Some of the victims of Haiti's cholera outbreak are being treated on hospital floors because all the beds are taken, and fever-wracked patients are waiting hours for a doctor to reach them.
Outside Saint Nicolas hospital, an overwhelmed facility at the heart of Haiti's growing public health disaster, hundreds of desperate relatives bring their sickened kin to the front door.
Some collapse before they reach the entrance and are stepped over by others clamouring for medical attention.
With lines of families bringing their young children to patiently sit inside the hospital, the corridors and even the hospital yard is filling up so fast that nurses wearing bright white smocks and surgical masks have to pick their way through piles of victims sprawled out on the floor.
So far 135 people have died and 1,500 people have been taken ill with the disease that is being blamed on the cholera-infected Artibonite river, an artery crossing Haiti's rural centre that thousands of people use for much of their daily activities from washing to cooking.
"I'm very weak (because) I lost a lot of weight in the last two days," said Edner Philemon. He said three members of his family died from cholera in a matter of hours.
Cholera is caused by a comma-shaped bacterium called Vibrio cholerae, transmitted through water or food that has typically been contaminated by human faecal matter.
It causes serious diarrhoea and vomiting, leading to dehydration. It is easily treatable by rehydration and antibiotics. But with a short incubation period, it can be fatal if not treated in time.
Responding well to treatment
The patients "respond well to treatment," said Yolanda Surena, a doctor dispatched to the affected region some 100 kilometres north of the capital Port-au-Prince.
"But we cannot send them home to avoid spreading the disease," Surena added, calling on international aid organisations to urgently send 500 beds for the patients who keep arriving.
Health officials fear an even greater public health disaster is awaiting the impoverished country if the epidemic spreads south to the teeming tent cities of the capital, still in ruins from the January earthquake that left over a million people homeless.
A wet month
October is the third wettest month in this tropical country and poor sanitation in the densely packed camps mean thousands of people without adequate housing or medical facilities risk exposure to infected water.
Local media here is instructing the population to take precautions to fight the outbreak and Surena reminded local residents that the most basic precautions can save lives.
"You must eat well cooked food, wash as often as possible, drink the treated water," the doctor said as patients received rehydration treatment in stairwells and waiting areas throughout the Saint Nicolas hospital.
(Sapa, October 2010)
Urgent medical needs in Haiti