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Ten months after Haiti's devastating earthquake, a more insidious disaster struck: cholera. Haiti hadn't seen cholera for at least a century. Then suddenly, the first cases appeared near a camp for United Nations peacekeeping forces. Since then, the disease has struck nearly 640,000 people - one out of every 16 Haitians; and it's killed 8,000.
This month, the Haitian government is expected to unveil an ambitious plan to eliminate cholera. NPR's Richard Knox reports on the chances of success.
RICHARD KNOX, BYLINE: Cholera hit Haiti with a bang. Within two days of the first cases, a hospital 60 miles away was admitting a new cholera patient every three and a half minutes.
DANIELE LANTAGNE: Part of the reason that we think the outbreak grew so quickly was the Haitian population had no immunity to cholera; something like when the Europeans brought smallpox to the Americas, and it burned through the native populations.
KNOX: That's Daniele Lantagne of Tufts University in Massachusetts. She says comparison of the Haitian cholera strain with one circulating in Nepal around the same time, shows the two differed in only one out of 4 million genetic elements.
LANTAGNE: That's considered an exact match - the same strain of cholera.
KNOX: Most scientists now think Nepalese soldiers unwittingly brought cholera to Haiti, when they joined a U.N. peacekeeping force there in 2010. The outbreak started just downstream from their camp. Sewage from the camp spilled into a nearby river.
Lantagne was one of four scientists appointed by the U.N. to look into the matter. Their report concluded the outbreak was caused by quote, "a confluence of circumstances." She says the report would come out different today.
LANTAGNE: If we had had the additional scientific evidence, we definitely would have written the report - in 2011 - to state the most likely source of introduction was someone associated with the peacekeeping camp.
KNOX: That's important because the U.N. insists that however cholera got to Haiti, terrible sanitary conditions and lack of clean water there, are responsible for its explosive spread. Brian Concannon doesn't buy that.
BRIAN CONCANNON: It's like lighting a fire on a dry field on a windy day, and then blaming the wind or the drought for the fire.
KNOX: He's with the Institute for Justice and Democracy, in Haiti. A year ago, the group filed a legal claim against the U.N., demanding that it accept responsibility. The U.N. hasn't admitted anything. But last month, Secretary-General Ban Ki-moon announced a plan to rid Haiti of cholera. Concannon says it's ambitious, but feasible.
CONCANNON: Cholera can certainly be eliminated from Haiti. It's been eliminated from the United States, from England, from many countries in South America. This is basically 19th century technology that needs to be installed in Haiti.
KNOX: The Haitian government is expected to release a detailed blueprint soon. That plan is expected to cost $2.2 billion, and take at least 10 years. So far, the U.N. has identified only 10 percent of the money. Concannon worries the rest may never be found.
CONCANNON: Dr. Jon Andrus acknowledges it's getting harder to raise money for Haiti, as the earthquake fades into history. He's deputy director of the Pan American Health Organization, an arm of the U.N.
DR. JON ANDRUS: It's a big challenge. The question is, can it be done? I believe it can. So we're ramping up efforts to do that.
KNOX: But even if the money can be found, it's going to take years to bring clean water and sewage treatment to Haiti. Meanwhile, people will still get cholera, and many more will die. One stopgap is to vaccinate Haitians at highest risk of cholera - such as the 266,000 babies born every year.
ANDRUS: Haiti has done some great things with vaccination. They've eliminated measles, rubella and polio; and you can't say that, in many countries in Europe. We believe they can do it.
KNOX: Cholera vaccination is 60 to 70 percent effective, and lasts about two years. And it will also take money. The U.N. says nothing has been decided yet on launching a cholera vaccination program in Haiti.
Richard Knox, NPR News.