The cholera epidemic that may have killed as more than 2,400 people in Haiti over the last month may have originated with a United Nations peacekeeper camp, according to a French scientist. However, this is being contested, and the UN and World Health Organization are going to undertake a study to try to pinpoint the origins of the outbreak.
The French scientist, Renard Piarroux, an epidemiologist and cholera specialist, appears to have reached his conclusions by a process of elimination, arguing that only poor disposal of human waste, documented at a camp of Nepalese peacekeeping troops in Meille upriver from the Artibonite Valley where the outbreak first occurred, could explain the phenomenon. The U.S. Center for Disease Control had earlier reached the conclusion that the strain of the cholera bacterium found in Haiti was Asian in origin.
UN authorities originally denied that the Nepalese troops could have been the source of the epidemic, as none of them had been sick. However, cholera is endemic in Nepal, which means that people there have a relatively high level of resistance, thus seemingly well people could be carriers. In contrast, there has not been a major cholera outbreak in Haiti for a hundred years, which means that people currently living have no natural resistance to the disease and become very sick very quickly when exposed to the microbe.
Cholera is relatively easily cured when detected and treated quickly. Replacing body fluids, which are drained catastrophically by the diarrhea that comes with the disease, is the one of the most critical early steps. The general disruption of life in Haiti due to the massive earthquake in January, which killed perhaps 300,000 people and left all kinds of infrastructure flattened, has contributed to the death toll by making it hard to get people to treatment in time. The extreme poverty of many people also makes it difficult for them to get soap, clean water and other things essential to preventing more people from being infected.
It is estimated that over 100,000 people have contracted the disease in Haiti in this outbreak. The Sydney Morning Herald reports that, of these, 54,500 have received hospital treatment. Over the last week the epidemic seemed to have slowed a bit, but now the pace has picked up again. And 32 cases have been reported in the Dominican Republic, with which Haiti shares the island of Hispaniola. Dominican authorities have set up mechanisms to check and decontaminate people passing into their country from Haiti.
A number of countries, including the United States, have sent private or government teams to Haiti to help the country deal with the epidemic. Cuba now has over 900 doctors, nurses and other health workers operating in Haiti. In his regular commentary in the Cuban press, the former Cuban president, Fidel Castro, called attention to the fact that Haitian cholera patients treated by the Cuban teams have a death rate significantly lower than that of those treated by others: “Among those treated by the Cuban mission, the mortality rate [has risen] to 0.83 percent. The mortality rate in other hospital institutions stands at 3.2 percent.” Castro attributes this to the Cuban public health practice of proactively sending out health teams even to the smallest and most isolated rural communities.
On Thursday, Dec. 16, the Washington Post reported that the United Nations has announced that it would conduct a more formal investigation into the origins of the epidemic. The head of UN peacekeeping forces, Alain LeRoy, announced that the UN and the WHO would charge an international panel with this task. Also, the General Assembly voted to urge nations who had promised aid to Haiti after the January earthquake to hurry up its delivery so as to enable Haiti to respond adequately to the cholera epidemic.
Image: The United Nations’ role in Haiti has been both helpful and problematic. Picture provided by United Nations Photo // CC BY-NC-ND 2.0
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