Head of aid agency Oxfam in Haiti resigns amid inquiry

from BBC NEWS

The director of Oxfam's operations in Haiti has resigned amid an inquiry into allegations of misconduct by staff.

The UK-based aid agency said Roland Van Hauwermeiren felt he needed to resign as he had been in charge at the time.

A small number of Oxfam workers in Haiti have been suspended, pending the outcome of an inquiry, it added.

The charity raised $98m (£60m) for relief operations after last year's massive earthquake but Oxfam said the allegations were not linked to fraud.

Oxfam has used the money to try to improve sanitation in the face of a cholera outbreak, said to have killed almost 6,000 people and made 420,000 ill.

The staff suspended are not thought to be British nationals.

Under Mr Van Hauwermeiren's direction, Oxfam was one of the few international aid agencies to openly criticise relief efforts.

On the anniversary of the quake in January, it said in a report that "the Haitian state, together with the international community, [was] making little progress in reconstruction".

"Too many donors from rich countries have pursued their own aid priorities and have not effectively co-ordinated amongst themselves or worked with the Haitian government," Mr Van Hauwermeiren said at the time.

Oxfam has been working in Haiti, the poorest country in the Americas, since 1978.

UN needs 'complete leadership overhaul', says British study

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By Steven Edwards,

Postmedia News

March 28, 2011

UNITED NATIONS — The United Nations is proficient at raising money from governments in times of emergency, but "very disappointing" in its ability to respond to the actual disaster, according to an independent review commissioned by the British government.

"There is rarely a vision beyond fundraising, and rarely an organizing narrative that draws together the disparate capacities," says the 61-page report, released Monday. "What is needed is a complete overhaul of strategic and operational leadership in the UN."

The study highlights shortfalls that are likely to also raise alarm bells among Canadian politicians and others focused on the Ottawa's contributions to UN humanitarian efforts.

It was led by Paddy Ashdown, former leader of Britain's Liberal-Democrats, who also served as UN high representative to Bosnia and Herzegovina.

"Regrettably, the leadership, management and co-ordination of the international community's efforts have not risen even to the challenges we currently face." Ashdown says in the foreword to his Humanitarian Emergency Response Review. "Unless we radically improve the quality of the leadership of the international effort in humanitarian crises, we will not succeed in dealing with what is ahead."

The study drew its conclusions after studying responses to a series of recent humanitarian disasters, including flooding in Pakistan, the earthquake in Haiti, and famine in Niger.

It says governments have come to look at the UN as the "only legitimate authority" in situations where a government of an affected country is unable to mount an effective humanitarian response.

But it adds: "In all but one of the case studies for this review, UN leadership was poor. This was especially true in the larger disasters. It is true at a strategic level and at an operational level. It is true across the international system, and in individual crises."

The report praises the World Food Program — to which Canada is the world's third-biggest contributor after the United States and the European Commission — for "rapidly delivering food to seven million people in flood-hit Pakistan." It also says UNICEF, the children's agency, was efficient in supplying infant food throughout Niger.

But it highlights the UN's "inability to treat and contain" the cholera outbreak in Haiti last year. More widely, it hints at unhealthy competition between the UN agencies by saying they "need to work more collegially."

Britain's 10-month-old Conservative-led coalition government called for the study to review how Britain responds to humanitarian emergencies.

A significant part of the report focused on the UN because the organization and its agencies are among the world's biggest deliverers of emergency help.

Ashdown led a task force of humanitarian experts from inside and outside government who began their study six months after the Haiti earthquake at the beginning of 2010.

The humanitarian situation in Haiti

Briefing on “The humanitarian situation in Haiti”, by the Deputy Director of the Coordination and Response Division, Office for the Coordination of Humanitarian Affairs (OCHA), and the Director of the Office of Emergency Programmes, United Nations Children’s Fund (UNICEF) (co-organized by OCHA and UNICEF)

Friday, 21 January 2011, at 1.30 p.m., in the conference room of the Office of the Under-Secretary-General, OCHA (380 Madison Avenue (between 46th and 47th Streets)).

[The briefing is open to members of permanent missions and observers missions. For further information, please contact Ms. Corazon dela Pena, OCHA (e-mail penac@un.org; tel. 1 (917) 357-2998).]

