Health workers collect the body of a cholera victim in Petionville, Haiti, in February 2011. The disease first appeared on the island in October 2010, likely introduced by U.N. peacekeepers from Nepal, possibly a single individual.
It was 11 on a Tuesday night nearly six years ago when Jean-Clair Desir's mother fell ill with cholera in the Boucan-Carre district of Haiti's central highlands.
"She started vomiting with diarrhea," Desir recalls. "I made oral rehydration for her, nothing worked. She died at 3 in the morning." She never made it to a hospital or clinic and so probably wasn't counted as a cholera victim.
After burying his mother, Desir, a third-year student at Haiti's University of Agronomy Sciences, nearly died of cholera himself.
Desir and his mother are among at least struck down by cholera since late 2010 — almost 8 percent of the population. More than 9,200 have died. It's the largest and most explosive cholera epidemic in modern times.
Since cholera is now endemic in Haiti, the epidemic . So far this year the disease has struck more than 7,800 people and killed nearly 100.
And there's new evidence that the toll from Haiti's ongoing cholera epidemic is significantly higher than official tallies suggest. Meanwhile, survivors appear to be making headway in a legal and public relations campaign to gain compensation from the agency they blame for introducing cholera to the island nation: the United Nations.
A study, which appears this month in indicates Haiti's official count of cholera cases and deaths are a big understatement. A house-to-house survey in four communities — two urban and two rural — has uncovered nearly three times more cholera deaths in the first six months of the epidemic than officially recorded. In some hard-to-reach villages, researchers found, cholera killed 1 in every 20 residents in the early months of the outbreak.
"It is likely that many other areas in the country suffered similar rates of death occurrence," says of Doctors Without Borders, an author of the study.
It's widely believed that U.N. peacekeepers — possibly just a single soldier — during deployment from Nepal, where cholera is a perennial threat. Before Haiti's epidemic began in October 2014, the disease hadn't been known in Haiti, this hemisphere's poorest country.
for peacekeepers allowed cholera-contaminated sewage to enter a tributary of Haiti's largest river, the Artibonite. Within days, hundreds of people downstream, like Jean-Clair Desir and his mother, were falling ill. The disease subsequently spread to the entire country.
, a Tufts University environmental engineer, is one of four independent experts appointed by the U.N. in 2011 to investigate the outbreak.
"I and the panel believe, and the scientific consensus is, that the most likely source was a peacekeeper or peacekeepers" at the U.N. encampment, Lantagne told NPR. "There is not an alternative hypothesis that is credible."
She adds that DNA analysis strongly suggests "this outbreak was probably started by one or very few infected, asymptomatic individuals — I would guess one."
of Partners in Health, a major provider of health care in Haiti, says the new study redefines the already huge toll from Haiti's cholera epidemic.
"This is a very important paper," Ivers says. "We've said all along that we thought cholera had a much bigger impact than the numbers were showing. There was no possible way all those deaths were being counted. I do think it raises the stakes in terms of what happens."
Those stakes are already very high. A three-judge federal appeals court panel held a March 1 on whether the U.N. should be held accountable for Haiti's devastating epidemic.
A federal district judge last year the class-action suit, ruling that international treaties immunize the U.N. from lawsuits. The plaintiffs appealed the lower court's dismissal, resulting in this month's hearing. The United States is defending the U.N., since the agency is headquartered in New York.
The lawsuit was brought by the Boston-based Institute for Justice and Democracy in Haiti and a sister group in Haiti on behalf of 5,000 cholera victims. They the U.N. to end cholera by installing a national water and sanitation system; pay reparations to cholera victims and their families; and publicly apologize for bringing cholera to Haiti.
The plaintiffs contend the U.N. forfeited its legal immunity when it failed to launch an internal process to adjudicate the plaintiffs' claims, as they say its own commitments require.
"The U.N.'s conditional immunity does not authorize impunity," plaintiffs' attorney Beatrice Lindstrom told the three-judge appeals panel.
The judges seemed to be struggling to find a way to provide some compensation to Haitian cholera victims.
For instance, Judge asked Assistant U.S. Attorney Ellen Blain, representing the U.N.'s position: "Would the United States government concede that if you're right and these people are completely remediless, that that is a very bad result?"
