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A cholera outbreak in a refugee camp in the Democratic Republic of Congo has spread to the eastern provincial capital of Goma, aid agency Medecins Sans Frontieres says.
The rising fears of an epidemic come amid warnings from rebels that they would fight any foreign forces sent to help government troops as they continued their standoff with the army.
Al Jazeera's Mohammed Adow, reporting from the Kibati refugee camp, 10km north from Goma, said there had been up to 50 cases of cholera at the crowded camp alone.
There were about 90 known cases across camps in the region, but the movement of people displaced by the fighting was raising concerns that the localized outbreaks could develop into a full-blown epidemic, our correspondent said.
Megan Hunter, who works for Medicins Sans Frontieres, said "everyone of the 50,000 people in this camp is at risk".
And Dr Claire-Lise Chaigot of the World Health Organisation warned that "all the ingredients are there" for a cholera epidemic.
"We have a serious risk of having a big cholera epidemic in this part of the world ... We have a population that is on the move, an unstable security situation and a population that does not have access to safe water and proper sanitation," she told Al Jazeera from Geneva.
Chaigot said that fresh fighting would further hinder efforts to get aid and medical supplies to people already hard to reach.
Our correspondent found desperate refugees surviving on leaves and hundreds of others trying to return to their homes - a movement that could lead to further cholera outbreaks, health workers say.
The humanitarian crisis exploded after rebel leader Laurent Nkunda launched an offensive on August 28, stopping his forces at the gates of Goma before declaring a ceasefire.
Retreating Congolese troops and rebels sent the population fleeing and sporadic clashes have broken out since then despite the ceasefire.
Thousands of refugees are packed into camps or sleeping out in the open and Weekend clashes between rebels and soldiers increased fears that patients could scatter and start an epidemic.
Vow to repel outsiders
A summit of southern African leaders said on Sunday that members could, if necessary, send peacekeepers to bolster UN peacekeepers.
The United Nations has a 17,000-strong peacekeeping force in DR Congo, and is asking for an extra 3,000 troops as the current force is thinly stretched across the country the size of western Europe.
But it appears unlikely that a European Union force will move to help the UN stem the fighting.
France failed to secure support from other European Union nations on Monday for sending a 1,500-strong EU battlegroup to eastern Congo to bolster the UN force.
Nkunda has said he will fight any troops sent to support the DR Congo army.
"If they come in and fight alongside the FARDC [DR Congo army] and the FDLR [pro-government Hutu fighters], they will be weakened," Nkunda told the Reuters news agency by telephone from eastern Congo.
"I am ready to fight them. They will share the same shame as the DRC government."
Southern African leaders also renewed calls for a ceasefire and the creation of humanitarian corridor.
But Nkunda said his forces were upholding a fragile ceasefire and called on the government to enter into negotiations.
"We declared the ceasefire, and we're still sticking to it," he said.
More than 250,000 people have fled their homes to escape the fighting between government forces and Nkunda's National Congress for the Defense of the People in recent weeks.
Hundreds of people are believed to have been killed in clashes.
PHOTO CAPTION
A boy with cholera receives treatment at a Doctors without Borders clinic inside the Don Bosco Center, in Goma in eastern Congo Monday, Nov. 10, 2008.
Al-Jazeera
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