Fidel Castro says "Ban Ki-moon is full of ...it"

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REFLECTIONS OF FIDEL
MINUSTAH and the epidemic

Taken from CubaDebate

APPROXIMATELY three weeks ago news and footage came in of Haitian citizens throwing stones and angrily protesting against the forces of the MINUSTAH, accusing it of having transmitted cholera to that country via a Nepalese soldier.

The initial impression, if one did not receive any additional information, is that it was a rumor born from the antipathy that every occupying force provokes.

How could that information be confirmed? Many of us were unaware of the characteristics of cholera and its means of transmission. A few days later, the protests in Haiti ceased and there was no more talk of the matter.

The epidemic followed its inexorable course, and other problems, such as the risks associated with the electoral battle, occupied our time.

Today, reliable and credible news came in concerning what really happened. The Haitian people had more than sufficient reason to express their indignation.

The AFP news agency textually affirmed that: "Last month, the eminent French epidemiologist Renaud Piarroux headed an investigation in Haiti and came to the conclusion that the epidemic was generated by an imported strain, and extended from the Nepalese base" of MINUSTAH.

For its part, another European agency, EFE, reported: "The origin of the disease is to be found in the little town of Mirebalais, in the center of the country, where Nepalese soldiers had based their camp, and it appeared a few days after their arrival, which confirms the origin of the epidemic…"

"To date, the UN mission in Haiti (MINUSTAH) has denied that the epidemic entered via its blue berets."

"…French Dr. Renaud Piarroux, considered one of the principal world specialists in the study of cholera epidemics, leaves no doubt as to the origin of the disease…"

"The French study was ordered by Paris at the request of the Haitian authorities, stated a French diplomatic spokesperson."
"…the appearance of the disease coincides with the arrival of the Nepalese soldiers who, moreover, originate from a country where there is a cholera epidemic.

"There is no other way of explaining such a sudden and fierce eclosion of cholera in a little town of a few dozen inhabitants.

"The report also analyses the form of the propagation of the disease, given that fecal water from the Nepalese camp was draining into the river from which the town’s inhabitants take their water."

As the same agency communicated, the most surprising thing that the UN did was "…to send an investigative mission to the Nepalese camp, which concluded that that could not have been the origin of the epidemic."

In the midst of the destruction wrought by the earthquake, the epidemic and its poverty, Haiti cannot do without an international force which can cooperate with a nation ruined by foreign interventions and transnational exploitation. The UN must not only fulfill its elemental duty of fighting for Haiti’s reconstruction and development, but also that of mobilizing the resources needed to eradicate an epidemic that is threatening to extend to the neighboring Dominican Republic, the Caribbean, Latin America and other similar Asian and African countries.

Why did the UN insist on denying that the MINUSTAH brought the epidemic to the people of Haiti? We are not blaming Nepal, which in the past was a British colony, and whose men were utilized in its colonial wars and are now seeking employment as soldiers.

We made inquiries with the Cuban doctors currently providing services in Haiti and they confirmed to us the news circulated by the abovementioned European news agencies with notable precision.

I will make a brief synthesis of what was communicated to us by Yamila Zayas Nápoles, a specialist in comprehensive general medicine and anesthesiology, director of a medical institution that has eight basic specialties and diagnostic tools from the Cuba-Venezuela project, inaugurated in October 2009 in the urban area of Mirebalais, with 86,000 inhabitants, in the department of Nord.

On Saturday, October 15 three patients were admitted with symptoms of diarrhea and acute dehydration; on Sunday 16th, four were admitted with similar characteristics, but all of them from one family, and they made the decision to isolate them and communicate what had happened to the Medical Mission; surprisingly, on Monday 17th, 28 patients were admitted with similar symptoms.

The Medical Mission immediately sent a group of specialists in epidemiology who took blood, vomit, fecal samples and data, which were sent with urgency to Haiti’s national laboratories.

On October 22, the labs reported that the strain isolated matched to the one prevalent in Asia and Oceania, which is the most severe. The Nepalese unit of the UN blue berets is located on the bank of the Artibonite River, which runs through the little community of Méyè, where the epidemic emerged, and Mirebalais, to which it then rapidly spread.

