UN Responds to Cholera Crisis in Haiti with Repackaged Aid

by Roger Annis (Haiti Liberte)
In a short ceremony in New York on
Dec. 11, UN Secretary-General Ban Ki-Moon announced
what appeared to be an important nod to international grassroots pressure to
fund a universal treatment and prevention program for cholera in Haiti. He said
that  $215 million from bilateral and
multilateral donors and $23.5 million from the UN’s own coffers were being
pledged to a plan by the governments of Haiti and the Dominican Republic to
limit the spread of cholera and eventually eliminate the disease from the
island that the two countries share.

on closer examination, it turns out that the $23.5 million is the only new
money involved, amounting to a mere one percent of the $2.2 billion some
estimate it will cost to eliminate cholera.
Ban did not acknowledge that UN troops brought the disease to the Caribbean
country, one of the key demands of a year-old suit by Haitian cholera victims.
Evidence from numerous studies has established that Haiti’s cholera epidemic,
currently the world’s worst, was caused by sewage from a garrison of Nepalese
UN soldiers leaking into the headwaters of the country’s largest river, the
Artibonite, in October 2010. To date, close to 8,000 have died, and over
630,000 have been sickened.
Secretary-General also announced that Dr. Paul Farmer, a
co-founder of the global health agency Partners In Health (PIH), will serve as
special advisor to his office on community-based medicine. Zanmi Lasante, PIH’s
Haitian arm, is one of the country’s most important health care providers.
Farmer already acts as the deputy to the UN’s special envoy to Haiti, former
U.S. president Bill Clinton.
While some in global health and aid
circles hailed Ban’s announcement, others were rightly circumspect, in view of
the string of lofty pronouncements on cholera throughout 2012 that have
produced little progress on the ground.
Behind the figures
Secretary-General’s announcement was in support of the “Call for Action for a
Cholera-free Hispaniola” made  in January
2012 by the Presidents of Haiti and the Dominican Republic with support from
the Pan American Health Organization/World Health Organization (PAHO/WHO), the
United Nations Children’s Fund (UNICEF), and the United States Centers for
Disease Control and Prevention.
That call led to the launch in
Brazil on Jun. 4 of the “Regional Coalition on Water and Sanitation for the
Elimination of Cholera on the Island of Hispaniola.” The Coalition has expanded
several times since then, always with plenty of fanfare.
The main focus of the UN’s cholera
prevention efforts, Ban said, are construction of clean drinking water and
sanitation systems in the two countries and increasing the use of oral
vaccines. His comments on the two paths of
treatment focused on vaccination, not on clean water and sanitation systems,
which experts argue is the only lasting way to eliminate the disease.
news outlets headlined that Ban had announced a ten-year, $2.2 billion cholera
plan for Haiti, but he gave no such figure. “Haiti will need almost $500
million over the next two years to carry out its national implementation plan,”
he said.
$2.2-billion and 10-year figures come from a UN “media backgrounder” for the
Dec. 11 announcement. They appear nowhere in the WHO/PAHO
on the Dec. 11 announcement nor in the Regional Coalition’s page on the PAHO website. The larger
plan and figures will undoubtedly be a centerpiece of Haitian government
announcements on the third anniversary of the Jan. 12, 2010 earthquake.
from launching an ambitious new initiative, the UN was merely repackaging a
still-unfunded, year-old effort,” wrote former AP correspondent in Haiti
Jonathan Katz and international aid blogger Tom Murphy in Foreign Policy on Dec. 18. Almost
all of the bilateral and multilateral $215 million announced had been pledged
already to Haiti but not yet delivered, they point out.
for the $2.2 billion plan, it “is purely aspirational,” they write. “The
initiative is almost totally unfunded,” unlike the 9,000-strong UN occupation
force MINUSTAH which is budgeted to receive $677 million over the next year
Pressure on international authorities
An article by Mark Weisbrot of the Center for
Economic Policy Research (CEPR) published by Al Jazeera on Dec. 12 said that
Ban’s announcement is a sign that organized political pressure on the world
body can produce results for Haiti. But the UN’s announced plan is too slow,
Weisbrot says. Some 700 people have died since seasonal rains began in April
2012, including close to 200 since Hurricane Sandy caused widespread flooding
on Oct. 23 and 24. “The necessary infrastructure work should begin immediately,
not years from now,” he wrote.
of pressure, Weisbrot explained, are the legal
action against the UN
brought by the Institute for Justice and Democracy in
Haiti (IJDH) and the Office of International Lawyers (Bureau des avocats internationaux or BAI) on behalf of 5000 Haitian
cholera victims in November 2011; editorials in the New York Times, Boston Globe, and other major newspapers; a July
2012 letter signed by 104 U.S. Democratic
Congresspeople; as well as constant street protests in Haiti and its diaspora.
pressure point on the UN is that cholera has killed nearly 400 people in the
Dominican Republic, endangering its tourism industry, which brings in over $4
billion annually. Dominican officials want “to dispel the idea that visitors
could be in danger of contracting cholera,” wrote Ezra Fieser on Infosurhoy.com
last year. She quotes the Dominican Health Minister as saying: “We as a nation
must fight to save our economy, which is basically tourism.”
