The cholera outbreak in Haiti has continued to grow worse, and now CNN reports a case has appeared in the Dominican Republic.
Effective treatment of the disease has run afoul of local and international politics. Haiti does not have a history of cholera, and the strain currently responsible for over a thousand deaths on the island of Hispaniola has been identified as a strain unique to South Asia. Many health experts believe it was brought to Haiti by U.N. peacekeepers from Nepal. Earlier this month, Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, told The Washington Post that cholera was clearly imported to Haiti, but couldn’t pinpoint the exact source. “It has to be either peacekeepers or humanitarian relief workers, that’s the bottom line,” she told the Post.
While leading cholera experts believe isolating the exact source of the outbreak would assist with treatment and containment, the United States Centers for Disease Control and the World Health Organization join the United Nations in declaring it impossible to do so. Increasingly violent protests in Haiti may have motivated them to make this declaration. Protesters in the northern city of Cap Haitien have escalated from burning tires, to cars, to the local police station. CNN says the riots have forced aid workers to suspend delivery of supplies and clean water to slum areas.
These riots are not entirely spontaneous. Local politicians have sought to gain power by stoking resentment of the U.N. presence, which has been working to maintain order for years. U.N. authorities say they are seizing this opportunity to destabilize the country for their own benefit. It seems to be working, as the national government is said to have “lost control” of Cap Haitien. A U.N. peacekeeper killed a demonstrator there on Monday.
Panic and politics are clearly making it difficult to halt the outbreak. Haiti is dying of cholera because it is Haiti. The United Nations resists pinpointing the source of the outbreak because it is the United Nations. The cholera epidemic is thought to have originated at a Nepalese peacekeeper base, whose personnel were not tested for the disease before deployment. CNN says the base was dropping untreated sewage into the local water supply. It seems clear there is room for improvement in United Nations procedures.
Harvard cholera expert John Mekalanos told the Washington Post the cholera outbreak is politically sensitive, and there is “an attempt to maybe do the politically right thing and leave some agencies a way out of this embarrassment. But they should understand that… there is a bigger picture here. It’s a threat to the whole region.” That bigger picture has a thousand corpses in the background. It is very difficult to save both impoverished, politically unstable people, and gigantic transnational institutions, from themselves.
Update: a woman in Florida has now tested positive for cholera after returning from an aid mission to Haiti. She is said to have made a complete recovery.