
John W. Poole / NPR
A makeshift latrine hangs over the water at the edge of Cite de Dieu, a slum in Port-au-Prince, Haiti.
Port-au-Prince is about the size of Chicago. But it doesn’t have a sewer system. It’s one of the largest cities in the world without one.
That’s a big problem, but never more so than during a time of cholera.
Since cholera was introduced into Haiti 18 months ago – most likely by United Nations peacekeeping troops from Nepal, where the disease is endemic – more than a half-million people have gotten sick and at least 7,050 have died.
Public health authorities say cholera will stay in the environment for a long time, because Haiti has the worst sanitation in this hemisphere.
It’s hard for Americans to imagine what this means.
The cumulative sewage of 3 million people flows through open ditches. It mixes with ubiquitous piles of garbage. Each night an all-but-invisible army of workers called bayakou descend into man-sized holes with buckets to remove human waste from septic pits and latrines, then dump it into the canals that cut through the city.







