Flies swarm over the patches of lumpy grass stinking of urine and decaying human waste. Nearby, mounds of trash pile up around the shelters made of sticks and sheets.
There are nowhere near enough toilets — portables, latrines or any other kind — for the tens of thousands living in the camps in and around Port-au-Prince. And relief agencies scrambling to put toilets up are still figuring out how to later dispose of their waste.
“Where people are living, that’s where they’re defecating,” said Lucienne Estimé, 49, who has organized volunteers at a Cité Soleil camp to sweep some of the trash — if not the human waste — away from tents and tarps and closer to the street.
“We pile it up and burn it because we don’t have a place to throw it, or trucks to pick it up,” said Louisena Michelle, 30, one of the sweepers. Nearby, children played on a rusty swing next to a patch of dirt people had used as an outhouse.
The camp at the site of the collapsed Saint-Louis de Gonzague school in Delmas had one portable toilet for some 10,000 people, residents said, until three latrines enclosed by white sheets went up on Monday.
“It’s too full,” said Elvire Constant, 40, pointing to where the original blue, overflowing plastic toilet stood unused. “We need someone to remove it.”
At a camp on a hill below the Pétionville Club, which the U.S. Army is using as an outpost, some residents have been using a lemon grove on the highest part of the camp as a bathroom — a potential problem if rains wash the waste down to the tents below.
Relief workers blame the shortage of toilets in part on having to deal with more urgent problems — like keeping people alive — immediately after the Jan. 12 earthquake.
But now, more than five weeks after the quake, the dangers of inadequate sanitation are starting to show.
In a report issued Friday by the United Nations Office for the Coordination of Humanitarian Affairs, or OCHA, health-related relief agencies warned of a risk of a large-scale diarrhea outbreak due to overcrowding, poor sanitation and lack of effective waste disposal systems in the camps.
“Diarrhea, abdominal pain, fever, lots of infection, vaginal discharge, headache, ear infection . . .” Fabienne Ulysse, a nurse practitioner from Columbia University who is working at an International Medical Corps tent in the Pétionville Club camp, listed as conditions she has been treating recently.
Phrasia Excellent, who is living in Pétionville’s Place St. Pierre, said two of her nine children living in the camp have had fevers. “The doctors gave them a pill,” she said.
Marie-Agnes Heine, spokeswoman for the Pan American Health Organization and the World Health Organization in Haiti, said doctors have not seen an alarming increase in illnesses due to the unsanitary conditions in the camps — yet.
“We are afraid it will become a big problem,” she said, adding that the organizations are monitoring patients to track any uptick in infectious diseases like typhoid, spread when bacteria gets into water used for drinking or washing food.
Some illnesses related to inadequate cleanliness have always been present in Haiti, Heine said, where sewage infrastructure is limited. According to UNICEF, only 58 percent of people regularly used clean water before the earthquake.
With the rainy season looming and about a million people living in makeshift settlements, it is becoming increasingly critical to bring portable toilets in and get the sewage out.
“I would say the response has been slow,” said David Delienne, who heads water and sanitation efforts for UNICEF, which is handling that part of the recovery effort.
Most of the estimated 400 camps do not have latrines, he and other relief workers said.
Delienne said UNICEF has rented 1,000 portable toilets that it hopes to install around the capital by the weekend, giving priority to the camps with most people. The agency is working with a contractor to put the toilets up and also empty them once they get full.