Abstract
ABSTRACT In 2010 following a catastrophic earthquake, Haiti saw the beginning of what would become the world’s largest cholera epidemic. Nepalese United Nations peacekeepers were later implicated as the source of cholera. Our research examines Haitian community beliefs and perceptions, six-and-a-half years after the outbreak began, regarding the origin of Haiti’s cholera outbreak. A narrative capture tool was used to record micronarratives of Haitian participants surrounding ten United Nations bases across Haiti. Seventy-seven micronarratives focused on cholera were selected for qualitative analysis from a larger dataset. Three themes emerged: who introduced cholera to Haiti, how cholera was introduced to Haiti, and preventative measures against cholera. With varying levels of confidence, the origins of the epidemic were conceptualised as directly resulting from the actions of the United Nations and Nepalese peacekeepers, exhibiting a distrust of foreign intervention in Haiti and frustration with inadequate water and sanitation infrastructure that facilitated widespread transmission of cholera. This study reinforces the need for additional transparent communication from the UN to address ongoing misconceptions surrounding the cholera outbreak, action to clean water and sanitation practices in Haiti, and for the voices of Haitian citizens to be heard and included in reforming foreign aid delivery in the country.
Highlights
On the heels of a devastating earthquake 10 months prior, in October of 2010, the government of Haiti declared a cholera epidemic that quickly spread to all departments across the country (Centers for Disease Control and Prevention [CDC], 2019)
Our thematic analysis identified four particular themes: (i) Speculation that MINUSTAH was responsible, (ii) Recognition that cholera was new to Haiti, (iii) Reported proof that MINUSTAH introduced cholera and (iv) Specific naming of Nepalese peacekeepers as being responsible
Our analysis has demonstrated that Haitian citizens are cognizant of the United Nations (UN)’s culpability in the cholera epidemic in various ways: MINUSTAH was believed to be responsible for the epidemic, cholera was recognised as novel to Haiti, and peacekeepers were thought to have brought the bacterium from Nepal
Summary
On the heels of a devastating earthquake 10 months prior, in October of 2010, the government of Haiti declared a cholera epidemic that quickly spread to all departments across the country (Centers for Disease Control and Prevention [CDC], 2019). The particular strain of Vibrio cholerae identified in the Haiti epidemic (serogroup O1, serotype Ogawa, biotype El Tor) is associated with severe symptoms (Piarroux et al, 2011). Cholera is most prevalent and most difficult to eradicate, in contexts with inadequate water and sanitation infrastructure (Tauxe, 2014). This made it challenging in Haiti, where in 2010, only 17% of the population had access to improved sanitation and 69% to improved water sources (World Health Organization & United Nations Children’s Fund, 2012)
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