Haiti’s Cholera Outraced the Experts and Tainted the U.N.

Excerpt from an article in

The New York Times

Sunday, April 01, 2012

Haiti’s Cholera Outraced the Experts and Tainted the U.N.

By DEBORAH SONTAG

MIREBALAIS, Haiti — Jean Salgadeau Pelette, handsome when medicated and groomed, often roamed this central Haitian town in a disheveled state, wild-eyed and naked. He was a familiar figure here, the lanky scion of a prominent family who suffered from a mental illness.

On Oct. 16, 2010, Mr. Pelette, 38, woke at dawn in his solitary room behind a bric-a-brac shop off the town square. As was his habit, he loped down the hill to the Latem River for his bath, passing the beauty shop, the pharmacy and the funeral home where his body would soon be prepared for burial.

The river would have been busy that morning, with bathers, laundresses and schoolchildren brushing their teeth. Nobody thought of its flowing waters, downstream from a United Nationspeacekeeping base, as toxic.

When Mr. Pelette was found lying by the bank a few hours later, he was so weak from a sudden, violent stomach illness that he had to be carried back to his room. It did not immediately occur to his relatives to rush him to the hospital.

“At that time, the word ‘cholera’ didn’t yet exist,” said one of his brothers, Malherbe Pelette. “We didn’t know he was in mortal danger. But by 4 that afternoon, my brother was dead. He was the first victim, or so they say.”

In the 17 months since Mr. Pelette was buried in the trash-strewn graveyard here, cholera has killed more than 7,050 Haitians and sickened more than 531,000, or 5 percent of the population. Lightning fast and virulent, it spread from here through every Haitian state, erupting into the world’s largest cholera epidemic despite a huge international mobilization still dealing with the effects of the Jan. 12, 2010, earthquake.

The world rallied to confront cholera, too, but the mission was muddled by the United Nations’ apparent role in igniting the epidemic and its unwillingness to acknowledge it. Epidemiologic and microbiologic evidence strongly suggests that United Nations peacekeeping troops from Nepal imported cholera to Haiti, contaminated the river tributary next to their base through a faulty sanitation system and caused a second disaster.

“It was like throwing a lighted match into a gasoline-filled room,” said Dr. Paul S. Keim, a microbial geneticist whose laboratory determined that the Haitian and Nepalese cholera strains were virtually identical.

And, as the deaths and continuing caseload indicate, the world’s response to this preventable, treatable scourge has proved inadequate. Cholera, never before recorded in Haiti, stayed one step ahead of the authorities as they shifted gears from the earthquake recovery. While eventually effective in reducing the fatality rate, the response was slow to get fully under way, conservative and insufficiently sustained.