points to looming funding cut-offs for cholera treatment. PIH, for example,
says that its U.S. funding for cholera
treatment will run out
in February. “In 2012, the UN requested just
$30m for cholera treatment, yet only
34% of this has been raised
,” he writes. “There were 205 cholera
treatment units and 61 cholera treatment centers in Haiti in August 2011; by
June 2012, these had fallen to 38 and 17, respectively.”
cholera shortfall is consistent with a broader funding shortfall for post-earthquake
reconstruction in Haiti. Of $5.3 billion pledged by governments to help Haiti
to date, just $2.8 billion (53%) has
been disbursed
Other reactions to plan
A joint statement
issued by the IJDH and BAI cautiously welcomed Ban’s announcement, calling its
promise of clean water delivery systems “one of the key remedies sought” in
their legal action launched in November 2011.
are pleased that the UN is finally taking steps consistent with its legal
obligations,” said Mario Joseph, lead counsel for the petitioners and Managing
Attorney of the BAI. “But more resources are needed, and there needs to be more
urgency. In the two years it took to launch this initiative… over 7,700 Haitians
have died. Haitians will continue to die from UN cholera until clean water and
sanitation is actually installed.”
an interview with the Canadian Broadcasting
Corporation’s radio program As It Happens
on Dec. 12, IJDH staff attorney Beatrice Lindstrom
explained that the cholera legal action has four main goals: assistance in
establishing clean water and sanitation systems in Haiti; a fair hearing before
international law for the victims of cholera; compensation to the families of
the victims; and an apology for the reckless conduct of the UN Mission to
Stabilize Haiti (MINUSTAH) in allowing the cholera bacteria to enter the country
via its soldiers and failing to act quickly to prevent its spread.
“The United Nations is good at
launching appeals for aid,” wrote Mark Doyle, veteran BBC reporter in Haiti,
after the Dec. 11 announcement. “It is less good at admitting its own faults.”
Cholera’s ongoing threat
the UN Secretary-General for the Dec. 11 announcement were Haiti Prime Minister
Laurent Lamothe and Dominican Health Minister Lorenzo Wilfredo Hidalgo.
Lamothe spoke for four minutes,
thanking governments and agencies assisting with cholera response and saying
that his government has a two-year $600 million project to fight cholera.
“We have to work together to bridge the remaining gap,” he said,
implying that the $238.5 million announced would go towards his government’s
To date, officials of the government
of President Michel Martelly, including Lamothe,  have not uttered a word about the cholera
lawsuit against the UN.
According to the most recent data
from the World Bank, only 69% of Haitians have access to “improved
drinking water” and just 17% have access to “improved
sanitation”, defined in the plan as “flush toilets, septic tanks,
ventilated improved pit latrines or composting toilets.” Among the poorest
20%, only 1% has access to improved water and more than 90% “practice open
air defecation.”
At a press briefing following Ban’s
announcement, UN Humanitarian Coordinator for Haiti Nigel Fisher would not
comment on whether the MINUSTAH occupation force is to blame for bringing
cholera to Haiti. Repeating statements he has made throughout 2012, he said the
issue “is with the legal office and as a staff member I am not authorized
to say anything about the legal process at this time.”
PAHO director Mirta Roses Periago
told the briefing that it is not necessarily advisable to screen every UN
soldier for diseases before they are deployed on international missions. But
she said PAHO has advised the Secretary-General “to have special
provisions for people coming from endemic areas and being sure that there is no
outbreak going on at the time that people are being deployed.”
She said that the main problem for
cholera in Haiti is poor sanitation and water infrastructure, noting that about
100 cases of cholera are imported to the United States each year without
causing an epidemic. UN officials have used variations of that argument to deny
culpability ever since the epidemic’s outbreak.
How you can help
than 7,500 people around the world have signed an online
on Avaaz initiated by film director Oliver
Stone demanding more and faster UN assistance for clean water infrastructure in
Haiti. It is still collecting signatures.
Ongoing information about Haiti
after the 2010 earthquake is published by the CEPR on its invaluable Haiti Relief and Reconstruction Watch blog. More
recently, the Just Foreign Policy organization that Mark Weisbrot also
co-directs has begun to publish the informative and innovative ‘Haiti Cholera Counter’ web page feature. You can
place the feature on any website.
            You can contribute financially to
the IJDH
and BAI
or volunteer your time to assist their work.
for events around the world to mark the third anniversary of Haiti’s
earthquake, including screenings, followed by panel discussions, of Michele
Mitchell’s 2012 documentary film, “Haiti:
Where Did The Money Go?
” and seminars in London, England. Full event
listings can be found on the website of the Canada Haiti Action Network.
Roger Annis is a coordinator of the Canada Haiti Action
Network and resides in Vancouver, Canada.
A Haitian cholera victim. Some 700 people have
died since rains began in April 2012, including close to 200 after Hurricane
Sandy caused widespread flooding.