I saw the news of a potential cholera outbreak on my twitter feed late on Wednesday, October 20th. Immediately, I knew it would not be a simple case of isolated infections. It is obvious that many health experts have predicted an outbreak ever since the earthquake, now that it is finally happening, we need to find the genesis of what could very well be the worst health epidemic in Haiti since the invasion of AIDS in the early 80’s.
Cholera as they referred to it in Haiti is a disease of “dlo sal” dirty water. It has been more than forty years since Haiti had a cholera outbreak, but that is not to say people haven’t been dying in isolation from the bacteria toxin. As much as we would like to think it’s because of good preventive measures that an outbreak has spared the country during that span, the reality of our healthcare system would tell us it has been more luck than anything else. Haiti’s conditions make it a perfect incubator for cholera and other pathogens like it.
To understand the reasons why more than 250 people have died so far, and scores are infected, we must take our time to analyze the roots cause of the outbreak, and what should have been done before it even went on this killing rampage.
Haiti, as a country has had a series of poor governments that have not prioritized or valued human lives. It is clear that bad water policies are at the core of this current outbreak. For a country so rich in natural water resources, it is a shame that our government could not implement basic treatment procedures to make clean, potable water accessible to people all over the country. The Haitian government inability to do this basic task is obviously the main culprit of why so many people’s lives are currently in danger to end because of cholera.
Instead of policies or plans to invest in water treatment facilities, we have been witnessing an erosion of the few water pipes we had in the capital and the other major metropolitan areas. There is not a single waste management facility in Haiti. Overall, the politics of water in Haiti has been a complete failure, and today we are paying a dear price for it.
It is easy for experts to point the fingers at the Artibonite River as the source of the cholera outbreak, but what they won’t tell people is that throughout Haiti, especially in the rural and remote areas, people have been using river water for everything, from cleaning their clothes to cooking. Why has it taken so long for cholera or other bacteria to really become problematic for the population?
We are all too familiar with the Haitian saying that “microbes do not kill Haitians.” Many of us truly believe that we are immunized to microbes and bacteria because we are born in unsanitary conditions and are very likely to die in those conditions, so it is naturally expected that microbes can’t kill us. This cholera outbreak is disproving this false theory.
The genesis of the outbreak is not really the Artibonite River as some would like to make us believe. It is true that the river might be contaminated with the bacteria, and the fact that people in the region are using for daily chores might have precipitated the outbreak, but the roots of the outbreak is directly tied with poor governance and lack of regulation.
The access to clean water is a right in most countries, but unfortunately in impoverished countries like Haiti, it is a luxury. Since this is the case, greed, corruption and monopoly can find room to make suffer the rest of the population.
For the Haitian entrepreneurs or businessmen without a conscience, the inability of the government to provide the most important substance of life to the people has opened an opportunity for them to make more money. Often times, we hear people talk about Haiti should not have to import agricultural products, but rarely does anyone question Haiti’s import of water.
Before I left Haiti in the mid 1990’s, Culligan was the major company providing treated water to folks who could afford it. Most people in the metropolitan area relied on CAMEP for clean water. Over the years, more companies and NGOs have entered the field of providing clean water to the population, but more than ever less and less people can afford to get clean water. There has been improvement in some areas, and at the same time the conditions have gotten a lot worse in other parts of the country.
Water distribution to the Haitian people has become a lucrative business for many, and it is an unregulated business. Anyone in the comfort of their home can start a business of selling “so-called” treated water. There is no lab test required, and no government agency that can certify indeed these people are selling clean water. Everything is left up to chance.
We have an organized water industry that is obviously controlled by well-to-do families, which is involved in the importation of water bottle. Rather than investing money locally to employ Haitians in water treatment and the build-up of modern water pipes throughout the country, the Haitian businessman is more concerned about making large profits at the detriment of the people. On average, a 12 oz. water bottle in Haiti can cost between 40-80 Gourdes. The daily minimum wage in Haiti is less than 200 Gourdes, so that tells you how hard it is for even an employed individual to get access to clean water, let alone the majority without a job.
The international community can pour in all the water they can, all the medicines they have to respond to this very real threat of the cholera outbreak, but until the Haitian government and the Haitian entrepreneurs understand this is really a national security threat, cholera and pathogens like it will continue to take lives.
The treatment for cholera and other bacterial outbreaks will not solely come from hospitals, doctors, or the international community. The technology of water purification is simple and not too expensive; Haiti is rich with water resources. If we truly need to prevent future outbreaks, it would be wise to start investing real capital in establishing water treatment facilities throughout the country, build up waste management facilities, invest in the education of the people, and for once treasure the importance of our rivers.
The Artibonite River might have been where this outbreak starts to escalate, but its origins begins with the Haitian government, which has failed to invest in the proper infrastructure, setup guidelines for those in the water business, and purely being ignorant about a very real danger. The absence of the government has allowed a few families to exploit the scarcity of clean water, and with the combination of impoverished conditions, people often found themselves going back to using dirty river water, which more often than not would be filled with all kind of toxins, including Vibrio cholera.