, shortcomings in the implementation of this short-term plan.

The National Plan for the Elimination of Cholera requires of US$2.2 billion in 10 years. It comprises three phases: short, medium and long term. Its four axes are: epidemiological monitoring, social awareness, management, and clean water and sanitation. Only 18 percent of the $450 million required for the first phase (2013-2015) was obtained. Not all donors and international partners fulfilled their promises repeated a thousand times at the time of the launch of the plan in 2013.

UNICEF representative in Haiti, Marc Vincent, warned in July that “only a firm commitment by the international community and additional resources can bring an end to the epidemic.” This, despite a 90 percent reduction in the number of cholera cases in Haiti since 2011.

Once the short term has concluded, the Haitian authorities will focus on the medium term set for 2016-2018, which makes up the second phase adjusted to be presented in August to the population and to the partners interested in backing it.

“Without more funds, cholera will not be eradicated and it may pose a threat to the Caribbean, to America and even the world,” François warns.

Meanwhile, the victims of the disease have filed a lawsuit against the UN seeking a public apology to the Haitian people for bringing the disease into the country by Nepalese soldiers, demanding that help be provided to the Haitian State to build infrastructure for clean drinking water and sanitation, and economic compensation for those affected.

They are being represented by the Office of International Lawyers (BAI) and the Institute for Justice and Democracy in Haiti (IJDH) who, in March 2016, argued their case against the UN before the judge of the US Court of Appeal for the Federal Circuit in Manhattan.

“This demands a lot of time, studies and assessments. According to experts who are used to defending cases before the Court of Appeal, this could take between three to six months. So, we just have to wait,” said Mario Joseph, head of BAI to Latinamerica Press. “In fact, the case file of the cholera victims progresses at its own pace.”

The BAI and IJDH have filed the cases of 5,000 victims in the initial complaint, but have approximately 15,000 other cases in their offices in Port-au-Prince. They demand the payment of $100,000 per person who died and $50,000 for each person infected.

Reparations for victims
The budget approved by the UN Mission for the period from July 1, 2015 to June 30, 2016 amounts to $380.3 million. The UN military arrived in the country in 2004, after the international community forced the then President Jean-Bertrand Aristide (1991, 1994-1996 and 2001-2004) to leave power. In its 12 years of presence in the country, the UN Stabilization Mission in Haiti (MINUSTAH) would be involved in cases of rape and robbery, according to reports by human rights organizations.

The cholera victims hope to prevail. According to Joseph, “what will cause the lifting of immunity of the soldiers and the opening of a way for reparations for the victims is the creation of a permanent claims commission whose duty would be to examine the files of the victims.”

As part of the strategies, the victims plan to organize demonstrations in the streets of the capital in the coming months. In December 2015, some 2,000 victims of the ongoing cholera epidemic sent a letter to the Security Council of the UN. That same year, they launched the campaign Faites Face à la Justice (Face Justice), along with Haitian humanitarian organizations and international solidarity groups that support the fight for justice for the victims.

Exhibitions were organized on that occasion in Port-au-Prince, New York and Geneva with images of some of the victims of the disease.

Several international studies, including one from Yale University; and the report of French epidemiologist Renaud Piarroux, have reached the same conclusion: there is a close link between the origin of cholera in Haiti and the MINUSTAH camp in Mirebalais, at 40 miles northeast of the capital, where the Nepalese peacekeepers coming from south Asia were camped.

The UN has always refused to officially admit its responsibility for bringing on the disease and to examine the claims for compensation for the victims. It hides behind the immunity that its soldiers enjoy, which shields them from persecution before national and international jurisdictions.

Despite the rejection by the UN to admit their responsibility and the reduced contribution of international partners, the fight against the disease has made great progress. However, much more remains to be done if we want to truly eradicate it. The battle is far from won. —Latinamerica Press.


Access to potable water and sanitation systems remain two of the biggest challenges in Haiti. / Milo Milfort
Latinamerica Press / Noticias Aliadas
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