The devastating earthquake that hit Haiti on January 12, 2010 will be forever remembered as one of the darkest moments in the country's history. The 7.0 magnitude earthquake tragically revealed the weak public infrastructure left by decades of stultifying debt and the haunting legacies of interventions and corruption[1]. With over 300,000 lives lost in the earthquake, the international community responded by sending vast infusions of international aid and rescinding Haiti's debt[2]. However, as Haitians continue to recover from the damage of the earthquake, another force continues to take a severe human toll on Haitians: the cholera epidemic that has spread throughout the country.
The first documented case of cholera occurred in October 2010 -- only nine months after the earthquake. After extensive medical research, repeated tests showed that cholera was introduced by U.N. peacekeepers from Nepal, where cholera is endemic. Since the first case was reported two years ago, the disease has spread unrelentingly, and the consequences have been catastrophic: 500,000 Haitians have been affected, and over 7,000 have died, approximately five percent of the total population[3].
Originally discovered described in the 19th century, cholera is a water-born illness caused by bacteria. The infected person experiences persistent diarrhea ultimately leading to death due to electrolyte imbalances and extreme dehydration[4]. Currently, over 200 new cases of cholera occur daily in Haiti, where less than half of the population has access to safe water[5]. To the extent that cholera has spread, the problem must be assessed systemically: the lack of proper water and sanitation systems in Haiti has exacerbated the situation.
Compare the two countries in Hispaniola: whereas few in Haiti have access to proper sanitation, over 93 percent of people in neighboring Dominican Republic have access to safe, drinking water. Efforts in the past to remedy the lack of public health infrastructure have failed due to external interference by other states: in 1998, when the International Development Bank approved $58 million to repair Haiti's water and sanitation systems, the United States blocked the initiative and prevented the funds from being disbursed. As a result, the country's infrastructure was compromised.
Notwithstanding, we must find ways to address structural conditions afflicting Haiti while finding immediate solutions. The first step is to acknowledge that access to safe water and sanitation is a human right. As recognized under international law, under the International Covenant on Economic, Social and Cultural Rights, access to safe water is a fundamental aspect of international development[6], Because the United Nations continues to have an active presence in Haiti after the earthquake, it is necessary for the organization to uphold and implement international human rights law in its missions and operations. In the case of Haiti, there are steps we can take to remedy the crisis.
First, the neglected public water and sanitation systems must be repaired. Given the current rain of the spring season, it is imperative to contain cholera by rebuilding the country's weak infrastructure. Second, the international community must continue vaccination programs and help those in the most vulnerable conditions that are likely to catch cholera. Vaccination programs have been instituted since the epidemic began and have proven successful when implemented, but more funding is needed to extend their reach. Third, global development institutions like the World Bank must expand and accelerate aid to Haiti. Dr. Jim Kim, co-founder of Partners in Health and recently appointed President of the World Bank, ought to facilitate the provision of aid to Haiti while simultaneously addressing Haiti's structural issues.
Lastly, the United Nations must take responsibility for responding to the cholera epidemic. As the Institute of Justice and Democracy has argued, the United Nations has a duty to help with rebuilding Haiti's infrastructure under the Status of Forces agreement signed with the Haitian government[7]. The United Nations peacekeepers in Haiti, MINUSTAH, have a budget of over $800 million per year. If those funds were spent on vaccinations and public health, tens of thousands of lives could be saved. It is essential for the United Nations to continue working in Haiti.
We have a moral responsibility to help Haiti recover. Dozens of people continue to be infected daily. We can stop cholera, and we must start now.
References:
[1] The Center for Human Rights and Global Justice et al., "Woch Nan Soley: The Denial of the Right to Water in Haiti," http://www.chrgj.org/projects/docs/wochnansoley.pdf
[2] World Bank, "World Bank Statement on Haiti Debt," http://go.worldbank.org/2BQD8Q7ER0
[3] Sean Casey, "Cholera in Haiti: Still an Emergency," The Guardian, November 7, 2011, http://www.guardian.co.uk/global-development/poverty-matters/2011/nov/07/haiti-cholera-still-emergency-donors
[4] Lloyd Denis, "Haiti Cholera Epidemic Causes and Effects," Yahoo! Voices, November 4, 2011, http://voices.yahoo.com/haiti-cholera-epidemic-causes-effects-7127644.html?cat=5
[5] Meera Dalal, "Cholera in Haiti: From Control to Elimination," Al Jazeera, January 13, 2012, http://www.aljazeera.com/indepth/features/2012/01/2012111193155842439.html
[6] This is implied in Articles 11 and 12 of the convention. See Office of the United Nations High Commissioner for Human Rights, "International Convenant on Economic, Social and Cultural Rights," http://www2.ohchr.org/english/law/cescr.htm#art11
[7] Kim Ives, "Lawyers for Haiti Cholera Victims Tell UN: 'Immunity Cannot Mean Impunity," Institute for Justice and Democracy, April 11, 2012 http://ijdh.org/archives/26227