Carelessness is self-defeating for the Biden administration, which has faced unprecedented influxes of illegal border crossers over the past year, including waves of Haitians. Now, the rapid spread of cholera may only deepen the desperation of Haitians leaving their country for the United States.
The escalating crisis in Haiti since Moise’s killing in July 2021, including the severe deterioration of the humanitarian situation in the country, is not surprising. The assassination left a vacuum of political legitimacy. President Ariel Henry, who lacked popular support, took office with the support of Washington and other Haitian international stakeholders. An already weak government has become impotent. It has been unable to crack down on violent criminal gangs linked to Haitian business interests that control key areas of the country, including an estimated 60 percent of the capital.
The quiet withdrawal of non-governmental aid organizations, including those based in the United States, has exacerbated the humanitarian emergency in the country, leaving the poorest and sickest segments of the population without help. The result has been increased chaos and worsened public health in a country of 11.5 million people, nearly 90 percent of whom live on less than $7 a day and 30 percent on just over $2 a day. Nearly half of the population lives in what the United Nations considers severe food insecurity, and about 20,000 people face starvation. The gangs closed large swaths of territory and facilities, including many schools across the country, and severely disrupted the movement of essential supplies.
In mid-September, one of the most notorious gangs, the G9, paralyzed the area around the main fuel terminal in the capital, Port-au-Prince. According to international health authorities, the blockade of fuel terminals was the trigger for the cholera outbreak. Drinking water supplies collapsed as transport essentially froze. Today, the number of suspected cases—likely a fraction of the actual total because of low public health coverage and mixed reporting—is closer to 15,000; nearly 300 people have died, according to the World Health Organization. Cholera has now spread to every major population center in the country.
The Biden administration’s efforts have fallen short. Beginning in mid-October, USAID deployed a disaster response team. However, Haiti’s local capacity is insufficient with only seven people. The team requires additional resources and personnel. President Biden also failed to nominate an ambassador to Haiti, or even send a top diplomat to Port-au-Prince.
Cholera is a relatively easy disease to treat. Access to safe drinking water and good sanitation, as well as decent healthcare, is rare in most countries. An oral vaccine, if widely available, could also be effective in controlling the outbreak in Haiti. However, the oral vaccine did not arrive in the country until mid-December, two months after the government detected the cholera outbreak. Gang-driven chaos in much of Haiti means the vaccines are unlikely to be distributed outside the capital. Inevitably, more Haitians will die needlessly.
The need for an aggressive response to the cholera outbreak in Haiti is all the more urgent given the lessons of recent history—more than 800,000 cases were reported in the country between 2010 and 2019, when the disease was imported from Nepal by UN peacekeepers of. More than 9,000 people died in one of the worst outbreaks of the century.
It was a reminder of Haiti’s extreme vulnerability to cholera – and a reminder that the United Nations still has a moral responsibility to upgrade Haiti’s glaringly inadequate water supply and sanitation infrastructure. The international community, especially the Biden administration and other wealthy neighbors, cannot in good conscience take their eyes off the new outbreak.
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