In spite of the sudden way in which cholera appeared in the small, but excellent hospital in the service of Haiti, only 13 of the first 2,822 sick persons died, giving a mortality rate of 0.5%; subsequently, when the Cholera Treatment Center was set up in a remote area, out of 3,459 patients, five in a serious condition died, giving 0.1%.

The total number of persons suffering from cholera in Haiti rose today, Tuesday, December 7 to 93,222 persons, and the number of patients who have died reached a total of 2,120. Among those treated by the Cuban Mission the mortality rate rose to 0.83%. The mortality rate in other hospital institutions stands at 3.2%. With the experience acquired, appropriate measures and the reinforcement of the Henry Reeve Brigade, the Cuban Medical Mission, with the support of the Haitian authorities, has offered a presence in many of the isolated 207 sub-communes, so that no Haitian citizen lacks medical attention in the face of the epidemic, and many thousands of lives can be saved.

Fidel Castro Ruz
December 7, 2010
6:34 p.m.

Translated by Granma International

Haiti: Epidemics of denial must end (UN is now covering it up)

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Haiti's cholera outbreak is a depressing reminder that the first victim of an epidemic is often the truth, says Debora MacKenzie

AS HAITI'S deadly cholera epidemic spreads, it may seem irrelevant to ask where the disease came from. The World Health Organization certainly thinks it is, describing the question as "unimportant".

That could not be further from the truth. Haitians themselves care deeply about how their country got cholera. There is widespread suspicion that the disease was brought in by United Nations peacekeepers from Nepal, and that the UN is now covering it up. This suspicion has sparked riots that have killed people, both directly and by impeding medical efforts.

We should care too. Haiti's cholera tragedy - more than 1600 dead and 30,000 hospitalised as New Scientist went to press - tells us something important about our highly interconnected planet, and how we should - but still don't - govern it.

Cholera bacteria thrive on poverty and disruption, and Haiti has plenty of both. The country was free of cholera when the earthquake struck in January, but when the disease broke out in October it quickly took off.

When the news broke on 20 October, suspicion fell rapidly on 454 Nepalese UN peacekeepers based in the town of Mirebalais, 60 kilometres north of the capital Port-au-Prince. Haitian officials tested the river by the base two days later.

There were reasons to suspect these Nepalese. Cholera, which is carried by faeces-tainted water, is endemic in Nepal: there was an outbreak in Kathmandu, the country's capital, just before the peacekeepers flew in from there between 9 and 16 October. Their camp in Mirebalais dumped sewagestraight into a stream that led to Haiti's main central river. The first cases were in Mirebalais and downstream, areas barely touched by the earthquake. What is more, the DNA in Haiti's cholera shows it was a single, recent introduction of a strain from south Asia, though we don't know if it is circulating in Nepal.

All of this is just circumstantial evidence, of course. The UN insists it is in the clear because the tests on water on or near the base did not find cholera, and none of the peacekeepers had symptoms.

Yet this doesn't clear the matter up. Many people with the strain now circulating in Haiti do not develop symptoms but shed bacteria in their faeces up to two weeks after infection. Nor are negative water tests conclusive: cholera researchers say the bacteria are hard to find in fast-flowing rivers. To settle the matter, the Nepalese soldiers themselves should have been tested, promptly.

A single positive swab from a soldier early in the outbreak would have strongly suggested they were the source. A negative result would not have entirely cleared them - tests can produce false negatives - but it may well have calmed public suspicion.

But no such tests were done. The Nepalese government claims the water samples alone prove that its troops are not the source. The UN Mission in Haiti even phoned me out of the blue to claim that tests cannot detect cholera in symptom-free people.

They can. That is an elementary scientific fact about cholera.

Why would the UN go to such trouble? I can only conclude that they are trying to protect themselves and their people. Many Haitians dislike the UN force; dozens of peacekeepers have been killed in violent clashes since the mission arrived in 2004 to stabilise the country in the face of political upheaval.

I asked Brian Concannon, head of human rights group Institute for Justice and Democracy in Haiti, who worked for the UN in Haiti in the 1990s, what he thought. He told me that most people in Haiti already blame the UN, and that an admission of guilt - if appropriate - might not have been as damaging as the UN assumes. "I can't see that it would have led to any greater anger." It might even have defused the situation, he says.

