PORT-AU-PRINCE The death toll from a cholera epidemic in central Haiti topped 200 on Saturday as the government and its aid partners doubled efforts to stop the disease from reaching the crowded, earthquake-ravaged capital.
With more than 2,300 cholera cases reported and experts predicting the numbers will rise, Haitian and international medical teams are working desperately to isolate and contain the epidemic in the Artibonite and Central Plateau regions.
These are north of the sprawling and rubble-strewn capital Port-au-Prince, with its squalid slums and around 1.3 million survivors of the January 12 earthquake packed into tent and tarpaulin camps. All are highly vulnerable to a virulent diarrheal disease like cholera.
It is the worst medical emergency to strike the poor, disaster-prone Caribbean nation since the earthquake killed up to 300,000 people and is also the first cholera epidemic in Haiti in a century.
Haitian health officials told a news conference on Saturday that 194 people had died from cholera in the Artibonite region, the main outbreak zone, with another 14 deaths in neighboring Central Plateau.
There are nearly 2,400 cases in all and affected places included a prison in Central Plateau.
United Nations and Haitian officials have said there are no confirmed cases so far in the capital. But they have stepped up disease prevention measures and surveillance of the camps housing people displaced by the earthquake while rushing doctors, medicine and water supplies to the affected areas.
"It's an enormous challenge and the thought of it coming to Port-au-Prince is awful," U.N. humanitarian spokesperson Imogen Wall told Reuters. "Obviously, preventing the disease spreading to the city is an absolutely paramount concern right now."
But one leader of a private U.S.-based humanitarian charity said a number of people sick with cholera were already in Port-au-Prince after they traveled south from the affected areas to seek medical treatment in the capital.
"I can confirm five cases personally," Daniel Rouzier, chairman of the Board of Trustees of Food for the Poor, told Reuters. "It was not originally in the geographical area of the camps. Now it is."
Rouzier, whose charity has sent water purification units to the cholera-infected central zones, faulted the Haitian government and its aid partners for not moving quickly and effectively enough to contain and isolate the epidemic.
"Right now, it's been over 72 hours. There is no safety cordon," he said. "If the sick had the proper healthcare where they were, they wouldn't have come to this chaotic city."
Aid workers in the town of Saint-Marc, in the heart of the Artibonite outbreak zone, have reported the main local hospital overflowing with patients, many lying outside in the compound hooked up to intravenous drips.
Haiti is due to hold presidential and legislative elections on November 28 but it is not clear whether the epidemic could threaten the organization of the vote.
CAMP DWELLERS FEAR CONTAGION
In the crowded camps that fill squares, streets, parks and even a golf course in Port-au-Prince, fears of contracting the disease are running high.
"All we can do is pray to God because if we catch this disease in these camps it will be a real disaster," said Helen Numa, 35. "You can see for yourself how people are living here, packed in like sardines."
Cholera, transmitted by contaminated water and food, can kill in hours if left untreated, through dehydration. But it can be treated easily with oral rehydration salts or just a simple mix of water, sugar and salt.
Haitian Health Minister Alex Larsen has urged people to wash their hands with soap, not eat raw vegetables, boil all food and drinking water and avoid bathing in and drinking from rivers. The Artibonite River, which irrigates all of central Haiti, is believed to be contaminated.
But many in the capital's camps said they did not have money to buy soap and chlorine to apply hygiene measures.
"We don't have anything, not even one dollar, because we don't have jobs," said Marjorie Lebrun, 45. "I'm afraid if I and my five children get sick, we could die."
Wall said the international relief effort in Haiti had enough antibiotics to treat 100,000 cases of cholera and intravenous fluids to treat 30,000. But these would need replenishing.
"It would be irresponsible of us not to prepare for the worst case scenario -- a nationwide outbreak," she said.
Most experts believe the number of cholera cases will rise before the epidemic is contained.
"There is still time to react. If the proper actions are taken, I think we will be able to limit the number of people who die," Rouzier said.
(Additional reporting by Pascal Fletcher in Miami; Writing by Pascal Fletcher; Editing by John O'Callaghan)