5 May 2011 — HLLN

Recommended HLLN Link:
– http://bit.ly/aaQpdT
Haiti’s case against the UN for importing cholera epidemic, by Ezili Dantò of HLLN, Oct 28, 2010
(Written less than one month after the outbreak by Ezili Dantò of HLLN:)

– http://bit.ly/c2GNZI
Is Haiti’s deadly cholera outbreak an imported disease?

The virus had been eradicated in Haiti, the Health Ministry said.

– UN-imported cholera to Haiti could affect 800000 people (Rwanda Genocide figures) people by year end : study
http://news.in.msn.com/international/article.aspx?cp-documentid=5043993

– Health experts say UN troops could have caused Haiti cholera outbreak, call for investigation
http://www.margueritelaurent.com/photogallery/JeteDlo/2.html#UNcholera

In this post

UN Role Is Found in Haiti Cholera
Wall Street Journal – Joe Lauria – April 4, 2011

UN panel: South Asian cholera strain in Haiti
http://bit.ly/ivCMbH, (AP) – Arpil 4, 2011

Haiti cholera outbreak linked to peacekeepers, UN admits
By Jon Swaine, New York 1:21AM BST 05 May 2011 | Telegraph.co.uk
http://bit.ly/joZNI6

Cholera Surge in Haiti Is Feared New York Times
http://nyti.ms/mfKVBB

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U.N. Role Is Found in #Haiti Cholera – WSJ.com
http://on.wsj.com/kfbS8Q
By JOE LAURIA

UNITED NATIONS—Fecal matter from United Nations peacekeepers that was improperly disposed of by a firm contracted by the U.N., along with a poor sanitation system for drinking water, was the cause of the cholera outbreak in Haiti last year that killed more than 4,500 people, a report by a U.N.-appointed panel said on Wednesday.

Another 300,000 people were made ill in an outbreak that is still sickening people and occurred because of a confluence of events, the report by the four-person panel of American, Indian and Bangladeshi experts.

The panel said that the cholera bacteria originated outside Haiti, which suffered its first cholera case in a century last October, and matched strains from Nepal in 2009.

The U.N. peacekeeping mission in Haiti, known as Minustah, has a camp in Mirebalais near the Meye River, a tributary of the Artibonite River, where Nepalese blue helmets are stationed.

“The sanitation conditions at the Mirebalais Minustah camp were not sufficient to prevent contamination of the Meye Tributary System with human fecal waste,” the report said.

U.N. officials previously dismissed as speculation that the outbreak originated at the camp. To get to the bottom of the allegations, U.N. Secretary General Bank Ki-moon appointed the panel at the end of last year.

The report plays down as a “hypothesis that soldiers deployed from a cholera-endemic country to the Mirebalais Minustah camp were the source of the cholera” which it said was “a commonly held belief in Haiti.”

But the report then describes in detail how the outbreak occurred because of contamination of the Artibonite River from the peacekeeping camp.

“The sanitation conditions at the Mirebalais Minustah camp were not sufficient to prevent fecal contamination of the Meye Tributary System of the Artibonite River,” the report said.

The contaminated river was the “likely route of the spread of Vibrio cholerae from the mountains of Mirabalais to the coastal areas around the Artibonite River Delta,” the report says, leading to an “explosive cholera outbreak eventually throughout Haiti.”

While the report says that the outbreak “was caused by bacteria introduced into Haiti as a result of human activity,” it said there were several reasons for its deadly outcome.

Among the reasons for the rapid spread of the disease, is the lack of immunity among the population after a century of living cholera-free; the salinity of the river delta; infected medical workers and patients who brought the disease home and the poor water and sanitation system in Haiti, the report said.

“The Independent Panel concludes that the Haiti cholera outbreak was caused by a confluence of circumstances … and was not the fault of, or deliberate action of a group or individual,” the report says.

Clifford Baron, who said he was owner of Sanco Enterprises of Port-au-Prince, the company contracted by U.N. to dispose of waste at the Mirebalais camp, said he was unable to comment.

