By Kieran Murray
ANTANANARIVO (Reuters) - A tiny coffin of raw wood stands empty outside Madagascar's main hospital, waiting for the latest victim of a cholera epidemic that could run out of control after powerful cyclones swept through the island.
Jean Baptiste Randrianomanana, a small farmer from a northern area hit hard by flooding, sits next to the coffin under a tree.
His one-year-old son died from cholera after five days in the capital's general hospital but he still has not been given the body and has no idea when it will be released.
A traditional Madagascan custom of periodically digging up the remains of relatives and holding a party for them -- even dancing with the dead and swirling them in the air -- has authorities worried it might lead to new infections.
They are apparently ordering cholera victims buried in a separate section of cemeteries rather than letting relatives put them in family tombs.
''They wouldn't let me take the body home because it was forbidden,'' a distraught Randrianomanana said on Sunday afternoon. ''Why can't I take my dead son to the ancestral tomb? I don't know. They won't let me.''
He said he himself survived the disease last month but that hospital conditions were poor, with up to four children to a bed.
''Many People Died''
''Many people died. I don't know how many but it was many, many people. Ambulances brought a lot of sick people to hospital and after two or four hours they died,'' the 41-year-old father of 10 said.
More than 20,000 cholera cases have been officially documented on the Indian Ocean island in the last year and over 1,200 patients have died -- a fatality rate of around six percent which is very high for a disease that is easily treated.
The infection and death rates have accelerated dramatically since the start of the year and medical experts say the situation can only get worse after two cyclones tore across the island over the past three weeks.
Cyclones Eline and Gloria killed 150 people as rivers burst their banks, flooding homes and small farms and triggering mudslides. Perhaps worse, the floods may have contaminated already scarce clean water and sanitation facilities in many areas.
''After any cyclone, we know there will be an impact on clean water supplies and, with the contamination of drinking water, there is every possibility that diseases like cholera and malaria will increase,'' said Edward Carwardine of the United Nations children agency Unicef.
Aid workers say health services are already stretched and there is a serious risk of cholera taking an even firmer hold in flooded rural areas and squalid districts of the capital Antananarivo.
Children Wade In Filthy Canals
Along the city's filthy canal, young children wade in foul- smelling water, plucking out dead fish and looking for old plastic bottles to sell to traders sitting next to the railroad tracks.
And sanitary conditions in the poorest areas of the capital are terrible, perfect conditions for the epidemic's spread.
Government officials have barred journalists from entering cholera wards in its hospitals and foreign aid agencies are not allowed to treat cholera patients.
That decision prompted the Swiss section of the private medical charity Medecins Sans Frontieres to pull out of Madagascar late last month, complaining that the authorities had failed to tackle the epidemic effectively.
''We cannot carry out long-term prevention programs at the same time as we stand by and watch people die of cholera for lack of urgent, adequate treatment,'' the group said.
The government, however, insists that its own doctors and hospitals are capable of bringing the epidemic under control.
Unicef and other aid agencies are working with the government on projects aimed at improving water and sanitation services and educating communities on how to prevent cholera.
This week they are distributing hundreds of thousands of water purification tablets to rural communities to limit the threat caused by the recent flooding.
- Reuters - Thomson Reuters Foundation
- For more humanitarian news and analysis, please visit https://www.trust.org/alertnet