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<div class="entry-date">December 19, 2012<br>
<br>
</div>
<div class="subheadlinestyle">The Cholera Plan Remains Totally
Underfunded</div>
<h1 class="article-title">UN Responds to Haiti’s Cholera Crisis by
Sending Repackaged Aid</h1>
<div class="mainauthorstyle">by ROGER ANNIS</div>
<div class="main-text">
<p>December 18, 2012–In a short ceremony in New York City on Dec. 11,
UN Secretary-General Ban Ki-Moon <a
href="http://www.un.org/apps/news/story.asp?NewsID=43743&Cr=cholera&Cr1=%23.UM_fqm9i63h"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.un.org']);">announced</a>
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.</p>
<p>However, 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.</p>
<p>Also, 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.</p>
<p>The 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.</p>
<p>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.</p>
<p><strong>Behind the Figures</strong></p>
<p>The 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 (PAHO)/World Health Organization
(WHO), the United Nations Children’s Fund (UNICEF), and the United
States Centers for Disease Control and Prevention.</p>
<p>That call led to the launch in Brazil on June 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.</p>
<p>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. But 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.</p>
<p>Many 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.</p>
<p>The $2.2-billion and 10-year figures come from a UN “media
backgrounder” for the Dec. 11 announcement. They appear nowhere in the <a
href="http://new.paho.org/hq/index.php?option=com_content&view=article&id=7880%3Apaho-director-welcomes-un-support-for-cholera-elimination-in-hispaniola-&catid=1443%3Anews-front-page-items&lang=en&Itemid=1926"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://new.paho.org']);">WHO/PAHO
report</a> on the Dec. 11 announcement nor in the Regional Coalition’s <a
href="http://new.paho.org/colera/?p=217"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://new.paho.org']);">page
on the PAHO website.</a> The larger plan and figures will undoubtedly
be a centerpiece of Haitian government announcements on the third
anniversary of the Jan. 12, 2010 earthquake.</p>
<p>“Far from launching an ambitious new initiative, the UN was merely
repackaging a still-unfunded, year-old effort,” write former AP
correspondent in Haiti Jonathan Katz and international aid blogger Tom
Murphy in <a
href="http://www.foreignpolicy.com/articles/2012/12/18/the_uns_haitian_shell_game?page=0,1"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.foreignpolicy.com']);"><em>Foreign
Policy</em> on Dec. 18</a>. Almost all of the bilateral and
multilateral $215 million announced had been pledged already to Haiti
but not yet delivered, they point out.</p>
<p>As for the $2.2 billion plan, it “is purely aspirational.” Unlike
the 9,000-strong UN occupation force MINUSTAH which is budgeted to
receive $677 million over the next year alone, “The (cholera)
initiative is almost totally unfunded.”</p>
<p><strong>Pressure on International Authorities</strong></p>
<p>An <a
href="http://www.aljazeera.com/indepth/opinion/2012/12/2012121263738325821.html"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.aljazeera.com']);">article
by Mark Weisbrot</a> 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
argues. 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.</p>
<p>Examples of pressure, Weisbrot explained, are the <a
href="http://www.haiti-liberte.com/archives/volume5-17/As%20Epidemic%20Rages.asp"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.haiti-liberte.com']);">legal
action against the UN</a> brought by the Institute for Justice and
Democracy in Haiti (IJDH) and the Office of International Lawyers (<em>Bureau
des avocats internationaux</em> or BAI) on behalf of 5000 Haitian
cholera victims in November 2011; editorials in the <a
href="http://www.counterpunch.org/2012/12/19/un-responds-to-haitis-cholera-crisis-by-sending-repackaged-aid/..:..:AppData:Local:Microsoft:Windows:Temporary%20Internet%20Files:OLKA2D5:_blank">New
York Times</a>, <a
href="http://www.counterpunch.org/2012/12/19/un-responds-to-haitis-cholera-crisis-by-sending-repackaged-aid/..:..:AppData:Local:Microsoft:Windows:Temporary%20Internet%20Files:OLKA2D5:_blank">Boston
Globe</a>, and other major newspapers; a July 2012 <a
href="http://www.cepr.net/index.php/blogs/relief-and-reconstruction-watch/104-members-of-congress-call-for-the-un-to-take-responsibility-for-cholera">letter</a>
signed by 104 U.S. Democratic Congresspeople; and constant street
protests in Haiti and its diaspora.</p>
<p>Another 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 <em>Infosurhoy.com</em> last year. She
quotes the Dominican Health Minister as saying, “We as a nation must
fight to save our economy, which is basically tourism.”</p>
<p>Weisbrot points to looming funding cut-offs for cholera treatment.
