Riots in the Time of Cholera

I reported three weeks ago on the nascent cholera threat in rural Haiti, apparently spread downstream from a toilet used by Nepalese peace-keepers which emptied into the Artibonite river without any treatment. Since that time the disease has spread to Port-au-Prince and, along the way, has thus far killed nearly 1,000 people. This is not going over well in Haiti, as you might imagine.

Protesters who hold U.N. soldiers from Nepal responsible for a deadly outbreak of cholera that has killed nearly 1,000 people barricaded Haiti's second-largest city on Monday, burning cars and stoning a peacekeeping base.

A case of cholera had never before been documented in Haiti before it broke out about three weeks ago. Transmitted by feces, the disease can be all but prevented if people have access to safe drinking water and regularly wash their hands.

President Rene Preval addressed the nation on Sunday to dispel myths and educate people on good sanitation and hygiene. But sanitary conditions don't exist in much of Haiti, and more than 14,600 people have been hospitalized as the disease has spread across the countryside and to nearly all the country's major population centers, including the capital, Port-au-Prince. Doctors Without Borders and other medical aid groups have expressed concern that the outbreak could eventually sicken hundreds of thousands of people.

The suspicions surround a Nepalese base located several hours south of Cap-Haitien on the Artibonite River system, where the outbreak started. The soldiers arrived there in October following outbreaks in their home country and about a week before Haiti's epidemic was discovered.

One of the most famous analyses of cholera was that by John Snow in London in the mid-nineteenth century, which helped establish the whole field of epidemiology. It is almost unthinkable that in the 21st century it could be spreading in Haiti seemingly without a concerted effort to stop its spread. Yet, that appears to be exactly what is happening.