There are broader lessons to be learned. UN peacekeepers around the world are largely supplied by poor countries, and of the top 15 contributors, which supply 71 per cent of UN troops, 12 harbour cholera. If Haiti's cholera did indeed come from Nepal, it was a foreseeable accident. More caution is called for.

Even more importantly, Haiti reminds us that the interconnectedness of our world allows pretty much any infectious disease to travel pretty much anywhere. We've seen it with HIV, West Nile virus, malaria, chikungunya and many more. Yet the knee-jerk reaction of every authority responsible for starting an outbreak, or letting one spread, is denial. No one wants to be the bearer of disease - but denial doesn't work, and can make things worse.

The interconnectedness of the world means that any infectious disease can travel anywhere

Remember BSE? Starting with the UK, government after government claimed that beef was safe, or that their cows didn't have it, and resisted tests that eventually showed otherwise. Their denials and stalling allowed the disease to be shipped worldwide. In 2004, China denied having H5N1 bird flu, even though scientists knew otherwise. The delay helped the virus spread across half the world. In 2003, denial in several countries worsened SARS.

You can understand why authorities deny responsibility for diseases: they think the truth will cause unrest. But as the UK's BSE inquiry concluded, cover-ups don't dampen public dismay - they deepen it.

The big lesson from Haiti is the same as with every new disease outbreak: do the tests, find out as much as possible, and tell the truth. What part of this is so hard to learn? Denial may seem safer, but with scientists increasingly able to track pathogens, and bystanders increasingly armed with cellphones and the internet, it isn't.

Accountability matters, vitally so in a networked world. It is too late now to do those tests in Haiti. It is not too late to learn why they should have been done.

Debora MacKenzie is New Scientist's Brussels correspondent

Haiti cholera: UN peacekeepers to blame, report says

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UN peacekeepers were the most likely source of the cholera epidemic sweeping Haiti, according to a leaked report by a French disease expert.

Epidemiologist Renaud Piarroux conducted research in Haiti on behalf of the French and Haitian governments.

Sources who have seen his report say it found strong evidence that the cholera outbreak was caused by contamination of a river by UN troops from Nepal.

The UN said it had neither accepted nor dismissed the findings.

The cholera epidemic has killed 2120 people, and nearly 100,000 cases have been treated, according to the Haitian government.

The report by Mr Piarroux found that the source of the outbreak was a Nepalese peacekeeping base, whose toilets contaminated the Artibonite river, according to a copy seen by the Associated Press news agency.

The river was the main focus of the outbreak when it began in October, but cholera has since spread throughout the country.

The UN mission in Haiti, Minustah, said there was "no conclusive evidence" that UN peacekeepers were the source of the epidemic.

Minustah said the report by the French expert was "one report among many," but it was taking it "very seriously".

Many Haitians were already blaming the Nepalese peacekeepers for bringing cholera to the country, and there have been violent demonstrations against them.

Imported strain

The strain of cholera had already been matched to one from South Asia, although it is present in other Latin American countries.

In an interview last week, Mr Piarroux said it was clear cholera had been introduced to Haiti, which had not seen an outbreak of the disease for more than a century.

"It started in the centre of the country, not by the sea, nor in the refugee camps. The epidemic can't be of local origin. That's to say, it was imported," he told the French news agency, AFP.

UN peacekeepers have been in Haiti since 2004 to help restore political stability after years of unrest.

They have also been helping relief efforts following last January's massive earthquake, which killed about 230,000 people.

Haiti: one more shameful UN betrayal

• 
• • Peter Hallward
  • The Guardian, Tuesday 23 November 2010
  • Article history

Cholera is just the latest disaster to be linked to the UN in Haiti – and the election won't change the nature of the mission

A cholera patient is treated in Saint Nicholas hospital, Haiti. Photograph: Joe Raedle/Getty Images

Almost everyone now accepts that the United Nations brought cholera to Haiti last month. The evidence is overwhelming and many experts (including the head of Harvard University's microbiology department, cholera specialist John Mekalanos) made up their minds to that effect several weeks ago.