PIH, for example, says that its <a
href="http://www.counterpunch.org/2012/12/19/un-responds-to-haitis-cholera-crisis-by-sending-repackaged-aid/..:..:AppData:Local:Microsoft:Windows:Temporary%20Internet%20Files:OLKA2D5:_blank">U.S.
funding for cholera treatment will run out</a> in February. “In 2012,
the UN requested just $30m for cholera treatment, yet <a
href="http://www.counterpunch.org/2012/12/19/un-responds-to-haitis-cholera-crisis-by-sending-repackaged-aid/..:..:AppData:Local:Microsoft:Windows:Temporary%20Internet%20Files:OLKA2D5:_blank">only
34% of this has been raised</a>,” he writes. “There were 205 cholera
treatment units and 61 cholera treatment centres in Haiti in August
2011; by June 2012, these had fallen to 38 and 17, respectively.”</p>
<p>The 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%) <a
href="http://www.counterpunch.org/2012/12/19/un-responds-to-haitis-cholera-crisis-by-sending-repackaged-aid/..:..:AppData:Local:Microsoft:Windows:Temporary%20Internet%20Files:OLKA2D5:_blank">has
been disbursed</a>.</p>
<p><strong>Other Reactions to the Plan</strong></p>
<p><a href="http://ijdh.org/archives/30090"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://ijdh.org']);">A
joint statement</a> 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.</p>
<p>“We 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.”</p>
<p>In <a
href="http://canadahaitiaction.ca/content/beatrice-lindstrom-ijdh-speaks-cbc-legal-action-against-un-cholera-haiti"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://canadahaitiaction.ca']);">an
interview</a> with the Canadian Broadcasting Corporation’s radio
program <em>As It Happens</em> on Dec. 12<em>, </em>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.</p>
<p>“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.”</p>
<p><strong>Cholera’s Ongoing Threat</strong></p>
<p>Joining the UN Secretary-General for the Dec. 11 announcement were
Haiti Prime Minister Laurent Lamothe and Dominican Health Minister
Lorenzo Wilfredo Hidalgo.</p>
<p>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 goal.</p>
<p>To date, officials of the government of President Michel Martelly,
including Lamothe, have not uttered a word about the cholera lawsuit
against the UN.</p>
<p>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.”</p>
<p>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.”</p>
<p>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.”</p>
<p>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.<strong> </strong></p>
<p><strong>How you can help</strong></p>
<p>More than 7,500 people around the world have signed an <a
href="http://www.avaaz.org/en/petition/End_Haitis_Cholera_Epidemic_with_UN_Action_Now_1/"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.avaaz.org']);">online
petition</a> 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.</p>
<p>Ongoing information about Haiti after the 2010 earthquake is
published by the CEPR on its invaluable <a
href="http://www.cepr.net/index.php/blogs/relief-and-reconstruction-watch/104-members-of-congress-call-for-the-un-to-take-responsibility-for-cholera"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.cepr.net']);">Haiti
Relief and Reconstruction Watch</a> blog. More recently, the Just
Foreign Policy organization that Mark Weisbrot also co-directs has
begun to publish the informative and innovative ‘<a
href="http://www.justforeignpolicy.org/haiti-cholera-counter"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://www.justforeignpolicy.org']);">Haiti
Cholera Counter</a>’ web page feature. You can place the feature on any
website.</p>
<p>You can contribute financially to the <a
href="http://ijdh.org/get-involved/jobs"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://ijdh.org']);">IJDH
and BAI</a> or volunteer your time to assist their work.</p>
<p>Watch 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, “<em>Haiti:
Where Did The Money Go?</em>” and seminars in London, England. Full
event listings can be found on the <a
href="http://canadahaitiaction.ca/"
onclick="javascript:_gaq.push(['_trackEvent','outbound-article','http://canadahaitiaction.ca']);">website</a>
of the Canada Haiti Action Network.</p>
<p><em><strong>Roger Annis</strong> is a coordinator of the Canada
Haiti Action Network and resides in Vancouver, Canada.</em></p>
</div>
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