FROM THE ANTHOLOGY: The Best of 2014

The Poor and the Sick

What Cholera and Ebola Have in Common

A health worker checks the temperature of a woman entering Mali from Guinea at the border in Kouremale, October 2, 2014. Joe Penney / Courtesy Reuters

The two deadliest outbreaks of this century can be traced to one thing: poverty. Cholera exploded in the Haitian countryside in October 2010, infecting more than 600,000 people and killing 8,600. Ebola surfaced this March in Guinea and has since spread to Liberia and Sierra Leone. As of mid-October, more than 8,000 have been infected and 4,000 have died, almost exclusively in West Africa.

At first glance, the two outbreaks couldn’t be less similar. Cholera moves quickly but it is a nineteenth-century disease, easily thwarted by modern water treatment systems and health care. It ravaged Haiti, but it has not spread beyond the developing world. Ebola, on the other hand, moves slowly and is not as easily treated. Further, it has reached the United States, earning it near-obsessive attention in U.S. news. As Greg Gonsalves, co-director of the Yale Global Health Justice Partnership wrote this month in Quartz, “Exotic infections for Americans, often from far away places, often Africa, strike fear into their hearts, but only once the pathogens have cleared customs.” Ebola has cleared customs in a way Haitian cholera never has. 

But a look at the long list of casualties reveals what the two diseases have in common. The right to health comes with a cover charge, and much of the world -- especially those in struggling states such as Haiti, Liberia, and Sierra Leone -- can’t pay it. In Haiti, cholera found its ideal host. The poorest country in the Western Hemisphere, Haiti lacks any system of modern water treatment. In the fall of 2010, United Nations peacekeeping troops from Nepal imported cholera to Haiti. They were stationed at a military base in rural Haiti, where their sewage was dumped, untreated, into Haiti’s waterways. As Paul S. Keim, a geneticist who studied the Haitian and Nepalese cholera strains, told The New York Times, in 2012, “It was like throwing a lighted match into a gasoline-filled room.

Ebola arrived in similarly combustible terrain in West Africa. Violent conflicts in Liberia had left

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