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Cholera outbreak in Haiti in 2010 tied to U.N. peacekeepers, report says

Lemaguel Alejuste grimaces in pain after fainting at the Samaritan's Purse cholera treatment facility in Cabaret. (Nikki Kahn/The Washington Post)

A group of scientists who investigated the source of a cholera epidemic in Haiti that killed thousands of people has concluded that U.N. peacekeepers from Nepal probably introduced the strain into the Haitian population.

In a report, the scientists concluded that the 2010 outbreak was not the result of “deliberate action” and was caused by a “confluence of factors.”

The findings marked a major retreat by the experts, who were part of an independent panel appointed by the United Nations and who had concluded just two years ago that incomplete evidence and the myriad factors in the epidemic’s spread — including inadequate water and sanitation infrastructure — made it impossible to assign responsibility for the introduction of the strain. Since then, the experts said, they have obtained new evidence, including microbiological samples.

“The exact source of introduction of cholera into Haiti will never be known with scientific certainty, as it is not possible to travel back in time to conduct the necessary investigations, and those on the ground at the time focused on outbreak response not source introduction,” the panel wrote in its new report. “However, the preponderance of the evidence and the weight of the circumstantial evidence does lead to the conclusion that personnel associated with the . . . MINUSTAH facility were the most likely source of introduction of cholera into Haiti.”

MINUSTAH is the acronym of the French translation for the U.N. Mission in Haiti.

Anderson Didier, 5, hugs his balloon while receiving treatment for cholera symptoms at the Samaritan’s Purse cholera treatment facility in Cabaret. (Nikki Kahn/The Washington Post)

The U.N. peacekeeping mission was established in 2004 to help bring security and stability to Haiti. In 2010, after a deadly earthquake, the United Nations expanded its presence in the Caribbean nation.

In trying to identify the introduction of the cholera strain, the U.N. panel’s new report tracks the arrival of a contingent of Nepalese peacekeepers from Kathmandu to a U.N. encampment in the village of Mirebalais in October 2010. Within days, hospitals in the region registered a dramatic increase in deaths from diarrhea and dehydration, signature symptoms of cholera. The illnesses marked the opening chapter in an epidemic that quickly spread across the country.

The report stated that the United Nations had constructed a “haphazard” system of pipes from the U.N. camps’ showers and toilets to six fiberglass tanks. The “black water waste,” which included human feces, was then transferred to an open, unfenced, septic pit, near where children and animals frequently roamed. The system presented “significant potential” for contamination, the report said.

The members of the U.N. panel — who no longer work for the world body — defended their initial findings, saying that the “majority of evidence” at the time of their first report was “circumstantial.”

The latest findings will increase pressure on the United Nations to acknowledge responsibility for introducing cholera into the country. U.N. Secretary General Ban Ki-moon and his top advisers had invoked the panel’s ambivalent 2010 findings in arguing that the United Nations bore no legal responsibility for the epidemic, although they said the organization was committed to lead international efforts to respond to the health crisis and improve the Haiti’s sanitation infrastructure.

The Boston-based Institute for Justice and Democracy in Haiti filed a compensation claim in November 2011 on behalf of the families of 5,000 victims, and it is preparing lawsuits against the United Nations in U.S. and Haitian courts on behalf of thousands more.

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