May 10, 2013
On May 3, the Boston based organization Physicians for Haiti released a report card titled Protecting Peacekeepers and their Public
which evaluates the status of the United Nations' efforts to eradicate
cholera in Haiti. It has been nearly three years since cholera first
appeared in Haiti, taking the lives of 8,289
people and infecting over 670,000. However, through effective
management, cholera does not pose a deadly threat if the proper
precautions are made. This is where the recently released Physicians for
Haiti report card gives the UN a failing grade in regard to their
inability to implement practical, attainable, and cost effective
reforms. What makes the matter worse is that the new report does not
critique the UN for failing to implement idealistic projects, but rather
for failing to implement their own recommendations.
Two years ago in May 2011, at the behest of Secretary General Ban Ki
Moon, the UN put together an independent group of international experts
who released a report on the cholera epidemic, the Final Report of the Independent Panel of Experts on the Cholera Outbreak in Haiti.
The report highlights that “the evidence overwhelmingly supports the
conclusion that the source of the Haiti cholera outbreak was due to
contamination of the Meye Tributary of the Artibonite River with a
pathogenic strain of current South Asian type Vibrio cholera as a result
of human activity.”
While sounding promising that the UN would trace the source of
cholera back to their Nepalese staffed UN Stabilization Mission in Haiti
(MINUSTAH) base located on the Artibonite, this was not the case.
Instead the report sought to divert attention from any discussion of
accountability, stating that “The Independent Panel concludes that the
Haiti cholera outbreak was caused by the confluence of circumstances as
described above, and was not the fault of, or deliberate action of, a
group or individual. The source of cholera in Haiti is no longer
relevant to controlling the outbreak. What are needed at this time are
measures to prevent the disease from becoming endemic.” It would later
be confirmed by the International Vaccine Institute that the cholera
strain found in Haiti was an “exact match” to the Nepalese epidemic earlier in the summer.
As the Physicians for Haiti report card reiterates, the 2011 UN
report also included seven recommendations to ensure that an outbreak
would not be repeated in Haiti or anywhere else in the world. Two years
after the publication of the report, the majority of the recommendations
have not been fully implemented.
It would be reasonable to expect that a lack of financial resources
would be the primary obstacle to the implementation of the
recommendations; however, this is not the case. As highlighted in the
report, the UN has not changed the medical screening protocol for
potential peacekeepers, mandated an immunization policy, or even
attempted to eliminate cholera pathogens by placing waste water in
barrels and treating them with bleach. These recommendations come at
either no cost to the UN or can be implemented at an extremely low cost.
While there have been important actions taken to attempt to address
the systemic issues of water security and sanitation infrastructure,
they remain severely underfunded, scattered, and largely
non-operational. For example, in December 2012, Ban Ki Moon announced a
$2.27 billion cholera eradication plan, but it has failed to get off the
ground due to lack of funding.
Troublingly, there have been no meaningful procedural reforms taken
to ensure that an outbreak like this will never happen again.
Furthermore, the UN has yet to release a statement of accountability,
choosing to travel down the path of impunity.
While the Physicians for Haiti report card provides a detailed
account of the action taken related to each recommendation, it does not
directly provide a final grade for the UN when it comes to the handling
of cholera in Haiti. Yet it only takes a quick read to infer that the UN
has indeed failed Haiti when it comes to cholera. Whether this is due
to a lack of political will or inept leadership—the outcome is that
cholera still remains a threat to the Haitian people.
When reading the report card, it becomes apparent that the disconnect
between policy creation and implementation is a major problem for the
UN in Haiti. The fact that three of the most achievable and cost
effective recommendations have not been undertaken remains extremely
problematic. If MINUSTAH bases cannot store and treat waste water in a
simple manner it speaks volumes about the political will of the mission
to ensure the immediate and long term safety of the Haitian people.
After all, on paper this is what they are supposed to be there for.