PORT-AU-PRINCE, Haiti — The sun shone on Stanley Joliwa as medical staff in an open-air clinic hovered around him, pumping air into his lungs and compressing his chest until he died.
His mother watched nearby.
“Only God knows my pain,” Willeen Enfant said.
Less than an hour later, her 22-year-old son’s body lay on the floor, wrapped in a white plastic bag with the date of his death scrawled on top. He joined dozens of other Haitians who died of cholera during a fast-spreading epidemic that is straining the resources of nonprofit organizations and local hospitals in a country where fuel, water and other basic supplies are becoming scarcer by the day.
Sweat gathered on the brows of staff at the Doctors Without Borders treatment center in the capital Port-au-Prince, where about 100 patients arrive each day and at least 20 have died. Families continued to rush in this week with loved ones, sometimes dragging their limp bodies into the crowded outdoor clinic, where the smell of waste filled the air.
Dozens of patients sat on white buckets or lay on stretchers as IV lines ran down to bags of rehydration fluids that glistened in the sun. So far this month, Médecins Sans Frontières has treated around 1,800 patients in its four centers in Port-au-Prince.
In Haiti, many patients are dying because they say they can’t get to a hospital in time, health officials say. A surge in gang violence has made it unsafe for people to leave their communities, and fuel shortages have shut down public transportation, gas stations and other key businesses, including water utilities.
Enfant sat next to her son’s body as she recalled how Joliva had told her he was feeling sick earlier this week. She had already warned him and her other two sons not to bathe or wash clothes in the sewage-polluted waters that flowed through a nearby ravine in their neighborhood – the only source of water for hundreds in the area.
Enfant insisted her sons buy laundry water and add chlorine if they were going to drink it. While Joliva was sick, Enfant tried to take care of him alone.
“I said to him, ‘Honey, you have to drink the tea,'” she recalled. “He said again, ‘I feel weak.’ He also said, “I can’t stand up.”
Cholera is a bacterium that sickens people who ingest contaminated food or water and can cause severe vomiting and diarrhea, sometimes leading to death.
Haiti’s first serious encounter with cholera occurred more than a decade ago, when UN peacekeepers introduced the bacteria into the country’s largest river via sewage at their base. Nearly 10,000 people died and thousands more fell ill.
Cases eventually declined to the point where the World Health Organization is expected to declare Haiti cholera-free this year.
But on October 2, Haitian authorities announced that cholera had returned.
At least 40 deaths and 1,700 suspected cases have been reported, but officials believe the number is much higher, especially in the overcrowded and unsanitary slums and government shelters where thousands of Haitians live.
The situation is exacerbated by fuel and water shortages, which began to dwindle last month when one of Haiti’s most powerful gangs surrounded a key fuel terminal and demanded the resignation of Prime Minister Ariel Henry. Gas stations and businesses, including water companies, are closed, forcing more people to rely on untreated water.
Shela Jeune, a 21-year-old hot dog vendor whose 2-year-old son has cholera, said she buys small bags of water for her family but doesn’t know if she’s been treated. She took him to the hospital, where he remains on IV fluids.
“Everything I give him to eat, he just throws it up,” she said.
Yune was among dozens of mothers seeking treatment for their children on a recent morning.
Lauriol Chantal, 43, told a similar story. Her 15-year-old son vomited as soon as he finished eating, prompting her to rush him to the treatment center.
While at the center, her son, Alexandre Francois, told her he was hot.
“He said to me … ‘Mom, can you take me outside to wash me or pour water on my head?'” she said.
She obeyed, but suddenly he collapsed in her arms. Staff rushed to help.
Children under the age of 14 account for half of Haiti’s cholera cases, according to UNICEF, with officials warning that rising cases of severe malnutrition also make children more vulnerable to disease.
Haiti’s poverty also worsened the situation.
“When you are unable to get safe drinking water from the tap in your own home, when you do not have soap or water purification tablets, and when you do not have access to health services, you may not survive cholera or other water-borne diseases,” said Bruno Maes, UNICEF Representative in Haiti.
Perpetti Juste, a 62-year-old grandmother, said one of her three grandchildren fell ill this week as she worried how their conditions might have led to her illness.
“We went many days without food, I can’t lie,” she said. “No one in my house has a job.”
Juste, who lives with her husband, five children and three grandchildren, said she worked as a cleaner until the owners fled Haiti.
The growing demand for aid is straining MSF and others as they struggle to care for patients with limited fuel.
“It’s a nightmare for the population and also for us,” said Jean-Marc Biquet, the organization’s project coordinator. “We still have two weeks of fuel left.”
Life was paralyzed for many Haitians, including Enfant, as she mourned the death of her son. She wants to bury him in her hometown of Les Ques on the south coast, but cannot afford the 55,000 gourdes ($430) it would cost to transport his body.
Enfant then fell silent and stared off into the distance as she continued to sit next to her son’s body – too stunned, she said, to stand up.
Associated Press writer Danica Cotto in San Juan, Puerto Rico, contributed to this report.