UN cholera which killed 9,000 could have been prevented for $2,000

The UN peace keeping force which moved to Haiti after the 2010 earthquake introduced cholera which killed 9,000 people. Haiti had not, for at least 100 years, and possibly never before, had a cholera outbreak. A new Yale study shows that it could have been prevented if the UN had spent just $2,000 for advance health checks and preventive antibiotics for their troops from Nepal who carried the disease. The cost of the UN incompetence in addition to the 9,000 lives lost is now estimated to be over $2 billion.

Of course, Ban Ki-moon spent months spinning the story and denying responsibility. (Just as he is still denying UN responsibility for the sexual predations of UN troops in Africa). Naturally anybody on UN duty is immune from any prosecution – even for blatant incompetence or gross negligence.

It can only be considered incompetence on the part of the UN when the study states “Prior to the outbreak, there were no biomedical interventions in place to prevent its occurrence despite the recognized risk for spread of infectious diseases from military to civilian populations”.

JA Lewnard et al, Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak, January 26, 2016, http://dx.doi.org/10.1371/journal.pmed.1001947

One of the most severe cholera epidemics of the modern era began in Haiti in 2010, causing over 700,000 reported cases and nearly 9,000 deaths to date. Prior to the outbreak, cholera had been absent from Haiti for over a century. Several pieces of evidence have contributed to widespread acceptance that the epidemic resulted from contamination of the Artibonite watershed with infected sewage from a United Nations Peacekeeping Mission in Haiti (MINUSTAH) base. The causative Vibrio cholerae strain was imported from Nepal and diverged from strains circulating in that country around the time 454 Nepalese troops were deployed to Haiti, and the first cholera cases in Haiti were seen downstream from the base days after troops arrived.

…. The cholera outbreak in Haiti arose from a confluence of preventable circumstances. Systemic inadequacies in sanitation infrastructure made Haiti vulnerable to water-borne disease, like other disaster-affected settings where peacekeeping operations are undertaken. Mass personnel movements from a cholera-endemic country and deficient waste management practices at a MINUSTAH base led to the introduction of V. cholerae to a susceptible population. Prior to the outbreak, there were no biomedical interventions in place to prevent its occurrence despite the recognized risk for spread of infectious diseases from military to civilian populations. While the UN has been reluctant to implement interventions in the wake of the epidemic in part due to uncertainties surrounding their effectiveness, our findings suggest antimicrobial chemoprophylaxis reduces the risk of disease introduction by over 90%. The low costs and minimal logistical burden of chemoprophylaxis relative to the other interventions suggest this approach warrants consideration as a strategy to limit risk for cholera introduction in future peacekeeping operations.

The Guardian writes:

The devastating Haiti cholera epidemic that has claimed thousands of lives and will cost more than $2bn to eradicate could have been prevented if the United Nations had used a basic health kit for a total of less than $2,000, scientists have found.

A team of Yale epidemiologists and lawyers has looked at how the cholera bacterium was introduced to Haiti by United Nations peacekeepers relocated there in the aftermath of its 2010 earthquake. Yale’s startling finding is that simple screening tests costing $2.54 each, combined with preventive antibiotics at less than $1 per peacekeeper, could have avoided one of the worst outbreaks of the deadly disease in modern history.

The Yale experts warn that the catastrophe in Haiti could be repeated as the UN appears to have failed to learn the lessons of its lack of preventive screening of peacekeepers. Some 150,000 UN peacekeepers are deployed from cholera-endemic countries each year but there is still no routine procedure to ensure they are free of the infection before being moved.

At least 9,000 Haitians, and possibly many more, have died in the continuing cholera epidemic that erupted in October 2010, it is thought as a result of untreated sewage from UN peacekeeping camps being dumped straight into a river. It was the first outbreak of the disease in Haiti in 150 years, and was almost certainly caused by the relocation of UN peacekeepers from Nepal, where cholera is present, to Haiti for emergency earthquake assistance.

Related:

UN’s own experts chastise Ban Ki-moon over handling of Haiti cholera outbreak


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