UN calls for probe into origin of Haiti cholera

The Washington Post

By JONATHAN M. KATZ

The Associated Press
Wednesday, December 15, 2010; 8:49 PM

PORT-AU-PRINCE, Haiti -- The United Nations secretary-general plans to call for an independent commission to study whether U.N. peacekeepers caused a cholera outbreak that has killed more than 2,400 people in Haiti, an official said Wednesday.

U.N. officials initially dismissed speculation about the involvement of peacekeepers. The announcement indicates that concern about the epidemic's origin has now reached the highest levels of the global organization.

"We are urging and we are calling for what we could call an international panel," U.N. peacekeeping chief Alain Le Roy said at a news conference at U.N. headquarters in New York. "We are in discussions with (the U.N. World Health Organization) to find the best experts to be in a panel to be completely independent."

Le Roy said details about the commission would be announced Friday by Secretary-General Ban Ki-moon. He said cholera experts and other scientists will have full access to U.N. data and the suspected military base.

"They will make their report to make sure the truth will be known," Le Roy said.

Soon after the cholera outbreak became evident in October, Haitians began questioning whether it started at a U.N. base in Meille, outside the central plateau town of Mirebalais and upriver from where hundreds were falling ill. Speculation pointed to recently arrived peacekeepers from Nepal, a South Asia nation where cholera is endemic.

U.N. officials rejected any idea the base was involved, saying its sanitation was air-tight.

WHO and the U.S. Centers for Disease Control and Prevention said at the time that it was unlikely the origin would ever be known, and that pinning it down was not a priority.

Then the Associated Press found not only sanitation problems at the base, but that the U.N. mission was quietly taking samples from behind the post to test for cholera.

When the CDC determined the strain in Haiti matched one in South Asia, cholera and global health experts said there was now enough circumstantial evidence implicating the likely unwitting Nepalese soldiers to warrant an aggressive investigation.

The experts have also said there are important scientific reasons to trace the origin of the outbreak, including learning how the disease spreads, how it can best be combated and what danger countries around Haiti could face in the coming months and years.

Many think the U.N. mission's reticence to seriously address the allegations in public helped fuel anti-peacekeeper riots that broke out across the country last month.

This outbreak, which experts estimate could affect more than 600,000 people in impoverished Haiti, involves the first confirmed cases of cholera in Haiti since WHO records began in the mid-20th century. Suspected outbreaks of a different strain of cholera might have occured in Haiti more than a century ago.

The current outbreak has spread to the neighboring Dominican Republic and isolated cases have been found in the United States.

French epidemiologist Renaud Piarroux argues that "no other hypothesis" from the Nepalese being the origin could explain his findings that cases of the diarrheal disease first appeared near the U.N. base in Haiti's rural center, far from shipping ports and the area affected by the Jan. 12 earthquake.

But his findings were laid out in an unpublished, somewhat informal paper and are not universally accepted by scientists. Alternate hypotheses include that the disease was introduced by environmental factors, or had been dormant in Haiti's soil.

Dr. David Sack, an epidemiologist at Johns Hopkins University, has said that weather patterns and cholera bacteria present in the Gulf of Mexico could also have caused the outbreak.

However, a team led by researchers from Harvard Medical School said this month in the New England Journal of Medicine that the disease was likely carried to Haiti by human activity and that it was indeed a South Asian strain which does not match cholera found elsewhere in Latin America.

At the Wednesday news conference, Le Roy said its investigations have not found the presence of cholera in its soldiers or at the base. But most people infected with cholera don't show symptoms. The AP also found last month that the environmental testing was done at a Santo Domingo hospital with ties to the U.N. mission that likely lacked the special expertise epidemiologists said testing for cholera requires.

The proposed panel is promised to be much more comprehensive. The head of the U.N. Stabilization Mission in Haiti told AP last month that a definitive finding on the origin of cholera would impact peacekeeping missions around the world.

A separate U.N. team of water, sanitation and hygiene experts was already sent to Haiti in recent weeks to review all sanitation systems in place at the mission's military, police and civilian installations, sources familiar with the review said on condition of anonymity because they were not authorized to discuss it with journalists.

Le Roy said the peacekeepers will "redouble our efforts" to ensure its bases worldwide have the best santiation and health standards possible.

---

Associated Press writer Anita Snow at the United Nations contributed to this report.

Food for Naught

click here to read this on newsweek.com

The World Food Programme's Somalia problem is only the latest in a string of scandals.

