CHAPOTEAU, Haiti – For three years, the United Nations has refused to address whether its peacekeepers brought a deadly strain of cholera to Haiti, insisting instead that it was more important to help the country stanch the disease once and for all.
But on that score, it is still very far behind. In some ways, Haiti is even less equipped to tackle cholera than it was three years ago.
The United Nations raised barely a fourth of the $38 million it needed last year to provide lifesaving supplies, including the most basic, like water purification tablets. Clinics have run short of oral rehydration salts to treat the debilitating diarrhea that accompanies the disease.
Josilia Fils-Aime, 11, who lives in this village on an isolated spit of land near the Artibonite River, where the epidemic first began, knows these shortcomings all too well. Her family had run out of water purification tablets, and she drank water from what must have been a polluted stream nearby.
“I felt dizzy and sick,” the girl said.
She was struck by sudden vomiting and diarrhea. Doctors diagnosed cholera.
Her predicament has multiplied across Haiti, which has had the most cholera cases in the world for three years in a row.
The United Nations has yet to raise the $5 million necessary to vaccinate 600,000 vulnerable people right away – as the rainy season approaches and the threat of waterborne illnesses like cholera looms – let alone the $2 billion that it promised to raise from rich countries to build Haiti’s water and sanitation infrastructure, which public health experts say is vital to ridding the country of cholera.
Pedro Medrano Rojas, the U.N. secretary-general’s newly appointed envoy for the cholera outbreak, attributed the shortfall to global “donor fatigue” in the face of other humanitarian crises.
“Had we had the resources, it would have been different,” Medrano said. “It’s not expensive. No one should be dying from cholera.”
Since the outbreak began in October 2010, 8,562 people in Haiti have died of cholera. New infections have declined, following the typical trajectory of an epidemic, from a peak of more than 350,000 reported cases in 2011 to a little more than 50,000 cases in 2013.
The United Nations is essential to solving the problem because, like many of the country’s institutions since the January 2010 earthquake, Haiti’s own health care system remains in shambles. Clean drinking water and sanitation remain as scarce as when the epidemic began. And where international nonprofit groups, along with the government, once operated 120 cholera treatment centers across the nation, the number has shrunk to barely 40 as aid groups have pulled out.
Perhaps that most troubling measure is the rising percentage of cholera patients who die in the treatment facilities that remain. As the U.N. mission said in its report to the Security Council in March, “That reflects weaknesses in the capacity of health centers to provide timely and adequate health services to patients affected by cholera and the longer travel time required for treatment as a result of the closure of many cholera treatment centers.”
Josilia, for instance, most likely survived because Partners in Health, a nonprofit that has worked in Haiti for years, opened a satellite clinic near her home.
Forensic studies, including one ordered by the United Nations, have concluded that the bacteria found in Haiti is an Asian strain common in Nepal, where hundreds of U.N. peacekeepers in Haiti came from. The forensic studies have also linked the spread of cholera to a flawed sanitation system at the Nepalese peacekeeper base, which contaminated a river tributary that many Haitians used for drinking and bathing water.
Three class-action lawsuits have been filed against the United Nations in U.S. courts, asserting it was responsible for the outbreak.