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MARY LOUISE KELLY, Host:

It's MORNING EDITION from NPR News. I'm Mary Louise Kelly, in for Renee Montagne.

STEVE INSKEEP, Host:

And I'm Steve Inskeep.

Day by day, we're tracking what we hope will not be a second catastrophe in Haiti. There was no way to stop the country's earthquake, but there may be ways to at least contain the spread of cholera. Doctors want to keep the outbreak close to St. Marc, where it began.

Here's NPR's Christopher Joyce.

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CHRISTOPHER JOYCE: The streets of St. Marc are a bedlam of cars, motorcycles, people on foot, people selling food and shoes, kids walking to school. There are shantytowns and canals with sewage, and the streets run with water whenever it rains. It's easy to see how cholera could emerge here.

St. Nicolas Hospital is hidden behind high walls. Most of the more than 4,000 people who've reported to hospitals with cholera over the past two weeks, came here.

The courtyard still holds the overflow. Colorful sheets of cloth strung over cots protect the patients from the sun. Most of the patients are elderly or children. Among them is Philomena Josephat and her father Joseph. He's a bent man in his 80s and has recovered. He's walking home today.

JOSEPH JOSEPHAT: (Through Translator) Well, I've never felt sick like that before. But I lost a child, and since then my health has really left me. And with this, that's even worse. So I felt like I was dying.

JOYCE: Philomena is a tall woman with a handsome face that doesn't reveal the things that cholera has visited upon her family.

PHILOMENA JOSEPHAT: (Through Translator) I actually lost a sister in it, Friday. With my sister, the same day that she got it, she died.

JOYCE: People here say the cholera took them by surprise. There hasn't been an outbreak in more than four decades. Now that it's here, medical authorities fear that it will stay. And they fear that people with the bacterial infection who are not yet sick will spread it. That's confirmed by a young man here for treatment, Jerry Antoine.

JERRY ANTOINE: Well, yeah. Lots of people left to go down to Port-au-Prince, to the capital city, so that they avoid the area and not getting sick.

JOYCE: Did they go just to Port-au-Prince? Or did they head to other places too?

ANTOINE: (Through Translator) Well, the population basically spreads wherever the disease has not reached.

JOYCE: Doctors here say things are not in control, but they're better; chlorine and freshwater are in good supply. In town, policemen in the street carry bottles of hand sanitizer to offer a drop or two to drivers stuck in traffic.

But Dr. Patrick Almazor says it's no longer just a problem in this northwestern city. Almazor works for Partners in Health, a medical aid group that helps run St. Nicolas and two other hospitals in the region, along the Artibonite River. He said it's where people and the bacteria go next.

The crowded capital of Port au Prince, just two hours drive to the south, is a sitting target.

PATRICK ALMAZOR: Yeah, I think this is a big risk to get this epidemic spread around all the country. But our projection, we thought like after four days we might have a lot of cases in Port-au-Prince. But we can say we are lucky and maybe the message was spread, a lot of people like are taking better measures.

JOYCE: Lucky so far. But doctors here from the Pan American Health Organization say they wouldn't be surprised if there are more outbreaks around the country. Port au Prince is in full preparation mode. Radio programs and even pickup trucks with loudspeakers are spreading the hygiene word.

But the bacteria could be spreading in other directions. I visited the northern town of Villard. A Christian aid group called Samaritan's Purse set up a cholera clinic there five days ago.

Justin Dennery is a registered nurse who came here to help with the January earthquake. Now his group is treating patients with simple hydration and antibiotics, to take the pressure off overwhelmed hospitals. Over five days, the number of new patients had dropped swiftly, but the epidemic is still on the move.

JUSTIN DENNERY: If the numbers continue to decrease we're going to follow the wave, depending on what area it's going. And right now, we have a team that's trying to track where the majority of the cases are so we set up another site.

JOYCE: Like other medical workers here, Dennery is by no means sanguine. Now that cholera is here, it could crop up again, so long as public sanitation and water supplies are sketchy as they are in Haiti.

Christopher Joyce, NPR News, Haiti.

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