Opinion | A cholera outbreak compounds Haiti's agony – The Washington Post

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The world has turned its back on Haiti and the political and humanitarian crises there triggered by the still-unsolved assassination of President Jovenel Moïse in 2021. The poorest nation in the Western Hemisphere is also among the most vulnerable to a ghoul’s gallery of public health threats.
One health menace, cholera, has seized hold of Haiti over the past three months, sickening thousands and killing hundreds. Its resurgence occurred after three years in which not a single case had been reported in the island nation. Washington could do more to impede the spread of what is ordinarily a highly treatable sickness.
Heedlessness is self-defeating for the Biden administration, which has faced an unprecedented flood of illegal border crossers over the past year, including waves of Haitians. Now, cholera’s rapid advance might only deepen Haitians’ desperation to leave their country and make their way to the United States.
The spiraling crises in Haiti since Moïse’s killing in July 2021, including the country’s woeful humanitarian deterioration, should not be a surprise. The assassination left a vacuum of political legitimacy. A president lacking popular support, Ariel Henry, was installed with the backing of Washington and Haiti’s other international stakeholders. The government, already weak, became ineffectual. It has been impotent to combat violent criminal gangs, affiliated with Haitian commercial interests, that have seized control of key parts of the country, including an estimated 60 percent of the capital.
The quiet departure of nongovernmental aid organizations, including ones based in the United States, has compounded the country’s humanitarian emergency, leaving the poorest and sickest segments of the population without help. The results are mounting chaos and deteriorating public health in a country where nearly 90 percent of the 11.5 million people live on less than $7 a day, and 30 percent struggle on a daily income of barely more than $2. Nearly half of the population lives with what the United Nations regards as acute food insecurity, and some 20,000 more face famine. The gangs have shut down swaths of territory and facilities, including many of the nation’s schools, and played havoc with the transportation of basic goods.
In mid-September one of the most notorious gangs, known as G9, paralyzed the area around the main fuel terminal in Port-au-Prince, the capital. The blockade of the fuel terminal was the trigger to the cholera epidemic, according to international health authorities. With transport largely frozen, deliveries of potable water collapsed. Today the number of suspected cases — probably a fraction of the real total, given poor public health coverage and spotty reporting — is approaching 15,000; nearly 300 people have died, according to the World Health Organization. Cholera has now spread to every significant population center in the country.
The Biden administration’s efforts have been lacking. Starting in mid-October, the U.S. Agency for International Development deployed a disaster response team. Yet with just seven people on the ground in Haiti, its capabilities are inadequate. That team needs additional resources and personnel.President Biden has also failed to nominate an ambassador to Haiti, or even assign a senior-level diplomat to Port-au-Prince.
Cholera is a relatively easy disease to treat. Access to safe drinking water and sound sanitation, along with decent health care, has made it rare in most countries. Oral vaccines, were they widely available, would also be effective in controlling the outbreak in Haiti. Yet it was only in mid-December, two months after the government detected cholera’s outbreak, that oral vaccines arrived in the country. And the gang-propelled chaos that has seized so much of Haiti means it is unlikely those vaccines will be distributed much beyond the capital. Inevitably, more Haitians will die needlessly.
The need for an aggressive response to Haiti’s cholera outbreak is especially acute, given the lessons of recent history — more than 800,000 cases were reported in the country between 2010 and 2019, after the disease was introduced there by U.N. peacekeepers from Nepal. More than 9,000 people died in one of this century’s worst outbreaks of the disease.
That was a reminder of Haiti’s extreme susceptibility to cholera’s ravages — and also that the United Nations still bears the moral burden of upgrading Haiti’s manifestly inadequate water and sanitation infrastructure. The international community, especially the Biden administration and other wealthy neighbors, cannot in good conscience avert its eyes from a fresh outbreak.
Editorials represent the views of The Post as an institution, as determined through debate among members of the Editorial Board, based in the Opinions section and separate from the newsroom.
Members of the Editorial Board and areas of focus: Opinion Editor David Shipley; Deputy Opinion Editor Karen Tumulty; Associate Opinion Editor Stephen Stromberg (national politics and policy, legal affairs, energy, the environment, health care); Associate Editor Jonathan Capehart (national politics); Lee Hockstader (immigration; issues affecting Virginia and Maryland); David E. Hoffman (global public health); James Hohmann (domestic policy and electoral politics, including the White House, Congress and governors); Charles Lane (foreign affairs, national security, international economics); Heather Long (economics); Associate Editor Ruth Marcus; and Molly Roberts (technology and society).


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