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CDC map quietly confirms the Haitian cholera epidemic started by UN peacekeepers (slate.com)
300 points by nkurz on Apr 15, 2016 | hide | past | web | favorite | 56 comments



I'd just like to point out that the CDC itself has published papers detailing the origins of the Haitian cholera strain: http://wwwnc.cdc.gov/eid/article/17/7/11-0059_article

As another example, Lee Katz, CDC's chief bioinformatician for the labs that study diseases like cholera (Who, full disclosure, used to work with my lab on Vibrio stuff): http://mbio.asm.org/content/4/4/e00398-13.short

There have been articles by other groups directly addressing the introduction of cholera by aid workers. The CDC also talks about this issue directly during conferences and presentations as an event that we need to learn from.


Well that seems to completely invalidate the article's premise. Thanks for this.

Now I just need somewhere else to direct my armchair rage...


Here's the actual quote from the CDC report linked above:

"Meille village hosted a MINUSTAH camp, which was set up just above a stream flowing into the Artibonite River. Newly incoming Nepalese soldiers arrived there on October 9, 12, and 16. The Haitian epidemiologists observed sanitary deficiencies, including a pipe discharging sewage from the camp into the river. Villagers used water from this stream for cooking and drinking.

On October 21, the epidemic was also investigated in several wards of Mirebalais. Inhabitants of Mirebalais drew water from the rivers because the water supply network was being repaired. Notably, prisoners drank water from the same river, downstream from Meille. No other cause was found for the 34 cases and 4 deaths reported in the prison.

On October 31, it was observed that sanitary deficiencies in the camp had been corrected. At the same time, daily incidence of cholera tended to decrease. Afterwards, incidence rose again to reach a second peak on November 10 "


I'm feeling Internet famous today, thanks! We had a ton of people on that study who contributed greatly, and I was happy to participate with a couple of follow up studies. I won't make any comments on the article because I don't want to be political (I'm a big stone-turner and not a politician if you know what I mean), but I like seeing an active conversation!


Yeah, a much more likely explanation is the one the CDC actually gave: That map was made with a specific purpose, and source tracing wasn't it.


Those papers are actually mentioned in the article.


Only the first linked article is mentioned, and the author blithely ignores the actual conclusions and misrepresents them... The author of this article pushes the narrative that CDC is hiding this information any chance he gets (presumably to sell his book).


FWIW, I work in Haiti, have numerous friends in the UN mission here, and they have long acknowledged this is true. Certainly Haitians know what happened. Talk radio is a big thing here and they've been talking about it forever.

I think the article is probably technically correct in terms of the highest levels of the CDC and UN being sensitive and slow-rolling the news...but I wouldn't say it's as pervasive a cover-up as the article implies.


I was surprised to even see the article posted because I didn't think there was a lot of doubt about this. I have no special knowledge of or interest in cholera, Haiti, or the UN, but I've known since around this time last year that the most recent outbreak was likely caused by UN peacekeepers improperly handling sewage. I stumbled upon this knowledge by... reading about it on Wikipedia. I wasn't even studying Haiti or the relief mission, I was just bored. If there was a cover-up going on, it was apparently the worst cover-up in history. Personally, I would bet on some knee-jerk untruths on top of a heaping pile of incompetence rather than a real organized hush job, based on having skimmed Wikipedia again to refresh my memory[0]. For instance, the relief mission initially denied responsibility because they have sanitation standards. I personally would have checked to make sure those standards weren't being ignored before I used them as an excuse so a reporter couldn't find out for me, which is exactly what happened (Note: MINUSTAH is the acronym for the UN relief mission, it makes sense in French):

>MINUSTAH officials issued a press statement denying the possibility that the base could have caused the epidemic, citing stringent sanitation standards. The next day, October 27, reporter Jonathan M. Katz of the Associated Press visited the base and found gross inconsistencies between the statement and the base's actual conditions.

Later, they took groundwater samples ("despite UN assertions that it was not concerned about a possible link between its soldiers and the disease") and announced they tested negative. Lying about test results definitely sounds like something you'd do during a cover-up, except apparently the tests weren't even done right:

>However, an AP investigation showed that the tests were improperly done at a laboratory in the Dominican Republic with no experience of testing for cholera.

