Registered nurse Jane Noble of Grimsby, Ont., takes care of a cholera patient at a Samaritan's Purse clinic in Haiti on Nov. 26. (Roseann Dennery/Canadian Press)

Potential violence that follows the release of Haiti's final election tally could derail gains made in the battle to contain the spreading cholera epidemic, a U.S. federal agency says.

"What we all worry about is if there is violence again and it disrupts for a couple of days," said Mark Ward, acting director of the U.S. Agency for International Development (USAID). "That's my biggest headache right now."

Release of final results in the disputed Nov. 28 election are on hold until an international panel of experts can review the vote, marred by accusations of fraud and low voter turnout.

Haiti's electoral commission was expected to release the tally Monday, but acquiesced to requests to allow international observers to review the vote. No new date is set for the release.

As the country remains on standby, USAID is busy stocking clinics with cholera treatment supplies in anticipation of violent protests similar to those that erupted immediately following the Dec. 7 announcement that a partial tally put former first lady Mirlande Manigat and ruling party candidate Jude Celestin in the January runoff vote.

Thousands of demonstrators took to the streets to protest the exclusion of presidential hopeful, singer and entertainer Michel Martelly, who garnered about one per cent fewer votes than Celestin, and the allegations of ballot rigging by ruling party INITE. Resulting roadblocks and violence caused problems for aid agencies trying to deliver supplies to clinics and hospitals.

Capital's fatality rate fell

"We're trying to empty out our warehouses and make sure that clinics where people are closest to those suffering are well stocked should there be a disruption," said Ward.

Nearly 2,600 cholera-infected people have died in Haiti since October. More than 121,000 cases have been logged by hospitals and clinics, a high number that Ward says is in fact a sign of optimism.

"That's a big burden on the medical system in Haiti but it's a good number because it means that people are taking this seriously now and if something's not right, they are going to get it checked out," Ward said during a conference call Tuesday.

The overall fatality rate across Haiti stands at 2.1 per cent, while in the capital, Port-au-Prince, it has fallen to 1.2 per cent.

Ward credits training local medical personnel in the capital in cholera care for the drop, but said the focus must now turn outside the centre, to rural communities and the north and northwest where cholera continues to spread.

A lasting effect

A key challenge plaguing medical aid workers is reaching rural areas where populations don't have access to medical facilities or cholera treatment.

To tackle that, USAID said it has trained nearly 10,000 community health workers to go door-to-door to teach households about cholera prevention.

The federal U.S. agency is also setting up mobile treatment facilities staffed by nurses and visited regularly by roving doctors and funding kiosk-type points in remote communities where residents can get oral rehydration solution, a mixture of salt, sugar and water that helps people regain electrolytes lost from the diarrhea and vomiting caused by cholera.

"It's really important to fill the country with [oral rehydration solution] and get the Haitians into the habit of using it when they get diarrhea. They don't have to have the diarrhea that leads to cholera. Any diarrhea, they should get into the habit of using [oral rehydration solution]."

Ward hopes one lasting effect aid agencies will have on the island nation when foreign medical workers leave is ingraining the use of the rehydration solution.

"A year from now when cholera is at an endemic level, as it is in many developing countries and even North America … [oral rehydaration solution] should be available in every shop, just like it is in South Asia. And that's what we're really striving for, is to really make that, really institutionalize that in the country because it's the best preventive measure for that, and clean water."