A year after a devastating earthquake, the immediacy of the need for aid to Haiti has passed, but the country remains desperate for long-term help, the head of a Portland-based aid group said Saturday.

Nathan M. Nickerson, executive director of Konbit Sante, who is in Cap Haitien, said those injured in the quake near the capital of Port-au-Prince who streamed north to get help have been treated, and the rate of increase in the number of cholera cases has slowed, although that disease “is now part of the landscape.”

He said the spread of cholera, “which has reached every corner and village of country,” highlights the need for improved sanitation and better health care in the impoverished country. Cholera is caused by drinking fecal bacteria-contaminated water, and many of the people who have died from the disease did so because they were unable to get proper care.

Konbit Sante has been working in Cap Haitien, about 50 miles north of last January’s earthquake, for about a decade. The organization has hired community health workers to get care to the area’s neighborhoods and also works with the Justinian Hospital, a 250-bed facility, in the city.

Nickerson noted that the earthquake sent streams of injured people from Port-au-Prince to Cap Haitien. After the injured were treated, he said, cholera began spreading because more people were drinking water from contaminated sources.

Ironically, sanitation is better in some of the tent camps for those displaced by the earthquake, and cholera has not spread as widely there as it has in other parts of the country, he said.

The outpouring of international aid in the wake of the earthquake helped lift hopes in the country, Nickerson said, “but that optimism was hampered by the lack of progress (on the country’s problems), and then cholera put a hold on the sense that better days were ahead.”

Nickerson said Konbit Sante has set up a treatment center for cholera patients and has also set up rehydration sites, where people can get clean water. Cholera causes severe diarrhea and vomiting, he said, and patients can become dehydrated very quickly.

Konbit Sante also hired a nurse who specializes in wound care, and more community health workers, he said. It is continuing its efforts to provide better training to doctors and nurses and helping Justinian Hospital purchase supplies.

Nickerson said the earthquake showed the world how poorly Haiti was functioning day to day.

“When everything collapsed, the pipeline (from the capital) got shut off,” he said.

“The earthquake exposed how fragile things are. The earthquake, as devastating a calamity as it was, was one more thing here. The cholera was one more thing.

“The amount of destruction each of them wrought was because of the fragility of the system and the poverty that’s here.”

That situation can make it discouraging for aid workers, he added.

“It’s a challenging place to work and see progress, and you work hard to see a little progress,” he said. “There are a lot of things that are broken here. But there are some amazing Haitian people here who are really the hope for tomorrow.”

Staff Writer Edward D. Murphy can be contacted at 791-6465 or at:

emurphy@pressherald.com