Nina Lakhani : Cuban Medics in Haiti Put World to Shame

Cuban medic treats cholera victims in Haiti. Photo from AFP / Getty Images.
Cuban medics in Haiti:
Castro's doctors and nurses are
the backbone of the fight against cholera

By Nina Lakhani / The Independent / December 28, 2010

They are the real heroes of the Haitian earthquake disaster, the human catastrophe on America's doorstep which Barack Obama pledged a monumental U.S. humanitarian mission to alleviate. Except these heroes are from America's arch-enemy Cuba, whose doctors and nurses have put U.S. efforts to shame.

A medical brigade of 1,200 Cubans is operating all over earthquake-torn and cholera-infected Haiti, as part of Fidel Castro's international medical mission which has won the socialist state many friends, but little international recognition.

Observers of the Haiti earthquake could be forgiven for thinking international aid agencies were alone in tackling the devastation that killed 250,000 people and left nearly 1.5 million homeless.

In fact, Cuban healthcare workers have been in Haiti since 1998, so when the earthquake struck the 350-strong team jumped into action. And amid the fanfare and publicity surrounding the arrival of help from the U.S. and the UK, hundreds more Cuban doctors, nurses and therapists arrived with barely a mention.

Most countries were gone within two months, again leaving the Cubans and Médecins Sans Frontières as the principal healthcare providers for the impoverished Caribbean island.

Figures released last week show that Cuban medical personnel, working in 40 centers across Haiti, have treated more than 30,000 cholera patients since October. They are the largest foreign contingent, treating around 40 per cent of all cholera patients. Another batch of medics from the Cuban Henry Reeve Brigade, a disaster and emergency specialist team, arrived recently as it became clear that Haiti was struggling to cope with the epidemic that has already killed hundreds.

Since 1998, Cuba has trained 550 Haitian doctors for free at the Escuela Latinoamericana de Medicina en Cuba (Elam), one of the country's most radical medical ventures. Another 400 are currently being trained at the school, which offers free education -- including free books and a little spending money -- to anyone sufficiently qualified who cannot afford to study medicine in their own country.

John Kirk is a professor of Latin American studies at Dalhousie University in Canada who researches Cuba's international medical teams. He said: "Cuba's contribution in Haiti is like the world's greatest secret. They are barely mentioned, even though they are doing much of the heavy lifting."

This tradition can be traced back to 1960, when Cuba sent a handful of doctors to Chile, hit by a powerful earthquake, followed by a team of 50 to Algeria in 1963. This was four years after the revolution, which saw nearly half the country's 7,000 doctors voting with their feet and leaving for the U.S.

Jacklin Anore, 24, a cholera patient at the Cuban-run Nicolas Armand hospital in Arcahaie, north of Port-au-Prince. Photo from APF / Getty Images.
The traveling doctors have served as an extremely useful arm of the government's foreign and economic policy, winning them friends and favors across the globe. The best-known program is Operation Miracle, which began with ophthalmologists treating cataract sufferers in impoverished Venezuelan villages in exchange for oil. This initiative has restored the eyesight of 1.8 million people in 35 countries, including that of Mario Teran, the Bolivian sergeant who killed Che Guevara in 1967.

The Henry Reeve Brigade, rebuffed by the Americans after Hurricane Katrina, was the first team to arrive in Pakistan after the 2005 earthquake, and the last to leave six months later.

Cuba's constitution lays out an obligation to help the worst-off countries when possible, but international solidarity isn't the only reason, according to Professor Kirk. "It allows Cuban doctors, who are frightfully underpaid, to earn extra money abroad and learn about diseases and conditions they have only read about. It is also an obsession of Fidel's and it wins him votes in the UN."

A third of Cuba's 75,000 doctors, along with 10,000 other health workers, are currently working in 77 poor countries, including El Salvador, Mali and East Timor. This still leaves one doctor for every 220 people at home, one of the highest ratios in the world, compared with one for every 370 in England.

Wherever they are invited, Cubans implement their prevention-focused holistic model, visiting families at home, proactively monitoring maternal and child health. This has produced "stunning results" in parts of El Salvador, Honduras, and Guatemala, lowering infant and maternal mortality rates, reducing infectious diseases and leaving behind better trained local health workers, according to Professor Kirk's research.

