As Haiti tries to push the United Nations to accept responsibility for a cholera outbreak that so far has killed 8,000 Haitians and sickened nearly 640,000 people, Cuba is coming to grips with what appears to be the first cholera outbreak there in well over 50 years.
The reintroduction of a disease that has been eradicated in much of the developed world is alarming to world health officials. In Cuba, officials believed they had stopped an outbreak of the disease over the summer. But it appears that another outbreak has occurred in central Havana, apparently killing a man earlier this month.
Cuban officials believe 51 people in Havana have been infected thus far. They believe the disease originated with a foodseller who may have caught it during the previous outbreak in eastern Cuba.
Health workers had noticed an increase in acute diarrhea in some areas and concluded that it was caused by cholera. Doctors have been going door to door in Havana, looking for people who have symptoms. Cuba has one of the most highly regarded healthcare systems in the Western Hemisphere.
In Cerro, the central Havana district where it is believed to have started, cafes and restaurants have been shuttered and patrons can only buy sealed food and drink. Cholera is carried by contaminated food or water, leading to severe dehydration that can prove fatal if untreated.
In Haiti, the poorest country in the Western Hemisphere, the cholera epidemic was deadly because the population was in fragile state after the earthquake three years ago; there was inadequate infrastructure to deal with it; and Haitians didn’t have an immunity to the disease.
But perhaps most devastating of all, it has since been discovered that the disease had been brought to Haiti by people who were there to help — a U.N. peacekeeping force from Nepal, which had experienced its own cholera outbreak. Scientists determined the Haitians were hit by the same strain of cholera that was in Nepal.
“Part of the reason we think the outbreak grew so quickly was the Haitian population had no immunity to cholera,” says Daniele Lantagne, an environmental engineer at Tufts University. “Something like when the Europeans brought smallpox to the Americas, and it burned through the native populations.”
A Boston-based group, Institute for Justice and Democracy in Haiti, filed a legal claim against the U.N. more than a year ago, demanding that it take responsibility for the outbreak. But the U.N. insists that however cholera got to Haiti, it spread because of terrible sanitary conditions and lack of clean water.
Brian Concannon, director of the institute, doesn’t buy the U.N.’s argument and is now trying to decide whether to sue the agency in a court in the United States, Europe or Haiti.
“It’s like lighting a fire in a dry field on a windy day and then blaming the wind or the drought for the fire,” Concannon told NPR.
According to Concannon, the U.N. was supposed to set up a process within the status of forces agreements that governs every peacekeeping operation. The process was to deal with claims of harm — from traffic accidents and alleged rapes involving peacekeeping soldiers to larger allegations. But the U.N. has never set it up, leaving it vulnerable to such claims.
While the U.N. hasn’t admitted anything, last month U.N. Secretary-General Ban Ki-moon announced a plan to eliminate cholera in Haiti and the neighboring Dominican Republic. But the plan is expected to cost $2.2 billion and take 10 years — and the U.N. has only identified funding for 10 percent of the cost.
Concannon told NPR he worries the rest of the funds may never be found.