The rate of deaths from Haiti's cholera outbreak appears to be stabilising, according to health officials in the country, even as large numbers of people continue to fall ill with the disease.
Gabriel Timothee, the health minister, said in a press conference on Monday that the recent spread of cholera had killed 259 people and made 3,342 others ill.
"The situation is beginning to stabilise. Since yesterday we have registered only six new deaths," Timothee said.
But Al Jazeera correspondent Sebastian Walker, who visited the Artibonite Department - the province where the outbreak is centered - spoke with clinic workers who said they have seen the illness rate stay the same.
Ian Rawson, the director of a clinic there, said he sees 20 to 25 new patients a day.
"This is what's seen in populations that don't have previous immunity," Eric Mintz, a worker for the US Centers for Disease Control, said. "So in countries in Asia where cholera is an occurrence every year, people do develop immunity after repeated exposures and they are much less likely to get severely dehydrated".
The announcement by Haitian health officials on Saturday that five cholera cases had been confirmed in the capital Port-au-Prince stoked fears that the disease could spread rapidly among hundreds of thousands of survivors of the January 12 earthquake who are sheltered in camps there.
But since then, UN and Haitian officials have expressed confidence that they might have the disease under control, at least preventing it from exacting a much higher death toll.
Yet Haitians that live in rural areas still have extremely poor access to clean water. Our correspondent spoke with people using a well located right next to the Saint-Marc River, which the United Nations has said is contaminated with cholera.
"This water behind me, we drink it, we wash our clothes with it, we cook with it; our water safety situation here is a catastrophe," Renel Consonde, a resident, said.
Lack of awareness
Al Jazeera's Craig Mauro, reporting from the capital's National Hospital, said many residents of Port-au-Prince said they were not even aware of the cholera outbreak.
One doctor specialising in infectious diseases told our correspondent that he believed the health system could control an outbreak in the city, but that the hospital had only 20 beds set aside for serious cases.
The first cases confirmed in Port-au-Prince since the epidemic started were people who had become infected in the main outbreak zone of Artibonite, north of Port-au-Prince, UN officials told Al Jazeera, citing the Haitian ministry of health.
|Though the death rate has slowed, more than 3,400 people are now sick [AFP]
The five had subsequently travelled to the capital, where they fell ill and are now being treated.
"These cases thus do not represent a spread of the epidemic because this is not a new location of infection," the UN's Office for the Co-ordination of Humanitarian Affairs said.
They are among more than 3,000 people who were infected in an outbreak mostly centered in the rural Artibonite region. Officials have warned that the death toll could rise as they reach hard-to-access areas.
Al Jazeera first discovered on Saturday that two suspected cholera patients were being treated at Port-au-Prince's National Hospital. Sebastian Walker, reporting from the capital, tracked one patient to a poor neighbourhood in the city.
Rosalind Alsaintdor told our correspondent that she had been suffering from acute diarrhoea and was told by doctors she would receive the result of her cholera test on Monday.
Containing the disease
Al Jazeera's Walker said the main priority for health officials now is containing the disease.
"The main focus is on the IDP (internally displaced person) camps. You have 1.3 million people living in very squalid conditions, conditions in which health officials have told us are breeding grounds for disease - very poor levels of sanitation, almost no drinking water."
Another problem in the camps is a lack of clean drinking water. Residents told Al Jazeera the water delivered routinely by the Red Cross in tankers makes them sick.
If the disease spreads into camps where those left homeless by the January earthquake are sheltering, a public health crisis could be imminent.
More than 250,000 people were killed in the earthquake and another 1.2 million left homeless.
|Cholera can kill children within four hours if not treated [REUTERS]
"It will be very, very dangerous," Claude Surena, president of the Haitian Medical Association, said. "Port-au-Prince already has more than 2.4 million people, and the way they are living is dangerous enough already. Clearly a lot more needs to be done.''
The first two cholera cases outside the Artibonite region were confirmed in Arcahaie, a town closer to the capital.
Experts were also investigating possible cases in Croix-des-Bouquet, a suburb of the capital, and radio reports said there were two dozen cases of diarrhoea, which can be a symptom of cholera, on Gonave Island across the Gulf of Gonave from the capital.
State of emergency
Cholera is a bacterial illness that infects the small intestine. It is spread primarily through contaminated drinking water and can also pass between humans through faecal matter. Severe dehydration, one of cholera's effects, can kill a small child in four hours if not treated.
Aid groups and the government were rushing medical teams, medicine, clean water and water purification to the affected areas. The health ministry also declared a state of emergency in Artibonite.
Cholera treatment centres ave been set up to isolate patients in the two worst affected provinces and in Port-au-Prince.
Officials have urged residents to take preventative action.
"Chlorine is being provided so to take advantage of those measures that will ensure that anything ingested whether it be water or food is properly prepared and that the source of the water is safe and adequately treated," Jon Andrus, the deputy director of the Pan American Health Organisation, said.