Poverty and a lack of rudimentary infrastructure compels much of Haiti's population to drink untreated water, but there has been no cholera there for decades. Haitians have no experience with – and therefore little resistance to – the disease. All the bacterial samples taken from Haitian patients are identical and match a strain endemic in southern Asia. Cholera broke out in Nepal over the summer, and in mid-October a new detachment of Nepalese UN troops arrived at their Haitian base in Mirebalais, near the Artibonite river. A few days later Haitians living downstream of the base started to get sick and the disease spread rapidly throughout the region. On 27 October, journalists visited Mirebalais and found evidence that untreated waste from UN latrines was pouring directly into an Artibonite tributary.

By early November, Mekalanos couldn't see "any way to avoid the conclusion that an unfortunate and presumably accidental introduction of the organism occurred" as a result of UN troops. Mekalanos and others also refute UN claims that identification of the source should be a low public health priority.

Probably as a result of UN negligence, more than 1,200 people are already dead and 20,000 infected, and the toll is set to rise rapidly over the coming weeks. So is the number and intensity of popular protests against this latest in a series of UN crimes and misadventures in Haiti in recent years, which include scores of killings and hundreds of alleged rapes.

Rather than examine its role in the epidemic, however, the UN mission has opted for disavowal and obfuscation. UN officials have refused to test Nepalese soldiers for the disease or to conduct a public investigation into the origins of the outbreak. Rather than address the concerns of an outraged population, the agency has preferred to characterise the fresh wave of protests as a "politically motivated" attempt to destabilise the country in the runup to presidential elections on 28 November. Protesters have been met with tear gas and bullets; so far at least three have been killed.

So far, in fact, so normal. The truth is that the whole UN mission in Haiti is based on a violent, bald-faced lie. It says it is in Haiti to support democracy and the rule of law, but its only real achievement has been to help transfer power from a sovereign people to an unaccountable army.

To understand this requires a little historical knowledge. The basic political problem in Haiti, from colonial through post-colonial to neo-colonial times, has always been much the same: how can a tiny and precarious ruling class secure its property and privileges in the face of mass destitution and resentment? The Haitian elite owes its privileges to exclusion, exploitation and violence, and only quasi-monopoly control of violent power allows it to retain them. This monopoly was amply guaranteed by the US-backed Duvalier dictatorships through to the mid 1980s, and then rather less amply by the military dictatorships that succeeded them (1986-90). But the Lavalas mobilisation for democracy, which began in the 1980s, threatened that monopoly and with it those privileges. In such a situation, only an army can be relied upon to guarantee the security of the status quo.

Haiti's incompetent but vicious armed forces, established as a delegate of US power, dominated the country for most of the 20th century. After surviving a brutal military coup in 1991, Haiti's first democratically elected government – led by president Jean-Bertrand Aristide – finally demobilised this hated army in 1995; the great majority of his compatriots celebrated the occasion. Lawyer Brian Concannon recalls it as "the most important step forward for human rights since emancipation from France". In 2000, Aristide was re-elected, and his Fanmi Lavalasparty won an overwhelming majority. This re-election raised the prospect, for the first time in modern Haitian history, of genuine political change in a situation in which there was no obvious extra-political mechanism – no army – to prevent it.

The tiny Haitian elite and their allies in the US, France and Canada were threatened by the prospect of popular empowerment, and took elaborate steps to undermine the Lavalas government.

In February 2004, Aristide's second administration was overthrown in another disastrous coup, conducted by the US and its allies with support from ex-Haitian soldiers and rightwing leaders of the Haitian business community. A US puppet was imposed to replace Aristide, in the midst of savage reprisals against Lavalas supporters. Since no domestic army was available to guarantee "security", a UN "stabilisation force" was sent in at the behest of both the US and France.

The UN has been providing this substitute army ever since. At the behest of the US and its allies, it arrived in Haiti in June 2004. Made up of troops and police drawn from countries all over the world, it operates at an annual cost that is close to twice the size of Aristide's entire pre-coup budget. Its main mission, in effect, has been to pacify the Haitian people, and make them accept the coup and the end of their attempt to establish genuine democratic rule. Few Haitians are likely to forget what the UN has done to accomplish this. Between 2004 and 2006, it participated in a campaign of repression that killed more than a thousand Lavalas supporters. It laid siege to the destitute pro-Aristide neighbourhood of Cité Soleil in 2005 and 2006, and has subsequently contained or dispersed popular protests on issues ranging from political persecution and privatisation to wages and food prices. In the last few months the UN has also kept a lid on the growing pressure in the capital, Port-au-Prince, for improvement in the intolerable conditions still endured by about 1.3 million people left homeless after January's earthquake.