I poked around the article that quote cites[1], which claims the tests were conducted at a regular hospital (with a surprisingly spiffy website: [2]) by an obesity specialist. Apparently you'd want those tests run somewhere more specialized because cholera is tricky and you get false negatives all the time. I'm not sure how available those facilities are, maybe there legitimately wasn't a better option, or maybe there was and somebody is just really bad at their job. If there was a deliberate, coordinated deception involved, I'd hope the conspirators would at least find a medical facility that would give their story more credibility.

Attributions to malice or incompetence aside, it's definitely clear that the relief mission and friends have not handled this event very well. There were some amounts of stupefying incompetence and bald corruption, and they should be held accountable regardless of what the proportions were. This extends beyond the current cholera situation, we could just as easily be talking about something like Cité Soleil, a large shantytown outside Port-au-Prince with a history of extreme poverty and armed conflict. That said, the other side of the story is that Haiti is an incredibly troubled country with a history of natural disasters, unstable government, and terrible epidemics. Any country would struggle with one of those, but Haiti wrestles with all of them at once. An earthquake wipes out infrastructure, which allows disease to spread unchecked, which hamstrings the economy, and so on. The relief mission is there because Haiti sorely needs it, even if it sucks and Haitians deserve a better one.

[0]: https://en.wikipedia.org/wiki/Haiti_cholera_outbreak

[1]: http://www.nbcnews.com/id/40280944/ns/health/t/un-worries-it...

[2]: http://www.cedimat.com/en/


It would be a tragedy if this cholera outbreak was the only cause of many poor people in Haiti. The UN have been killing people over there for many years:

http://www.democracynow.org/2005/7/11/eyewitnesses_describe_...

http://haitiaction.net/News/HIP/1_21_7/1_21_7.html


Bit of a major screw up there. If they'd been open about the source they probably could have fixed it. Even now googling Cholera prevention it mostly seems to be sorted by chlorinating the water supply and using bleach on cholera contaminated stuff - not rocket science and could probably be done without $2bn. When I'm 3rd world travelling I tend to figure if the tap water smells of chlorine you're ok.

Funny seeing the London map. My flat's on that. Thankfully we have less cholera these days. I remember being struck in Nepal about 20 years ago by seeing some guy crapping directly on the river bed of the main river in Kathmandu which was probably being used for water by villages downstream. Again some of this stuff is not rocket science.


It's been widely known that the UN peacekeepers originated the outbreak for years now. The issue isn't closed source data, it's the UN being organizationally incapable of holding people responsible for fuck ups.

EDIT: Recent example - http://www.nytimes.com/2016/03/20/opinion/sunday/i-love-the-...


So if you come to a bar with the flu and get me sick should I hold you responsible for fuck ups? Or maybe the bar? What if one of their workers is the one with the flu?

I'm not sure it's comparable, flu only kills 4x more people as cholera and honestly I'd personally like it if I could sue people for getting me sick by going out to public places when they know they are sick. (A friend of mine just gloated on twitter that he probably got 100 people sick by attending a meetup with the flu.)

That said, since most people don't seem to agree with me and just take it as normal that sicknesses get passed on with a ¯\_(ツ)_/¯ type attitude I guess I'm unsure how to hold the UN any more responsible.


> honestly I'd personally like it if I could sue people for getting me sick by going out to public places when they know they are sick

You definitely can do this. They'd need to have something more serious than the flu. Forcible quarantine for severe communicable diseases is a feature of US law.

> flu only kills 4x more people as cholera

How many people have the flu, vs how many having cholera?


He'd only need to sue for damages because they violated reasonable self-quarantine principles and put him and others at risk - not force the state to actually quarantine them.

And he could definitely sue. USA!


It's not like this was inevitable, had the UN peacekeepers simply setup adequate sanitation, they wouldn't have polluted and infected so many Haitians.


I had no idea UN was so bad. I've heard so many stories of their failures. But I didn't realize it was systemic. That makes a lot more sense now, understanding those stories in the context of a nepotistic bureaucratic mess.

