DAKAR, 26 October 2010 (IRIN) - As the floodwaters begin to recede in parts of Benin, the new threat is a major outbreak of infectious diseases, particularly cholera and malaria.

The worst flooding in nearly half a century in the country of some 9 million people has cut many communities off from health centres, "paralysing access to health care in a situation that lends itself to a potential outbreak of waterborne disease," the NGO CARE in Benin said in a communiqué.

"This situation hits hard, especially in the case of children with infections or diarrhoea," CARE's Loetitia Raymond told IRIN.

An early government and interagency assessment found that 92 health centres across the country were flooded; in many areas clinics are totally inaccessible, a local health official said. Those still on dry ground are inhabited by people whose homes crumbled in the floods, which the UN says had two-thirds of the 112,000-sq km country under water. Flooding has affected some 680,000 people and killed at least 46, the UN says.

"Health centres that should be there to help people suffering from diarrhoea and infections linked to the water and sanitation conditions cannot function," Yevi Magloire, head of medicine and paediatrics in the southeastern department of Ouémé, told IRIN.

CARE's Raymond said: "Even for people who are near a functioning health centre they do not have the means to pay for care; they are worrying about how they'll eat. People have lost everything."

The most urgent needs for flooded communities are water purification tablets, mosquito nets, malaria medicine and antibiotics, said Bonou Isidore, a Red Cross volunteer who recently did an assessment around the capital, Porto Novo, in the southeast.

Aid workers stress that malaria is a considerable worry, given the standing water everywhere. Cholera had already hit the country prior to the flooding; the economic capital Cotonou has some 500 of the 846 reported cases, with seven deaths.

In addition health experts are concerned about other diarrhoeal infections, acute respiratory problems and skin infections, Léon Kohossi with the World Health Organization in Benin told IRIN.

"The disease risk is imminent and means solid epidemiologic surveillance will be paramount," Kohossi warned. "This is what we are working on now with national and international partners."

Residents say the water is beginning to recede in many areas. "But the damage is done," CARE's Raymond said.