In a statement, Mr. Ban said he would “convene a task force” within the U.N. system to “study the findings and recommendations” of the report.

Calls to Haiti’s mission to the U.N. in New York and its embassy in Washington went unanswered.
Write to Joe Lauria at newseditor@wsj.com

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UN panel: South Asian cholera strain in Haiti
http://bit.ly/ivCMbH,
(AP) – Arpil 4, 2011

UNITED NATIONS (AP) — The cholera outbreak that has killed nearly 5,000 people in Haiti was caused by a South Asian strain that contaminated a river where tens of thousands of people wash, bath, drink and play, a U.N. independent panel of experts said Wednesday.

Although many have blamed the epidemic on U.N. peacekeepers from South Asia working in Haiti, the report issued by the panel declined to point the finger at any single group for the outbreak, saying it was the result of a “confluence of circumstances.”

“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 cholerae as a result of human activity,” the report said.

It said the panel concluded the epidemic “was not the fault of, or deliberate action of, a group or individual.”

U.N. Secretary-General Ban Ki-moon requested the independent probe amid reports of poor sanitation at a U.N. base housing Nepalese peacekeepers near Mirebalais, the central town where the outbreak was first reported.

Besides killing almost 5,000 people in a country still recovering from a devastating earthquake more than a year ago, the outbreak has sickened another 250,000.

The belief that the Nepalese peacekeepers are to blame for the epidemic is widespread in Haiti, straining relations between the population and U.N. personnel. Angry protests berating the peacekeepers erupted late last year, and just last week about 100 demonstrators blamed the United Nations for the spread of cholera.

Ban will carefully consider the panel’s findings and recommendations, U.N. spokesman Martin Nesirky said.

The spokesman said the U.N. chief will convene a task force to study the findings and recommendations to ensure they are dealt with promptly.

Haitian officials in the health ministry declined to comment Wednesday afternoon, saying they had not yet read the report. The U.N. envoy to Haiti Edmond Mulet was to deliver the report to the government Wednesday.

Doctors Without Borders, a medical charity that has treated about 130,000 cholera patients since the outbreak, welcomed the report’s release.

“We’re happy that there’s a process to ensure the origins of the epidemic can be investigated, and that the report has been made public for full transparency,” said Sylvain Groulx, the group’s chief of mission in Haiti.

The report came amid concerns from the U.S.-based medical aid group Partners in Health that an increase in new cholera patients in rural Haiti may signal a new surge of the epidemic with the onset of the spring rainy season.

Panel members said Haiti’s outbreak underscored the need for U.N. personnel and other first responders coming from countries where cholera is endemic to be screened for the disease, receive a prophylactic dose of appropriate antibiotics before departure, or both.

They also recommended that U.N. installations worldwide treat fecal waste using on-site systems “that inactivate pathogens before disposal.”

In their report’s conclusions, panel members said the Artibonite River’s canal system and delta “provide optimal conditions for rapid proliferation” of cholera, that Haitians lacked immunity to the disease, and that many areas of the country suffer from poor water and sanitation conditions.

It also said the South Asia strain that caused the outbreak “causes a more severe diarrhea due to an increase in the production of a classical type of cholera toxin and has the propensity of protracting outbreaks of cholera.”

“The conditions in which cholera patients were initially treated in medical facilities did not help in the prevention of the spread of the disease to other patients or to the health workers,” it added.

“The introduction of this cholera strain as a result of environmental contamination with feces could not have been the source of such an outbreak without simultaneous water and sanitation and health care system deficiencies,” panel members said.

Associated Press reporter Trenton Daniel in Port-au-Prince contributed to this report.

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Haiti cholera outbreak linked to peacekeepers, UN admits
By Jon Swaine, New York 1:21AM BST 05 May 2011 | Telegraph.co.uk
http://bit.ly/joZNI6

Last year’s deadly cholera outbreak in Haiti, which killed 4,500 people, was linked to Nepalese UN peacekeepers who were stationed at a base in the country, a UN panel has conceded.

