More than two years and nearly 7,800 deaths after UN troops brought the dread disease of cholera to Haiti, a plan has finally been put forward to do something to get rid of it. While we are still a long way from implementation, there are important lessons to be learned from this experience.
Perhaps most importantly, it shows that organised political pressure can work. There have been protests from many thousands of Haitians, and the Institute for Justice and Democracy in Haiti went to the UN to file for damages and reparations. Many other groups and individuals kept the issue in the news and wouldn't let it go away, as much as the UN and powerful governments wanted it to disappear.
Newspaper editorial boards such as those of the New York Times and the Boston Globe called on the UN to take responsibility for the disaster that it caused. As a result of grassroots organising, the majority of Democrats in the US House of Representatives signed a letter to the same effect.
Still, the UN has continued to deny its responsibility despite conclusive scientific and forensic evidence that its troops had brought the disease from South Asia, and transmitted it by dumping human waste into a tributary of Haiti's main water supply. This was gross negligence of the highest order.
Lack of clean water and sanitation
Haiti is especially vulnerable to this type of a water-borne disease because of its lack of clean water and sanitation. Troops coming from areas where cholera was present should have been adequately screened and tested, and of course there is no excuse for their reckless disregard in polluting the Artibonite river with the deadly bacteria.
In March of this year, Bill Clinton, UN Special Envoy to Haiti, admitted that the UN military mission was responsible for the deadly outbreak, but the organisation maintains its denial.
Tuesday's announcement by the governments of Haiti and the Dominican Republic, together with the UN, of a 10-year plan to eradicate cholera from the island shared by the two nations is a step forward, and a result of all the pressure that has been brought to bear over the past two years. Better late than never, but it is still just the beginning.
In the first place, the plan is much too slow. This is an ongoing national health emergency: about 700 people have been killed by cholera just since the first rains began in April, 167 of them since Hurricane Sandy caused widespread flooding. But this is a 10- year plan. We are still looking at several years before serious work begins to provide Haiti with the clean drinking water and sanitation needed to get rid of cholera.
According to the most recent data from the World Bank, only 69 per cent have access to "improved drinking water" and just 17 per cent have access to "improved sanitation", defined in the plan as "flush toilets, septic tanks, ventilated improved pit latrines and composting toilets". Among the poorest 20 per cent, only 1 per cent has access to improved water and more than 90 per cent "practice open air defecation". The necessary infrastructure work should begin immediately, not years from now.
Haiti is a very small country, smaller than the state of Maryland, with 10 million people. There is no civil war or violence that would prevent or delay the construction of water and sanitation facilities. The two-year delay in even announcing a plan has been tremendously costly in human lives; this plan needs to be implemented immediately and much faster than it appears to be scheduled for.
No funds to treat affected people
Meanwhile, even the funds for treatment of people with cholera are lacking. One of the most important non-governmental organisations in Haiti, Partners in Health, says that its US funding for cholera treatment runs out in February.
In 2012, the UN requested just $30m for cholera treatment, yet only 34 per cent of this has been raised. There were 205 cholera treatment units and 61 cholera treatment centres last August; by June, these had fallen to 38 and 17, respectively.
And that is perhaps the biggest problem: for all the talk of "building back better" after the earthquake nearly three years ago, very little has been delivered. Of $5.3bn pledged by governments to help Haiti, just $2.8bn (53 per cent) has been disbursed. (For the US, it is $250m of $900m pledged, or just 28 per cent.)
So now we have the UN once again putting its hand out for money, for a 10-year plan to deal with a national emergency that has not even been nearly adequately dealt with over the last two years, with treatment facilities two years in a row closed just before the rainy season caused a spike in cholera infections. It is not a promising track record; rather a track record of broken promises.
With that in mind, thousands of people around the world have already signed a petition - initiated late last week by film director Oliver Stone - to keep up the pressure to accelerate this project and make sure that it actually happens. It's the least that the international community can do, after all of the suffering it has inflicted on Haiti in recent years as well as centuries: just clean up some of their own mess.