A speedy official response in containing the outbreak is seen as a relative success. But with elections only a month away and the public already fatigued by a lack of relief 10 months after January's earthquake, the cholera outbreak comes at a sensitive time. In addition to political ramifications, it has raised concern about how quickly disease can spread in Haiti, where many communities have long lacked access to potable water in part because the US itself has blocked loans for crucial water projects.
Haitian President René Préval on Saturday voiced concern about contagion at polling stations, raising the possibility that the Nov. 28 election would be delayed. Even if the vote happens as scheduled, observers say some might stay home out of fear.
Haitians are unlikely to hold Mr. Préval responsible for the outbreak, but it will stretch patience with the UN mission, he adds. For many Haitians, life has changed little since the earthquake destroyed 300,000 buildings and left millions homeless. At tent cities around the capital, sanitation is poor, illnesses such as diarrhea are common, and frustration is high with the lack of relief.
"Patience is wearing thin with the UN. It's a very fragile environment," says Professor Carey.
'Situation is stabilizing'
More than 250 people have been killed and 3,000 infected by the bacteria since last week, but the rate of increase has slowed. Only six deaths were reported in the last 24 hours, according to Reuters, after dozens of deaths daily.
"The number of deaths registered has significantly diminished, the number of people being hospitalized has also diminished," Gabriel Thimote, director general of Haiti's Health Department, said at a news conference Sunday in Port-au-Prince.
"We think that the situation is stabilizing," he said. "That doesn't necessarily mean we have reached a peak."
Five people diagnosed with cholera in the countryside were discovered in Port-au-Prince on Saturday, but they were quickly contained and the disease has not spread in the capital.
Jason Erb, deputy country director for the International Medical Corps, told CNN that the outbreak could be kept out of the capital. "I think we'll be able to contain it fairly well, but it is a risk, it is a major risk," he was as quoted saying today.
Agencies were prepared
Aid workers and officials have feared an earthquake or hurricane might hit or disease might emanate from the sprawling tent camps. Cholera, not seen in Haiti in more than a century, was the last thing expected, although aid workers were prepared nevertheless. Antibiotics, dehydration salts, and other supplies were on hand to send in to the affected areas.
The United States declared Haiti’s cholera outbreak a disaster on Sunday, opening the way for emergency funding. The US Office of Foreign Disaster Assistance has donated 1,000 special cholera beds and an initial $100,000 in emergency support to the Haitian Ministry of Health. The US also dispatched a joint Haitian-US epidemiological team to Saint Marc, the Haitian city at the center of the cholera outbreak.
Highlights water system
While the US government was quick to release aid, some observers fault the US for in the past blocking funds to improve Haiti's water systems. In 2001, in response to the policies of then-President Jean-Bertrand Aristide, the US blocked the Inter-American Development Bank from loaning $54 million to assist Haiti's public-water system.
The report "Wòch nan Soley: The Denial of the Right to Water in Haiti," found that "the United States actively impeded the Haitian government’s capacity to fulfill Haitians' human right to water through its actions, thus breaching its duty to respect human rights."
Margaret Satterthwaite, an associate professor of clinical law at New York University School of Law, who authored the report with Dr. Paul Farmer and several others, says that the money's delay hindered progress, though some of it eventually did go toward improving the water system in Saint Marc.
The incident underscores the international community's failure to put first the interests of Haitians and preference for working with NGOs instead of the Haitian government, says Professor Satterthwaite.
"It’s unacceptable to hold hostage people’s access to water. It has dramatic impact on people’s health and livelihood," she says.