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Kevin ClarkeOctober 25, 2010

It has been on the back of many minds since the Jan. 12 earthquake took perhaps a quarter of a million lives and left about 2 million Haitians homeless: when would the next crisis begin, this one emerging from the dangerous conditions in temporary tent cities now home to thousands of dislocated families (more than 1.3 million alone are crowded into temporary shelters around the capital Port-au-Prince). Sadly, we have an answer and the 2010 earthquake, 250 more new victims. That's the toll taken so far by a cholera outbreak in Haiti's central rural region around the Artibonite River, 60 miles north of the capital. There have been more than 3,100 cases confirmed so far.

Development and relief agencies have been warning for months of the potential for a devastating outbreak of disease if the wretched living conditions of many survivors was not rapidly addressed. Medical workers are tentatively hopeful that the worst may already be over, but fear remains strong that the terrible illness—which can kill a victim in a matter of hours—may spread to the capital city where many dislocated by the quake still live in crowded and unsanitary conditions. If efforts to keep cholera out of the camps fail, "The worst case would be that we have hundreds of thousands of people getting sick at the same time," Claude Surena, president of the Haiti Medical Association, told the AP.

The New York Times reports: "Port-au-Prince is tensely preparing for [cholera's] arrival in the densely populated slums and tent camps here, with treatment centers being established, soap and water purification tablets being distributed and public safety announcements stressing hygiene. The government reported optimistically on Sunday that the epidemic might be stabilizing. Fatalities have declined — from 10.6 percent of known cases three days earlier to 8.2 percent now.

"But international health authorities cautioned against premature optimism. 'We cannot read too much into the slight improvement in the fatality rate,' Dr. Michel Thieren of the Pan American Health Organization said. 'The epidemic has not spread yet, but it is still increasing roughly at the same rate in the Artibonite area.'"

"Since the January earthquake, this devastated country has been bracing for a secondary disaster — a hurricane, an eruption of violence, an outbreak of disease. But nobody anticipated that cholera would make its first appearance in 50 years. It was 'the one thing we thought we were relatively safe on,' said Imogen Wall, spokeswoman for the United Nations humanitarian coordination office."

Catholic Relief Service's Robyn Fieser told AP she was confident that aid groups and the Haitian government will be prepared to respond to an outbreak should it occur in the camps. But said the challenge of preventing its spread is "immense."

"There are proven methods to contain and treat cholera, so we know what we're dealing with. The biggest challenge is logistics, that is, moving massive amounts of medicine, supplies and people into place to treat them and prevent the disease from spreading."

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