By Clément Paule
Translation: Lawrence Myers
Passage au crible n°104
Source: Chaos International
On January 12, 2014, the Republic of Haiti commemorated the fourth anniversary of the destructive earthquake that devastated the metropolitan area of Port-au-Prince and the immediate surrounding region. Yet, another catastrophe, this one sanitary, arose in the country at the end of 2010. It concerns the cholera epidemic which to date has cost the lives of nearly nine thousand people on the island of Hispaniola. Despite the united efforts of international aid operators and Haitian authorities for more than three years, centers of Vibrio cholerae remain active in twenty locations, according to a recent communiqué produced by the MSPP (Haitian Ministry of Public Health and of the Population). While the uncertain battle against this lethal poison is being organized, the controversy on the origin of the contamination reached a major scale when the suspicions were directed towards a Nepalese contingent of the MINUSTAH (United Nations Stabilization Mission in Haiti), the multilateral peacekeeping force present in Haiti since 2004. The responsibility of the United Nations in triggering the worst contemporary cholera epidemic is now a major debate.
The sanitary crisis began in autumn 2010 in the Center county of the country, not far from Mirebalais, a city located sixty kilometers northwest of Port-au-Prince. Until then unknown in Haiti, the disease spread very rapidly, to such an extent that in November 2010, an official of the MSPP alluded to a concern for national security. The humanitarian response by stakeholders in international assistance came together under the leadership of the WHO (World Health Organization), of the CDC (Centers for Disease Control and Prevention) and of NGOs (Non-governmental organization) like MSF (Doctors Without Borders) with the extension of centers and treatment units in the entire country. Otherwise, authorities seemed overloaded by a series of emergencies, particularly the landfall of Hurricane Tomas on the island at the beginning of November, which complicated an already unstable situation. Several hundreds of thousands of people, categorized under the label IDP (internally displaced people), are still living in tents within the capital traumatized by the January 12 earthquake. In this case, the scourge quickly spread to the entire Haitian territory before striking the Dominican Republic – tens of thousands of cases – and to a lesser extent Cuba.
But the question of the introduction of Vibrio cholerae was immediately the subject of persistent rumors designating a MINUSTAH military base situated in the Mirebalais region. In this instance, the investigations carried out on the pathogenic strain of the bacteria permitted the determination of its Asian origin – of serotype O1 El Tor Ogawa -, therefore imported. Beginning in December 2010, the publication of an epidemiological study lead by a French doctor seemed to confirm the trail of the UN peacekeeper camp whose deficient drainage system – confided to a Haitian subcontractor – supposedly set off the contamination of a tributary of the Artibonite, the largest river in Haiti. After several weeks of controversy, other studies strengthened this hypothesis and definitively rejected the alternative theories of a spread beginning on the coast due to the climate situation.
For the moment, more than 6% of the Haitian population is allegedly concerned by the illness – that’s more than 700,000 cases, likely an under-valued assessment – which continues to kill by recurrent outbreaks, in particular in remote areas where medical personnel remains insufficient and access to water nonexistent. In this regard, we can cite the statistics by the MSPP from the third week of January 2014: 75 people were hospitalized, and three of them succumbed to Vibrio cholera. If from now on the threat appears relatively contained, the country remains in a state of permanent wakefulness and the eradication should spread for years – even decades – while international emergency programs are closing, for lack of financing.
1. The irresponsibility of an international organization. If the SNU (United Nations System) has firstly ignored the controversy, its representatives have progressively developed rhetoric centered on the technicalization of the problem and the implicit refusal of all forms of accountability.
2. The timid mediation of an outdated State. For a long time unmoving in this sociotechnical controversy, the Haitian government recently attempted to regain control by proposing a series of initiatives aiming to find a political solution to the health crisis.
Adding to a national context that since 2004 is already affected by the presence of foreign troops, the mobilization of victims is organized around movements such as the COMODEVIC (The Collective Solidarity with the Victims of Cholera) or the MOVIK (People Who are Cholera Victims). Several protests have taken place in the country – and in New York – in order to demand symbolic compensation from the United Nations – in the form of a public apology – and material compensation, namely indemnities for mourning families. Note that these protesters activities have been passed onto the legal field, in particular with the filing of a complaint in November 2011 in the name of five thousand people represented by two sister organizations: the IJDH (Institute for Justice and Democracy in Haiti) – an NGO founded by an American lawyer and human rights expert – and the BAI (Bureau des Avocats Internationaux) [International Bureau of Lawyers], its legal counterpart. Two years later, a new measure has been undertaken against the UN by Haitian legal experts in New York in order to demand compensation for the population. Finally, we can cite the publication from the end of 2013 of an overwhelming report drafted by researchers from Yale University, which incriminates the MINUSTAH, both in terms of public health and law.
However, during the first weeks of the epidemic, UN leaders were limited to a strategy of systematic denial: moreover, executive staff of the WHO and the CDC, opting for the technical treatment of a health problem, affirmed that the investigation of the origin of the scourge did not constitute a priority. Let us recall that at that time the country was in an electoral period, and that financial backers had strongly supported the precipitated organization of a presidential election judged essential to the reconstruction process. For all that, the series of experts challenging the MINUSTAH drove the United Nations to conduct a mediatized and legal counter-offensive. In order to reject the claims of Haitian lawyers invoking the SOFA agreement (Status of Forces Agreement) signed in 2004 between the UN and the Haitian government – which most notably provided for the setting up of a claims commission -, in February 2013, the Organization resorted to section 29 of the 1946 Convention on Privileges and Immunities of the United Nations. In this respect, the requests for damages were judged unacceptable: note that the Secretary General Ban Ki-moon spoke out insisting on the 140 million dollars of multilateral funds invested against cholera, all the while implicitly refusing to recognize any responsibility in the health crisis.
Facing the magnitude of the controversy, the Haitian state limited itself to many months of silence, which testifies to its dependence on the international community, but equally the incessant conflicts between the new President and Parliament. The Foreign Minister even declared in October 2012 that he had no proof implicating the UN force in the propagation of Vibrio cholerae. In autumn 2013, however, the Haitian Prime minister began a reversal as he alluded to the “moral responsibility” of the UN before proposing, during the 68th General Assembly of the United Nations, the creation of a mixed structure in charge of finding a compromise. Let us highlight how much this timid way out relies especially on a year plan of eradication of 2.2 billion dollars, which aims to construct an efficient network of water and sanitation all the while containing the epidemic by campaigns of oral vaccination. For as much, this late initiative will only receive 1% of its funding from the United Nations which prefers to appeal to the private sector and to philanthrocapitalism. So the implicit strategy of impunity chosen by the United Nations appears to have to be paid by its complete discredit. In this case, the cholera scandal in Haiti shows the limits of an approach focused on a population who needs treatment while neglecting the necessary accountability to the people.
Paule Clément, « La gestion capitaliste d’une catastrophe naturelle. Le deuxième anniversaire du séisme haïtien, January 12, 2012», Fil d’Ariane, Chaos International, Feb. 2012.
Transnational Development Clinic, Jerome N. Frank Legal Services Organization, Yale Law School, Global Health Justice Partnership of the Yale Law School and the Yale School of Public Health, Association Haïtienne de Droit de l’Environnement,
« Peacekeeping Without Accountability. The United Nations’ Responsibility for the Haitian Cholera Epidemic», August 2013, available at : http://www.yaleghjp.org [January 11, 2014].