Medical training in Cuba lasts six years -- a year longer than in the UK -- after which every graduate works as a family doctor for three years minimum. Working alongside a nurse, the family doctor looks after 150 to 200 families in the community in which they live.

This model has helped Cuba to achieve some of the world's most enviable health improvements, despite spending only $400 per person last year compared with $3,000 in the UK and $7,500 in the U.S., according to Organization for Economic Co-operation and Development figures.

Infant mortality rates, one of the most reliable measures of a nation's healthcare, are 4.8 per 1,000 live births -- comparable with Britain and lower than the US. Only 5 per cent of babies are born with a low birth weight, a crucial factor in long-term health, and maternal mortality is the lowest in Latin America, World Health Organization figures show.

Cuba's polyclinics, open 24 hours a day for emergencies and specialist care, are a step up from the family doctors. Each provides for 15,000 to 35,000 patients via a group of full-time consultants as well as visiting doctors, ensuring that most medical care is provided in the community.

Imti Choonara, a pediatrician from Derby, leads a delegation of international health professionals at annual workshops in Cuba's third city, Camaguey. "Healthcare in Cuba is phenomenal, and the key is the family doctor, who is much more proactive, and whose focus is on prevention... The irony is that Cubans came to the UK after the revolution to see how the NHS worked. They took back what they saw, refined it and developed it further; meanwhile we are moving towards the U.S. model," Professor Choonara said.

Politics, inevitably, penetrates many aspects of Cuban healthcare. Every year hospitals produce a list of drugs and equipment they have been unable to access because of the American embargo which prevents many U.S. companies from trading with Cuba, and persuades other countries to follow suit.

The 2009/10 report includes drugs for childhood cancers, HIV, and arthritis, some anaesthetics, as well as chemicals needed to diagnose infections and store organs. Pharmacies in Cuba are characterized by long queues and sparsely stacked shelves, though in part this is because they stock only generic brands.

A member of Cuba's medical brigade working in Haiti. Photo from Getty Images.
Antonio Fernandez, from the Ministry of Public Health, said: "We make 80 per cent of the drugs we use. The rest we import from China, former Soviet countries, Europe -- anyone who will sell to us -- but this makes it very expensive because of the distances."

On the whole, Cubans are immensely proud and supportive of their contribution in Haiti and other poor countries, delighted to be punching above their weight on the international scene. However, some people complain of longer waits to see their doctor because so many are working abroad. And, like all commodities in Cuba, medicines are available on the black market for those willing to risk large fines if caught buying or selling.

International travel is beyond the reach of most Cubans, but qualified nurses and doctors are among those forbidden from leaving the country for five years after graduation, unless as part of an official medical team.

Like everyone else, health professionals earn paltry salaries of around $20 a month. So, contrary to official accounts, bribery exists in the hospital system, which means some doctors, and even hospitals, are off-limits unless patients can offer a little something, maybe lunch or a few pesos, for preferential treatment.

Cuba's international ventures in healthcare are becoming increasingly strategic. Last month, officials held talks with Brazil about developing Haiti's public health system, which Brazil and Venezuela have both agreed to help finance.

Medical training is another example. There are currently 8,281 students from more than 30 countries enrolled at Elam, which last month celebrated its 11th anniversary. The government hopes to inculcate a sense of social responsibly into the students in the hope that they will work within their own poor communities for at least five years.

Damien Joel Suarez, 27, a second year student from New Jersey, is one of 171 American students; 47 have already graduated. He dismisses allegations that Elam is part of the Cuban propaganda machine. "Of course, Che is a hero here but he isn't forced down your neck."

Another 49,000 students are enrolled in El Nuevo Programa de Formacion de Medicos Latinoamericanos, the brainchild of Fidel Castro and Hugo Chavez, who pledged in 2005 to train 100,000 doctors for the continent. The course is much more hands-on, and critics question the quality of the training.

Professor Kirk disagrees: "The hi-tech approach to health needed in London and Toronto is irrelevant for millions of people in the Third World who are living in poverty. It is easy to stand on the sidelines and criticize the quality, but if you were living somewhere with no doctors, then you'd be happy to get anyone."

There are nine million Haitians who would probably agree.