Blain said the U.S. government "certainly recognizes that this is an unfortunate and tragic humanitarian catastrophe," but asserted that the U.N. has "absolutely immunity ... for a very important reason."
She was alluding to U.N. officials' fear that if the Haitian plaintiffs succeed in piercing the agency's cloak of immunity, it will open the way to unlimited lawsuits seeking compensation for acts of the U.N. or the 150,000 peacekeeping forces it sends out into the world each year.
But this argument is being by some of the U.N.'s own staff – a group of five "special rapporteurs" who are appointed to act as internal watchdogs.
In a letter to U.N. Secretary General Ban Ki-moon presented on March 15 to the U.N. Human Rights Council, the rapporteurs rejected the argument that compensating Haitian cholera victims would be "opening the floodgates to claims against the United Nations." This is believed to be the ther than member nations.
The rapporteurs also criticized the U.N.'s efforts to control cholera through clean water and sanitation as "clearly insufficient." So far the U.N. about $140 million on cholera control in Haiti — only 6 percent of the $2.2 billion the will be needed to eliminate cholera there.
In unusually blunt language, the rapporteurs told Ban that the U.N.'s denial of "an effective remedy" for cholera "challenges the credibility of the Organization as an entity that respects human rights."
NPR asked the secretary general's office for a copy of his response to the rapporteurs' letter. A spokesman said Ban's response could not be released. But he said the secretary general told the rapporteurs that he "reaffirms the U.N.'s commitment to the fight against cholera in Haiti and the protection and promotion of human rights."
In perhaps the most significant disclosure, the spokesman said Ban welcomes the rapporteurs' offer "to discuss further what additional steps might be taken to assist the victims of cholera and their communities." It's evidently the first time Ban has hinted at the possibility of such a discussion.
Meanwhile, the U.N. has received from Haitian cholera victims detailing how the disease has affected them and their families.
One letter was from Jean-Clair Desir, the student who lost his mother to cholera early in the outbreak. "President, Members of the United Nations Security Council and all other responsible, I lift my head to look at the sky so I may strongly salute you," he wrote. "I know you are promoting human rights and respect, [but] in fact ... you refused to compensate us; that is bad."
OP: The following article may be helpful as it provides some useful definitions: Do You Know What 'Vector' And 'Endemic' Mean? We Can Help — Sort Of. Among the definitions provided in the article is the following: "The words and have more precise definitions. The former is used to describe according to the Centers for Disease Control and Prevention. So there'd be an endemic level — or expected number — of flu cases in the U.S. each year. The latter refers to multiple outbreaks happening across the globe at the same time."
Also, here are some additional links with regards to the history of Haiti. One question many people ask is: why is Haiti so poor? The answer has a lot to do with a truly horrible history of outside intervention and meddling.
Haiti is, along with the Dominican Republic, one of the two countries on the island of Hispaniola (Haiti also includes a few smaller islands).
Haiti's people are almost entirely descended from African slaves imported to the region to replace the original indigenous inhabitants, which had been virtually eliminated by Christopher Columbus and the Spanish (OP: Columbus day should be abolished, IMO!).
In the 18th century, Haiti was a French colony and the picture was VERY different: "In the 18th century, under French rule, Haiti – then called Saint-Domingue – was the Pearl of the Antilles, one of the richest islands in France's empire (though 800,000-odd African slaves who produced that wealth saw precious little of it). In the 1780s, Haiti exported 60% of all the coffee and 40% of all the sugar consumed in Europe: more than all of Britain's West Indian colonies combined." (The quote is from this reference. See also this reference.)
A slave revolt began in Haiti in 1791. Led by a brilliant general and freed slave named Toussaint LOuverture (who, after ending slavery on the island, was captured by the French and later died in a French prison) the Haitians eventually won their freedom. "Jean-Jacques Dessalines, one of l’Overture’s generals and himself a former slave, led the revolutionaries at the Battle of Vertieres on November 18, 1803 where the French forces were defeated. On January 1, 1804, Dessalines declared the nation independent and renamed it Haiti. France became the first nation to recognize its independence. Haiti thus emerged as the first black republic in the world, and the second nation in the western hemisphere (after the United States) to win its independence from a European power." (From this reference.)
