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A man suffering cholera symptoms holds his serum bag as he is treated in Robine, Haiti, on Saturday. A spreading cholera outbreak in rural Haiti threatened to outpace aid groups as they try to keep the disease from reaching the camps of earthquake survivors in Port-au-Prince. (Ramon Espinosa/Associated Press)

GENEVA — Haiti’s cholera outbreak appears to be diminishing nationwide but the death rate in rural areas remains alarmingly high, the United Nations said Friday.

The mixed picture comes from Haitian government figures citing 231,070 reported cases and 4,549 deaths since the epidemic began in October.

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National mortality rates from cholera are down to 2 percent, from as high as 9 percent earlier, but in some rural areas, more than one-in-ten people who contract the disease die.

In Haiti’s Sud Est region, the mortality rate hit 10.7 percent as of Feb. 9, while in Nippes it was 6.7 percent and in the Grande Anse region, 5.9 percent. The rate should be under 1 percent, according to the World Health Organization.

“It’s there (in rural areas) that we absolutely have to strengthen our efforts,” said Elisabeth Byrs, a spokeswoman for the U.N. humanitarian coordination office. “For that we need money.”

The U.N. also is concerned about the possible spread of the disease during Haiti’s upcoming Carnival season.

The U.N. has asked for $175 million to deal with Haiti’s cholera outbreak, much of which is distributed to local partners and non-governmental organizations to carry out aid work. So far, however, donors have provided only $80 million.

The U.N. itself has been accused of inadvertedly starting the cholera epidemic in Haiti through bad sanitation, a claim the global body has sent experts to Haiti to investigate.

The World Health Organization said Friday it was trying to keep the anti-cholera efforts in Haiti from collapsing.

“Even if many NGO’s are leaving for different reasons, there is an exit strategy,” WHO spokeswoman Fadela Chaib said. “WHO is working with the Ministry of Health to replace the NGOs that were running these cholera centers.”

The U.N. health agency won’t rest until Haiti’s mortality rate for cholera has been further reduced, she said. “We are not giving up on getting it under 1 percent.”

But as things stand now, cholera “will be a disease for the months and years to come in Haiti” despite it being previously unknown to generations of Haitians, she said.

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