An ambulance arrives at a hospital in Port-au-Prince, Haiti.

United Nations, October 7 (RHC)-- Surging violence and insecurity have turned Haiti into a “time bomb for cholera,” the UNICEF representative in the country told Al Jazeera, as aid groups and local authorities ramp up their response to an outbreak in Port-au-Prince.

In an interview on Wednesday, Bruno Maes said 1.2 million Haitian children are threatened due to the resurgence of the illness in the capital, where local health authorities have reported dozens of suspected cases since the beginning of October.  “Many of the poorest Haitian families, they have no option but to drink and use unsafe water … Garbage is not collected in the streets.  Hospitals are closed or unable to operate,” Maes said.   “All these ingredients have turned Haiti into a time bomb for cholera, and now it is exploding.”

Haiti’s Public Health and Population Ministry said on Wednesday that five cholera cases had been confirmed between October 1 and October 4, along with one death at a health facility. It also reported 52 suspected cases, of which 15 were among children aged four and under.

Maes said seven fatalities were under investigation in various neighbourhoods of Port-au-Prince, including areas where widespread violence and a lack of access to potable water and other services puts residents at heightened risk.  “Access to basic, essential care is lacking — crucially lacking — on a big proportion of the territory now of Port-au-Prince,” he added.   

Haiti had last reported a cholera case more than three years ago, after a 2010 outbreak linked to United Nations peacekeepers caused approximately 10,000 deaths and more than 820,000 infections.  That outbreak was linked to a sewage leak from a UN peacekeeping base, spurring condemnation and sowing public distrust in the international body across Haiti. The UN apologised in 2016 for its role in the epidemic.

Cholera is an illness caused by drinking water or eating food contaminated with cholera bacteria. It can trigger severe diarrhoea as well as vomiting, thirst and other symptoms, and can spread rapidly in areas without adequate sewage treatment and clean drinking water.

Earlier this week, Haiti’s public health department said one cholera case was confirmed in an area of Port-au-Prince, while several other suspected cases were reported in Cite Soleil, a violence-stricken neighbourhood of the capital.

“As of 2 October 2022, more than 20 suspected cases of cholera, including 7 fatalities … were detected by healthcare personnel,” the Pan American Health Organization, a branch of the World Health Organization (WHO), also said.

A deteriorating security situation in Port-au-Prince is complicating efforts to respond to the outbreak, as armed gangs have been battling for control of key neighbourhoods in the aftermath of President Jovenel Moise’s assassination last year.

Most recently, gangs have blockaded fuel terminals in anger over cuts to government subsidies.  The surge in violence, coupled with a widespread lack of petrol, has made it difficult for many residents to move around freely. Some Haitian hospitals also recently warned that they could be forced to cut back on services because they lacked fuel to power the facilities.

“The resurgence of cholera is taking place at a time when the Haitian population faces enormous difficulties in accessing health care”, Doctors Without Borders (Medecins Sans Frontieres, or MSF) said this week.

As of Monday, the organization said 68 patients had been admitted to new cholera treatment centres in the Port-au-Prince neighbourhoods of Brooklyn, Cite Soleil and Turgeau. “Sadly, a three-year-old child died,” it said, without providing additional details.

As international aid efforts ramp up, the WHO also said this week that it would help local partners distribute equipment such as tents to set up treatment centres. Spokesperson Christian Lindmeier told reporters that the organisation was submitting a request for cholera vaccines for Haiti as well.

“Now with an outbreak starting, and with the humanitarian situation as it is … we should expect, unfortunately, [for] cases to be higher and to rise,” Lindmeier said during a news conference in Geneva on Tuesday.

Meanwhile, Haitian authorities have called on residents who develop acute diarrhoea to seek medical care, while UNICEF said it is supporting the government with supplies, including 755,000 water purification tablets and 28,230 soap bars.

An order of chlorine has also been placed, UNICEF said, to assist Haiti’s water and sanitation agency “in chlorinating the water in Port au Prince, disinfecting affected households, and supplying health centers in affected areas”.

Maes on Wednesday called for a humanitarian corridor to allow fuel to reach the main hospital in the capital, as well as any cholera response centres.

Representatives from several countries, including Canada, the United States and France, this week also urged an immediate humanitarian truce to get fuel out of a blockaded Port-au-Prince terminal and meet the country’s urgent needs.

“But for the time being, there is no progress there,” Maes told Al Jazeera. “There is no access to fuel … for [the] emergency humanitarian response, including the cholera response.”