Gerant Santilien is used to fending for himself.
So when the 70 year old, who has spent a lifetime caring for his five children and disabled wife, started feeling queasy one recent morning, he suffered in silence.
First came the vomiting, then the watery diarrhea.
He wasn't the first person in the tiny, hilltop village of Debroché in northern Haiti to come down with cholera, a waterborne bacterial disease that causes dehydration so severe it can kill a person in a matter of hours.
When his daughter found out Gerant was sick, she took matters into her own hands.
She had two villagers unhinge a door from the house. They strapped Gerant to it, propped a baseball cap over his eyes, and started on the two-hour journey down a jagged path to the nearest health center, with the makeshift gurney balanced on their heads.
By the time they arrived, Gerant was unconscious.
Disease Spreads to Countryside
"They're coming earlier now," says Sister Rose Marie, a Spanish nun with St. Vincent de Paul who is volunteering at the Catholic Relief Services-supported health center in the nearby village of La Branle.
"They'll say the diarrhea and vomiting started an hour ago," as opposed to three or four hours ago.
Across Haiti, cholera is working its way into remote villages.
While many feared the growing epidemic would take hold in the tent cities that dot the capital, it is the countryside that is seeing the worst of disease, which has killed more than 3,000 people. Nearly 150,000 cases have been reported, and cholera is now in every one of Haiti's 10 departments.
Sick Haitians like Gerant are being carried to health centers and hospitals on doors, in the arms of family members, and on the backs of donkeys.
When cases first started showing up about two months ago, the small staff in La Branle, a tiny village with one dirt road and two buildings, one of the them the clinic, was overwhelmed.
Nurses laid patients on the ground for lack of beds and worked around the clock with limited supplies.
There are beds now, a designated cholera center, and enough rehydration solution and antibiotics—the simple supplies needed to treat cholera—to take care of the clinic's stream of patients.
La Branle is one of several health clinics and seven hospitals in Haiti to receive CRS supplies, which also include aqua-tabs for purifying water, bleach, hand sanitizer and soap.
Meanwhile, to help stop the spread of cholera, CRS and other organizations are teaching prevention practices to village representatives. They, in turn, teach their neighbors.
Haiti has all the classic risk factors for cholera, including a lack of safe drinking water, improper elimination of human waste and poor hygiene practices.
Even before the January earthquake, less than 50 percent of Haitian's had access to clean water.
Cholera is relatively easy to diagnose and treat, but prevention is critical.
"It's really about talking to people about washing their hands, boiling the water they drink, cooking their food," says Laura Dills, director of programs in Haiti. "We are literally giving out bars of soap and showing people how to wash their hands."
Part of that message, says Dills, is making sure people understand that at the first sign of symptoms, they should drink the oral rehydration solution and get to a health center.
A bottle of the stuff, a mixture of salts and sugar, probably saved Marie Came Gabriel's life.
She drank it as her son and nephew carried her on a door down from Debroché the same day Gerant arrived.
Like Gerant, she was unconscious by the time she arrived.
Cholera Cases Decreasing
The two were among about a dozen people, including a few children, being treated in the tarp-covered cholera center in La Branle.
A man in an apron fashioned from trash bags roamed the ward spraying everything with a disinfectant solution. Visitors washed their hands with disinfectant soap and stepped in a foot dip before they entered the ward.
As Sister Rose Marie made her way between the rows of beds, she said that while the number of patients is decreasing, they're coming from more remote areas.
A glance at the cholera register shows the number of cases has dropped from 29 to 11 in the last two weeks. The number of deaths has dramatically decreased.
Sister Rose Marie is not sure if that's because of the prevention messages CRS is spreading or because the bacteria is simply moving on.
Whatever it is, she says, it's working.
By day's end, both Marie and Gerant were doing better.
Marie was on her fifth bag of intravenous rehydration solution and Gerant was not far behind.
Both were conscious, a vast improvement from just a few hours before, and there was hope they could go home the next day.
Robyn Fieser is CRS' regional information officer for Latin America and the Caribbean. She is based in the Dominican Republic.