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Poor Sanitation Persisted at U.N. Missions Long After Haiti Cholera Crisis

Years after medical studies linked the 2010 cholera outbreak in Haiti to infected United Nations peacekeepers, the organization’s auditors found that poor sanitation practices remained unaddressed not only in its Haitian mission but also in at least six others in Africa and the Middle East, a review of their findings shows.

The findings, in audits conducted by the United Nations Office of Internal Oversight Services in 2014 and 2015, appear to reflect the organization’s intent to avoid another public health crisis like cholera.

But the findings also provide some insight into how peacekeepers and their supervisors may have been either unaware of or lax about the need to enforce rigorous protocols for wastewater, sewage and hazardous waste disposal at United Nations missions — despite the known risks and the lessons learned from Haiti, where at least 10,000 people have died from cholera and hundreds of thousands have been sickened.

The United Nations acknowledged for the first time this week that it bore some responsibility for the Haiti disaster, after having repeatedly presented a public face of ignoring the incriminating evidence and invoking its diplomatic immunity from legal action. The acknowledgment came after the organization’s special adviser on the cholera epidemic, in a confidential report seen by The New York Times, called such a position morally indefensible.

The audits may illustrate a more systemic weakness of United Nations peacekeepers, the blue-helmeted soldiers who are supposed to protect the vulnerable and uphold high moral standards in the 16 missions they operate. They are not supposed to be public health risks.

The peacekeeping missions that were audited — in Haiti, the Darfur region of Sudan, the Democratic Republic of Congo, Ivory Coast, Lebanon, Liberia and South Sudan — all practiced varying degrees of “unsatisfactory” waste management.

“The results are egregious and show that this is a massive problem across U.N. missions around the world,” said Beatrice Lindstrom, a lawyer with the Institute for Justice and Democracy in Haiti, a Boston-based advocacy group that has been pressuring the United Nations for accountability in the cholera crisis.

The audits, Ms. Lindstrom said, showed a pattern of unsanitary practices “that continued to be a problem, not only in Haiti.”

In Liberia, for example, auditors of peacekeeping facilities found untreated sewage in rainwater drains, inadequate plumbing, cracked septic tanks and inadequately contained “gray water,” or waste from sinks, bathtubs and washing machines. In Lebanon, they found failures to maintain septic tanks and remove sludge, and the unacceptable mixing of hazardous and organic wastes.

In the Democratic Republic of Congo, they found insufficient septic tanks and “soak pits,” which are porous chambers that allow wastewater to slowly leach into the ground. In Darfur, they found partly treated wastewater had been discharged into open fields and farms. In one location, the Darfur audit said, “kitchen organic waste was dumped into open pits exposing them to rodents and bugs and the growth of microbial pathogens.”

Perhaps most troubling were the findings in Haiti, which showed that more than three years after the cholera outbreak, peacekeepers were pouring inadequately treated sewage into public canals, ignoring laboratory warnings about fecal contamination, failing to inspect water treatment plants and septic tanks, and leaving some camps laden with garbage and overflowing toilets.

Several studies have traced the cholera outbreak to a contingent of Nepalese peacekeepers in the Haitian mission whose fecal waste had leaked into a river adjacent to their base. The bacterial strain of cholera in Haiti, where the disease had not been seen for a century, was similar to the strain in Nepal, where a cholera outbreak was underway.

The audits have not been publicized by the United Nations, although they are accessible on the Office of Internal Oversight Services’ website by searching for “waste” on the Internal Audit Reports page. The audit of the Haiti mission, however, was not accessible for months after it had been completed, for reasons that remain unclear.

Ms. Lindstrom and other lawyers for Haitian victims of the cholera epidemic, who have been trying to sue the United Nations for compensation, first learned of the Haiti mission audit this month when Fox News reported it was on the oversight office’s website. But it took a broader search of the website to find the audits of the other United Nations missions.

It is unclear from the audits, which are generally available online 30 days after they are completed, whether the sanitation problems they enumerate have been addressed.

In an emailed response on Thursday to requests for comment, the office of the United Nations Departments of Peacekeeping Operations and Field Support, which is responsible for the missions, said that all 13 of the auditors’ “critical recommendations” had been met, as had 14 of their 19 “important recommendations.” It did not specify which problems remained.

The office also said that all of the waste management audits in the missions had been undertaken after the Haiti cholera crisis began.

Similar audits are planned this year and next for the missions in the Central African Republic, Mali and Somalia.

Waste management specialists who reviewed the audits said they found them troubling but were not necessarily surprised. They acknowledged the challenges of minimizing public health risks from poor sanitary practices in some of the world’s most unstable places.

Daniele Lantagne, a professor of civil and environmental engineering at Tufts University who specializes in water treatment, said the audits showed that in some places like Haiti, peacekeeping missions installed on-site sanitation facilities but failed to maintain them, contributing to “breaks in the system that could lead to transmission of disease.”

Ms. Lantagne, who was a member of a panel of experts commissioned by the United Nations to study the cholera outbreak, also tempered her criticism.

“On-site sanitation is hard. It requires a good system and ongoing maintenance,” she said. “What you see in these reports is that in some places they try to do something better, and in some places it’s not a simple problem to solve.”

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