The foreign-aid industry has had a bad news cycle. First, British newspapers were consumed with a spat between the British Broadcasting Corp. and Live Aid founder Bob Geldof over a BBC report that tens of millions of dollars of aid to Ethiopia during the 1984–1985 famine were used for arms. Now a more current and equally egregious scandal involving the world's largest humanitarian agency has spun out of Ethiopia's neighbor Somalia. A U.N. report released last week paints a damning portrait of the World Food Programme's operations there: an estimated 50 percent of food delivered by the U.N. agency is essentially being stolen—not only by the WFP's own personnel and contractors, but also Somalia's armed militias, some of whom are radical Islamists.

Somalia is not the first crisis for the agency. These new allegations join a series of recent missteps there that have brought its contracting and operations under scrutiny for its role in aid missions around the world, from North Korea to the Horn of Africa. And the report sent the U.N. backpedaling in its war of words with Washington over the Obama administration's decision to cut aid to Somali operations last year. What is going on at the WFP?

The ugliest revelations are in the report's details. Three Somali businessmen won about 80 percent of the agency's $200 million in transport contracts last year, in what is described as a 12-year-old "de facto cartel." One of them, Abdulqadir Nur "Enow," apparently staged a hijacking of his own trucks in order to sell the food. In another case, the report cites witnesses saying Enow's company sold hundreds of thousands of dollars of food aid in local markets, an outcome made possible by the fact that WFP depended on a local agency run by Enow's wife to verify his deliveries. Meanwhile, a second WFP trucking contractor, Abukar Omar Adaani, used his wealth to finance a rebel militia that launched an offensive in Mogadishu last year against Somalia's U.N.-backed transitional government and African Union peacekeepers. Adaani also persuaded the WFP to fund a road officials said was designed to give Islamist insurgents access to an airstrip, according to the report.

In response, the WFP has suspended contracts with the three businessmen and accused U.N. investigators of overstating the amounts of its trucking payments. (In January it suspended operations in some areas controlled by Islamist rebels.) The agency didn't respond to a question from NEWSWEEK about its knowledge of Somali trucking magnate Adaani's links to Somali insurgents, and it said that the Adaani-built road it had funded was meant for the delivery of humanitarian aid.

Except these aren't isolated problems. Next door, in Ethiopia (one of the largest recipients of food aid in the world), the WFP has spent millions on contracts with transport companies controlled by the country's increasingly authoritarian ruling party, NEWSWEEK has learned. In the country's eastern, Somali-speaking region, where nearly 2 million people receive food aid overseen by the WFP (along with other aid agencies) and where insurgents have long claimed the Ethiopian government uses food as a weapon, a mere 12 percent of food reached the people for which it was intended in 2008, according to figures from the U.S. State Department.

Meanwhile, for its $1.2 billion, three-year food-relief program in Afghanistan, the WFP's trucking and shipping costs for food were two to three times above commercial rates, according to an analysis by Fox News's George Russell published last month, which noted that less than 40 percent of the mission's budget was actually for food. Likewise an investigation by Russell last year also found WFP's planned shipping costs to send more than a half billion dollars of food aid to North Korea were inflated—prompting the agency to admit that some of its shipping budget went to companies owned by dictator Kim Jong Il's government.

As for the WFP, it says it doesn't know how the United States arrived at its calculations about aid deliveries in Ethiopia. In Afghanistan, it said the need to construct warehouses and replace trucks helped account for its high transit costs, and it notes that donor governments and agencies have funded less than a fifth of its North Korea operations. North Korea's remote location and lack of competition in shipping routes to the country also account for the high costs, Ramiro Lopes da Silva, a WFP spokesman said in an e-mail.

Admittedly, places like Afghanistan and Somalia are some of the most difficult countries in the world for aid agencies to work. Some leakage of aid is inevitable. But the U.N.'s agencies are notorious for their high administrative costs and the opacity of their spending. A 2008 Brookings paper coauthored by William Easterly, a well-known aid researcher, ranked 39 large aid donors on criteria including transparency, overhead costs, and selectivity of aid spending. The WFP, which received $4 billion in donations last year—including $1.8 billion from the United States—tied for last place (though the study noted that data from some agencies was unavailable).

The problem in part may be that U.N. aid agencies see themselves as accountable to the world's governments, which provide 92 percent of the WFP's funding, rather than to the public. Asked for data on its contracts with ruling-party trucking companies in Ethiopia—including one owned by a conglomerate whose No. 2 official is the Ethiopian prime minister's wife—the WFP said disclosing such information to the public would jeopardize "its ability to negotiate the best possible rates and delivery conditions." A spokesman did not respond to a request for how much it pays Kim Jong Il's government to ship food to North Korea.

Indeed, what's so unusual about the report on Somalia aid isn't just its conclusions, it's the mere fact that an independent body conducted a thorough probe into U.N. contracting and published its findings. As the Brookings paper notes, "it is a sad reflection on the aid establishment that knowing where the money goes is still so difficult and that the picture available from partial knowledge remains so disturbing."