By Emma Fawcett *

Inside a cholera treatment center in Haiti. Photo Credit: CDC Global / Flickr / Creative Commons

As the number of Zika victims rises into the tens of thousands and dominates the media, Haiti’s cholera outbreak rages on – reaching 785,530 cases and 9,361 deaths since 2010.  According to the Haitian Ministry of Public Health and Population, more than 3,500 people were infected and 26 died in June alone.  Ten communes in Haiti’s Center and West departments are on “red alert,” indicating a surge of cholera cases.  This surge is expected to continue throughout hurricane season, as the increased rainfall leads to further contamination of open water sources.  Recent research by Doctors Without Borders has indicated that, if anything, the Ministry’s death tolls have understated the severity of the epidemic, as several of the hardest hit communities experienced death counts three times higher than officially recorded.

• Unlike Zika, cholera can be prevented through hand-washing and water purification, but campaigns to distribute soap and chlorine tablets and increase public education have met with limited success. Moreover, those infected require immediate treatment with intravenous fluids and oral rehydration therapy, and there are too few cholera treatment centers to handle the number of patients.

The crisis is all the more dismaying because cholera is not endemic to Haiti.  The disease was brought to the country in the wake of the 2010 earthquake by Nepalese United Nations peacekeepers with poor sanitation controls.  The UN delayed by more than a year the release of its own audit report, which found that wastewater was not properly managed or treated and was released directly into a tributary of the Artibonite River.  The UN has been sued in New York federal court by a group of 5,000 cholera victims, who have demanded that the UN provide a national water and sanitation system, pay reparations to victims, and issue a public apology.  The UN claims that international treaties give it immunity.  The case is currently before the U.S. Court of Appeals.  Some 130 members of the U.S. Congress, in a rare bipartisan effort, sent a letter to Secretary of State John Kerry accusing the UN of failing to “comply with its legal and moral obligations” to assist cholera victims and noting that “the State Department’s failure to take more leadership in the diplomatic realm might be perceived … as a limited commitment to an accountable and credible UN.”

Public awareness of Haiti’s ongoing cholera epidemic – one of many tragedies in the hemisphere’s poorest country – has been eclipsed by fears about the Zika virus.  While the more than one thousand reported cases of microcephaly are devastating and frightening, Zika is very rarely fatal.  Unlike Zika, cholera has not spread throughout the hemisphere or grabbed headlines at the Olympics, and so the disease rages on in a country plagued by political dysfunction and grinding poverty.  Virtually every institution has abdicated responsibility.  The United Nations has been accused of actively covering up its own role, and its attempts at combating the epidemic have been slow and poorly executed.  Haiti’s medical residents and interns have been on strike for the last four months, protesting low pay and poor conditions, resulting in the closure of many public hospitals.  The Haitian government has been more focused on political infighting and securing international funding for its next round of elections than for additional cholera support, and even nongovernmental organizations render most healthcare services in haphazard fashion.  While bureaucrats point fingers, politicians dawdle, and global attention turns elsewhere, Haiti’s poorest continue to suffer through the worst cholera outbreak in recent history largely in silence. 

August 15, 2016

*Emma Fawcett recently completed a PhD in International Relations at American University.  Her doctoral thesis focused on the political economy of tourism and development in four Caribbean case studies: Haiti, Dominican Republic, Cuba, and the Mexican Caribbean.