[This article was first published in the British daily, The Independent.]

Thanks to Jeffrey Segal / The Rag Blog

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Ansel Herz : Behind the Barricades in Haiti

Coffins used as street barricades in Cap-Haiten, Haiti. Photo by Ansel Herz / Mediahacker / The Rag Blog.
Streets barricaded in Cap-Haitien:
Protests in Haiti have popular support

By Ansel Herz / November 19, 2010

CAP-HAITIEN, Haiti -- The first barricade looked harmless enough. Foot-long rocks piled next to each other in a line.

But as the bus driver slowed down, flying rocks landed in the street -- thrown by youths crouching in the bushes up the hill.

“We don’t really have a country! The police don’t do anything!” a nun sitting across from me complained after the bus driver negotiated, with a little cash, our way past.

The man next to her said the country will always be mired in problems until a leader like Hugo Chavez or Fidel Castro takes power.

We must have passed a dozen more barricades, most unmanned.

After Limbe, where cholera has killed at least 100 people, we came to the biggest “barikad” yet in the highway. Thick trees lay across the road and hundreds of people, a few holding machetes, blocked the way.

The bus driver once again descended to negotiate, but didn’t appear to be making any progress. Most passengers grabbed their belongings and got out.

I decided to go too. As I gathered my things, there was a debate among the remaining passengers:

“He’s a blan (foreigner), he’s going to get hurt.”

“No no no, he speaks Creole, he’ll be fine.”

“They’re going to think he’s MINUSTAH. They’re not logical.”

MINUSTAH is the acronym for the UN peacekeeping mission. As I stepped off the bus, people standing at the road called me over and urged me not to go. It was the third day of so-called “cholera riots” against foreign troops blamed for introducing the disease into the country.

Someone said the protesters are violent “chimere,” a word for political gangs. I explained that it’s my job as a journalist to go talk to them.

Then two Haitian journalists who were on the bus pushed their way through the crowd and wrapped their arms around me. Everyone agreed, finally, that together with the two guys I could get through the barricades.

Elizer and Duval were coming back home to Cap-Haitien. They were scared for me, saying under no circumstances should I talk with protesters or take photos. I reluctantly agreed to follow their instructions.

I wondered if perhaps the UN peacekeeping mission was right in saying these protests were organized by a politician or gang. “Enemies of stability and democracy,” MINUSTAH mission head Edmond Mulet called them. So far, I’d only seen young men in the street.

But as we passed through each barricade, everyone -- young girls and rotund market women mingling with demonstrators -- yelled out, “MINUSTAH ou ye?”

I yelled back, “Non, mwen se yon journalis Amerikan.” The suspicious stares softened into smiles and understanding looks. After passing the third barricade that way, we started laughing.

One teenager who threw a rock at us as we approached on motorcycle said, “pa gen pwoblem” -- no problem -- after I held out my press badge.

As we arrived on the outskirts of Cap-Haitien proper, the streets were deserted except for people gathered around barricades. One was still flaming. At another, dozens of men milled around a burnt out car.

“Press! Press!” I called out, and they beckoned me through the crowd, many hands pushing me forward until I was through.

I was glad when an elderly man walking in the street stopped me. I finally had a chance to do an interview, against the advice of my companions. I whipped out my audio recorder. He was Amos Ordena, the local section’s elected Kazek -- an official dispute mediator.

“The population has information that MINUSTAH introduced cholera,” he told me. “So many people have died. They’re obligated to hold fast, to demonstrate, so that the authorities will take responsibility. They’re asking MINUSTAH to leave the country.”

Haitian street demonstrators want the UN's MINUSTUH troops to leave. Photo by Ansel Herz / Mediahacker / The Rag Blog.
Asked if the protests are by a single group or the general population, he said all elements of society are participating in “the movement.” He said MINUSTAH are not firing weapons in self-defense, in the air to disperse protesters, but firing at people. He heard that at least one person had died earlier in the day.

We finally turned off the main road and walked into an alleyway. Elizer’s modest home was at the end (he lost his wife, children, and house in the capital in the earthquake). One of his brothers, blind and handicapped, lay on the floor beneath a television showing a soccer match. He smiled and introduced himself when I walked in.

Elizer reminded me to use hand sanitizer. Then his frail mother, beaming at us, served us fresh mais moule (corn) and papaya juice.