Haiti is actually "the first, and the only, successful slave revolt in the history of the world". So, a country founded by black former slaves who had, during their war for freedom, "fought and defeated three great European powers: France, Britain, and Spain. Moreover, the revolution liberated 90 percent of the population, which had been living under a brutal system of slavery." (From this reference.)
It should be noted that the United States did not recognize Haiti until 1862. "But the independent republic of Haiti that eventually emerged in 1804 was never an equal among the brotherhood of Western nations. To the north, the United States, a nation of slaveowners, regarded Haiti, a nation of free blacks, with unvarnished horror and boycotted its merchants." (From this reference.) For instance it should be noted that Thomas Jefferson (president 1801-1809), himself a slave owner, did not look kindly on the Haitian revolution and nation. (See this reference.)
As for France, while it recognized Haiti earlier (i.e. in 1825) its recognition came with a heavy price tag for the fledgling nation. "Meanwhile, France, the spurned former colonial ruler, fumed at its losses. In 1825, with a French flotilla threatening invasion, Haiti was compelled to pay a king's ransom of 150 million gold francs — estimated to be ten times the country's annual revenues — in indemnities to compensate French settlers and slaveowners for their lost plantations. The sum would be later reduced to 90 million gold francs, but that was little consolation: Haiti, in effect, was forced to pay reparations for its freedom.
This history is not as distant as it may seem. It set the stage for many decades of Haitian economic misery and underdevelopment to come—the country, one of the poorest nations in the Western hemisphere, did not finish repaying its 19th century debts to France and the U.S. until the middle of the 20th century." (From this reference.) It has (rightly, in the OP's opinion!) been argued that France should repay this amount to Haiti (France has so far not been very receptive to this idea).
Another notable event in Haitian history is the U.S.' invasion and occupation of the country from 1915 to 1934.
Writes Haitian author Edwidge Danticat: "I am writing this in Les Cayes, Haiti, where one of the worst massacres of civilians took place on December 6, 1929, during the nineteen-year American occupation of Haiti, an occupation that began a hundred years ago today. The Cayes massacre took place during a demonstration, which was part of a nationwide strike and an ongoing local rebellion. U.S. Marine battalions fired on fifteen hundred people, wounding twenty-three and killing twelve.
On July 28, 1915, United States Marines landed in Haiti on the orders of President Woodrow Wilson, who feared that European interests might reduce American commercial and political influence in Haiti, and in the region surrounding the Panama Canal. The precipitating event was the assassination of the Haitian President, Jean Vilbrun Guillaume Sam, but U.S. interests in Haiti went back as far as the previous century. (President Andrew Johnson wanted to annex both Haiti and the Dominican Republic. Twenty years later, Secretary of State James Blaine unsuccessfully tried to obtain Môle-Saint-Nicolas, a northern Haitian settlement, for a naval base.) By 1915, the Americans were also afraid that an ongoing debt Haiti was forced to pay to France tied the country too closely to its former colonizer; Germany’s growing commercial interests in Haiti were another major concern. So one of the first actions carried out by the U.S. at the start of the occupation was to move Haiti’s financial reserves to the United States and then rewrite its Constitution to give foreigners land-owning rights.
There is a commemorative banner near the site of the 1929 massacre acknowledging the day—something to show that the town remembers. But it is very hard to figure out what to commemorate, what to remember and what to forget, during a nineteen-year occupation.
In my own family, there were many stories. My grandfather was one of the Cacos, or so-called bandits, whom retired American Marines have always written about in their memoirs. They would be called insurgents now, the thousands who fought against the occupation. One of the stories my grandfather’s oldest son, my uncle Joseph, used to tell was of watching a group of young Marines kicking around a man’s decapitated head in an effort to frighten the rebels in their area. There are more stories still. Of the Marines’ boots sounding like Galipot, a fabled three-legged horse, which all children were supposed to fear. Of the black face that the Marines wore to blend in and hide from view. Of the time U.S. Marines assassinated one of the occupation’s most famous fighters, Charlemagne Péralte, and pinned his body to a door, where it was left to rot in the sun for days.
