PORT-AU-PRINCE A tropical cyclone barreling toward Haiti threatens hundreds of thousands with deadly floodwaters and will likely worsen a cholera epidemic that has already killed more than 440 people, the United Nations said on Wednesday.
Tropical Storm Tomas is expected to hit Haiti on Friday, unleashing torrential rains and a storm surge of up to 6 to 9 feet that will put 1.5 million people at risk, said Nigel Fisher, the U.N. humanitarian coordinator in Haiti, citing government estimates.
"The biggest fear is people being caught by high waters and the potential spread of cholera," Fisher said in an interview. "People should (not) be under the misapprehension that it (the epidemic) is under control. The cholera epidemic is likely to spread."
The outbreak of the diarrheal disease, which has taken 442 lives, has triggered another national emergency in the Western Hemisphere's poorest nation.
It came as the deforested and mountainous land, which is very vulnerable to flash floods and mudslides, was still struggling to recover from a January 12 earthquake that killed more than a quarter of a million people and left about 1.3 million quake survivors still living in fragile outdoor camps.
Tomas has a terrifying potential to add to the country's misery. It hit the Caribbean's eastern islands as a hurricane four days ago, killing at least five people in St. Lucia before weakening. It is seen gathering force again to start battering Haiti and Jamaica from Thursday night, forecasters said.
"Hurricanes never come at a good time but we are particularly stretched right now," Fisher said.
The worst fear is a hurricane-strength storm that hits multiple regions simultaneously, overwhelming the capacity of the government and the aid community to cope, he said.
"The big challenge is saving lives. If the hurricane is so huge that all over the country is hit severely ... we will really be stretched and we will have to make difficult choices about where to put scarce assets," he added.
Tomas restrengthened to a tropical storm on Wednesday, packing top sustained winds of 45 miles per hour and moving northwestward. Its core was expected to approach Haiti on Friday, the U.S. National Hurricane Center said.
"Tomas could be approaching hurricane strength as the center nears Haiti," the Miami-based hurricane center said.
On Wednesday afternoon, the storm was about 305 miles southwest of Port-au-Prince.
In Jamaica, which is also expected to feel the effects of Tomas, authorities were preparing shelters and urging people to evacuate from low-lying and flood-prone areas.
In Haiti, the government is urging people in low-lying areas to start a voluntary evacuation to higher ground if they can stay with friends or family or in community shelters.
But government capacity to speed an evacuation is limited and leaving will be difficult for hundreds of thousands in cramped tent cities and makeshift camps in the capital.
Fisher said up to half would not be able to find shelter with friends or relatives.
"We are in month nine of responding to people with needs in camps because of the earthquake. We have just had to mobilize a lot of people and resources ... to respond to cholera," he said, adding the United Nations immediately needed about 150,000 tents and tarpaulins to provide additional shelter.
With the storm threat and the spreading epidemic, Haiti faces major disruption less than a month before November 28 presidential and legislative elections. Electoral officials have not moved to postpone the vote.
Jocelyne Pierre Louis, director of the government's family health department, said on Wednesday that more than 6,700 people had been hospitalized with cholera. The vast majority of the dead, 336, were from the central Artibonite region, she said.
(Additional reporting by Joseph Guyler-Delva; Editing by Tom Brown and Peter Cooney)