A neighbor of Elizer called up TV reporter Johnny Joseph, who came to meet me and help me get to the house where I was planning to stay. Elizer refused to accept any money for all his trouble.

Before leaving with Johnny, I spoke to Aristil Frito, a 24-year-old student standing outside talking with his neighbors. “The objective of the movement is clear: they’re asking for the departure of MINUSTAH.”

He said irresponsibility by the leaders of the country had led to this situation. In a more developed country, without so many young unemployed people in the street, the protests might have been more peaceful, he said.

“But the real solution is for people to live in a climate of peace, in dialogue. Today all Haitians should work together finish with hunger and poverty,” he said. “The best solution is the promotion of social dialogue.”

Johnny and I hopped on a motorcycle taxi, taking backstreets to bypass the barricades. We passed a five-foot deep trench dug in a narrow dirt road. Johnny said a MINUSTAH vehicle fell into the trench Wednesday and people threw bottles at them. The troops opened fire, killing an innocent bystander whose body was taken downtown, he said.

MINUSTAH blamed the death on local gangs.

At one junction, a young man in a purple shirt and black cap blocked our path and stuck out a knife as his friends looked on. I realized my press badge was tucked into my shirt. I pulled it out as Johnny talked the man down.

“You need to have your badge out,” the young man told me, glaring. “It’s a principle.” That’s been the only instance of serious hostility directed at me since I arrived in Cap Haitien.

So it’s bewildering to read the reporting of CNN’s Ivan Watson, who claimed that armed rioters control the city. He told viewers while being filmed on the back of a fast-moving motorcycle that it’s only way to move about the city amidst “violent protests.”

He doesn’t use that adjective to describe the actions of UN troops, accused of killing at least three demonstrators since Monday.

“They shot many people. We took them to the hospital. We’re asking MINUSTAH to leave the country,” a middle-aged man who declined to give his name told me.

He stopped bicycling past an intersection barricaded with coffins to stop and share his anger. “We have bottles, we don’t have guns to shoot them, but they’re shooting us. We have to defend our rights, MINUSTAH is a thing that doesn’t work in this country.”

Another of Watson’s reports claimed that Christian missionaries were forced to speed on a bus away from out-of-control-mobs, like in a Hollywood-style chase scene.

High drama = high ratings.

As I walked towards the downtown’s central public square on Wednesday, finally nearing the house, I saw several dozen people facing Haitian police in full riot gear standing in their way.

They said they had no beef with foreigners generally -- only MINUSTAH.

Theodore Joel said they respected the Haitian police, because they’re brothers and family -- though two police stations were reportedly set on fire during the first day of protests.

“Those soldiers are tourists! The money that’s invested in MINUSTAH -- they could invest that money in education. They could invest in constructing hospitals, in cleaning up the country. but they’re paying those soldiers instead. We don’t have guns like in 1803... but each time we put our heads together, we’re marked in history.”

Thursday marked 203 years since the Battle of Vertières, where Jean-Jacques Dessalines led the final major assault on French armies to drive them off Haitian soil. They renamed the city: from Cap Francois to Cap-Haitien.

While many expected demonstrations to continue in commemoration of Haiti’s independence struggle, the streets were quiet. No further confrontations were reported. I walked around downtown Cap on my own, trying to find an Internet connection to send out a radio story.

I’m asking everyone I meet here -- from local journalists, vendors, men at the barricades, to a local magistrate -- if these protests were organized by a gang or political group.

The unanimous answer is no -- people are fed up with UN peacekeepers and the cholera outbreak is the straw that broke the camel’s back. The magistrate said he understands and respects the people demonstrating, but he wishes the barricades weren’t impeding the transportation of medical supplies to fight cholera in his commune, where people are dying in the street.

As the head of MINUSTAH warned that “every second lost” because of protests means more suffering and death from cholera, the anti-UN demonstrations continued in Port-au-Prince on Thursday.

CNN’s Watson led his report this way: “Like cholera itself, Haiti’s protests against the United Nations spread Thursday to the capital, Port-au-Prince, as angry people took to the streets demanding the global body get out of their country.”

