Haiti's Cholera Outbreak: The Role of the UN then, and now.

[Drew Phipps]

Haiti's Cholera Outbreak: The Role of the UN then, and now.

Cholera broke out in Haiti in October 2010, and continues to constitute a grave medical emergency. Overwhelming evidence has established that reckless disposal of human waste by a United Nations (UN) peacekeeping base in Mirebalais poisoned Haiti's rivers with a particularly deadly strain of cholera bacteria and created the epidemic. Now, despite even UN Special Envoy to Haiti Bill Clinton's acknowledgment that the UN was the "proximate cause" of the epidemic, the UN continues to refuse to accept responsibility and control cholera in Haiti.

In November 2011, the "Institute for Justice and Democracy in Haiti" filed 5,000 claims with the UN, seeking:
A) The installation of a national water and sanitation system that will control the epidemic,
B) Compensation for individual victims of cholera for their losses,
C) A public apology from the United Nations for its wrongful acts

In February 2013, after 15 months of silence, the UN tersely dismissed the claims in a two-line decision deeming the claims "not receivable." Since then, their strategy continues to be denial and stonewalling the media. On October 9, 2013, BAI, IJDH, and law firm Kurzban, Kurzban, Weinger, Tetzelli & Pratt (KKWT) filed a lawsuit against the UN in NY Federal Court. Click here for a full timeline of the events that led up to this.


On October 23, 2014 a judge heard oral arguments on the question of UN immunity. On January 9, 2015, the judge dismissed IJDH's case. On February 12, 2015, IHDH filed a notice of appeal to begin the appeals process. On May 27, 2015, the IJDH filed the Plaintiffs' Principal Appellate Brief. On August 26, 2015, the United States filed an Amicus Curiae Brief in support of affirmance. On September 25, 2015, IJDH filed the Appellants Reply Brief.

*****
The US has weighed in for the UN. So, in addition to the "black helicopters," depriving nations of their sovereignty, and Alex Jones's worst nightmare (see "Amerigeddon;" no, really, don't go to see it) now apparently they have the power to come to your neighborhood, dump raw and diseased sewage into your drinking water, and they can't even be hauled into court.

By the way, the UN could have prevented the cholera outbreak with a $2000.00 health kit. http://www.theguardian.com/world/2016/ap...e_btn_link

[Drew Phipps]

An Update: Appeal pending decision

http://www.huffingtonpost.com/jason-silv...ir=Science

Why The Haitian Cholera Victims Deserve Their Day In Court
06/30/2016 11:10 am ET
Jason Silverstein

The battle between victims of the cholera epidemic in Haiti and the United Nations may resemble a classic David and Goliath story, except in this case Goliath hasn't even shown up to fight. The reason is that the United Nations is granted "immunity from every form of legal process" even though public health experts believe UN peacekeeping troops are responsible for the cholera outbreak in Haiti, which has infected more than 750,000 people and killed more than 9,000 since October 2010. (Though a recent paper from Médecins Sans Frontières researchers suggests that there may be "a substantially higher cholera mortality rate than previously reported.")


Nevertheless, on Jan. 9, 2015, US District Court Judge J. Paul Oetken dismissed a class action lawsuit brought by the Institute for Justice and Democracy in Haiti. But in March the Second Circuit Court of Appeals agreed to review the District Court's ruling. The decision of the three judges is pending. The United Nations should not be able to invoke immunity in order to foreclose on justice. The 1946 convention that granted them immunity also charged them with a responsibility. They aren't to be accountable to no one. Rather, according to the convention, the UN "shall make provisions for appropriate modes of settlement." But the UN has refused to do so in this case.



The United Nations should account for their role in one of the deadliest outbreaks of cholera in recent history. Some argue that time is better spent on halting the epidemic and not trying to point fingers at who started it. But while that trade may satisfy members of elite organizations, it is unlikely to satisfy people like Lisette Paul, one of the plaintiffs in the lawsuit. Her brother, Fritznel, became sick while working in the fields. He vomited and had diarrhea for seven days straight until he died. His medical and funeral expenses plunged his family into debt. Soon, they could no longer afford to send his daughter to school. The suffering of Fritznel, Lisette, and those like them shouldn't be pitted against the prevention of future pain. They should have a forum to air their claims and the UN should provide it.



