Allison Shelley / Reuters Fifteen-year-old cholera patient Jonas Florvil lies on a cot in a nearly empty ward at a Samaritan's Purse cholera treatment center in the Cite Soleil neighborhood of Port-au-Prince, January 8, 2011. 

Peace and Pestilence

Lessons on Peacekeeping and Public Health from the Haitian Cholera Epidemic

For centuries, war and disease have gone hand in hand. Smallpox served as vanguard for the Spanish forces in their conquest of the Americas, and yellow fever and typhus finally turned the tide—in Haiti and Russia, respectively—against the strategic genius of Napoleon. In fact, it wasn’t until World War I that a major conflict saw more soldiers perish on the battlefield than from disease—yet those soldiers’ comrades played a key role in spreading the 1918 flu pandemic, which claimed far more lives worldwide than the war.

Not long after the United Nations was formed in the aftermath of World War II, the world came to the novel conclusion that soldiers could be used not to wage war but to promote peace, resulting in the creation of United Nations Peacekeeping. Although peacekeeping has changed the role of the soldier, however, it has not severed the connection between soldiers and the spread of disease. The Haitian cholera epidemic, which has resulted in more than 730,000 infections and 8,900 deaths since 2010, originated with UN peacekeepers. This tragedy serves as a warning, as yet largely unheeded, about preventing those sent to help vulnerable populations from becoming a vector for disease. 

An earthquake survivor looks at the rain in the early morning in a provisional camp in downtown Port-au-Prince, November 5, 2010.

An earthquake survivor looks at the rain in the early morning in a provisional camp in downtown Port-au-Prince, November 5, 2010. 

Until peacekeepers brought Vibrio cholerae to Haiti, the country had not recorded a case of cholera in at least a century. Conclusive scientific proof about the origins of the epidemic—Nepalese peacekeepers stationed at a base in Mirebalais, from which human waste was negligently allowed to enter the rivers that serve as the primary water source for tens of thousands of Haitians—has not spurred the United Nations to take effective action to end the epidemic, compensate the victims, or even simply admit responsibility. This is despite the fact that the risks of cholera transmission were well known, and that its introduction easily avoidable; effective screening of troops before deployment would have helped, as would have adhering to basic principles of sanitation on the base. 

Left with no other options, victims of the epidemic

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