Seems that for Watson, these protests are like a disease. It continues: “a planned protest began peacefully in the center of the city but turned violent as it moved toward the presidential palace, with one woman overcome by tear gas, witnesses said.”

Again, the protesters are the ones implicated in the violence. But a timeline report released by International Action Ties, an independent human rights monitoring group, said the demonstrations were largely peaceful after returning to Champs de Mars plaza.

UN troops and Haitian police fired at least 30 tear gas canisters into the Faculty of Ethnologie and surrounding tent camps, the report said, sending children and old women fleeing into the streets. Police ignored the group’s pleas to stop firing.

Are protests against the UN meant to destabilize the country? Are Haitians who’ve taken to the streets being used, like puppets, by powerful politicians for their own ends? Are the protests violent?

The foreigners I’ve talked to say yes. A few American liberals living in Haiti tell me they fear the protests are violent and meant to cause chaos, echoing the statements of MINUSTAH and reporters like Watson. Some Haitians in the professional middle class don’t want to participate.

But most Haitians I’ve spoken with say no. They say this is the inevitable outcome when troops who operate in Haiti with seeming impunity may have introduced a deadly, misery-multiplying disease into the country. It’s an angry, popular movement -- protesting however they can, emotions running high -- against a five-year-old foreign occupation.

What do you think? We’ll see how this plays out in the next nine days, ahead of the Nov. 28 election. Stay tuned.

[Ansel Herz, a former Austin activist, is a multimedia journalist and web designer based in Port-Au-Prince, Haiti. This article first appeared on Ansel's blog, Mediahacker.]

Source / Mediahacker

• Listen to Ansel Herz speaking about the protests on Democracy Now! and Flashpoints Radio.
• Read Landon Yarrington’s account of how the protests began, which the magistrate disputes.
• See more pictures from the Cap Haitien anti-MINUSTAH movement series on Mediahacker's photostream on Flicker
• And see Ansel Herz's earlier posts from Haiti on The Rag Blog.

Video posted by Pierre Durohito De Venchy of the first three days of protests:



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Ansel Herz : Cholera Spreads in Haiti

Above, MINUSTAH soldier points his gun at former Austin activist/independent journalist Ansel Herz in Port-au-Prince, Haiti, on October 15, 2010, at a demonstration against the renewal of MINUSTAH, the UN peackeeping mission. Photo from Gaentantguevara / Flickr.

For more about photo see sidebar story below.

Port-au-Prince fears the worst
as cholera spreads in Haiti

By Ansel Herz / The Rag Blog / October 24, 2010

PORT-AU-PRINCE -- Days after an outbreak of cholera began in Haiti’s rural Artibonite region [see story below], killing at least 200 people, there are now five confirmed cases of cholera in the busy capital city.

The cases “do not represent spread of the epidemic” because they originated in central Haiti, according to a bulletin circulated by Haiti’s UN peacekeeping mission with the heading “Key Messaging,” obtained by IPS.

“The fact that these cases were picked up and responded to so fast demonstrates that the reporting systems for epidemic management we have put in place are functioning,” it concludes.

Residents of the capital city are not so confident. “It’s killing people -- of course, I’m scared. We’re in the mouth of death,” 25-year-old Boudou Lunis, one of 1.3 million made homeless by the quake living in temporary settlements, told the Miami Herald.

Radio Boukman lies at the heart of Cite Soleil, an impoverished slum crisscrossed by foul trash-filled canals where cholera could be devastating. The station has received no public health messages for broadcast from authorities, producer Edwine Adrien told IPS on Saturday, four days after reports of cholera-related deaths first emerged.

At a small, desolate camp of torn tents nearby, a gleaming water tank is propped up on bricks. Camp-dwellers said it was installed by the International Organization for Migration last week, more than nine months after the January earthquake damaged their homes.

But it’s empty because no organization has filled it with water. “We need treated water to drink,” a young man named Charlot told IPS matter-of-factly.

Cholera, transmissible by contaminated water and food, could be reaching far beyond the capital city. There are suspected cases of the disease in Haiti’s North and South departments, according to the Pan-American Health Organization, as well as confirmed cases in Gonaives, the country’s third largest city.

In Lafiteau, a 30-minute drive from Port-au-Prince, Dr. Pierre Duval said he had stabilized two cholera-infected men in the town’s single hospital, but could not handle more than six more patients. One died yesterday. All of them came from St. Marc, near the epicenter of the epidemic.

