An independent panel set up by the United Nations to investigate the source of the cholera outbreak that has claimed more than 4,500 lives in Haiti since it emerged last October has found that a “confluence of circumstances,” and not the fault of any group or individual, was responsible for the fast-moving outbreak.
The report of the four-member panel of experts, released today, includes a series of recommendations for the UN and the Haitian Government so they can help prevent the future introduction and spread of cholera within the impoverished Caribbean country.
Secretary-General Ban Ki-moon announced that he plans to convene a task force to study the report’s findings “to ensure prompt and appropriate follow-up.”
Nearly 300,000 Haitians have been sickened since the outbreak started and fresh infections and deaths continue to occur.
The experts’ report states that the evidence “overwhelmingly supports” the conclusion that the source was human activity contaminating a tributary of the Artibonite River with a pathogenic strain of cholera.
Scientific analysis indicate that the bacteria did not originate from the native environment of Haiti, but from a strain “very similar but not identical” to South Asian strains currently circulating within Asia.
The outbreak was able to spread so quickly and widely through the Artibonite River delta and eventually all of Haiti because of a series of factors, including:
- Tens of thousands of Haitians use the river system for washing, bathing, drinking and recreation;
- Thousands of agriculture workers are regularly exposed to the river waters, especially those working in rice paddy fields;
- The local population lacked immunity to cholera;
- The country suffers from poor water and sanitation conditions;
- Infected individuals fled to their home communities after the initial outbreak, thus dispersing the outbreak.
“The introduction of this cholera strain as a result of environmental contamination with faeces could not have been the source of such an outbreak without simultaneous water and sanitation and health-care system deficiencies,” the report concludes.
“These deficiencies, coupled with conducive environmental and epidemiological conditions, allowed the spread of the Vibrio cholerae organism in the environment, from which a large number of people became infected.
“The Independent Panel concludes that the Haiti cholera outbreak was caused by the confluence of circumstances as described above, and was not the fault or, or deliberate action of, a group or individual.”
Mr. Ban set up the panel in early January amid reports that Nepalese peacekeepers serving with the UN force in Haiti (MINUSTAH) may have been the source.
The panel members note that the outbreak highlights the risk of cholera being transmitted in the wake of a major emergency, such as occurred last year in Haiti when a catastrophic earthquake killed more than 200,000 people.
The report recommends that UN personnel and other emergency responders travelling from cholera-endemic areas should either receive a prophylactic dose of appropriate antibiotics before departure or be screened to confirm the absence of the relevant cholera strains.
UN peacekeeping missions operating in areas with cholera outbreaks should ensure that staff be immunized with oral vaccines, receive prophylactic antibiotics, or both, according to the report.
It also calls on UN installations around the world to treat faecal waste using on-site systems that inactivate pathogens before disposal, with the systems operated or supervised by qualified and trained UN staff.
In addition, the report recommends that the Haitian Government and the UN prioritize investing in piped, treated drinking water supplies and better sanitation throughout the country.
Until that can be put in place, the panellists urge the expansion of programmes to treat water at the household or community level with chlorine or other effective method; hand washing with soap; and the safe disposal of faecal waste.
In a statement issued by his spokesperson, Mr. Ban said he would carefully consider the report’s findings and recommendations and stressed that the UN would continue to support the Government and people of Haiti as they battle the cholera epidemic.
“The cholera outbreak has caused significant loss of life and widespread infection throughout the country,” he said. “On behalf of the UN family, the Secretary-General reiterates his deepest sympathies to the victims of the epidemic and their loved ones.”
The panel was chaired by Alejandro Cravioto of Mexico, from the International Center for Diarrhoeal Disease Research in Bangladesh. The other three members were Claudio Lanata of the Instituto de Investigacion Nutritional in Peru, Daniele Lantagne of Harvard University in the United States, and Balakrish Nair of the National Institute of Cholera and Enteric Diseases in India.