A nurse check the vital sign of a patient at the cholera treatment centre at the hospital Sant Dyagnostik Entegral Migabale in Mirebalais, Haiti where the first cholera cases were reported about 60 km northeast of Port-Au-Prince. November 19, 2010.Natasha Fillion for The Globe and Mail
Inside the white plastic walls of the makeshift tent that serves as this town's cholera treatment centre, a bleak but swift contest between life and death unfolds.
Patients lie listlessly on 36 numbered beds, each fashioned with a hole cut strategically above a bucket to catch human waste. Some clutch rolls of toilet paper, others stare with glassy eyes at nothing. Everything, in fact, feels strangely still until a wilted 59-year-old woman named Rosette Renal begins to die.
That morning, her husband, Dieusieu, had fed her chicken and plantains. By noon, a Nicaraguan doctor violently pumped her chest to no avail. He closed her eyelids and swaddled her in a flowered blanket as a medic sprayed the floor with chlorine.
Dieusieu's grief, however, was eclipsed by more practical worries. Because his wife died of cholera, he could not find anyone to help carry her body home, a 10-hour walk away. Nor could he bury her here in Mirebalais, because the mayor forbids it. "I don't know what I am going to do. I have no money, no nothing," said the 61-year-old farmer and father of five, slumped in a metal folding chair.
His ordeal, overheard by a group of Haitian medics nearby, resonates in a tangled way in Mirebalais, the epicentre of the cholera outbreak where tensions are now rising one week ahead of national elections to choose a successor to President René Préval.
"Cholera is killing us because our government has abandoned us," said Adrien Pierre Louis, a 39-year-old Haitian who volunteers to scrub the clinic floors for no pay.
"Because they prefer elections to people. They let other nations give us help. Other nations, instead of our own government," he said with disdain.
In Mirebalais, where the first cases of cholera were logged, skepticism over the coming election is as evident as the brightly coloured campaign posters that festoon the dirty streets.
Residents say they are overcome with weariness over their government's successive failures to lift Haiti from poverty, reconstruct after the earthquake and stem the outbreak of cholera that has claimed more than 1,100 lives and sickened about 18,000.
"Am I going to vote? I am voting against cholera. I am voting against this government," declared Benôit Jeune, a corn and millet farmer with bloodshot eyes who carried the limp body of his five-year-old son to the clinic that morning.
He has no idea how his son, Evinsky, became infected with cholera, whose symptoms have ravaged all of his five children. But he knows exactly how to punish the government for their torment on election day.
"I have to vote but not for this government. They have done nothing for this country, nothing for me," he said, fanning Evinsky's unconscious face with a clean diaper and checking the intravenous drip inserted in his bony arm.
Adaq Mendosa, the young Nicaraguan doctor on duty, is equally disgusted with the Haitian government. Sixty patients have died in Mirebalais on his watch. About 4,000 are sick, according to the hospital director. The clinic itself is funded by Partners in Health, which is based in Massachusetts.
Most of Dr. Mendosa's patients are poor, illiterate farmers who are shocked to learn that cholera can be warded off with simple hygiene. Most of them don't own soap, and drink water sourced from the Artibonite River, the same water in which they bathe and wash their clothes.
"They don't know anything and the politicians don't say anything. They only care about being first on election day. It's a big problem. They are not talking about cholera at all," said Dr. Mendosa, a 27-year-old who came to Haiti as a volunteer after the earthquake.
Most of the deep anger of residents is fuelled by rumours that a Nepalese military contingent that arrived in Haiti last month to join the UN force may have been the source of the cholera, which is new to Haiti but prevalent in Nepal.
Initial tests at the UN base in Mirebalais showed no cholera, but health authorities acknowledge they are not conclusive. Recent riots near the base forced the troops to temporarily relocate.
On Friday, rioting spread to the capital of Port-Au-Prince, where hundreds of people clashed with UN troops they blame for the worsening epidemic.
Gunfire echoed through the streets as protesters erected roadblocks with burning tires and dumpsters overflowing with garbage.
Mr. Préval, meanwhile, has pleaded for calm, denouncing protest organizers for stoking rage on the streets.
Although cholera has reached the capital, the epidemic is still mainly concentrated in the north, in villages such as Mirebalais, where Dieusieu's ultimate decision came down to a difficult compromise.
With nobody to help carry his wife's body all the way home, he would do it himself.
Rosette would be buried off the side of the road, halfway between Fond Cheval, the village where she was born, and Mirebalais, the one where she died.
Editor's Note: The U.N. peacekeeping mission in Haiti has approximately 12,000 members. This online article has been updated from a previous version.