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Haitian Cholera Victims to UN: Practice What You Preach

Rivye Kano, Haiti – Gathered silently in the shade of a mango tree here, dozens of people patiently wait their turn to tell us about the horror that descended on their community a year ago. Shortly after drinking from the local water source, entire families started to get violently ill with diarrhea and vomiting. It was an outbreak of cholera, the vicious waterborne disease that can kill within hours. One by one, we hear stories about desperate family members rushing fathers and mothers and children over the rutted mountain roads to the local hospital. An oral rehydration solution developed by the World Health Organization is effective in treating most cases of cholera, if administered quickly enough, but many of the ill in this community did not reach care in time. On the single day of October 20, 2010, one hospital in the region reported 400 emergency admissions and 44 deaths.

Rivye Kano, Haiti – Gathered silently in the shade of a mango tree here, dozens of people patiently wait their turn to tell us about the horror that descended on their community a year ago. Shortly after drinking from the local water source, entire families started to get violently ill with diarrhea and vomiting. It was an outbreak of cholera, the vicious waterborne disease that can kill within hours.

One by one, we hear stories about desperate family members rushing fathers and mothers and children over the rutted mountain roads to the local hospital. An oral rehydration solution developed by the World Health Organization is effective in treating most cases of cholera, if administered quickly enough, but many of the ill in this community did not reach care in time. On the single day of October 20, 2010, one hospital in the region reported 400 emergency admissions and 44 deaths.

Saint Claire Vincent tells how her mother's body was taken from the hospital in a bag to be thrown into a pit with other kolera victims. Maudena Zalys and her brother survived cholera infection, but her father did not. “I can't explain the feeling I got when they announced he had died,” she says.

The community's leader, a man named Esec, had to send his regrets for this meeting. He was burying his father today, another victim of cholera. Beginning with its dramatic outbreak here in October 2010, where almost 2,000 Haitians died within the first month, the cholera epidemic has claimed over 7,000 lives and infected over a half million more people.

Since Haiti had not reported a single instance of cholera in over a century, physicians and public health experts were stunned by the flood of dying patients in the Artibonite region. Cholera is an infection of the small intestine caused by the ingestion of bacterium Vibrio cholera found in water or food contaminated by fecal matter. So, what was the source of the bacteria that was killing the Haitian people? Investigations into the cause of the outbreak pointed to a surprising culprit: the United Nations.

Overwhelming evidence, including studies by the US-based Centers for Disease Control and an investigation commissioned by the UN itself, identifies the likely source of the cholera outbreak as Nepalese troops participating in the United Nations Stabilization Mission in Haiti (MINUSTAH). Writing in the July 2011 volume of The Lancet, epidemiologist Renaud Piarroux noted the exact correlation in time and place between the arrival of a Nepalese battalion from an area experiencing a cholera outbreak and the appearance of the first cases in the Meille region of Haiti a few days after. Other researchers, including the Harvard Cholera Group, found that the Haitian strains of cholera are a genetic match for the cholera found in Nepal.

Now, the folks here at Rivye Kano and some 5,000 other Haitian cholera victims, represented by the partnership of Port-au-Prince-based Bureau des Avocats Internationaux and Boston-based Institute for Justice and Democracy in Haiti, have filed an extraordinary claim against the entity their own petition calls “a unique global leader” – the United Nations.

The factual basis for the claim boils down to three points: First, the UN failed to appropriately screen the troops arriving from Nepal for cholera infection, despite the fact that cholera is endemic there and the country had just reported a surge in infections in the very Kathmandu Valley area where the troops had been training before deployment to Haiti. Second, the UN did not maintain adequate sanitation and water disposal procedures at the MINUSTAH camp where Nepalese troops are stationed, recklessly allowing disposal of the troops' untreated waste into the Meille Tributary, a tributary of Haiti's largest river, the Artibonite. And finally, the claim alleges that the UN actively worked to block the discovery of the cholera source, thereby delaying action that would have slowed the outbreak.

If the allegations of UN responsibility are clear enough, the process by which they are to be reviewed is not. The UN peacekeeping mission has maintained a continuous presence in Haiti since 2004, and pursuant to a status of forces agreement with the Haitian government, the peacekeepers have civil and criminal immunity from claims filed in the Haitian courts. In return, the UN pledged to establish a commission to receive and review any claims for injury, illness, or death attributable to peacekeepers' actions.

The human rights lawyers representing the cholera victims say no such commission has ever been established in Haiti. In November, they filed a 37-page claim with the MINUSTAH office in Haiti and with the UN Office of the Secretary General in New York, asking for compensation for the victims and for the UN to partner with the Haitian government to establish a much-needed countrywide safe water program. On the day the claim was filed, UN spokesman Martin Nesirsky told reporters in New York that the evidence is inconclusive as to who bears responsibility for the cholera outbreak. To date, there has been no formal UN response to the claim. If no tribunal is created to hear the claim, the lawyers for the cholera victims say they will file suit in Haitian courts.

“This case is important because it calls for the United Nations to uphold the principles they promote, especially the most basic human rights of life, health, and justice,” says Bureau des Avocats Internationaux's directing attorney Mario Joseph. Joseph himself grew up in the rural Artibonite Valley here, drinking from an irrigation ditch that is now contaminated with cholera. He makes no effort to hide his anger at the UN's response to the outbreak. “There is a lot of hypocrisy going on. People with the UN talk a lot about human rights, but then they turn around and don't respect the rights of Haitians. The UN needs to stop denying its crime.”

On the 63rd anniversary of the signing of the Universal Declaration of Human Rights in early December, some of the cholera victims staged a demonstration in front of MINUSTAH headquarters in the Saint Marc region, which has been particularly hard hit by the epidemic. Their signs read, “'Universal' Means Haitians, Too.”

The UN is the world's chief source of rhetoric about the rule of law, and knows well this country's notorious and ongoing history of impunity for the powerful. A brutal former dictator, Jean-Claude Duvalier, returned here last year and walks the streets of Port-au-Prince without yet facing trial or even imprisonment. The current president, Michel Martelly, was elected only after the majority political party was blocked from the polls. The country's legacy of violent military coups and political assassinations is well documented. Will the United Nations become the latest gwo neg, Creole for big man, to hold itself above the law here? Or will it acknowledge a duty to remedy this latest disaster in a country whose people have already suffered so much?

Here in Rivye Kano, Ylianise Oscar, who watched helplessly as her mother died last winter, knows what she thinks the answer should be. “A mother is something special and precious; the most important thing in my life,” she says. “The UN should take responsibility for having brought the kolera into our community and our lives.”

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