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You say “blame game,” I say “rule of law”: the UN’s responsibility for cholera in Haiti

The contamination of Haiti’s Artibonite River with cholera bacteria by the UN’s MINUSTAH (the French acronym for the UN Peacekeeping force in Haiti) soldiers was no accident, but a risk that was well known and could have been easily avoided. Now that 542,000 Haitians have gotten sick and 7,140 have died from the UN’s malfeasance, it’s well past time for the UN to take responsibility.

As an organization built on ideals of justice and the rule of law, effective self-regulation by the UN should be a given.  In Haiti, as in other Peacekeeper recipient countries, treaties ensure that UN soldiers have immunity from the criminal and civil courts of the country in which they are stationed, on the rationale that bringing UN troops before the host country’s (potentially corrupt) courts would impede the UN’s ability to function.  In return for immunity, the UN agrees to police itself and set up an internal claims system to right any wrongs that occur.  Sadly, the UN is abusing its legal privileges and robbing victims of their due by denying any accountability for cholera in Haiti.

Cholera was introduced to Haiti in October 2010, and “a mountain of evidence” shows that waste from a MINUSTAH base in the rural central plateau of Haiti was the source of the disease. According to multiple investigations, the sanitation system at this Mirebalais base was inadequate, consisting of haphazard, leaky sewer pipes and an open-air pit that overflowed into a nearby waterway during heavy rain.  Just weeks before the outbreak, the UN deployed soldiers from Nepal—where cholera is endemic—to Haiti without testing them for cholera.  The soldiers carried Vibrio cholerae bacteria with them, their untreated waste leaked into the Artibonite river system, and the epidemic began.  In the words of microbial geneticist Dr. Paul S. Keim, “It was like throwing a lighted match into a gasoline-filled room.”
For 19 months, UN officials have denied any responsibility for cholera, referring over and over to a single sentence in a July 2011 report created by a UN-commissioned Independent Panel of Experts. This sentence states:

“The Haiti cholera outbreak was caused by [a] confluence of circumstances [e.g., Haiti’s poor health, water and sanitation facilities], and was not the fault of, or deliberate action of, a group or individual.”  
On the basis of this sentence, which was taken entirely out of context, the UN has argued: first, that the source of cholera can’t be determined, and second, that the source of cholera is unimportant because a “confluence of circumstances” spread the disease, relieving the UN from blame.  The UN has also made a third argument for why no one should investigate its responsibility for cholera in Haiti: engaging in a “blame game” detracts from cholera response. These arguments have no basis in fact or law.

UN Myth 1: The Source of Cholera Cannot be Determined

Just last month, Secretary General Ban Ki-Moon’s spokesman Martin Nesirky reiterated that the source of cholera could not be determined, stating “it was not possible to be conclusive about how cholera was introduced to Haiti…” However, in making this claim the top UN brass are willfully ignoring the numerous renowned scientists, epidemiologists, and geneticists who have all converged on the conclusion that troop waste from the Mirebalais base was the source of the epidemic.

Among these experts is Renaud Piarroux, a renowned French epidemiologist whose report entitled ‘Nepalese Origin of Cholera Epidemic in Haiti’ precisely maps the path of the outbreak back to the UN’s Mirebalais base.  Also supporting the UN troop introduction theory is Dr. Paul S. Kiem, one of the authors of a report that used pulsed field gel electrophoresis (DNA comparisons) to very closely match the Haiti and Nepalese isolates of cholera.  

In fact, two members of the Independent Panel of Experts (their report was the source of the oft-cited “confluence of circumstances” sentence) have recently spoken out against the UN on this matter.  Microbiologist G. Balakrish Nair confirmed that there is “irrefutable molecular evidence” that Haiti’s cholera came from Nepal.  Engineer Daniele Lantagne also clarified that “the most likely scenario is that the cholera began with someone from the MINUSTAH base.”

UN Myth 2: “Confluence of Circumstances” is to Blame for the Epidemic

Second, UN officials claim the source of the epidemic doesn’t matter, because Haiti’s weak water, health, and sanitation infrastructures—a “confluence of circumstances”—were the true culprits behind the epidemic. This blame-the-victim styled argument is legally unsupportable. A basic two-part legal argument shows why the “confluence of circumstances” defense would be laughed out of court.  

Part A: The UN is responsible for the damage it could foresee, and the UN could definitely foresee the possibility of a cholera outbreak.  

