Cholera returned to Haiti with deadly force in October 2022, with an outbreak that quickly spread through communities whose water and sanitation infrastructure had been compromised by the gang fuel blockade, the political crisis, and years of inadequate investment in public health infrastructure. By late November, the disease had killed at least 223 people and infected thousands more, with health officials warning that the outbreak could become much worse if conditions did not improve.
The outbreak emerged in areas of Port-au-Prince where the gang blockade of the Varreux fuel terminal had disrupted water treatment and distribution, allowing contaminated water to reach households that had previously accessed relatively safe supply. The conditions were precisely those that public health experts had warned about when the 2021 gang blockade caused similar disruptions — a direct line from criminal violence to infectious disease outbreak.
Health facilities responding to the outbreak faced a cruel paradox: treating cholera required oral rehydration therapy and intravenous fluids, which required clean water and functioning medical infrastructure, precisely the things that the crisis had disrupted. Hospitals without reliable electricity and water struggled to provide the basic treatment that could prevent cholera deaths in most cases.
The cholera outbreak drew painful comparisons to the 2010 epidemic introduced by UN peacekeepers, which had killed at least 10,000 Haitians. Health organizations warned that without immediate action to restore water and sanitation services and scale up treatment capacity, the 2022 outbreak could develop into a major epidemic. They called on the gang coalition to allow humanitarian access and on the international community to provide emergency health resources.