No one doubts that the ongoing cholera epidemic in Haiti is a man-made disaster. The debate is who, or what, was responsible. Cholera is a bacterial infection that causes diarrhea and vomiting and, unstopped, eventually dehydration and sometimes death. People can catch it from contaminated water. But it hadn't been in Haiti for 100 years at least. So how did it wind up there in October 2010?


The short answer is human activity from South Asia. One team of public health experts matched the strain of cholera to a South Asian type. Another made a circumstantial case that the disease came from a camp of UN peacekeeping troops from Nepal. Before the troops were deployed to Haiti, there had been a cholera outbreak in Kathmandu, Nepal. Less than two weeks after the first cases, the Associated Press reported an overflowing septic tank, the "stench of excrement," and "a reeking black flow" from the camp's pipes to the Artibonite River, which 1.5 million Haitians use.



The UN doesn't deny all of these claims. In fact, they rounded up an independent panel that reached many of the same conclusions. They also found that the cholera strain matches the South Asian type and the outbreak happened "as a result of human activity." But the UN panel report arrives at a different conclusion. Though they agree someone must have brought cholera to Haiti, they say no one should be blamed. This is because, they argue, there was a "confluence of circumstances." These circumstances include the environmental conditions, the role that Haitians played in spreading the disease, an especially deadly strain of cholera, and the country's poor sanitation and water conditions. Indeed, by the time the cholera outbreak hit, a mere 17% of Haitians had access to facilities that separate human waste from human contact.



The "confluence of factors" argument amounts to little more than victim blaming. If only Haiti had better water and sanitation, the argument goes, then cholera would not have spread. But does that mean someone should be able to leak contaminated raw sewage with impunity? "From a legal perspective that stuff is all totally irrelevant," counters Brian Concannon, the executive director of the Institute for Justice and Democracy in Haiti. "If the UN negligently introduced this disease into an environment they knew was weak, then legally it's still responsible." Still, this isn't an open-and-shut case. Daniele Lantagne and the rest of the UN panel give two reasons why not. First, there is no hard scientific link between the peacekeepers and the outbreak. Someone else from South Asia could have been in Haiti at the time and, however miniscule the possibility, they could have carried the strain. Second, the introduction of cholera undoubtedly was an accident and not a deliberate act.



But this only raises more questions that the UN should answer. No one argues that the peacekeepers contaminated the water supply on purpose. If they had the disease, they may have had no idea. In fact, it is possible to be totally asymptomatic. But this doesn't answer why they weren't screened for the disease. After all, a cholera outbreak was reported on September 23, 2010, in Kathmandu, which is where the peacekeepers trained for three months. They received a medical examination before traveling to Haiti. Why weren't they tested for cholera? A recent article in PLOS Medicine reports that the rapid diagnostic test only costs $2.54 per person and a single-dose prophylaxis on the higher end runs $1.32 per person.



Even if they were definitively singled out as the cause, it would be unfair to punish the peacekeepers. They weren't experts. Peacekeeping troops are hired out, largely from poor countries, to the UN for $1,028 per soldier per month of duty. But that doesn't mean no one could have foreseen harm. Just two days after the January 2010 earthquake, the US National Center for Medical Intelligence wrote that it "expects damage to urban water and sewage infrastructure will increase rates of diarrheal disease, possibly to include cholera." Even if an accidental act and a confluence of factors spread cholera, the important ethical questions are when those factors were known, and by whom.



It isn't only outsiders like Brian Concannon and the IJDH who are calling on the UN to hear claims from the victims of cholera. In his first report as the UN's independent expert on the situation of human rights in Haiti, Gustavo Gallón called for a "reparation commission for cholera victims." Given that the UN proclaimed that victims of human rights violations must be able to seek remedies and reparations, Mr. Gallón reminds us, anything less would be hypocritical. In October 2015, four UN Special Rapporteurs joined Gallón to argue that "the victims of cholera have access to a transparent, independent and impartial mechanism that can review their claims and decide on the merits of those claims in order to ensure adequate reparation, including restitution, compensation, satisfaction and guarantees of non-repetition." More recently, Jan Eliasson, the Deputy Secretary General of the United Nations, wrote a letter that the "Secretary General and I are fully committed to ensuring that the Organization fulfills its human rights obligations." Yet the letter doesn't mention financial compensation nor does it mention any "transparent, independent and impartial mechanism" to review claims.



