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jeudi 14 juillet 2011

How we helped pave Haiti’s road to hell

This article is from The Tyee, the award-winning online source for news and ideas based in Vancouver. Articles from The Tyee will appear regularly on the Opinion page of thestar.com.
Since last October, cholera has so far infected more than 370,000 Haitians and killed more than 5,500 of them. A proportionate epidemic in Canada would have sickened 1.2 million of us, and killed more than 18,000.
It was a totally avoidable disaster. Worse yet, it came to Haiti with the United Nations peacekeepers who were supposed to be protecting the Haitians. Since Canada is involved with MINUSTAH, the UN agency that effectively runs Haiti, we share some of the responsibility for inflicting needless suffering and for failing to admit it.
The outbreak started along the Meille River in a rural area, downstream from a MINUSTAH peacekeepers’ camp that had just received a contingent of Nepali soldiers. Suspicion fell on them at once.
After all, the soldiers had left Nepal in late September during a cholera outbreak. While they all had medical exams (including some stool tests), they then had 10 days’ home leave before reassembling in Kathmandu.
The Nepalese army denied its troops were to blame. MINUSTAH also denied the accusations, claiming the Nepalis had tested negative for cholera.
When the UN finally investigated the origin of the outbreak, it indirectly admitted the Nepalis had brought the disease. But it didn’t mention them explicitly. The UN spent more time blaming the Haitians for their lack of clean water and a sewage system.
Meanwhile, a team led by Renaud Piarroux of the Université de la Méditerranée did its own survey. Piarroux has just published a detailed report in Emerging Infectious Diseases, a peer-reviewed journal of the U.S. Centers for Disease Control.
Piarroux’s devastating report finds evidence that “strongly suggests” the epidemic emerged from the Nepalis’ camp.
Worse yet, Piarroux argues that to infect people using water from the Meille and Artibonite rivers, the quantity of Vibrio cholerae bacteria would have to come from at least one seriously sick cholera victim in the camp.
This directly refutes Secretary General Ban Ki-moon’s representative in Haiti, who had claimed “negative” test results on the Nepalis.
Cholera causes spectacular diarrhea and vomiting, so everyone in the base would have known about it. Suppressing information about such an outbreak would have required the collusion of senior Nepali officers, MINUSTAH officials, and at least some health-care professionals in WHO and the Haitian public health ministry.
But MINUSTAH said only that Piarroux’s study had been followed “by many others . . . each with different possible scenarios.” To my knowledge, no such alternate studies exist, and MINUSTAH didn’t cite any. We have only the UN report and that of Piarroux.
So the Piarroux report is an unrefuted indictment of the United Nations and its agents in Haiti, including the World Health Organization. The UN denials and press releases only aggravate the problem.
WHO faces a serious charge of suppressing or denying vital information about the epidemic while it spread explosively through the whole island of Hispaniola, including the Dominican Republic.
When the next serious outbreak arrives, therefore, we will wonder whether the scare is really a scam or a coverup. Such skepticism could cost lives.
Canada’s credibility is also in question. Many Canadian doctors have worked in Haiti. A Canadian, Nigel Fisher, is the UN’s Haiti Humanitarian Coordinator, supervising UN projects and coordinating with non-governmental organizations. He has said nothing publicly about the Piarroux report.
Nor has our last Governor General, the much-beloved Haitian-born Michaëlle Jean, who is now the UNESCO special representative to Haiti. When Canadian health experts, humanitarian coordinators and spokespersons are silent in the face of a UN coverup, they look complicit.
Importing cholera looks like incompetence made worse by misplaced political priorities. In September 2010, 5,044 Nepali troops were serving on peacekeeping missions. The UN was reimbursing Nepal to the tune of $1,028 (U.S.) per soldier per month.
Demand for infectious peacekeepers being zero, Nepal would therefore stand to lose over $5 million a month, and the UN might have trouble finding replacements.
The Piarroux report has embarrassed all concerned, including the Canadians in Haiti who have not protested MINUSTAH’s denials. It’s also a reminder of how little the UN has done to eliminate the squalor that cholera thrives on.
Dr. Rupert Virchow, the 19th-century doctor and politician, famously said that “medicine is a social science and politics is nothing else but medicine on a large scale.” In the case of Haiti’s cholera, Canada and the UN have committed malpractice on a very large scale.
Crawford Kilian is a contributing editor of The Tyee, where a longer version of this article appeared. He blogs about cholera and other diseases at H5N1.
http://www.thestar.com/opinion/editorialopinion/article/1025144--how-we-helped-pave-haiti-s-road-to-hell

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