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The panel found that “evidence overwhelmingly supports” the conclusion that the epidemic began via the contamination of the Artibonite River near the troops’ base, with a south Asian strain of cholera.

In a report published on Wednesday night, it also listed a series of measures that the UN should introduce to ensure its peacekeepers do not introduce cholera to the countries in which they work.

But the panel refused to single out the troops for blame, stating that Haitians – who had recently suffered a devastating earthquake – should not have been using the river for drinking or washing.

The group, convened by Ban Ki-Moon, the UN Secretary-General, insisted the crisis was due to a “confluence of circumstances” and “not the fault of, or deliberate action of, a group or individual”.

Haitians began contracting cholera, a water-borne disease, in October 2010, 10 months after the country was struck by a devastating earthquake that killed an estimated 250,000 people.

Various theories circulated about how the disease, which had not been detected in Haiti in a century, had arrived. These included the evolution of existing diseases or the result of tectonic plate shifts.

But most fingers were pointed at Nepalese UN troops at a base in Mirebalais, around the centre of the country. Nepal had recently suffered an outbreak, and Haitian cases began soon after the troops’ arrival.

A report published in December by Renaud Piarroux, a French specialist who is one of the world’s most eminent cholera experts, said that the troops were indeed most likely to blame.

Dr Piarroux, who was sent by France to assist Haitian officials, concluded the epidemic originated in a tributary of Haiti’s Artibonite river, next to the UN base. “No other hypothesis could be found,” he said.

Protesters in Port-au-Prince armed with rocks attacked UN facilities and personnel in revenge.

The new UN report found that the sanitation conditions at the peacekeepers’ camp “were not sufficient to prevent fecal contamination” of the river’s tributary system.

It also said that bacteria from Haitian cases was found to be “very similar, but not identical, to the South Asian strains of cholera”, confirming that the outbreak “did not originate from the native environs of Haiti”.

But it chose also to criticise “the widespread use of river water for washing, bathing, drinking, and recreation” by Haitians, tens of thousands of whom were forced to live in “tent towns” as a result of the earthquake.

It also said the river had provided ideal conditions for the spread of the disease, and that Haitians who had contracted it had unwittingly spread cholera by returning to their homes in other areas.

“The introduction of this cholera strain as a result of environmental contamination with faeces could not have been the source of such an outbreak without simultaneous water and sanitation and health care system deficiencies,” it said.

The panel said that all UN peacekeepers travelling from and to cholera-affected areas should be immunised against the disease, and that UN bases should chemically treat their waste comprehensively.

Mr Ban said he would “carefully consider” the report’s findings and convene a “task force within the United Nations system” to follow up its recommendations.

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Cholera Surge in Haiti Is Feared
New York Times | http://nyti.ms/mfKVBB | May 4, 2011

PORT-AU-PRINCE, Haiti (AP) — An increase in new cholera patients in rural Haiti has raised concern that the outbreak may be starting to surge again with the spring rainy season, a medical aid group based in the United States said Wednesday.

Health experts in Haiti warned in January when the cholera outbreak began to slow that there could be a surge of new cases in the spring, when rain would help spread contaminated water.

Workers for the aid group Partners in Health have noted an increase in new patients at treatment centers in the countryside, as well as in Port-au-Prince, the capital, said a spokeswoman for the group, Kathryn Mahoney.

At centers in Mirebalais, a central town near where the outbreak was first detected in October, the number of new cholera patients has roughly tripled in recent weeks, Ms. Mahoney said.

Sylvain Groulx, chief of mission in Haiti for Doctors Without Borders, which has had a leading role in responding to the outbreak, said that group’s workers had seen only a slight increase in new cases in the countryside.

NationalJournal.com – Haiti’s Cholera Outbreak Worse than Expected … The threat from cholera in post-quake Haiti is much higher than UN agencies projected, and the epidemic is likely to sicken close to 800,000 people and kill 11,000 of them, U.S. researchers reported on Tuesday. ( http://bit.ly/ffAeA5 )