Reminds me of modern universities where 75-90% of the expense is going to administrators instead of the core service (education). Which is a big reason why tuition keeps rising.


> it mostly seems to be sorted by chlorinating the water supply

Haiti is still in a poor state following the 2010 earthquake. Many communities do not have access to a reliable water supply. I have no idea about the costs, but it would no at all shock me to find it would cost $2 billion (or more) to get the entire population access to reliable water supplies that could be treated appropriately.

Not sure why the water access isn't getting more press given its direct relation to disease.


One jug of bleach per person would give everyone clean water for years. Even at $10 per jug that's only 100 million


Wow, you've really solved this!


A few Nigerian peacekeepers spread HIV in Cambodia which had been previously relatively free.


This is a huge concern, but it seems like a broader problem than Nigeria:

* Not much is known about the prevalence of HIV among peacekeepers, because the UN rejects mandatory testing.

* In 2000, a US Intelligence Council Report estimated an HIV prevalence rate of between 10 and 20% among the armed forces of the Ivory Coast and Nigeria, and an even higher prevalence of 40–60% among the militaries of the war-affected countries of Angola and the Democratic Republic of the Congo.

* Surveys of Dutch personnel suggest that 45% routinely had unprotected sex with sex workers in Cambodia during a tour there.

http://journals.lww.com/aidsonline/pages/articleviewer.aspx?...


That's pretty bad. Just testing a bit and leaving the HIV infected ones at home could fix things. That's a lot of Cambodians they are killing to save some embarrassment.


is the UN's decision motivated by the UN's embarrassment, though?

I assumed it was more about the UN's fear of major dropoff in volunteer rates from countries/orgs that would be embarrassed about their infection rates. After all, the UN only exists because of the participation of all the member countries. They are right to fear hurting participation rates...

I'm not defending the spread of HIV, just noting that it's a nuanced challenge.


One can only wonder what kind of peace the Dutch were keeping in the brothels.

I was joking once that people in the hellholes of this world have enough problems even without our help.

Now I am not sure it is a joke.


You know besides being the abstract concept of 'peace keepers' they are also just human beings.


But human beings should also know that having unprotected sex with a person you don't know is not particularly smart.


Each year all the sophomores at my high school take an 11-day wilderness trek in the Great Smokey Mountains. One of the many things we learn is not to shit near water. I probably remember this particularly well because when someone in my troupe fucked this up, we got an angry lecture from our guide.

I like to be gracious but I can't imagine how the UN fucked this up


The answer is easily.

UN troops are simply troops rented by the UN from member countries. They are no less or better trained nor less corrupt than their fellow soldiers back home who are not wearing blue helmets.

Renting troops to the UN is a racket that nets a lot of money. Countries have even been known to cheat the UN by pretending they have more troops or equipment deployed than is actually the case so they earn more.

Think of them as Pakistan, French, Australian or Nigerian etc. troops wearing blue helmets, they are nothing more than that.


>UN troops are simply troops rented by the UN from member countries. They are no less or better trained nor less corrupt than their fellow soldiers back home who are not wearing blue helmets.

At least in my country (Finland), the troops who volunteer to UN duty get specific training for it.

The training is not very long, but on the other hand, there is a selection process that means that by no means everyone theoretically eligible gets to go, so we can well argue that the troops in blue helmets are better trained (and much better paid) than the average conscript, and the process to select them also impacts who gets to go.


Agree. There is a huge difference between them.

I try to get them to tell any time I speak to any of thise veterans and what I hear is scary.

Example: one Danish officer had to go so far as to tell UN soldiers from another country that they would be shot if he took them for buying kids again.

Another story: painting endangered turtles UN blue and shoot at them just for fun. Can't say for sure who did but I have a hunch this one was Scandinavians.


In the book 'Shake Hands With the Devil', Lieutenant-General Roméo Dallaire (the head of the UN peace keeping mission in Rwanda) goes into this in great detail. Certain countries would dump their troops on the UN so that they wouldn't have to pay for their upkeep. Nice way to skip on the bill for your armed forces, and claim do-gooder status at the same time.