In legal terms, and by UN Special Envoy Bill Clinton’s own admission, the UN’s contamination of Haiti’s rivers was the “proximate cause” of the epidemic.  Entire books are dedicated to the legal concept of proximate cause, but in short the law tries to pin responsibility on the person or people who knew (or should have known) about a risk, but nevertheless neglected to exercise reasonable care and triggered the harmful event anyway.

Applying this concept to cholera in Haiti, the UN knew that water-borne diseases like cholera posed a great risk to Haiti. In fact, UN doctors and officials had issued ominous warnings about cholera in Haiti for years, and were especially vocal about this risk post-earthquake. Nevertheless the UN neglected to take the reasonable steps to keep cholera bacteria from spreading, and through these omissions, the UN triggered the cholera epidemic. In other words, the Haiti cholera epidemic was no “accident,” but rather a foreseeable danger that the UN systematically ignored by failing to test soldiers from a cholera-endemic country, and failing to maintain sanitation facilities that kept human waste out of a major Haitian drinking source.

Part B: Once the proximate cause for an injury is established, the defendant is responsible for all harms that flowed naturally from the proximate cause.  

The apposite legal maxim here is: “You take your victim as you find him.”  In other words, a defendant whose actions proximately caused some harm must pay to repair all the harm, even if that harm was unexpected or the defendant didn’t intend to cause so much harm.  For example, imagine that a driver strikes a pedestrian down, and the pedestrian suffers injuries that, if treated properly, would have been minor.  However, due to a system malfunction, no ambulance comes to treat the pedestrian, and the pedestrian dies. The driver is responsible for the full extent of harms that she triggered, including the wrongful death.  By hitting the pedestrian, the driver set off a chain of events that led naturally to the pedestrian’s death.  An ambulance team might have intervened to stop this tragedy from occurring, but the driver isn’t relieved of responsibility because the ambulance never showed up.

Applying this reasoning to the UN’s responsibility for cholera, even if a “confluence of circumstances” eased the transmission of cholera, because poor water and sanitation infrastructure magnified the epidemic’s size and severity, the UN is still responsible for the full extent of the damages that flowed naturally from the initial negligent contamination.

Tragically, the full harm the UN proximately caused by the contamination of Haiti’s largest river system includes the deaths of over 7,140 people and the sickness endured by 542,000 Haitians.  The UN is responsible for all of it.

UN Myth 3: The “Blame Game” Detracts from Cholera Response

Moving on to the third and final UN excuse on cholera, UN officials argue that the UN shouldn’t be dragged into a cholera “blame game,” because focusing on the UN as the source of cholera only distracts from the UN’s more important work of responding to the outbreak. Indeed, such criticisms were voiced after the Institute for Justice & Democracy in Haiti (IJDH) and our Port-au-Prince-based partner Bureau des Avocats Internationaux (BAI), filed claims for 5,000 victims of cholera against the UN in November 2011. Our clients have three demands: 1) investment in comprehensive clean water and sanitation, 2) compensation for victims’ losses, and 3) an apology.

Under any legal code, acting carelessly to poison a major water source and kill thousands of people brings serious consequences.  Call it “the blame game” or call it “the rule of law,” but innocent Haitians’ basic legal rights, health, security, and families were harmed, and they deserve to be made whole. The UN doesn’t get a pass on liability just because the organization works on humanitarian causes, just like a ‘nice person’ shouldn’t get a pass for committing a crime.  Haitians don’t have to forego justice just because they are poor, or Black, or because so many of them were harmed.

The fact that the UN triggered cholera also matters because now that so much harm has been done, the UN is the best-placed institution to finance and coordinate the water and sanitation infrastructure improvements necessary to control the epidemic, save thousands more lives (not to mention the lives of thousands of children who die in Haiti from other water-borne diseases) and prevent future outbreaks.

So far, the UN’s efforts fall far short of this mark, and legal action highlighting the UN’s responsibility may be the only way to compel the UN to take on their moral and legal responsibilities to control cholera in Haiti.

Shirking behind feeble arguments and relying on immunity from Haitian courts, the UN’s responses to cholera has shown that the people they’re best protecting in Haiti are themselves.  

Kelly Geoghegan is a staff attorney at the Institute for Justice & Democracy in Haiti (IJDH), which represents 5,000 cholera victims in a suit against the United Nations. Info at www.ijdh.org