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“I don’t think we’re anywhere near the end of this,” said Dr. John Jensen, a Canadian doctor volunteering with his wife, a nurse, for nearly a month at the clinic about 12 miles (20 kilometers) west of Cap-Haitien.

Fear over the spread of cholera even triggered a violent witch-hunt in the remote southwestern Grand Anse region, where locals have killed at least 12 neighbors on suspicions they used “black magic” to infect people, national police spokesman Frantz Lerebours said Thursday.

Cholera made its first appearance on record in Haiti near the central town of Mirebalais. From there it spread north through the Artibonite region. It has sickened thousands in the capital, but it is the vast rural population that is most vulnerable because cholera is spread by bacteria in contaminated water, and poor rural people often have no access to clean water and no clinics nearby.

“Most Haitians live in rural areas and most don’t have latrines,” said Dr. Louise Ivers of the medical aid group Partners in Health. “Most people have to do their business in a hole in the back garden and drink water from an unprotected source.”

It is these people who have the fewest options when they get sick. “Why do you die from cholera? Because you don’t have access to health care,” Ivers said.

A hospital in the central Haitian city of Maissade has just two physicians to care for a population of 60,000. That center alone had treated 350 cholera patients as of last week, said Dr. Tim Rindlisbacher of Toronto, Canada, who recently worked there as a volunteer with the Canadian aid group Humanity First.

He said he believes many more never got treatment.

“It is easy to miss it in the rural areas,” Rindlisbacher said. “There’s a lot of people who never make it to a hospital, never make it to a doctor and there’s no way of tracking those people.”

In much of the countryside, public transportation is rare. The nearest doctor or nurse could be a trek of many hours through the mountains. Even in the cities, ambulances don’t exist and cholera patients usually travel by taxi or collective transport.

Associated Press journalists this week came upon four men carrying a 14-year-old boy on a stretcher along a dirt road, his mother trudging alongside. They had been walking four hours from their village to the town of Grand Riu Du Nord, in mountains about 16 miles (25 kilometers) south of Cap-Haitien to reach a clinic staffed by Cuban doctors, who treated the boy.

A maddening fact about cholera, which rapidly drains the bodily fluids from its victims, is that it is easy to treat and most people survive if they get medical attention. Doctors Without Borders says the disease has a mortality rate of less than 1.5 percent among people who reach the more than two dozen treatment centers it operates around Haiti.

Yet no one knows how many are dying uncounted and alone out in the countryside.

One small village visited by Guytho Alphonse, a public health promoter for the aid group Oxfam, is a three-hour walk from the nearest medical clinic. He said villagers told him that an entire family of six had died of the disease. His visit was meant to prevent such tragedies: He was distributing oral rehydration mixture and chlorine for treating wells.

Dr. Thony Michlet Voltaire, who runs a hospital in the town of Sante Borgne, about 40 miles (65 kilometers) from Cap-Haitien, said he was getting 40 patients a day. He said seven people had arrived in such bad shape over the past week that they could not be saved.

“A lot of people are dying at home because they can’t make it to us,” said Voltaire, who said his clinic, the Alliance Sante Borgne, was in dire need of medicine, volunteers and such basic supplies as clean bed sheets.

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