Today, cholera or no cholera, the UN's priority is to ensure that next week's elections go ahead as planned. For Haiti's elite and their international allies, these elections offer an unprecedented opportunity to bury the Lavalas project once and for all.

The political programme associated with Lavalas and Aristide remains overwhelming popular. After six years of repression and infighting, however, the political leadership of this popular movement is more divided and disorganised than ever. Fanmi Lavalas itself has simply been barred from participation in the election (with hardly a whisper of international protest), and from his involuntary exile in South Africa, Aristide has condemned the ballot as illegitimate. Many if not most of the party's supporters are likely to back its vigorous call to boycott this latest masquerade, as they did in the spring of 2009, when turnout for senate elections was less than 10%. This time around, however, half a dozen politicians associated with Lavalas have chosen to run as candidates in their own name. They are likely to split the vote. Haiti's people will be deprived of what has long been their most powerful political weapon – their ability to win genuine elections.

Since it is almost guaranteed to have no significant political impact, this is one election that might well achieve its intended result: to reinforce the "security" (and inequity) of the status quo, along with the many profitable opportunities that a suitably secured post-disaster Haiti continues to offer international investors and its business elite. "This will be an election for nothing," says veteran activist Patrick Elie. Properly managed, it may even provide an opportunity for rightwing presidential candidates like Charles Baker to pursue the goal that has long been at the top of their agenda: restoration, with the usual "international supervision", of Haiti's own branch of the imperial army.

And if that comes to pass, then when the UN eventually leaves Haiti its departure may only serve as a transition from one occupying force to another, reversing decades of popular sacrifice and political effort. In the meantime, though, it looks as if the UN may soon have more opportunities than ever before to fulfil its mission in Haiti.

Experts: Did UN troops infect Haiti?

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By JONATHAN M. KATZ
The Associated Press
Wednesday, November 3, 2010; 5:40 PM

PORT-AU-PRINCE, Haiti -- Researchers should determine whether United Nations peacekeepers were the source of a deadly outbreak of cholera in Haiti, two public health experts, including a U.N. official, said Wednesday.

The U.S. Centers for Disease Control and Prevention found that the strain of cholera that has killed at least 442 people the past three weeks matches strains found in South Asia. The CDC, World Health Organization and United Nations say it's not possible to pinpoint the source and investigating further would distract from efforts to fight the disease.

But leading experts on cholera and medicine consulted by The Associated Press challenged that position, saying it is both possible and necessary to track the source to prevent future deaths.

"That sounds like politics to me, not science," Dr. Paul Farmer, a U.N. deputy special envoy to Haiti and a noted expert on poverty and medicine, said of the reluctance to delve further into what caused the outbreak. "Knowing where the point source is - or source, or sources - would seem to be a good enterprise in terms of public health."

The suspicion that a Nepalese U.N. peacekeeping base on a tributary to the infected Artibonite River could have been a source of the infection fueled a protest last week during which hundreds of Haitians denounced the peacekeepers.

John Mekalanos, a cholera expert and chairman of Harvard University's microbiology department, said it is important to know exactly where and how the disease emerged because it is a novel, virulent strain previously unknown in the Western Hemisphere - and public health officials need to know how it spreads.

Interviewed by phone from Cambridge, Massachusetts, Mekalanos said evidence suggests Nepalese soldiers carried the disease when they arrived in early October following outbreaks in their homeland.

"The organism that is causing the disease is very uncharacteristic of (Haiti and the Caribbean), and is quite characteristic of the region from where the soldiers in the base came," said Mekalanos, a colleague of Farmer. "I don't see there is any way to avoid the conclusion that an unfortunate and presumably accidental introduction of the organism occurred."

Cholera, which had never before been documented in Haiti, has killed at least 442 people and hospitalized more than 6,742 with fever, diarrhea and vomiting since late October. It is now present in at least half of Haiti's political regions, called departments.

