Cholera Continues to Spread After Hurricane Sandy

November 20, 2012

Hurricane Sandy dumped up to 20 inches of rain of parts of Haiti last month and, in addition to the immediate devastation on crops, people, roads and homes, it has led to an increase in the number of cholera cases throughout the country. On November 16, the International Organization for Migration confirmed that 3,593 new cholera cases had been counted since the hurricane. These numbers, however, lag far behind what the Haitian Ministry of Health (MSPP) has recorded since Sandy. There are now three weeks of data post hurricane, and as can be seen in Table 1, there have been over 9,000 new cases recorded by the MSPP.

Table I.

As can be seen, the increase has been dramatic; both in terms of the number of cases recorded (a 46 percent increase) as well the number of deaths (an 85 percent increase). In fact, since the passage of Hurricane Sandy, the death rate has increased as well, from 0.7 percent to 1 percent. While still much lower than the death rate in the immediate aftermath of the outbreak of cholera, this is nevertheless a worrying sign. As Dr. Juan Carlos Gustavo Alonso of the Pan American Health Organization noted after Sandy, the west department, which includes most of the remaining 370,000 IDPs, has seen the greatest increase in cases. In fact, according to MSPP data, since Sandy, over 37 percent of all cases were in Port-au-Prince, which includes Carrefour, Cité Soleil, Delmas, Kenscoff, Petion Ville, Port-au-Prince, and Tabarre. Given the declining humanitarian services in the camps, and the fact that funding for cholera is now running out, the increase in the capital is especially worrisome. Additionally, Sandy crippled the cholera response infrastructure in the country, destroying 61 cholera treatment units.

Since its introduction into Haiti by UN troops in October 2010, cholera has now killed at least 7,699 people and sickened over 615,000 more. Last year, Haiti recorded more cholera cases than the rest of the world combined. As has been pointed out previously, these are likely underestimates, as the MSPP cholera data is often lacking reports from many areas.

In recent weeks, a number of op-eds and editorials have been written calling on the UN to take responsibility for the introduction of the disease. Last week CEPR Co-Director Mark Weisbrot wrote in The Guardian:

If Haiti were any other country in this hemisphere, a human-created disaster of this proportion would be a big international scandal and everyone would know about it. Not to mention the institution responsible for inflicting this damage – in this case, the UN – would be held accountable. At the very least, they would have to get rid of the epidemic.

In this case, getting rid of the epidemic could be easily accomplished. Cholera is transmitted mainly through drinking water that is contaminated by the deadly bacteria. To get rid of it, you need to create an infrastructure where people have clean drinking water and adequate sanitation. The Pan American Health Organization estimates that this would cost about $1bn for Haiti. In fact, that is close to what the UN has been spending in just one year to keep its 10,000 troops in the country.

The UN is still denying its responsibility, despite studies published by the New England Journal of Medicine, the Centers for Disease Control and Prevention, and even by the UN itself (pdf) tracking the origin of Haiti’s cholera bacteria to UN soldiers. A study by a team of 15 scientists last year produced even more conclusive evidence, using whole genome sequence typing and two other methods that matched the cholera strain in Haiti to a sample from Nepal that was taken at the time that the Nepalese UN troops arrived in the country.

In short, there is proof beyond reasonable doubt that the UN mission is responsible for bringing this disease to Haiti.

Adding their voices to the growing chorus calling for the UN to take responsibility was the Boston Globe editorial board and the Director of the International Human Rights Clinic at Western New England University School of Law, Lauren Carasik.


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