Back to the source. the "black" open water pit where wastewater from the Nepalese camp was spilled twice a week.
Final Report of the Independent Panel on the cholera outbreak in Haiti
evidence "overwhelmingly" suggests that cholera was inadvertently brought to Haiti by peacekeepers of the UN, an independent group concludes in a report to the Secretary General of UN Ban Ki-moon, which was published yesterday. the report is based on a review of genetic and epidemiological data and a study of the sanitation system of a UN camp near the site of the first cases. so beware not to assign blame, the report presents a series of recommendations aimed at preventing similar disasters in the future, including UN personnel screening in cholera endemic areas for the presence of Vibrio cholerae before leaving the house and giving them prophylactic antibiotic dose.
Shortly after the beginning of the outbreak, which has sickened nearly 300,000 people and killed nearly 5,000 Haitians fingering the United Nations Stabilization Mission in Haiti (MINUSTAH), which has a camp populated of Nepalese soldiers in Mirebalais in the Centre department, very close to where the first cases of cholera occurred. The camp was also blamed in an epidemiological report released by a French expert from cholera Renaud Piarroux the University of the Mediterranean in Marseille, written at the request of the Haitian government. Several genetic studies have shown that other Haitian cholera strain strongly resembled recently found in South Asia, although not specifically identified Nepal.
Yet some scientists, including cholera Rita Colwell, considered by many as a giant in the field, argued that the bacteria were more likely found in local waters, and that the epidemic was triggered by a combination of factors environment.
The panel of four members, headed by Alejandro Cravioto the International Centre for Diarrhoeal Disease Research, Bangladesh, unambiguously rejects that theory. Microbes isolated from patients in different parts of Haiti are genetically identical, suggesting an introduction to a single point, the report said. Genetically, the Haiti strain is very similar to the South Asian strains of V. cholerae . "Analysis of the available data refutes the argument that the Haitian strains arose locally from the Haitian environment," the panel wrote.
Mirebalais, the site of a camp of Nepalese MINUSTAH, is probably the place where this introductory happened, the committee concluded. Not only the first case, it should, but the times when new cases occurred a few days later on the Artibonite river water velocity data are compatible with an introduction near Mirebalais which was carried out downstream of the river .
In addition, there was ample opportunity for germs of cholera to enter the Meye Tributary System of the Artibonite River in Nepal and around the camp. At the camp, the so-called "black water" is water containing human waste material was collected in six tanks 2500 liters fiberglass. But the pipe in the shower and toilet main camp area was poor, and there was "great potential" for sewage leaks in a drainage ditch running through the camp and ends in Meye system.
Another site of contamination was just outside the camp. Twice a week, a Haitian contractor would send a truck to collect wastewater from the camp and transport containers in an open septic tank (photo) on a nearby hill that was far from assured. "There is no fence around the site, and children were observed playing and stray animals in the area around the pit," the report said. The pit overflow in the system depends Meye during rainfall.
The wastewater from two other camps for the forces of Nepal MINUSATH in the Central Department (called Hinche and Red Earth) was also trucked to the pit, meaning they too could cause of the epidemic.
The report concludes that sanitation in and around the camps MINUSTAH was "not enough" and recommended that UN installations worldwide "treat feces using on-site systems inactivate pathogens before disposal. " But perhaps not to fan the flames, he stops blaming Nepalese or MINUSTAH. Instead, the report stresses that the disease has become a major disaster in the wake of a series of circumstances, including bad drinking water in Haiti and sanitation infrastructure and lack of medical services. The epidemic "was not the fault, or deliberate action of a group or an individual," he said.
The researchers say that the report should put scientific controversy to rest. "Personally, I am glad that I am able to read the tea leaves correctly, because God knows I took some colleagues flack, "says molecular biologist John Mekalanos of Harvard Medical School in Boston, who has published evidence that the strain came from South Asia in an article the New England Journal of Medicine in January.
Piarroux, who had been worried that the truth might never come out, said he feels justified because the report confirms many of the conclusions in its report to the Haitian government. "They did a great job," he said. A paper describing the findings has been accepted by Emerging Infectious Diseases , said Piarroux.
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