When humanitarian officials in Haiti try to describe their concerns about a new, rapidly spreading cholera epidemic, they struggle to find words strong enough: “alarming,” “chaotic,” even “a disaster.”

A sizeable portion of the island’s population is isolated – and lacking access to health care – either from severe fuel shortages or from the brutal armed gangs that control vast areas.

And without medical attention, cholera patients suffering from acute diarrhea can die of dehydration within hours.

“It is a disaster. We are overwhelmed,” doctor Jean William Pape told AFP. His NGO, called Gheskio, runs two of the country’s 15 cholera treatment centers.

In one of them, in the capital Port-au-Prince, “we have 80 beds and they’re all occupied,” he said. “Because of the fuel shortage, people in the slums have told me that there have been several deaths in their area because it was not possible to transport the sick.”

An armed gang has blocked a key fuel terminal in Varreux, north of the capital, for weeks, compounding the country’s paralysis.

Cholera was brought to Haiti by UN peacekeepers in 2010, ultimately resulting in thousands of deaths.

But until the last outbreak, no case of the disease had been reported in Haiti since 2019.

As of Wednesday, the Ministry of Health had recorded 33 cholera deaths and 960 suspected cases.

And that number could seriously underestimate the problem, according to Bruno Maes, UNICEF’s representative in Haiti.

The situation is all the more frustrating, experts say, because even severe cholera cases are easily treatable with a few days of rest and rehydration that there is a cholera vaccine.

However, this vaccine is only effective for about five years, and the last major targeted vaccination campaign in Haiti was in 2017.

About half of all cases here involved children under the age of 14, who are particularly at risk if their immune systems are weakened by poverty-related malnutrition.

“Many of them are very malnourished,” said doctor Pape, adding that it was difficult to find their veins to give solutions intravenously.

The United Nations estimates that 4.7 million Haitians, almost half the country’s population, are acutely food insecure.

Doctors Without Borders (MSF) operates four centers totaling 250 beds and about 20 oral rehydration clinics, deputy head of mission Moha Zemrag told AFP.

He said a priority is securing access to drinking water in gang-controlled areas like the borough of Brooklyn in the capital’s Cite Soleil community, which has not had fresh water for three months.

Cholera is caused by ingesting water or food contaminated with a bacterium called Vibrio cholerae.

The high risk of kidnapping by the gangs has prevented aid groups from entering these areas to disinfect homes and buildings with chlorine.

While MSF has set up a shuttle system to get its staff safely to treatment centers, fuel shortages could make that impossible “in a few weeks,” Zemrag said.

Concern is also growing for rural residents, who without access to fuel may have to walk for days to get help. Early cases were discovered in the southern region of Nippes and in Artibonite to the north.

Armed groups are now blocking highways heading both north and south, Maes said.

“Port-au-Prince is literally surrounded, choked off,” he said.

UNICEF offices were ransacked and shipments of medicine blocked at the port.

The return of cholera has conjured up nightmarish memories of the epidemic, which was unleashed by UN blue-helmet peacekeepers in 2010 after a massive earthquake devastated the country. The disease claimed more than 10,000 lives from then until 2019.

But conditions are different today, said Sylvain Aldighieri, deputy director of public health emergencies at the Pan American Health Organization.

“Right now we’re not seeing (in cases) an explosion like what we saw in the early months of 2010,” he said.

He said authorities had “10 years of experience with cholera” and the key now was to “reactivate the mechanisms” that worked previously.

However, doing so comes with challenges.

The UN imposed sanctions on several gangs on Friday, including an arms embargo. However, opinion remains divided as to whether a new international force should be sent to the country.

Such a force, Aldighieri said, could be able to establish “difficult zone humanitarian corridors” and help release supplies now blocked at ports.

For now, he added, planes with additional supplies are expected in the coming days.