PORT-AU-PRINCE, Haiti — After three years without a new case, at least one person has died of cholera in Haiti, officials here said, stoking fear of an outbreak as widespread gang control over vast swaths of the country hinders access to fuel, clean drinking water and medical care.
Two confirmed cases of the acute waterborne diarrheal illness, one resulting in death, have been detected so far, health ministry officials said Sunday. Cholera killed about 10,000 people in the country after the 2010 earthquake.
The Pan-American Health Organization said health-care facilities reported an increase in severe acute diarrhea among hospitalized adults and children in the capital and that more than 20 suspected cholera cases and seven suspected deaths were being investigated.
The announcement of cholera’s potential resurgence came as the Caribbean nation confronts a confluence of humanitarian and political crises that have left many people at risk of infection and threaten to imperil a response.
Violent armed gangs have tightened their chokehold on several parts of the country, at times blocking the movement of critical humanitarian aid and other supplies. The G-9 federation of gangs has for several weeks blocked access to the main fuel terminal here, forcing businesses and hospitals to reduce their hours or shut down altogether.
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The fuel shortages have also compelled at least one major distributor of potable water to shut down. Gang blockades have prevented water trucks from resupplying some neighborhoods, and fuel is also needed to make city water pumps work, Guito Edouard, chief of Haiti’s sanitation agency, said at a news conference Sunday.
All of this is a problem for controlling cholera, which is spread primarily when people ingest contaminated food or water. The disease is extremely virulent and if untreated can kill people within hours.
“Many people will die if effective measures are not taken,” said Etzer Emile, an economist in Haiti. “The gangs will make things worse.”
For several weeks, thousands of Haitians have taken to the streets in some of the largest demonstrations in years to protest the government of interim prime minister Ariel Henry and soaring fuel prices. Some have looted shops, schools and humanitarian warehouses. One regional leader described the social unrest engulfing the country as a “low-intensity civil war.”
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The Pan-American Health Organization said one potential cluster of cholera cases under investigation is in Cité Soleil, the largest slum in Port-au-Prince, where hundreds were killed and thousands more trapped without food or water this year by clashes between rival gangs.
“You are in a lawless country. Nobody is in charge. It’s the gang that’s in charge,” said Cécile Accilien, vice president of the nonprofit Haitian Studies Association. “People cannot go get clean water because they are barricaded by the gang. … People have died because they can’t get to the hospital.”
Haiti recorded its first cholera case in October 2010, several months after a powerful earthquake rocked the country, killing more than 300,000 people.
The illness was introduced by a contingent of U.N. peacekeepers who had recently completed training in Kathmandu, Nepal, at a time when cholera was circulating there. More than 800,000 Haitians were infected with the illness.
In 2016, after years of sidestepping questions about responsibility for the deadly outbreak, Ban Ki-moon, then secretary general of the United Nations, said the body was “profoundly sorry” for its role.
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“This has cast a shadow upon the relationship between the United Nations and the people of Haiti,” he said. “It is a blemish on the reputation of U.N. peacekeeping and the organization worldwide.”
Advocates have argued that the United Nations has not done enough to compensate victims.
Vélina Élysée Charlier, a member of an anti-corruption group called Noupapdòmi, said she has been living under self-imposed “house arrest” to protect herself from gang violence.
The cost of bottled water has gone up by about 100 percent in some areas, she said, and she recently spent 3,500 gourdes — about $29 — per gallon of gasoline on the black market.
“I’m very worried. I have four daughters — my youngest is almost 5 months,” she said in a WhatsApp message. “Access to clean water is a big challenge, and the poorest who already had no access to clean water will suffer more.”
With early intervention, cholera’s fatality rate is less than 1 percent. But many Haitians are at the mercy of unofficial borders drawn by rival gangs and have limited access to health care.
“You don’t go to any areas that are controlled by gangs, unless you’re a journalist, and even then, you are taking the risk of not making it back alive,” Charlier said. In the event of a medical emergency, her plan is to “start walking and calling friends to see if anybody can help.”
Kasulis Cho reported from Seoul, and Coletta reported from Toronto.