Death occurs when patients go into shock from extreme dehydration. The epidemic has diverted resources needed for the expected strike of a hurricane this week, and could spread further if there is flooding.

Suspicions that the Nepalese base could have been a source of the infection intensified Monday after the CDC revealed the strain in Haiti matches those found in South Asia, including Nepal.

But nothing has been proven conclusively, and in the meantime the case remains politically charged and diplomatically sensitive. The United Nations has a 12,000-strong force in Haiti that has provided badly needed security in the country since 2004. But their presence is not universally welcomed, and some Haitian politicians have seized upon the cholera accusations, calling for a full-scale investigation and fomenting demonstrations.

Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, said it is clear that the disease was imported to Haiti but that it is still not clear by whom or how. She said the epidemic will contain lessons for humanitarian relief work and disaster relief around the world.

"It has to be either peacekeepers or humanitarian relief workers, that's the bottom line," she said.

Mekalanos said researchers might be more aggressive in finding the source of the infection if the case was less sensitive.

"I think that it is an attempt to maybe do the politically right thing and leave some agencies a way out of this embarrassment. But they should understand that ... there is a bigger picture here," he said. "It's a threat to the whole region."

He also cast doubt on U.N. military tests released this week that showed no sign of cholera. The tests were taken from leaking water and an underground waste container at the base a week after the epidemic was first noted and processed at a lab in the neighboring Dominican Republic, U.N. spokesman Vincenzo Pugliese said.

Mekalanos said that it is extremely difficult to accurately isolate cholera in environmental samples and that false negatives are common.

The Nepalese troops were not tested for cholera before their deployment if they did not present symptoms. But health officials say 75 percent of people infected with cholera bacteria do not show symptoms and can still pass on the disease for weeks.

A spokesman for the World Health Organization said finding the cause of the outbreak is "not important right now."

"Right now, there is no active investigation. I can't say one way or another (if there will be). It is not something we are thinking about at the moment. What we are thinking about is the public health response in Haiti," said spokesman Gregory Hartl.

The Harvard experts said more conclusive evidence would be available following closer examinations of the genetic material in the strain.

CDC spokeswoman Kathryn Harben said in an e-mail that the center will make the full genomic DNA sequence available when it is confirmed.

"At some point in the future, when many different analyses of the strain are complete, it may be possible to identify the origin of the strain causing the outbreak in Haiti," she said.

Farmer, who co-founded the medical organization Partners in Health that is a leading responder in the epidemic, said there is no reason to wait.

"The idea that we'd never know is not very likely," he said. "There's got to be a way to know the truth without pointing fingers."

---

Associated Press reporter Colleen Barry in Geneva contributed to this article.

Keep An Eye On The U.N.

Claudia Rosett, 01.28.10, 12:01 AM ET

If you don't like your tax bill now, watch out for the plans of the United Nations. The U.N. has been cooking up proposals to tax you every time you fly, drink, bank, use the Internet or earn a buck.

For an institution that has yet to master the art of policing its own accounts, that's awfully ambitious. But an urge to dig ever deeper into your wallet, dear tax-payer, has become a staple on the drawing boards of U.N. plan-o-crats.

The U.N. already collects billions in both dues and voluntary contributions from the governments of the developed world--first and foremost from the U.S., which typically foots the bill for roughly one-quarter of most major U.N. activities. The actual U.N. budget is a slippery number. The book-keeping is opaque, often tardy or incomplete and spread across many parts of the U.N. archipelago, with no single U.N. office fully accountable for the entire system. In 2006 then-Secretary General Kofi Annan said the U.N. system-wide budget was about $20 billion; by now, with ever-expanding U.N. operations, funding appeals and hazily defined "partnerships," it is certainly larger. But for U.N. spenders this torrent of other people's money is not enough.

Since its founding in 1945, as essentially a diplomatic talking shop headquartered in the U.S., the U.N. has ballooned into a sort of post-colonial global empire, involving scores of thousands of staff, peacekeepers, agencies and proliferating agendas worldwide. With that has come a voracious hunger for money, in which U.N. planners keep casting an acquisitive eye at global commerce, looking for ways to tap in and open the spigots straight into the U.N.'s coffers.

