One year on from the cholera epidemic in Haiti – in pictures

The cholera epidemic has struck every level of Haitian society. It has highlighted the weaknesses of the government and the serious deficiencies in water, sanitation, health, and education. In this picture, the walls of a Rap Creole concert venue in Port-au-Prince warn against the dangers of the disease Photograph: Felipe Jacome, Sabina Carlson

Children play in Cité Soleil, a housing project that was built in the 1980s and is now a slum with more than 300,000 residents. As most of the sanitation blocks here are unusable, many residents are forced to relieve themselves by the ocean, in the canals, or in 'flying helicopters': plastic bags full of faecal matter that are thrown into the air, and can land on rooftops or into people’s houses Photograph: Felipe Jacome, Sabina Carlson

Residents of Cité Soleil are often on the receiving end of much of the rubbish from the rest of Port au Prince. A young social movement has been inspiring communities to clean up through a traditional labour exchange called 'konbit'. Here, a konbit clean the canals of Soley 17 block. Young men have come from previously warring blocks to participate in the clean-up in exchange for nothing but loud music, maybe some rum, and the knowledge that others will help their neighbourhoods in future Photograph: Felipe Jacome, Sabina Carlson

A child pushes a wheelbarrow through a block in Cité Soleil that was destroyed by gang warfare in 2005. Even after residents try to clean up their communities, there is nowhere to dispose of the rubbish. It gets thrown into the ocean, the canals, into derelict houses, or into overflowing skips. After heavy rains, this waste is generally washed back into the streets of Cité Soleil Photograph: Felipe Jacome, Sabina Carlson

Cholera treatment centres (CTCs) – such as this one in Les Cayes – are often makeshift operations run out of a tent, but they increase a patient’s survival chance more than 50 times. Funds for CTCs began drying up just as the rainy season started, leaving the few remaining centres overwhelmed with patients. Fewer CTCs means longer distances to travel for treatment and worse dehydration levels on arrival. In September, the only CTC in Haiti’s Sud Department, run by the International Medical Corps, saw an increase in new cholera cases to levels reminiscent of the beginning of the epidemic Photograph: Felipe Jacome, Sabina Carlson

Timing is key with cholera: the patient must quickly replace water lost to the disease through oral or intravenous rehydration, or dehydration can kill in a matter of hours. Household remedies for diarrhoea range from sweets to teas made from tree bark, but more people are beginning to understand the importance of rehydration in fighting diarrhoeal diseases. Fear of stigmatisation has caused some people to delay seeking help until it is too late Photograph: Felipe Jacome, Sabina Carlson

People in the triage room of a treatment centre in Les Cayes wait to be diagnosed. Greater awareness of the disease has led more people to seek help at the onset of diarrhoea and vomiting Photograph: Felipe Jacome, Sabina Carlson

Canals act as the garbage disposal system of Port-au-Prince. Rubbish from the higher districts of Petionville and upper Delmas has passed through canals until it has reached communities living at the edge of the sea. With each rainfall, the St George canal flushes rubbish into Cité Soleil. Storms can cause it to overflow, sending garbage-filled sludge into the homes of the people living nearby. In November 2010, the canal overflowed into La Difference, causing 30 cases of cholera within a week in a community that had battled to stay free of the disease through street cleaning Photograph: Felipe Jacome, Sabina Carlson

School children march in Les Cayes raising awareness of preventative hand washing. Over the past year, every corner of Haiti has seen campaigns to promote awareness of cholera. Although this has played an important role in controlling the spread of the disease, it's a challenge to maintain the focus on prevention given the limited access to safe water and latrines Photograph: Felipe Jacome, Sabina Carlson

Women and children collect water at Carrefour. Water is at the heart of the cholera issue: it can prevent the disease, as well as carry it and cure it. Water is also at the heart of Haitian life: it is hard enough to come by in the city centre but the shrill jingles of the water trucks become even rarer as you head into the mountains of Port au Prince, where water is scarcer still Photograph: Felipe Jacome, Sabina Carlson