The notion that there were indispensable nation-building benefits to this occupation falls short, especially because the roads, schools, and hospitals that were built during this period relied upon a tyrannical forced-labor system, a kind of national chain gang. Call it gunboat diplomacy or a banana war, but this occupation was never meant—as the Americans professed—to spread democracy, especially given that certain democratic freedoms were not even available to the United States’ own black citizens at the time. “Think of it! Niggers speaking French,” Secretary of State William Jennings Bryan said of Haitians.
During the nineteen years of the U.S. occupation, fifteen thousand Haitians were killed. Any resistance to the centralized, U.S.-installed puppet governments was crushed, and a gendarmerie—a combination of army and police, modelled after an occupation force—was created to replace the Marines after they left. Although U.S. troops officially pulled out of Haiti in 1934, the United States exerted some control over Haiti’s finances until 1947." (The rest of the article is here.) (This reference also has a bit of information on the invasion. Here is another reference.)
Brutal dictator Francois 'Papa Doc' Duvalier came to power in Haiti in 1957 and "operated a regime of terror, causing nearly 30,000 deaths". (See this reference as well as this one.) He was followed by his son, Jean-Claude 'Baby Doc' Duvalier in 1971 (his 'reign' ended in 1986), who reigned in the same brutal fashion his father had. The United States supported their dictatorship in order to ensure that Haiti 'did not fall under Cuba's sway'. (See also this reference.)
Under 'Baby Doc's regime, "Hundreds of political prisoners held in a network of prisons known as the “triangle of death” died from their extraordinarily cruel treatment. Others were victims of extrajudicial killings. Duvalier’s government repeatedly closed independent newspapers and radio stations. Journalists were beaten, and in some cases tortured, jailed, or forced into exile." (From this reference.) The Duvaliers also reportedly stole money from the Haitian people. (See also this reference.)
Subsequent U.S. intervention has not always had salutary effects. Bill Clinton has himself admitted that his administration's policies with regards to the rice market had disastrous effects in the country: "On March 10, in testimony before the Senate Foreign Relations Committee, Bill Clinton apologized for his administration's role in exporting cheap U.S. rice to Haiti, undercutting local growers. According to a study by the Center for Economic and Policy Research, Haitian farmers provided 47 percent of the country's rice in 1988. By the 2008, the figure had dropped to 15 percent. And in a recent report on NPR's Planet Money, reporters described how bags of American rice are still being sold in Haitian markets." (From this reference. See also this reference.)
It should be noted that the U.S. led a further military intervention of Haiti in 1994-1995 (i.e. during Clinton's administration). A trade embargo and economic sanctions were placed on the nation in 1991 following a military coup (i.e. this coup removed the government of President Aristide, the first popularly elected president in Haitian history), during the administration of Bush Sr. and continued under Clinton's administration: these had a dramatic impact on the poorest segments of the population. When the invasion was over and the U.N. took over (they are still there to this day), the members of the murderous junta (who may have been in the pay of the CIA) and their supporters were legitimized and pardoned by the U.S. (Jimmy Carter, who led a delegation to Haiti in search of a negotiated settlement to the issue in 1994, reportedly invited the leader of the military regime, Raoul Cedras, to teach Sunday school at his church.) (See also here.) The Bush Jr. administration reportedly broke its own arms embargo to sell arms to the Haitian police, despite its being known to be guilty of human rights abuses.
During the Obama administration, then Secretary of State Hillary Clinton reportedly "pressured then-President René Préval with the loss of U.S. and international aid unless the [first round] election results were changed (...)" (i.e. this was in 2010, and led to the third place candidate, Michel Martelly, going to the second round -he eventually won the presidency). (The quote is from this reference.)
There has also been criticism of the Clintons' support of an industrial park which has been described as a 'glorified sweatshop'.
The Obama administration has been accused of complicity in the current Haitian government's efforts to rig the presidential elections (these were recently scrapped). (There have even been reports that the Obama administration tried to intervene to keep wages low in the country.)
OP: I thought a historical recap might be useful.