Cholera on the Uptick in Haiti as Donor Response Falters

November 25, 2014

From January through August of 2014, 69 Haitians died from cholera and some 8,628 fell ill, a 76 percent drop from the previous year, the United Nations reported. In October, at a high-level donor conference convened to raise money to help fight cholera, World Bank director Jim Kim told the assembled diplomats that the reduction in cases was “an achievement of which Haiti and its development partners can be proud.” The U.N. decreased their projections for the number of new cases in 2014 to 15,000 from 45,000 and proudly stated that the “case fatality rate is below the 1 per cent target rate set by the World Health Organization.”

But the last few months have shown the optimism to be premature, at best. As heavy rains have hit Haiti, so too has a resurgence of cholera. With data through November 21, 2014 [PDF], the number of cases in 2014 has already shot past the 15,000 estimate to over 20,000. More worryingly, since the beginning of September, 135 Haitians have died from cholera, nearly twice as many as had died over the first 8 months of the year. Further, the much-watched case fatality rate stands at 1.3 percent over that time period, above the 1 percent target.

Yesterday, Medecins Sans Frontieres (MSF), which has treated nearly 30 percent of those sickened by cholera in Haiti, warned that the response capacities inside Haiti were severely limited and unable to cope with the recent increase. “We have tried to refer patients to other cholera treatment centers, but we soon realized there were not enough beds,” explained Olivia Gayraud, MSF medical coordinator in Haiti. “The Martissant center was quickly overwhelmed by the number of patients, as national health structures are poorly prepared to react to cholera outbreaks, despite them being predictable during the rainy season,” she added.

Oliver Schultz, the head of mission for MSF in Haiti, noted that “despite the existence of a National Plan for the Elimination of Cholera” there remains “no system in place to provide urgent care.” Just two weeks ago, Senior U.N. Coordinator for the Cholera Response in Haiti, Pedro Medrano, warned that, “support for Haitian initiatives against cholera and other waterborne diseases has been disappointing.” “The donor community has to do better,” he added, while pointing out that it would take more than 40 years at the current donor disbursement rate to eliminate cholera in Haiti.

“If the response falters and resources are not forthcoming, hard-won gains may be compromised and cholera could persist in localized areas,” Medrano said. Given the recent increases, those “hard-won” gains appear to already be compromised. Further, Haitians are slowly losing their immunity to the disease, reports MSF. The result has been a near doubling of cases handled by MSF over the last few months compared to 2013.

The U.N., whose troops introduced cholera to Haiti, according to scientific studies, have continued to avoid accountability and have failed to mobilize the needed resources. “There are few things, in the last decade of the United Nations, more illegitimate, more reprehensible, more despicable than the United Nations scurrying for cover behind the tattered, discredited banner of immunity when applied to the cholera tragedy in Haiti,” said Stephen Lewis, the former Canadian ambassador to the U.N., in a recent speech. “If I were Secretary-General, I’d have a hard time sleeping at night,” he concluded. Lewis also takes aim at the United States, which he says “doesn’t want even a whisper of compensation to enter the controversy.” The U.S. government has argued on behalf of the U.N. that the multilateral organization should be immune from lawsuits stemming from the introduction of cholera.

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