Cholera has killed at least 13 people in southwest Haiti in the wake of Hurricane Matthew, government officials told Reuters on Saturday, as health workers sought to reach the epicenter of one outbreak.

Six people died of Cholera in a hospital in the southern town of Randel, which is inland near a river, and another seven died in the western coastal town of Anse-dAinault, the officials said, likely as flood waters mixed with sewage. “Randel is isolated, you must cross water, you must go high in the mountains, cars cannot go, motorcycles cannot go,” said Eli Pierre Celestin, a member of team that fights Cholera for the health ministry. “People have started dying.”

“There are nurses but no doctors,” he said, concerned that Cholera would spread due to lack of hygiene and as ground water moved because of rain and floods. He said there were also outbreaks in Port-a-Piment and Les Anglais.

Cholera causes severe diarrhea and can kill within hours if untreated. It is spread through contaminated water and has a short incubation period, which leads to rapid outbreaks.

Hurricane Matthew left almost 900 people dead in Haiti and caused major flooding and loss of livestock.

It slammed into South Carolina on Saturday, after skirting the Atlantic coast of Florida and Georgia, causing widespread power outages and flooding.

Dr. Donald Francois, head of the Haitian health ministrys cholera program, said 62 others were sick with Cholera as a result of the storm. “We are concerned about these new outbreaks of Cholera we are seeing in new districts,” he told Reuters. “The situation is particularly difficult in Randel and (nearby) Port-a-Piment.”

“I am on my way to the south region to assess the situation and ensure all the necessary measures are in place,” he said, adding that he had heard unconfirmed reports that as many as 50 people may have died from Cholera in southern Haiti.

The aid group Doctors Without Borders scrambled teams by helicopter to southern Haiti to respond to Cholera cases.

Clifford Gauther, the health ministrys director for Haitis Sud Department, said Cholera treatment centers, many made of metal sheeting, were destroyed by the hurricane. The ministry was rebuilding them. “Almost every October we have a spike (in Cholera cases), but this time it's worse, 70 to 80 cases,” he said.

Before the hurricane struck, the Central Emergency Response Fund released a loan of $8 million to UNICEF, the United Nations Childrens' Fund, to ramp up the response to a worsening Cholera epidemic in Haiti.

“In 2016 almost 27,000 Cholera cases have been reported in Haiti, and over 240 people have died. Hurricane Matthew is feared to significantly worsen the situation and increase the risk of a larger outbreak,” CERF said in a statement on Friday.

It was hot and sunny on Saturday in Les Cayes in southern Haiti. Flood waters receded and residents cleared some debris from the streets. One man was putting up a tarpaulin over his exposed roof.

As the shock of the storm wore off, the enormity of the damage was beginning to sink in. “I have land but I don't have a house anymore. It's starting to traumatize me, my head hurts. I think about it too much," said Jean Vinel Joseph, 36, a medical orderly.

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