Hold the UN accountable for Haiti’s cholera epidemic

By Myrtha Désulmé

Myrtha Désulmé is President of the Haiti-Jamaica Society and the Caribbean Representative of the Haitian Diaspora Federation

On 24 August, Tropical Storm Isaac pummelled Haiti, resulting in floods, mudslides, and storm surges; downed trees and power lines. The storm threatened the lives of millions, particularly the more than 400,000 homeless Haitians, still living in flimsy tents, exposed to the elements like sitting ducks, two-and-half years after the January 2010 earthquake. Painful images of tent-dwellers bracing against fierce winds, with a background of flying tents containing all of their worldly possessions, were streamed on CNN between news of another US shooting incident, and the joys of Australian river rafting.   Adding to the crisis, was the fear of an ensuing surge of the cholera epidemic introduced into Haiti by the UN forces. The initial death toll from TS Isaac is reportedly at twenty-four, but this number could spike due to the potential increase in cholera cases.

On 21 October, 2010, ten months after the greatest natural disaster of the modern age, cholera exploded in the Artibonite region along Haiti’s central river system, quickly spreading to other areas. Haiti went from never having had a cholera outbreak in recorded history, to now having, based on the Pan-American Health Organization (PAHO), “one of the largest cholera epidemics in modern history”, which has killed more than 7,585 Haitians, and infected over 594,198 to date.

According to Duke University Professor Deborah Jenson, who has written extensively on Haiti, research of 19th century newspapers, and sea merchants’ journals, reveals that while cholera raged in the United States and much of the Caribbean, it always failed to take root in Haiti. When it first arrived in the Americas in 1832, Haitian President Boyer immediately announced public health measures to prevent the invasion of cholera. In 1892 President Hippolyte again published protocols to prevent the introduction of a Euro-American infection.  It is in fact this Euro-American epidemic, which led to the development of sanitary sewer systems in Europe and America.

Numerous independent DNA tests and epidemiological studies, including those of the UN itself, have established that Nepalese troops to the UN peacekeeping mission in Haiti (MINUSTAH) brought the vibrio cholerae bacteria to Haiti.  Geneticists have precisely matched the epidemic strain in Haiti to a particularly virulent, deadly cholera strain found in Nepal in the summer of 2010, just before the troops were deployed.  Although Nepal has endemic cholera, the UN did not test or treat the Nepalese peacekeepers for cholera prior to their deployment.  In Haiti, they lived on a base with a haphazard and inadequate sewage system, and recklessly dumped all waste into an unfenced pit.  It was easily foreseeable that human faeces containing cholera bacteria could contaminate a tributary, which runs just meters from the base into the Artibonite River, travelling downstream to infect the Haitian families who drink, bathe, play, and wash laundry in the river.

Three of the brave souls who have taken on the UN Leviathan are Attorneys Marguerite Laurent of the Haitian Lawyers Leadership Network (HLLN), Mario Joseph of the Bureau des Avocats Internationaux (BAI), and Brian Concannon of the Institute for Justice & Democracy in Haiti (IJDH).

Givens Dorgil, 29, holding his grandmother’s hand with his own hand covered in a glove to protect him from contracting cholera as well. His grandmother, Virginia Sencilna, 67, became ill and was taken to Au Secours Hospital in Gonaives, Haiti, for treatment (photograph by Rick Loomis, Los Angeles Times)

On 3 November, 2011, BAI and IJDH filed a lawsuit on behalf of 5,000 cholera victims. The case demands that the UN provide the only long-term solution, which is the comprehensive clean water and sanitation infrastructure necessary to control the epidemic. Cholera is generally easily treatable with oral rehydration solutions.  But for those who lack access to clean water and medical care, it can kill in a matter of hours. Medical treatment, vaccinations, and chlorine tablets are saving some lives for now, but cholera immunity lasts only a few years, while the cholera bacteria will remain in Haiti indefinitely.  The water and sanitation infrastructure will not only eradicate cholera, it will reduce all water-borne diseases in Haiti, which kill thousands every year.

Incredibly, the UN initially denied responsibility on the premise that a “confluence of factors”, including Haiti’s weak sanitation and health infrastructure, were the real reasons for the outbreak. This preposterous, and legally invalid defence, is akin to starting a fire in a dry field, and blaming the wind for the spread of the fire. Before the outbreak, Haiti was widely known to be one of the most water insecure countries in the world, and after the devastating earthquake of January 2010, experts warned that outbreaks of water-borne diseases, especially cholera, would have disastrous effects.  Haiti’s fragile conditions created a heightened responsibility for the UN to exercise care in its operations. Yet the UN failed to take simple measures that would have prevented the outbreak, like testing of its soldiers known to come from a cholera-endemic region, proper management and disposal of waste, and immediate corrective action.  By any legal code, the UN is legally responsible, because their carelessness directly caused foreseeable harm to victims.

