Via the O'Neill Institute Blog: A Call for U.N. Accountability for Cholera in Post-Earthquake Haiti – Part III: Raising U.N. Disease Prevention Standards. Click through for the whole post and some good links. Excerpt:
This series has primarily considered the problem of U.N. accountability for the international spread of disease. Part I of this series explored the mounting evidence against the U.N. that suggests the international body negligently, if unintentionally, transported cholera to Haiti through infected Nepalese peacekeeping personnel. Part II of this series took a close look at the immunity provisions that could pose a major challenge to Haiti’s cholera victims from obtaining effective judicial relief from the U.N.
Aside from accountability concerns, however, the U.N.’s standards for preventing and timely responding to the international spread of disease that ostensibly led to Haiti’s first outbreak of cholera in a century – and, importantly, from a South Asian strain of the disease previously unknown to Haiti – remain unimproved.
More specifically, U.N. peacekeeping operations (UNPKO) pre-deployment protocol creates the potential for further inadvertent transmissions of disease across borders while the dubious leadership roles of U.N. peacekeeping missions allow the U.N., as a non-state actor, to skirt critical surveillance and response obligations that the World Health Organization (WHO) has imposed on states for the effective response to incidents of international spread of disease.
On the prevention side, UNPKO deployments constantly create new potentially disastrous routes for pathogens to travel by regularly recruiting personnel from resource-poor and biogenetically diverse contexts to staff its missions. In Haiti, peacekeepers arrive to serve in MINUSTAH from Guatemala, Sri Lanka, Bangladesh, Burkina Faso, Burundi, Rwanda, Sierra Leone and Yemen, which constitute only a portion of the fifty-seven countries that comprise the evolving international security force.
Around the world, the U.N. continues to deploy over one hundred thousand personnel, often from countries experiencing their own political conflicts and public health challenges, to man its sixteen peacekeeping missions around the world.
Dr. Louise Ivers of Partners In Health recently warned in the American Journal of Tropical Medicine and Hygiene, “The risks of globalization must not be seen just as the south to north “spread of disease” or “reintroduction of disease” but also of the inverse—the introduction of deadly pathogens through routes previously not traveled.”
The deployment of uniformed personnel from one impoverished, institutionally-weakened or conflict-beleaguered country to another for purposes of carrying out peacekeeping operations should be seen as creating an entire network of previously untraveled “south-south” routes for infectious diseases.
When taken that globalized diplomacy creates the potential for fast-tracking pathogens between vulnerable populations, the U.N.’s pre-deployment protocol appears entirely inadequate to prevent the inadvertent spread of disease.
In particular, UNPKO regularly deploys new peacekeepers to missions like MINUSTAH as often as every six months but does not require that uniformed personnel undergo laboratory testing for infectious diseases, including cholera, unless the personnel present active symptoms.
Such standards do not account for important circumstantial indicators, such as the fact that cholera was known to be endemic to Nepal and that approximately 75 percent of Nepalese cholera carriers do not show active symptoms.
The pre-deployment screening standards also did not take caution of the fact that shortly before the outbreak of cholera in Haiti, a surge in cholera infections was reported in the Kathmandu valley where Nepalese peacekeepers train for three months before departing to Haiti.
I often wonder what the people at WHO and PAHO must be thinking when they know that the UN, their parent organization, is responsible for the health disaster they're trying to deal with in Haiti.
