The UN's report on origins of cholera in Haiti

Via Yahoo! News, a report from The Associated Press: UN panel: South Asian cholera strain in Haiti. Excerpt:

The cholera outbreak that has killed nearly 5,000 people in Haiti was caused by a South Asian strain that contaminated a river where tens of thousands of people wash, bath, drink and play, a U.N. independent panel of experts said Wednesday. 

Although many have blamed the epidemic on U.N. peacekeepers from South Asia working in Haiti, the report issued by the panel declined to point the finger at any single group for the outbreak, saying it was the result of a "confluence of circumstances." 

"The evidence overwhelmingly supports the conclusion that the source of the Haiti cholera outbreak was due to contamination of the Meye Tributary of the Artibonite River with a pathogenic strain of current South Asian type Vibrio cholerae as a result of human activity," the report said. 

It said the panel concluded the epidemic "was not the fault of, or deliberate action of, a group or individual."

Here is the full report as a PDF. After a very quick scan of the document, I can say that it's an excellent history of the early phase of the outbreak. 

It's also a masterpiece of diplomatic writing that never once directly names the Nepali peacekeepers as the carriers of the South Asian strain of Vibrio cholera that has killed almost 5,000 persons and sickened a quarter of a million. 

The closest it comes is to say: "A specific form of the third hypothesis, that soldiers deployed from a cholera-endemic country to the Mirebalais MINUSTAH camp were the source of the cholera, is a commonly held belief in Haiti." The report confirms this belief without quite saying so.

In fact, the report blames the victims much more directly: 

These research findings indicate that the 2010 Haiti cholera outbreak was caused by bacteria introduced into Haiti as a result of human activity; more specifically by the contamination of the Meye Tributary System of the Artibonite River with a pathogenic strain of the current South Asian type Vibrio cholerae. 

This contamination initiated an explosive cholera outbreak downstream in the Artibonite River Delta, and eventually throughout Haiti. This explosive spread was due to several factors, including

the widespread use of river water for washing, bathing, drinking, and recreation; 

regular exposure of agricultural workers to irrigation water from the Artibonite River;

the salinity gradient in the Artibonite River Delta, which provided optimal environmental conditions for rapid proliferation of Vibrio cholerae;

the lack of immunity of the Haitian population to cholera; the poor water and sanitation conditions in Haiti; 

the migration of infected individuals to home communities and treatment centers; 

the fact that the South Asian type Vibrio cholerae strain that caused the outbreak causes a more severe diarrhea due to the larger production of the more potent classical type of cholera toxin; 

and, the conditions in which cholera patients were initially treated in medical facilities did not prevent the spread of the disease to other patients or to the health workers. 

The introduction of this cholera strain as a result of environmental contamination with feces could not have been the source of such an outbreak without simultaneous water and sanitation and health care system deficiencies. 

These deficiencies, coupled with conducive environmental and epidemiological conditions, allowed the spread of the Vibrio cholerae organism in the environment, from which a large number of people became infected. 

We have to understand that the MINUSTAH forces are there because of a coup organized by the US and Canadian governments against the elected Haitian government of Jean-Claude Aristide. Rather than send in the US Marines, who ran the country early in the 20th century, it was now politically expedient to hand the dirty work over to the UN.

The UN, in turn, had to find peacekeepers. These come nowadays from developing countries who can use the cash paid for contributing their soldiers. Nepal had a long, proud tradition of providing soldiers for the British Empire; the Gurkhas terrified the Germans in in North Africa during World War II, for example.

But now, as then, they are basically mercenaries fighting other people's wars. They do so because Nepal is a poor country with not enough jobs for young men, and in poor countries cholera is more or less endemic. 

Five thousand dead Haitians are effectively collateral damage of a North American attempt to get rid of a political embarrassment. To silence a problem in one poor country, they imported mercenaries from another poor country. For the same money, they could have left the Nepalis in Kathmandu and made a good start on building a sanitation infrastructure in Haiti. 

Postscript: An Al Jazeera article describes new president Michel Martelly as Haiti's second great disaster.