One out of every fourteen Haitians has been infected with cholera. They deserve an official forum to examine why this happened and who is responsible. People like Claudine, another client of IJDH, who spent her life savings to bury her father should be made financially whole. As of today, none of this will happen.

[Drew Phipps]

U.N. Admits Role In Haiti Cholera Outbreak That Has Killed Thousands

August 18, 20161:27 PM ET

http://www.npr.org/sections/thetwo-way/2...-thousands

In the fall of 2010, months after a devastating earthquake struck Haiti, a new disaster began: a cholera outbreak that killed thousands of people and continues to sicken people across the country. Experts determined that the source of the disease was a U.N. peacekeeping camp. And now, nearly six years later, the United Nations has admitted it played some role in the deadly outbreak. At a briefing Thursday, U.N. spokesman Farhan Haq said that over the course of the past year, "the U.N. has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera."


He said the U.N. would announce new actions to address the issue within the next two months. "Our legal position on this issue has not changed," Haq said, adding that the U.N. was not describing any of its actions as "reparations." The U.N.'s acknowledgement was first reported by the New York Times, which notes that the statement from Haq "stopped short of saying that the United Nations specifically caused the epidemic." The newspaper adds:

"Nor does it indicate a change in the organization's legal position that it is absolutely immune from legal actions. ... But it represents a significant shift after more than five years of high-level denial of any involvement or responsibility of the United Nations in the outbreak, which has killed at least 10,000 people and sickened hundreds of thousands."

Cholera, as our Goats and Soda blog has explained, is an infectious disease that causes severe, watery diarrhea. It spreads through contaminated water. The illness causes dehydration and can lead to death, sometimes in just a few hours, if left untreated. The beginning of the epidemic in Haiti was swift and catastrophic. Here's how Richard Knox described the outbreak for NPR in 2013:

"Suddenly, the first cases appeared in the central highlands near a camp for United Nations peacekeeping forces. ...
"The disease struck with explosive force. Within two days of the first cases, a hospital 60 miles away was admitting a new cholera patient every 3 1/2 minutes.
" '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.' "

Before 2010, cholera had been unknown in Haiti for at least a century. And the impoverished, earthquake-devastated country was already struggling with water and sanitation. A panel of experts appointed by the U.N. found that the strain of cholera that popped up in Haiti was "a perfect match" for a strain found in Nepal. Nepalese peacekeepers were staying at the U.N. camp, and poor sanitation sent sewage from the camp into local waterways. In 2013, activists sued the U.N. over the cholera outbreak.

Earlier this year, NPR's Jason Beaubien offered an update on that case:

"A three-judge federal appeals court panel held a hearing March 1 on whether the U.N. should be held accountable for Haiti's devastating epidemic.
"A federal district judge last year dismissed the class-action suit, ruling that international treaties immunize the U.N. from lawsuits. The plaintiffs appealed the lower court's dismissal, resulting in this month's hearing. The United States is defending the U.N., since the agency is headquartered in New York.
"The lawsuit was brought by the Boston-based Institute for Justice and Democracy in Haiti and a sister group in Haiti on behalf of 5,000 cholera victims. They want the U.N. to end cholera by installing a national water and sanitation system; pay reparations to cholera victims and their families; and publicly apologize for bringing cholera to Haiti.
"The plaintiffs contend the U.N. forfeited its legal immunity when it failed to launch an internal process to adjudicate the plaintiffs' claims, as they say its own commitments require.
" 'The U.N.'s conditional immunity does not authorize impunity,' plaintiffs' attorney Beatrice Lindstrom told the three-judge appeals panel."

As the Times noted, the U.N. did not walk back its claim of immunity in its acknowledgement of some responsibility in the outbreak. As Jason reported, U.N. officials are concerned that if the U.N. is held responsible for the cholera outbreak, it will be vulnerable to lawsuits around the world over actions of its peacekeeping forces. Some of the U.N.'s own special rapporteurs have sharply criticized that stance and say U.N. efforts to address the crisis are "clearly insufficient."


Again, the cholera crisis that began in 2010 continues. The disease is now endemic in the country; thousands of people are sickened every year.