FP Explainer

Did U.N. Peacekeepers Bring Cholera to Haiti?

Not necessarily.

Efforts to combat Haiti's rapidly spreading cholera outbreak, which has so far killed more than 1,000 people in the country, were hampered this week by widespread anti-U.N. rioting in the country's north. The rioting has forced the United Nations and nongovernmental agencies to suspend the delivery of badly needed medical and sanitation supplies. The violence is thought to be partly the result of Haitians' longstanding resentment of the 12,000-member U.N. peacekeeping mission in the country, but has also been caused by the widespread belief that the peacekeepers themselves introduced the disease. Could that possibly be true?

Perhaps, but it's far from certain. Haiti has not had a cholera outbreak in several decades, while Nepal, where many of the peacekeepers are from, is currently suffering one. Media attention has focused on the U.N. camp near the northern city of Cap-Haitien, the epicenter of the outbreak, which has poor sanitation facilities and is located near a river. Additionally, the initial tests by the U.S. Centers for Disease Control (CDC) indicate that the particular strain of cholera currently plaguing Haiti matches one found in South Asia. Despite these clues, there's still a very good chance that cholera was present in Haiti long before the Nepalese troops arrived.

The bacteria that cause cholera can exist in an environment, usually an enclosed body of water, for long periods before infecting a human population. (The bacteria have even been found in the Chesapeake Bay.) When the bacteria are ingested, the human intestine acts as an incubator for the disease, making it more virulent. (Not everyone who ingests cholera will get sick; an individual's overall health and genetic disposition also play a role.) When the person then excretes the bacteria back into the environment through defecation, the disease can spread though a population's water supply.

It's not unprecedented for cholera to suddenly break out in an area with little warning. A cholera epidemic broke out in Peru in 1991 after the disease hadn't been seen in South America in more than a century. Later tests revealed that the bacteria had been present in the water supply for some time. While there are hundreds of serotypes -- or varieties -- of cholera, only a few are virulent enough to cause outbreaks. Over time, however, the virulent and nonvirulent types cross-breed and produce new genetic configurations, increasingly the likelihood that someone will ingest them.

In modern times, cholera outbreaks almost invariably occur in places with poor sanitation and little access to clean drinking water. In the case of Haiti, many doctors are less surprised by cholera's emergence than by the fact that it hadn't happened sooner. One University of Florida microbiologist had in fact warned of the likelihood of a cholera outbreak after a trip to Haiti this past summer -- several months before the outbreak.

The CDC test is also not necessarily conclusive. Outside observers say the center's tests are not as specific as those used by other organizations and more research is needed to pinpoint exactly which strain is present in Haiti. The CDC itself says that despite the similarity of the disease to South Asian strains, it's not possible to accurately pinpoint the source.

Public health experts debate whether it's even worth the effort to trying to find out where the disease come from at a time when scarce resources are being devoted to halting its spread. The World Health Organization has said that investigating the origin of the outbreak is "not important right now," though longtime Haiti public-health advocate and U.N. deputy special envoy Paul Farmer counters that finding the source "would seem to be a good enterprise in terms of public health" and that the reluctance of international organizations to investigate further is politically motivated.

For its part, the U.N. peacekeeping mission says that medical tests on its troops showed no signs of cholera. But that answer is unlikely to satisfy the desperate protesters on the streets of Cap-Haitien.

Thanks to David Sack, professor of global disease epidemiology and control at the Bloomberg School of Public Health at Johns Hopkins University.    

Spencer Platt/Getty Images

FP Explainer

Why Does Turkey Always Arrest So Many People at the Same Time?

To make a statement.

This week in the eastern Turkish city of Diyarbakir, 151 Kurdish activists, including 12 mayors of local towns, were put on trial for ties to the militant Kurdish Workers' Party (PKK). In addition to the crime of belonging to the group, the activists are also accused of holding illegal demonstrations and distributing anti-government propaganda. According to reports, a special courtroom had to be built in Diyarbakir because of the number of defendants.

But trials of this size are hardly unprecedented in Turkey. Indeed, they're becoming the norm. Eighty-six alleged PKK members were arrested in a nationwide crackdown this February. One-hundred-twenty suspected al Qaeda members were arrested in January. More than 100 people were arrested in connection with an alleged coup plot in January 2009. And Eighty-six were arrested for ties to the rumored "Ergenekon" coup conspiracy in 2008. In a less politically fraught move, 46 people were arrested following an investigation into soccer match-fixing this year. Why does Turkey always arrest so many people at once?

It's probably not because Turkey has more massive criminal conspiracies per capita than anywhere else. Other countries manage to break up terrorist plots without resorting to mass arrests -- it was the Buffalo Six not the Buffalo 86, for instance. More likely, Ankarauses the public spectacle of mass arrests to send a message. Under Turkish law, an individual can be charged for simply belonging to a banned organization, even if he or she hasn't actually participated in any illegal activities. Because groups like the PKK don't exactly keep membership rolls, Turkish authorities have pretty wide leeway to crack down on anyone they deem to be subversive. Many of those arrested in this week's roundup may not actually be PKK members, but by lumping them in with the actual militants, the government could be sending a signal that it won't tolerate overt Kurdish nationalism.

In the case of the shadowy ultranationalist organization Ergenekon, many doubt that it actually exists at all and believe the Turkish government is using it as a pretext to attack hard-line secularists in the military.

Despite its mass arrests, Turkey has a relatively low conviction rate -- around 50 percent. Out of the original 86 Ergenekon arrests, only 48 are still on trial. But because Turkish law allows suspects to be held in prison during their trial, the arrest and trial itself can often be punishment enough -- and a powerful deterrent for those who might think of instigating their own plots.

It's not clear whether the mass-arrest strategy is working to quiet unrest -- in the Kurdish case, discontent seems to be growing. But it's certainly a logistical nightmare. In addition to the special courtrooms and prisons that have had to be built for Turkey's conspiracy trials, the paperwork alone can be crippling. The Ergenekon indictment was 2,455 pages long and took more than 280 hours to read aloud in court.

Thanks to Gareth Jenkins, Istanbul-based journalist and senior fellow at the Silk Road Studies Program.