The victims of cholera filed complaints directly with the UN’s internal claims unit. MINUSTAH’s operations in Haiti are governed by a Status of Forces Agreement (SOFA), which affords the UN and MINUSTAH broad immunities from civil or criminal prosecution in Haitian courts. To balance this immunity, the SOFA requires the establishment of an independent Standing Claims Commission, to hear claims and compensate victims, who have been injured in the course of UN operations. Despite this requirement, no commission has been established during the eight years MINUSTAH has operated in Haiti.  In fact, there has never been a Standing Claims Commission established in over 60 years of UN peacekeeping, even though these commissions are a standard feature of most SOFAs.

Momentum has been building, to pressure the UN to respond justly to the epidemic. In January,

ABC News published an article entitled: UN Soldiers Brought Deadly Superbug to Americas.

In March, President Bill Clinton, UN Special Envoy for Haiti, publicly affirmed that UN peacekeepers were the “proximate cause” of the cholera epidemic.  Hundreds of Haitians marched from the UN’s base to the Haitian parliament, demanding justice for cholera victims. The New York Times ran a front-page story confirming the UN’s responsibility in bringing cholera to Haiti, and exposing its failure to respond accordingly.  After a visit to Haiti by the UN Security Council, the missions of the U.S., France, and Pakistan, declared to the Security Council that the UN must do “whatever is necessary to make this situation right”.

In April, The Economist published a scathing piece calling on the U.N. to accept responsibility for its wrongdoings in Haiti.  In May, Nigel Fischer, UN Humanitarian Coordinator in Haiti, acknowledged that the UN’s current efforts were “patchwork, Band-aid work,” and that “the long-term solution was investment in improved drinking water sources and waste management.”

The U.S. Centers for Disease Control and Prevention (CDC), and prominent French epidemiologists have published studies confirming the source of the disease; while Washington Post editorials, TransAfrica Forum, Human Rights groups, and faith-based organizations, like the Church World Service, have called for the UN and the international community to take responsibility swiftly in ending the epidemic.

On 17 July, US Representative John Conyers, Jr. (D-Mich.), and 103 other Members of Congress sent a letter to Susan Rice, U.S. Ambassador to the United Nations, applauding her call for UN accountability, and asking her to urge the organisation to take a leading role in addressing the cholera crisis in Haiti, which according to the Haitian Government, infects 600 new victims every day.

The Congressmen wrote: “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 eliminate this deadly disease from Haiti…. A failure to act will not only lead to countless more deaths: it will undermine the crucial effort to reconstruct Haiti.”

The IJDH/BAI lawsuit aims to compel the UN to spend $750 million – 1.2 billion on comprehensive water and sanitation infrastructure, which would improve Haiti for decades.  By comparison, MINUSTAH’s operating budget in Haiti for one year is around $800 million, and only half of the $5.33 billion pledged for earthquake recovery has been disbursed. With nearly half-a-million homeless earthquake victims in sprawling tent camps, exposed to disease, eviction, arson, and violence, the Red Cross, whose core mission is humanitarian assistance during emergencies, is planning to build a hotel on a property it purchased for $10.5 million of funds collected in the name of suffering Haitians, while the Clinton-Bush Haiti Fund made a $2 million equity investment in the 5-star Royal Oasis hotel.

If the lawsuit is successful, the clean water and sanitation infrastructure will save between 50,000  – 70,000 lives over the next ten years, by eradicating cholera, and all other water-borne diseases.

On 4 June, 7 months after the filing of the lawsuit, a “Regional Coalition on Water and Sanitation for the Elimination of Cholera in the Island of Hispaniola”, was launched by UN agencies, World Health Organization (WHO), and UNICEF, in collaboration with the Pan-American Health Organization (PAHO), the Centers for Disease Control and Prevention (CDC), the Spanish Agency for International Development Cooperation (AECID), and the Inter-American Association of Sanitary and Environmental Engineering (AIDIS). The Coalition pledged to support efforts by the governments of Haiti and the Dominican Republic “to harmonize and streamline international assistance and investments in water and sanitation infrastructure aimed at eliminating cholera from the island”.  On 18 September, CARICOM joined the Coalition.  But four months after its launch, the Coalition has done nothing to save lives or eliminate cholera, and does not even have any funding in place. It is merely “urging governments and international organizations to support their efforts”. While the UN, which has the funds and the legal obligation to right its wrongs, is not responding. Some believe that the Coalition is just a smokescreen, to take the pressure off the UN, which is simulating a response, without setting the precedent of accepting liability.

In the words of Betsey Chace, a finance volunteer with IJDH:

“… fair treatment of Haiti by the international community [is] the only thing that will enable Haiti to break the cycle of extreme vulnerability to disasters.  There is little natural about a death toll in the [hundreds] of thousands from an earthquake of 7.0 magnitude, or massive loss of life from heavy rainfall. These unnatural disasters result from political, environmental, and economic conditions, that will improve only when Haitians are supported rather than thwarted in building a system of laws, rights, and accountability, that are the foundation of a just and safe society.”

On 28 July 2010, the UN General Assembly adopted a Resolution recognising access to clean water and sanitation as a human right essential to human dignity, and to the realisation of all other human rights.  We urge the entire Caribbean family to remain vigilant, to ensure that the basic human rights of the Haitian people are upheld, and that the UN returns to its core mission, of fighting infectious diseases, not spreading them.