Haiti's Cholera Crisis

Editorial, New York Times, Sunday May 13, 2012

The cholera epidemic in Haiti, which began in late 2010, is bad and getting worse, for reasons that are well understood and that the aid community has done far too little to resolve. A chronic lack of access to clean water and sanitation make Haitians vulnerable to spreading sickness, especially as spring rains bring floods, as they always do. Summer hurricanes are bound to come; more misery and death will follow. The Pan American Health Organization has said the disease could strike 200,000 to 250,000 people this year. It has already killed more than 7,000.

Doctors Without Borders said this month that the country is unprepared for this spring's expected resurgence of the disease. Nearly half the aid organizations that had been working in the rural Artibonite region, where this epidemic began and 20 percent of cases have been reported, have left, the organization said. "Additionally, health centers are short of drugs and some staff have not been paid since January."

It gets worse: the Centers for Disease Control and Prevention released a report this month that cholera in Haiti was evolving into two strains, suggesting the disease would become much harder to uproot and that people who had already gotten sick and recovered would be vulnerable again.

The United Nations bears heavy responsibility for the outbreak: its own peacekeepers introduced the disease through sewage leaks at one their encampments. Before that, cholera had not been seen in Haiti for more than a hundred years. But the United Nations humanitarian coordinator for Haiti, Nigel Fisher, admitted in an interview on May 3 that "what we are doing is sort of patchwork, Band-Aid work on a fundamental problem." While two nongovernmental organizations began a vaccination program last month in Port-au-Prince, it is only a trial that will protect a tiny part of the population. It is a worthy effort that will save lives, but not a substitute for basic water and sanitation.

A letter circulating in Congress calls on Susan Rice, the United States ambassador to the United Nations, to urge the world body to fully commit to eliminating cholera from the island of Hispaniola. The C.D.C. estimates that adequate water and sanitation systems will cost $800 million to $1.1 billion, a sum that can surely be wrested from the billions that nations have pledged to Haiti, though contributions have flagged as attention to the crisis has faded.

The Congressional letter echoes a demand from the Institute for Justice and Democracy in Haiti, a human rights group that has sued the United Nations on behalf of 5,000 cholera victims. The U.N. and the international community have a responsibility to meet the crisis head-on. There are pledges to fulfill, dollars to deliver and lives to save.