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Denying Haiti Cholera Claims, Ban Says Recommendations Implemented

By Matthew Russell Lee

UNITED NATIONS, July 7 -- When UN Secretary General Ban Ki-moon belatedly responded on Friday to the May 30 letter from 19 members of the US Congress urging him to take responsibility for the UN introducing cholera into Haiti, he reiterated his finding that legal claims for those killed were “not receivable.”

  Based on the timing and lassitude, only Inner City Press which asked about the Congressional letter back on June 3, then on July 2 and July 5 and one other media went and got the letter and reported on it, at least in English.

  The UN's goal? To dump and bury the news or make heroes out of itself and Secretary General Ban Ki-moon, said to “Vow to Fight Cholera” and “Assure Help to Haiti.”

Inner City Press minutes after the letter was put on a counter in Ban's spokesperson's office scanned it and put it online here, and wrote about its implications again on Saturday, here.

  In the letter, Ban also claimed that of a study he committed, the majority of the recommendations have been implemented. This is not the case. From the report card:


The Haiti cholera outbreak highlights the risk of transmitting cholera during mobilization of population for emergency response. To prevent introduction of cholera into non-endemic countries, United Nations personnel and emergency responders traveling from cholera endemic areas should either receive a prophylactic dose of appropriate antibiotics before departure or be screened with a sensitive method to confirm absence of asymptomatic carriage of Vibrio cholerae, or both.

NOT IMPLEMENTED. UN guidelines [PDF] for medical screening of potential peacekeepers recommend to test stool samples only if the applicant exhibits symptoms (diarrhea). That the majority of cholera carriers are asymptomatic has been documented in the medical literature for decades. The cost of medical screening is borne by the troop-contributing nation. Thus, the cost to the UN for implementing this recommendation is virtually zero.


United Nations missions commonly operate in emergencies with concurrent cholera epidemics. All United Nations personnel and emergency responders traveling to emergencies should receive prophylactic antibiotics, be immunized against cholera with currently available oral vaccines, or both, in order to protect their own health and to protect the health of others.

NOT IMPLEMENTED. UN guidelines currently recommend prophylaxis and vaccination for several diseases. Cholera is not one of them. The UN would not bear any cost of implementing this recommendation. Doxycycline, an antibiotic used for malaria prophylaxis in areas where malaria causing Plasmodium species are chloroquine-resistant, can also be used as cholera prophylaxis. Eighty seven percent of peacekeepers are deployed to areas with malaria. Thus, for many troop contributing nations, the additional cost of cholera prophylaxis would be minimal


To prevent introduction of contamination into the local environment, United Nations installations worldwide should treat fecal waste using on-site systems that inactivate pathogens before disposal. These systems should be operated and maintained by trained, qualified United Nations staff or by local providers with adequate United Nations oversight.

NOT IMPLEMENTED. Most MINUSTAH black water containers hold 2,500L (660gal) of waste. Approximately 550mL (19oz) of household bleach (5.25% sodium hypochlorite) in a tank would raise the chlorine level to 12mg/L, enough to neutralize pathogens. Most bases have multiple tanks which are emptied weekly. For example, the Meye camp has 6 2,500L containers [PDF]. For the 780,000L (206,050gal) of black water produced yearly at the Meye camp, it would require only 156L (41gal) per year to implement this recommendation. Bleach costs pennies per liter. Storing and handling household bleach does not require additional training or infrastructure. Given that the 2012-2013 peacekeeping budget is US$ 7.33bn, implementing this recommendation would incur a relatively small cost to the UN. Implementing this recommendation would not only prevent another introduction of cholera but all other diseases present in the waste.

  There: the first three of seven recommendations have not been implemented; of the others, some are partial or have nothing to do with the UN. The review or report card of Ban Ki-moon is as it was in Iceland. Watch this site.

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