Aside from its own cholera epidemic, along with water, health, and disaster relief crises, in 2014 Nepal had a lower per capita GDP than Haiti.[0,1]

I appreciate the desire to make the UN a truly global effort, but maybe there should be some filter where peacekeepers only help at home or in countries worse off. Otherwise, we're not only raising the risk of incidents like this and other peacekeeper scandals, but also taking soldiers away from vulnerable populations at home that already need their help.

[0] http://www.tradingeconomics.com/nepal/gdp-per-capita

[1] http://www.tradingeconomics.com/haiti/gdp-per-capita


Countries like Nepal do peacekeeping because it effectively reduces their own military expenditure: http://m.dw.com/en/what-drives-south-asians-to-peacekeeping/...

PK is economically more attractive for a poor country with an oversized army than a rich country with a relatively small army.


There is also the Brigade of Gurkhas in the British Army which is composed of soldiers from Nepal:

https://en.wikipedia.org/wiki/Brigade_of_Gurkhas


> Countries like Nepal do peacekeeping because it effectively reduces their own military expenditure

Sure, but why would the rest of the world be interested in peacekeepers from incompetent countries who are being fobbed off on the UN to reduce military bills at home? Was Haiti better off after receiving these guys?


Is there any evidence that the deployment of the nepalese soldiers had any ill effects at home? That their absence handicapped responses to those crises?

On the other hand, deploying the nepalese soldiers equips them with practical experience (some of which might well have come in handy after the 2015 quake), and I assume they are fairly well paid on a UN mission too. Injecting some cash into Nepal is not a bad thing.


From the UN website it looks like poorer countries stand to make a (small) profit on deployment:

>Peacekeeping soldiers are paid by their own Governments according to their own national rank and salary scale. Countries volunteering uniformed personnel to peacekeeping operations are reimbursed by the UN at a standard rate, approved by the General Assembly, of a little over US$1,332 per soldier per month. http://www.un.org/en/peacekeeping/operations/financing.shtml


Obviously, salaries aren't the full cost of a military, especially not on deployment, but US$1332 is ~140k Nepalese rupees, which is 4x the national average salary.

http://www.salaryexplorer.com/salary-survey.php?loc=151&loct...

I would suspect this is fairly lucrative.


Unfortunately, the Nepalese soldiers didn't do shit (so to speak) in terms of the relief efforts after the quake. Source: Doctor I know who was doing relief work there at that time.

It was also in the Clinton emails that were released (Chelsea Clinton was there and writing to her parents) https://foia.state.gov/searchapp/DOCUMENTS/HRCEmail_August_W...

"Speaking of censuses, the UN also needs a census of itself and its materials in country - including of the peacekeeper bases outside Port Au Prince. For example, we drove by 2 bases on the way to Cange and there were collectively, I would estimate, more than a hundred trucks and buses just sitting between the two, as well as at least 800 Napali soldiers (according to locals) laying effectively fallow - and I don't think anyone expects an outbreak of violence on the Central Plateau in the near future so even if they and their colleagues are deployed under UN Charter Chapter 6, surely preserving the peace could be interpreted to work with the settlements? At the least, their hardware could be used more effectively in Port Au Prince."


> Is there any evidence that the deployment of the nepalese soldiers had any ill effects at home?

https://en.m.wikipedia.org/wiki/Opportunity_cost

Take their travel expenses and peacekeeping salaries and repurpose those as a practical domestic training program or foreign aid.

I only propose this as an alternative to the status quo, which apparently features useful practical lessons about sanitation, but only through trial and error in someone else's backyard.


I seem to remember that the countries providing peacekeepers are compensated for their efforts. Even if not, there must be some benefit or they wouldn't participate.

There could also be some benefit for these soldiers. It must be quite the learning experience for a Nepalese soldier to work in Haiti. I know there have been numerous problems with such deployments, but there's an upside to it even if it's hard to measure.


Things aren't that bad in Nepal on the whole. The low GDP is mostly because a lot of them are subsistence farmers and don't have much cash.


