Epistemological rehabilitation of “shoe leather” epidemiology: the lesson of cholera in Haiti

Excerpt

In December 2016, the United Nations Secretary-General, Ban Ki-moon, finally apologized to the Haitian people for role that the U.N. played in the cholera epidemic in Haiti, which has impacted the country since October 2010 (https://​www.​un.​org/​sg/​en/​content/​sg/​statement/​2016-12-01/​secretary-generals-remarks-general-assembly-new-approach-address, accessed July 11, 2017). He affirmed that cholera must be eliminated in Haiti and promised to do much more to combat the epidemic. Despite the accumulated evidence that a peacekeeper contingent imported the epidemic from Nepal by contaminating a river with camp sewage [1], the U.N. continued to deny their unfortunate role and consistently declared immunity to avoid facing the victims’ damage claims. Although understanding the origin of this epidemic should impact the strategies to eliminate cholera and the acquisition of necessary resources, influential scientists and experts opined that it was unhelpful and unfair to blame responsibility on a stabilization and aid force [2]. Furthermore, of 220 articles referenced in PubMed with search terms “cholera” AND “Haiti” between 2010 and 2016, only 26% mentioned or evoked the hypothesis of cholera importation from Nepal. This may also have epistemological explanations. …