Institute for Justice and Democracy in Haiti

Fight The Outbreak: Frequently Asked Questions about the UN & Cholera in Haiti

1.     What is cholera?

Cholera is a waterborne illness that causes acute, profuse diarrhea and vomiting.  Dehydration can be so rapid that a woman who weighs 54 kgs (120 lbs) may lose 4.5 kgs (10 lbs) of her bodyweight within a few hours.  Cholera disproportionately impacts the poor and vulnerable; it 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.  Between the outbreak of cholera in October 2010 and March 2012, the Haitian government reports that 7,040 people have died and over 530,000 have been infected in Haiti.

2.     How did the cholera epidemic spread through Haiti?

On October 21, 2010, cholera exploded in Haiti.  People watched family members and friends suffer severe diarrhea and die within hours of the onset of symptoms.  Within the first 30 days, Haitian authorities recorded almost 2,000 deaths from cholera.  The cases were concentrated in the Artibonite region, home to Haiti’s central river system, but quickly spread to other areas.  While cholera is endemic in some developing countries, Haiti has not had a cholera epidemic in recorded history. Almost immediately, experts began suspecting that the cholera bacteria was imported, and epidemiological mapping indicated that it originated in the sewage from a UN peacekeeping base in Mirebalais.

3.     Did the UN really bring cholera to Haiti?

Numerous independent scientific studies, including those of the UN itself, have documented that MINUSTAH personnel deployed from Nepal brought the vibrio cholerae bacteria to Haiti. DNA testing shows that the cholera strain in Haiti is a perfect match to a strain active in South Asia.  Cholera surfaced in Haiti with the arrival of a new battalion of peacekeepers from Nepal, a country that was suffering from its own epidemic at the time. The UN did not test or treat the peacekeepers for cholera prior to deployment.  Moreover, the UN’s own investigation revealed that the sewage piping at their Mirebalais base was “haphazard” and “inadequate,” and that the base dumped its wastes into an unfenced pit.  It was easily foreseeable that human waste containing cholera bacteria could contaminate a tributary that runs just meters from the base into the Artibonite River.  In fact, the record speed of the outbreak caused epidemiologists to hypothesize that a full cubic meter of cholera-ridden water was dumped into the Artibonite and traveled downstream like a plume, infecting the Haitian families that drink, bathe, play and do laundry in the river along the way.  In March 2011, Former U.S. President Bill Clinton who currently serves as UN Special Envoy to Haiti, acknowledged in a statement that MINSTAH was the “proximate cause” of the outbreak.

4.     What are victims of cholera asking from the UN?

On November 3, 2011, over 5,000 victims of cholera filed claims with the UN and MINUSTAH, seeking a) the clean water and sanitation infrastructure necessary to control the epidemic; b)compensation for victims who have lost family members or were ill from cholera; and c) a public apology from the UN. PAHO estimates that the necessary water and sanitation infrastructure for Haiti and the Dominican Republic will cost between $750 million – 1.1 billion.  By comparison, MINUSTAH’s operating budget in Haiti for one year is around $800 million.

The petitioners asking for clean water and compensation include people like Nadine,[*] whose father suddenly fell ill from cholera and died at a nearby treatment center.  The body was disposed in a mass grave, and Nadine took out loans to pay to retrieve her father’s body for proper burial. She has been unable to repay the debt.

5.     What makes the UN legally responsible?

Bill Clinton, UN Special Envoy to Haiti, acknowledged in March 2012 that peacekeepers from South Asia introduced cholera into Haiti’s rivers, and that this was the “proximate cause” of the epidemic.  Still, the UN claims that even if peacekeepers did introduce cholera into Haiti, a “confluence of factors,” including Haiti’s weak sanitation and health infrastructure, are the real reasons for the outbreak, thus negating UN responsibility.  This is a legally invalid defense, akin to starting a fire in a dry field and blaming the wind when the fire spreads.  Before the outbreak, Haiti was widely known as 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, like cholera, would have disastrous effects.  Haiti’s fragile conditions created a heightened responsibility for the UN to exercise care in its operations in Haiti.  Yet the UN failed to take reasonable, modern day measures that would have prevented the outbreak.  The UN failed to properly manage and dispose of its waste, failed to test its soldiers known to come from a cholera-endemic region, and failed to take immediate corrective action, willfully delaying investigations and obscuring discovery of the source of the outbreak at the cost of thousands of lives.

6.     Is the UN being held responsible in a court of law?

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 actions in Haitian court.  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 the UN’s operations.  Despite this requirement, no commission has been established during the seven 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.  This accountability gap needs to be addressed for the UN to maintain credibility in its calls for increased global accountability.

7.     Has the UN responded to the claims?

The UN has confirmed receipt of the victims’ claims, but has not otherwise provided an official response.  Since the outbreak, the UN and MINUSTAH have never issued a statement acknowledging its responsibility in the outbreak or the harm caused to the Haitian people. At most, on January 7, over two months after the cholera epidemic broke, UN Secretary General Ban Ki Moon appointed the independent panel of experts to investigate and determine the source of cholera in Haiti.  Despite the findings that “the evidence overwhelmingly supports the conclusion that the source of the outbreak was due to contamination of the …Artibonite River” by a pathogen from South Asia as a result of human activity, the UN refused to link it to its own operations, and has followed up the investigation with silence.

Unofficially, the UN responded to the claims through the World Health Organization, Pan-American Health Organization (PAHO), UNICEF, and others, several months after the filing of the claims, when these organizations announced a “One Team Against Cholera” initiative to eradicate cholera through investments in comprehensive water and sanitation. Member States are also pushing for action. In a March 8, 2012 Security Council meeting, France acknowledged the damage cholera has done to Haitians and the UN’s reputation there, declaring, “We can regret this, but we cannot ignore it.”  Pakistan further voiced that cholera has severely tested Haiti, and called for a UN apology, adding that the UN must do “whatever is necessary to make this situation right.”

8.     What can I do?
–          Learn more:

  • Visit IJDH’s Cholera Accountability page;
  • Visit our page on Facebook: FightTheOutbreak;
  • Watch Baseball in the Time of Cholera, a short documentary on the cholera outbreak that premiers at the Tribeca Film Festival on April 21, 2012:

–          Speak out:

  • Tell the UN to act by sending tweets to@UN;
  • Participate in the conversation on Twitter: #cholera and #FightTheOutbreak ;

–          Support the case:

  • Donate to support our efforts to obtain accountability and investments in clean water & sanitation in Haiti:
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