> Things aren't that bad in Nepal on the whole

> a lot of them are subsistence farmers

These statements directly contradict each other.


The interventions in Haiti post-earthquake are an embarrassment and a tragedy. The massive outpouring of money was largely sucked up by the salaries and comforts of the administration of parasitic NGOs, governments' main provision was armed troops, and imported food aid decimated local agriculture.

Here are years of too much detail:

http://cepr.net/blogs/haiti-relief-and-reconstruction-watch/

edit:

The group’s failures went beyond just infrastructure.

When a cholera epidemic raged through Haiti nine months after the quake, the biggest part of the Red Cross’ response — a plan to distribute soap and oral rehydration salts — was crippled by "internal issues that go unaddressed," wrote the director of the Haiti program in her May 2011 memo.

Throughout that year, cholera was a steady killer. By September 2011, when the death toll had surpassed 6,000, the project was still listed as “very behind schedule” according to another internal document.

The Red Cross said in a statement that its cholera response, including a vaccination campaign, has continued for years and helped millions of Haitians.

But while other groups also struggled early responding to cholera, some performed well.

“None of these people had to die. That’s what upsets me," said Paul Christian Namphy, a Haitian water and sanitation official who helped lead the effort to fight cholera. He says early failures by the Red Cross and other NGOs had a devastating impact. “These numbers should have been zero."

How the Red Cross Raised Half a Billion Dollars for Haiti ­and Built Six Homes

https://www.propublica.org/article/how-the-red-cross-raised-...


I can actually understand the impulse to keep this quiet. Lack of trust in Aid missions or Peace Keeping missions is already hurting a lot of people.


"Our great and noble intentions accidentally wiped out a bunch of people... but we swear we are the good guys!!!!"

I've seen hundreds of marketing types and executives prefer to chase their greed over recognizing the importance of accountability. Now, I'm witnessing altruistic types chase unfalsifiable humanist ideologies over recognizing the importance of accountability.

I can't tell if you assume the downtrodden are so stupid they'll accept any charlatan who spouts beautiful intentions no matter the actual cost or that the noble hearts are so special that they deserve freedom from consequence indefinitely. Without accountability, both conclusions are the foundation of atrocity.


These days, fucking up seems to be everything the UN peacekeepers are known for, though. The number of sexual assaults committed with impunity is staggering.

I don't recommend googling it, because some of it is so heinous beyond your wildest imagination.


Bad peacekeepers should be imprisoned. And a special place in hell is reserved for people who cover up abuse. That said, "what they're known for" may say more about the controversy-obsessed nature of media that anything. "Peacekeepers keep peace" will not sell, will it? And there are of course certain groups who would rather all authority be removed from the UN so they can operate freely.


> That said, "what they're known for" may say more about the controversy-obsessed nature of media that anything

Yeah, they're a lot like Blackwater that way.

Snark aside, I find it deeply fascinating just how broad a benefit of the doubt UN peacekeepers get, compared to anything that has to do with the US military, or, heaven forbid it, Blackwater. Especially considering that most of what we hear about those organisations is filtered through the very same "controversy-obsessed" media.


> I find it deeply fascinating just how broad a benefit of the doubt UN peacekeepers get, compared to anything that has to do with the US military

Yes, it's really hard to imagine why UN peacekeepers have a bigger benefit of the doubt than a foreigner invading troop. Very hard. \s


Indeed, but consider that these efforts have benefits that are hard to measure, mostly because there's no counterfactual control group. If UN peacekeepers have had their intended effect ('keeping the peace') just once how many lives did that save? How many rapes are avoided? It's unfortunate that we have no other worlds to experiment with and no news channels dedicated to non-events.


I'm not saying UN peacekeepers aren't good; I just don't think it helps their cause to sweep all their glaring disasters under the rug. If the goal is trust, then this strategy seems self-defeating. Better to have transparency and justice.


To be fair, what they are known for to you will depend mostly on what is reported by the media and what gets upvoted on social media sites.


..."started by" or "(was) started with"?

Regardless of origination locale, can we (HN) try to be more universal with our topics?


I had to laugh! It's Friday.




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