The Second Calamity

Rains bring Haiti's quake victims a new scourge: cholera

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Moises Saman for TIME

Near the center of the epidemic in Petite Riviere, flooding from Hurricane Tomas has villagers fearing an increase in the cholera-infection rate.

No one wants to shake hands in Haiti anymore. The fear of contagion, of someone's unwashed fingers being where the cholera bacteria may have been, has led to an alternative greeting: people bump elbows nowadays. Even Haiti's President, René Préval, has been seen knocking elbows with his staff. Haiti's latest misfortune hasn't come close to claiming the massive numbers of victims the Jan. 12, 2010, earthquake did — about 8,200 people infected, just under 600 fatalities as of Nov. 9. But cholera has assumed fearsome proportions because of two things: its presence in filthy water, which Haiti has aplenty, and the fact that so much more water poured in with a storm called Tomas.

It could have been worse. The hurricane could have struck the nation directly. But the rain it deposited as it brushed past was enough to increase the potential for the bacteria, borne by feces, to seep south and west from the Artibonite region, north of Port-au-Prince, where the disease had been gingerly contained since its late-October outbreak. In a district of the capital, Delmas 33, canals did not flood only because a group of men started picking up piles of trash with their bare hands to keep the waterways from clogging.

Cholera is easy to prevent: wash your hands; boil the water you drink. But contracting it can bring excruciating suffering in the form of severe diarrhea and vomiting, which lead to serious dehydration and organ failure. Already, confirmed cases have been reported in Port-au-Prince. Hospitals and medical centers have geared up for the infected. One silver lining is that so many drugs are already in the country as a result of the quake-relief effort.

Haiti hadn't experienced an outbreak of cholera in decades. How did the disease get there? The strain apparently matches one common in South Asia. As a result, there has been finger-pointing at U.N. peacekeepers, who include soldiers from Nepal. The government is allaying the xenophobia. "We know that it came from South Asia, but anyone who has taken a plane could have traveled anywhere in the world and brought it here," says Prime Minister Jean-Max Bellerive. "It's not a question of who brought it into the country. Let's eradicate it."