Let's Talk About Cholera

The bad news: as I'm sure anyone who reads this blog knows by now, thousands of people have come down with cholera in the Artibonite, about 50 miles north of Port-au-Prince. There have been about 300 deaths so far, all inhabitants of that region. The rumor mill has it that the UN might be responsible for the outbreak: the Nepalese base is located in St. Marc near the Artibonite region. In September there was a cholera outbreak in Nepal, so if there was a Nepali troop rotation recently, its possible (probable?) one way or another their waste made it into the Artibonite river, and into people's drinking water. Nothing has been confirmed, but its all over the radio and television here. The deaths in the north are tragic and tragically unnecessary (of all the things Haitians already had to worry about, at least they didn't have cholera), but this has the potential to become a disaster of major proportions if cases start appearing in Port-au-Prince, with several million people densely packed together in camps and slums. Whether or not this develops into a major epidemic, the cholera bacteria is now present in the Haitian water supply and will probably be a risk for people for many years to come. Even the DR is feeling the consequences, as tourists are reluctant to visit the island. So much for my mother coming to visit me for Christmas.

The mildly good news: So far there have been cases in Port-au-Prince, but they are all people who came from the Artibonite to the capital to seek care. So far, to the best of my knowledge, no one has contracted the illness in Port-au-Prince. Haitians and the international community alike are mobilized to educated people all around the country about water sanitation and to distribute water treatment tablets. Today I saw a van with speakers driving through the city announcing the wonders of hand washing and water treatments. Critics have been decrying the NGO world, saying they blew it (one particularly salient and well-written example can be found here: http://tinyurl.com/38nay48). The absence of a post-earthquake epidemic was the one success that the international community could claim, and now they've f-ed that up too. Putting aside the UN (they should really feel ashamed), I think it is too early to judge whether or not the development world has blown this or not. The introduction of the bacteria happened, there is nothing that can be done about that now, but really how treatment and prevention is really going to be what decides whether or not the NGO world here is legit or just a racket and a charade.

It's important to recognize that its not only the international community that is taking action. The responsibility for public health is also taken up by the Haitian government, community groups, and media outlets. The television and radio have been talking about cholera and prevention all weekend, the Ministry of Health is also mobilized and investigating the situation. Although in all fairness the Ministry of Health is probably inextricably tied to UN health organizations. But we must be on guard from thinking that this is solely the responsibility of the international world and ignoring the efforts, however constricted, of Haitians from helping each other. The expectation that Haitians can't take care of themselves is one of the modern day manifestations of colonial racism which is unfortunately still present in the development world today. Even if the reality is that Haitians need the NGOs for many of their most basic services like health care, we should never abandon the belief that Haiti should be taking care of itself.