The main hospital in St. Marc is crowded with the infected. Supplies of oral rehydration salts were spotty when he arrived Friday after rushing from Port-au-Prince, American medic Riaan Roberts told IPS.

“We first talked to some lady from the UN who told us, ‘Oh I have to go to a meeting, I’ll mention your names, but just come back tomorrow,’” he said. “These microcosms of operational logistics are just beyond them.”

Roberts said a Doctors Without Borders team quickly put his skills to use, adding, “[The UN] is so top-heavy with bureaucracy that they can’t effectively react to these small outbreaks which quickly snowball and spread across an area.”

Buses and tap-taps filled with people speed in both directions on the dusty highway connecting the Haiti’s stricken central region to Port-au-Prince. There are no signs of travel restrictions or checkpoints near the city.

At a Friday meeting convened by the Haitian government’s Ministry of Water and Sanitation, “there were conversations around shutting down schools and transportation routes,” said Nick Preneta, Deputy Director of SOIL, a group that installs composting toilets in displacement camps.

“But if that’s the conversation now, however many hours after the first confirmed case, it’s already too late,” he continued. “One of the recommendations was to concentrate public health education at traffic centers... there were a lot of no-brainers at the meeting.”

Cholera bacteria can cause fatal diarrhea and vomiting after incubating for up to five days, allowing people who appear healthy to travel and infect others. The medical organization Partners In Health calls it “a disease of poverty” caused by lack of access to clean water.

The Artibonite river, running through an area of central Haiti known as “the breadbasket” for its rice farmers, is considered the likely source of the epidemic after recent heavy rains and flooding. Analysts say the regional agrarian economy has been devastated by years of cheap American imports of rice to Haiti.

Be sure to check the Haiti Documents Index for the latest internal reports, (mostly) free of spin, from officials.

[Ansel Herz, a former Austin activist, is a multimedia journalist and web designer based in Port-Au-Prince, Haiti. This article also appears on Ansel's blog, Mediahacker, and was distributed by IPS.]

Relatives of Haitians struck by cholera, outside a local hospital in Saint Marc, Haiti, October 22, 2010. St-Felix Evens / Reuters.

Health workers scramble to keep
cholera out of crowded camps

Some 1.3 million people have lived in makeshift camps throughout Port-au-Prince since the January earthquake devastated the city. Living conditions are "appalling," according a recent report by Refugees International.

But one bright spot of the multi-billion-dollar relief effort, touted by the United Nations and Haitian President Rene Preval, has been the prevention of the spread of a highly infectious, catastrophic disease.

Until now.

At least 160 people have died this week [the number has now passed 200] from an outbreak of cholera in the central Artibonite region, according to Zanmi Lasante, the Haitian arm of renowned health organization Partners in Health.

The fear now is that the disease will reach Port-au-Prince [see story above] and wreak havoc in the crowded camps by contaminating the water.

There are already six suspected cases of the illness in the capital city, Monica Ferreira, a Portuguese medic, told IPS on Friday. Her team has operated a health clinic for quake victims since January.

"All defensive countermeasures should immediately focus on Cite Soleil and Lafiteau if they want to save Port-au- Prince," said Dr. James Wilson of the Haiti Epidemic Advisory System (HEAS).

A HEAS partner reported that a market woman and child died from cholera in the small town of Lafiteau, just 25 kilometres from the capital.

Melinda Miles, director of the Haitian organization KONPAY, told IPS she witnessed a man die of cholera Friday afternoon at the Hospital Centre of the Haitian Academy in Lafiteau. Doctors at the hospital could not be reached for comment before publication.

"We went into the room and he died right in front of us," she said. "He came from St. Marc. The doctor said there are a lot more patients on their way with cholera."

"If a case from St. Marc has had time to arrive in Lafiteau, then it's had time to arrive in Port-au-Prince. So I'm really scared," she added.

The Haitian government says the disease is cholera, a waterborne bacterium that can incubate in bodies for days and suddenly cause death by dehydration. Officials from the Pan American Health Organization, the regional arm of the Geneva-based World Health Organization, said Friday that laboratory tests had confirmed the outbreak.