Some years back, the U.N. welcomed the new millennium with a proposal that wealthy nations start turning over 0.7% of their gross national product for aid to the developing world. At the same time the U.N. ramped up its "climate change" campaign for de facto taxes and controls on carbon emissions (based on the U.N.'s politicized "science"), with visions of the command-and-control transfer of billions--or ultimately trillions--around the globe. In such schemes, the U.N. envisions itself manning the main switch.

The U.N. has also been debating a raft of ideas for more targeted global taxes. Just this month comes a dispatch by George Russell, executive editor of Fox News, that the World Health Organization has been honing a "suite of proposals" for asking member states to levy tolls that would be paid directly to the U.N. The WHO notions range from taxes on Internet use, to financial transactions to alcohol, tobacco and weapons.

These campaigns have yet to pan out into the full bonanzas the U.N. hopes for. But for the U.N., there is little cost to trying again and again, gaining traction here and there. All it usually takes is the ability of ambitious U.N. bureaucrats to put together a conference. The planning group for the conference becomes a secretariat. That secretariat becomes the seed of the next U.N. mandate, department or initiative, with the next suite of tax proposals on the table.

So who is keeping an eye on these increasingly acquisitive ambitions of the U.N.? And who is minding the books for its ever-expanding budgets?

The sorry answer is that while U.N. ambitions and spending have soared, U.N. reform efforts have largely fizzled. Oversight has been receding to dismal levels. In a Jan. 12 story headlined "U.N. cuts back on investigating fraud," John Heilprin of the Associated Press outlined just how bad the situation now is. In the wake of Oil-for-Food plus a slew of other scandals, a special task force was set up at the UN in 2006 to probe corruption. That task force uncovered, Heilprin reports, at least 20 major schemes "affecting more than $1 billion in U.N. contracts and international aid." The U.N. response was to dissolve the task force at the beginning of 2009. Since then, reports Heilprin, "Not a single significant fraud or corruption case has been completed, compared with an average of 150 cases a year investigated by the task force." Several reports from late 2008 "still await a final decision from Secretary-General Ban Ki-moon more than a year later."

The U.N. has an office of internal oversight, set up at U.S. behest as part of a push for U.N. reform in the mid-1990s. But this office has itself been bedeviled by favoritism, erratic coverage of U.N. activities, under-staffing, under-funding and cover-ups. The U.N. also has a so-called external Board of Auditors, which devotes itself chiefly to inside baseball--cranking out lengthy but largely toothless reports. This board is run by rotating trios of U.N. member states; the current trio consists of France, South Africa and China.

Among the U.N.'s 192 member states, the only member with any record of serious effort to clean up the U.N. is the U.S. (with the U.K. running a distant second). Right now, despite President Barack Obama's professed interest in the U.N., the U.S. is largely missing in action on U.N. oversight. In recent years, for instance, the U.S. Mission to the U.N. began doing its bit for U.N. transparency by posting U.N. internal audits on the U.S. Mission Web site. That ended, quietly, with the beginning of the Obama administration and the arrival of Ambassador Susan Rice. Since late 2008, no more U.N. audits have been posted (I hope that mentioning this does not result in the U.S. Mission scrubbing even the old audits still there).

The U.S. Congress has also largely lost interest in how the U.N. handles the money of U.S. taxpayers. A few legislators still try to keep watch, such as Sen. Tom Coburn and Rep. Ileana Ros-Lehtinen. But the congressional staffers who developed expertise in delving into the U.N. money maze are mostly gone from government. Sen. Norm Coleman, who did sterling work digging into billions in corruption under Oil-for-Food, is now gone from the Senate. That seat is now filled by Sen. Al Franken, who has displayed more interest in riding herd on Sen. Joe Lieberman than on the U.N.

There are few subjects more tedious than audits and oversight of the alphabet soup empire of the U.N. But the current mix of an ever-greedier U.N. with less and less oversight has the makings of scandals ahead that will dwarf Oil-for-Food. With President Barack Obama lauding the U.N. as a forum for global peace and progress, what's Washington going to do about this mess?

Claudia Rosett, a journalist in residence with the Foundation for Defense of Democracies, writes a weekly column on foreign affairs for Forbes.