In Haiti, surviving cholera is just the beginning

More than 1,000 have died, but Emmanuel Tima's small son has been saved. However the future is still uncertain

Audio slideshow: 'The people here pray a lot'

Emmanuel Tima thanks the doctors as he walks out of the clinic with his son, weak but alive, clutched to his chest after four days' successful treatment. "Merci, thank you, gracias," he smiles.

More than 1,000 have died in Haiti's cholera epidemic, but here at least, in this crowded but well-resourced Médecins sans Frontières clinic, a relieved father, a saved child.

A nurse gives Tima a poster with pictures showing how to avoid the disease: use a clean toilet, wash hands with soap, boil water and food. The 34-year-old single father studies it, smiles and thanks her too.

As the pair leave it is, from the emergency medical viewpoint, the end of the story. But in a country with a razor-thin line between normality and emergency it is worth asking: what happens next? What happens after a patient – over 17,000 so far – has been saved?

Tima, a softly spoken man in flip-flops and grubby trousers, allows the Guardian to accompany him and his son, also called Emmanuel, on their return home. The first issue is the 23p bus fare. He doesn't have it. His pockets are empty save for a frayed, miniature Bible so Tima borrows coins and squeezes onto one of the capital's colourfully painted, belching tap-taps.

A cacophony of trucks, motorbikes and SUVs honks through Rue Nacional but little Emmanuel, eyes glazed, barely notices. His father explains their circumstances. Originally from Cap-Haïtien in the north, he placed a five-year-old daughter in an orphanage after his wife walked out. "I was the mama as well as the papa, it was not easy."

After January's earthquake he came with his son to Port-au-Prince to look for an aunt, who was presumed dead. Her body was never found.

The pair stayed with Tima's mother in a slum near Cité Soleil until three months ago when they moved to a place of their own at a nearby camp. Tima rushed the boy to a clinic after he was stricken with diarrhoea and vomiting last week.

Now they are returning home and the unemployed mason, who is also a preacher, quotes Ecclesiastes: "A time to be born and a time to die, a time to plant and a time to uproot." No dying today, he adds with a grin.

They get off the bus 12 miles north of the city at a camp sprawled over rocky hillside: Canaan, home to an estimated 30,000 people. At the foot of the slope there are cinder block houses, but as you climb the ridge, concrete gives way to wood and tarpaulin, then cardboard and twigs. As late arrivals the Timas got a high, exposed spot. "It's good exercise," jokes Tima, not breaking stride, his exhausted son asleep in his arms.

Near the top he stops at a collection of 10 rickety poles stuck into the soil, with corn sacks sagging between them. "Here we are. Home." It is not even close to being a shack. They had a better shelter but Hurricane Tomas shredded it earlier this month.

Tima's mother gave him the poles and the sacks he bought with money from helping other families' erect tents. A neighbouring family with an earth-floor house has offered them temporary shelter. They live on potatoes and bananas.

"I'm rebuilding our house. It'll look better soon," Tima says apologetically. Inadvertently he is paraphrasing Bill Clinton, the UN's envoy to Haiti, who speaks of "building back better". Almost a year on from the quake, with reconstruction stalled and rubble ubiquitous, more than a million displaced Haitians would probably just settle for building back.

Tima plops young Emmanuel on the hardened mud and rereads the cholera-prevention poster. It shows a family boiling food and washing with buckets of foamy water. Toilets and water in Canaan, notes Tima, are a steep climb down to the bottom of the hill. He has no soap, nor money for soap. Cooking food properly is a luxury given how scarce firewood and charcoal are. Reality mocks the advice written on the sheet.

MSF, also known as Doctors Without Borders, had places like this in mind when it warned of Port-au-Prince's "chaotic and troubling" danger. "When people have finished their treatment and they leave the centres, they go back to what is potentially a cholera-infected area," said Stefano Zannini, the group's head of mission.

A mosquito swarm descends and Tima picks and flicks insects from Emmanuel's hair. The child, drained and listless, seems oblivious and does not register the orange sun sinking into the Caribbean. This would have almost been a postcard view were it not for the camps and smoke from burning rubbish dumps.

Squalor, earthquake, hurricane, cholera: to residents it may seem apt that Canaan is named after a land cursed and destroyed in the Old Testament. They have adapted and survived, yes, but that does not make things less hellish, says one neighbour.

Tima tries to see the bright side. He is alive. Emmanuel is alive. Tomorrow may be better. "We sleep well. We say a lot of prayers." The part-time preacher is a full-time optimist. "Satan does not come here."

Contributor

Rory Carroll in Port-au-Prince

The GuardianTramp

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