Mounting death tolls and calls for justice are intensifying the pressure on the United Nations to address the cholera epidemic it started in Haiti. Cholera has raged through Haiti like a wildfire for 16 months, leaving 7,050 dead and sickening 531,000, according to the Haitian Ministry of Health. Epidemiologists and cholera experts had never seen the disease take hold of a population so quickly, or so violently, and today the epidemic is the worst in modern history.
Overwhelming evidence shows that soldiers from the United Nations Stabilization Mission to Haiti (MINUSTAH) introduced cholera into Haiti. Recently the UN has been under ever-increasing pressure to respond. In February 2012, US Ambassador Susan Rice called for accountability on cholera after a 4-day trip to Haiti, during which she encountered public demonstrations and repeated questions from journalists and Parliamentarians on cholera.
In a March Security Council meeting, France acknowledged the damage cholera has done to the UN’s reputation in Haiti, adding, “We can regret this, but we cannot ignore it.” Pakistan, a MINUSTAH-contributing nation, urged the UN to do “whatever is necessary to make this situation right.”
In addition to such calls for justice, the UN faces a lawsuit filed by 5,000 cholera victims asking for clean water, individual compensation, and an apology. However, the UN has protection from jurisdiction in Haitian courts under the terms of the Status of Forces Agreement (SOFA) signed by the UN and Haiti, and no clear forum exists where these claims could be heard. One of the victims’ demands is that the UN set up a Standing Claims Commission, outlined in the SOFA, with the capacity to hear their cases. UN spokesperson Martin Nesirky told reporters on Monday that the UN is “studying the claims.”
“Haiti’s cholera epidemic is not simply an unfortunate accident followed by bungling by the international community,” said Mario Joseph, Managing Attorney for the Bureau des Avocats Internationaux in Haiti, the lead attorney for the cholera victims in their suit against the UN. “It is a failure by the UN to obey the law in maintaining its sewage treatment, followed by a refusal to bear the clear legal responsibility for its law-breaking. This is a textbook example of the dangers of impunity. Only an institution with no fear of consequences could have acted so recklessly with such dangerous bacteria.”
The UN claims that even if it did introduce cholera into Haiti, that it is not responsible for the spread of the disease, because other factors- especially Haiti’s poor health, sanitation and water infrastructures – contributed to the epidemic itself. Cholera disproportionately affects the poor, since transmission occurs in places where drinking water becomes contaminated by fecal matter. In pre-earthquake Haiti, only 12 percent of the population had access to piped, treated water, and only 17 percent had “improved sanitation,” including simple pit latrines. According to the UN, this “confluence of factors” was the reason the outbreak spread so rapidly, soon overwhelming Haiti’s limited health infrastructures.
The victims’ attorneys point out that under the law, this is no defense. Even if Haiti’s weak systems exacerbated the cholera outbreak, legal culpability still falls on those responsible for triggering this horrific course of events. “The UN’s excuse for standing by while cholera victims die – that other factors caused the cholera introduced by the UN to spread throughout Haiti, would be laughed out of court, except that the UN makes sure that it is never brought to any court for the wrongful acts of its missions,” said Brian Concannon, Jr., Director of the Institute for Justice & Democracy in Haiti (IJDH) which also represents the cholera victims. “The UN’s holding itself above the law deeply subverts its mission of promoting the rule of law, in Haiti and throughout the world.”
The UN’s “confluence of factors” argument also fails to address the fact that Haiti’s susceptibility to water-borne diseases was extremely well known. The UN’s own medical experts had repeatedly warned that a water-borne disease like cholera would be devastating given the nation’s weakened health and sanitation infrastructures. “It was like throwing a lighted match into a gasoline-filled room,” Dr. Paul S. Keim told New York Times reporters. Keim’s laboratory performed the genetic analysis that proved the Haitian and Nepalese cholera strains were virtually identical.
Centuries ago, cholera outbreaks served as the catalyst for installing public water and sewage in major cities like London, Boston, and New York, and such infrastructures are recognized as the only sustainable way to control the disease. UN agencies estimate the cost of comprehensive clean water and sanitation in Haiti and its neighbor, the Dominican Republic, at $700 million - $1.2. billion U.S. By comparison, the current annual budget of MINUSTAH is $800 million U.S, and governments pledged $4.5 billion in aid following the earthquake.
Fifteen months after the epidemic began — but only two months after the cholera case was filed — UN officials announced an initiative to seek funding to build a comprehensive clean water infrastructure in Haiti and the Dominican Republic. In January 2012, the Haitian and Dominican governments, UNICEF, the World Health Organization and the Pan-American Health Organization unveiled their joint “One Team Against Cholera” campaign to achieve a cholera-free Hispaniola. However, this campaign has yet to translate into concrete, funded plans. Until such plans are realized, Haiti will continue to endure successive waves of cholera, intensified by rainy season conditions. Epidemiologists estimate that this spring and summer will produce up to 1,000 new cholera cases in Haiti per day, and claim hundreds of lives.
Kelly Geoghegan is a Staff Attorney with the Boston-based Institute for Justice & Democracy in Haiti, www.ijdh.org, which represents 5,000 victims of Haiti’s cholera.