Authorities have rushed medical resources to St. Marc, about 70 kilometers north of Port-au-Prince, where a single hospital is overcrowded with patients. Villagers who traveled from far away are lying on the floors, hooked up to IV drips, while lines amass outside the gate.

Attempting to cope with the overwhelming patient load, a Doctors Without Borders team has moved from the hospital to construct their own treatment center, spokesperson Petra Becker told IPS.

Other medical teams are gathering information from rural villages to isolate areas where the illness is concentrated and discourage people from moving, she said.

In a blog post on Partners in Health's website, Chief Medical Officer Joia Mukherjee called cholera "a disease of poverty". She wrote that loans from the Inter-American Development Bank meant for the development of a public water supply in the Artibonite region were blocked on political grounds during the tenure of President Jean-Bertrand Aristide.

"The international community's failure to assist the government of Haiti in developing a safe water supply has been violation of this basic right," Muhkerjee continued.

If the disease reaches Port-au-Prince, the number of victims is likely to skyrocket.

The New York Times reported Friday that cholera cases are surfacing on the island of La Gonave, as well as the areas of Arcahaie and Croix-des Bouquets closer to the capital.

The United Nations and Haitian government are holding emergency meetings in Port-au-Prince to counter the cholera outbreak. Daily truckloads of water delivered by relief group Pure Water for the World to the seaside slum of Cite Soleil have received double the usual chlorination, said Noelle Thabault, the group's deputy director.

Nesly Louissaint, who lives in Camp Carradeux, an officially recognized camp for thousands of quake victims, received a short text message on his cell phone alerting him to the outbreak of the disease. But no authorities have visited the camp with further information, he said.

It's not clear what prevention measures have been taken in the capital city. Traffic, schools, businesses and markets were open Friday and the streets appeared to be bustling as usual.

"I have not seen any general information distributed in the streets or camps at this time. I don't see relief groups out here," Mark Snyder, a development worker with International Action Ties, told IPS.

"I do see U.N. peacekeeping trucks full of troops, but they are not being utilized to spread information," he continued. "They're doing security patrols, which seems like a waste of resources."

Earlier this week, at least 12 people died when heavy rains flooded some of Port-au-Prince’s displacement camps. Dr. Wilson warns that October is the peak of Haiti's rainy season, making any further outbreak of the disease more difficult to contain.

-- Ansel Herz / Oct. 22, 2010

MINUSTAH peacekeeper guards food in Haiti, January 17. Photo by Win McNamee / Getty Images.

UN peacekeeper to photographer:
'Shoot me and I'll shoot you'

By Mac McClelland / October 21, 2010

SEE PHOTO AT TOP OF POST

When I showed this amazing picture [at top of post] to my friend, after she registered what she was looking at, her eyes went huge while she exclaimed, "Oh my god!" with her hand over her mouth.

The scene is a protest last week in Port-au-Prince. The guy on the left is a clearly unarmed and videotaping journalist from Texas named Ansel Herz, whom I happened to work with when I was in Haiti last month. The uniformed fellow pointing a gun directly at his face is a United Nations peacekeeper.

I didn't meet many (okay, any) Haitian fans of MINUSTAH, the UN stabilization force that's been in the country since 2004. I have, for the record, met some MINUSTAH who are definitely good guys and have, for example, helped a woman in labor get to the hospital, and helped stop a man who was trying to kill his wife for refusing to have sex with him.

But the force has also shot civilians. It's had to have meetings about how not to sexually abuse the Haitian population. In fact, last week's protest erupted after the UN officially renewed MINUSTAH's mandate.

Some of the protesters' complaints, which echo those I heard while in-country, are that MINUSTAH doesn't actually do anything to protect civilians living in filthy, violent, rape-infested displacement camps, and that the money could be better spent dealing with those issues.

I asked Ansel how he ended up on the business end of a UN gun, just in case there was any kind of conflict or missing context surrounding this photo. Not so much, he says: "Maybe they felt threatened by my camera."

--Mac McClelland / Mother Jones

Also see:

• Citizen Protests, Government Repression Mount in Haiti by Beverly Bell / Oct. 18, 2010 / CommonDreams.
• Previous posts from Haiti by Ansel Herz on The Rag Blog.

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