Despite a growing body of evidence to the contrary, the United Nations is still getting blamed for bringing cholera to Haiti.
Three people have been killed, dozens injured, in rioting sparked by these accusations. And tensions remain high between many Haitians and UN peacekeeping troops, making the job of assisting with this island nation’s many humanitarian needs all the more difficult.
Meanwhile, the disease has now taken grip of Haiti, spreading rapidly and having so far killed perhaps 2,000 people. It is expected to sicken hundreds of thousands more before it burns itself out in perhaps a year or so. Many believe UN troops from Nepal, carrying the infection, brought the bacterial scourge to this already devastated nation.
“It’s tragic because it’s almost certainly incorrect,” said Rita Colwell, a world-renowned cholera expert and former director of the National Science Foundation.
Initial rumors of UN troops importing the bug gained credence among many Haitians when CDC scientists said the cholera bacteria matched strains from South Asia. This was widely viewed as supporting the contention that the Nepalese peacekeeping team caused the massive outbreak by allowing its sanitation facilities to overflow into a river.
The initial reluctance of the UN to address the allegations, combined with other high-profile medical experts saying the bug’s South Asian pedigree pointed to the UN peacekeeper team further fueled the controversy.
What got missed by many, however, is that the CDC scientists emphasized that where a cholera strain is first identified geographically doesn’t prevent it from establishing a foothold anywhere else in the world.
“The very nature of the way cholera travels around the globe makes it very difficult to pinpoint where it originated,” said Tom Skinner, CDC spokesman. The waterborne bug now wreaking havoc in Haiti, Skinner said, could have arrived anytime in a ship’s ballast, through water importation, contaminated food or any of a number of routes.
“We may never know where this came from,” Skinner said.
Amid all the furor was a little-noticed news report a few days ago from Maria Elena Hurtado at SciDev.net, an online news organization that reports on scientific research and development issues.
SciDev’s story quoted Colwell and other world-renowned cholera experts like Dr. David Sack saying that the nature of this large-scale outbreak indicated the bacteria was almost certainly already present in Haiti and just exploded due to the combination of social disruption and environmental factors.
“The pattern of distribution and rapid spread across a large area indicates it was already present,” said Colwell, whom I talked to by telephone yesterday. A single source — such as the UN peacekeepers camp — would not have caused such a massive and rapid spread of cholera, she said.
After first refusing to investigate, the UN has been testing for cholera among the peacekeeper troops. Reportedly, all the tests so far have come back negative.
Part of the problem here, Colwell said, is that the medical community is still taught that cholera outbreaks are primarily caused by person-to-person spread. In fact, she and other microbiologists who study this bacterial scourge have shown that it is often changes in weather patterns, climate and the water environment of a community that allows cholera to flourish.
“Physicians are just not taught about the environment as it contributes to disease,” Colwell said. “It takes a long time to change the paradigm within the medical community.”
Meanwhile, she and her colleagues have obtained water samples from the Haiti outbreak and are doing their own analyses. Other teams, including the CDC, are also doing studies aimed at confirming the source.
Colwell hopes that a more precise analysis will help bring a more evidence-based perspective to the outbreak and perhaps reduce the tensions — and the potential for further violence — already plaguing the UN’s ability to assist in efforts to help Haiti.
“It’s especially important in these kinds of situations that we don’t rush to judgment,” Colwell says.