Julie Schindall: A huge influx of aid and medicine is needed in the worst-hit areas

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The Independent US

This has become a very serious situation, although the cases of cholera that have been reported in the capital are not surprising given how people have moved all over the country since the disastrous earthquake that struck in January.

The epidemic appears to have started in a rural province considered to be the "rice bowl" of Haiti. There is a lot of water in the area and a river flows through it, which some are saying was the source of the outbreak.

We know that many people fled here after the disaster, although we do not have an accurate head count, but this has been true all over the country and it just made a bad situation even worse.

Nearly 90 per cent of rural people were living on less than $2 (£1.20) per day before the earthquake and the disaster displaced more than two million Haitians. This included nearly 600,000 who initially went to the countryside.

Few services were ever available outside of the capital before the earthquake – and many in Port-au-Prince were destroyed in the earthquake.

So there is very little healthcare provision in rural areas. But this is a condition that is treatable – and can be helped by a public health campaign – but it means that we need a huge influx of medicine and other aid into the worst-affected areas. The areas where we are seeing the cholera cases are not where our response to the earthquake has been centred.

I have heard reports that children are dying within four hours from the effects of the cholera. The old and the young seem to be the most vulnerable, and this appears to be one of the more virulent strains of cholera that we have seen.

Cholera dehydrates the body very, very quickly through diarrhoea. If patients are far gone, they have to be put on an intravenous drip and we need to get them to hospital fast. But if we get to them early, we only need to use oral rehydration salts.

We're doing massive public health campaigns on hand-washing and using clean water. What is encouraging in this case is that the cholera has been recognised early and we have been working with people on the ground to help them identify new cases.

We are now trying to ensure there are no new cases in the areas in which we are working.

Julie Schindall works for Oxfam in Haiti