Haitian hospitals face overcrowding as the cholera epidemic continues to spread through the impoverished country.

More than 1,000 people have died and at least 14,600 have been hospitalized in Haiti. Health care workers consider those numbers to be understated.

The United Nations forecasted up to 200,000 Haitians could contract cholera as the outbreak extends.

Aid workers fear the growing numbers may soon overwhelm Haiti’s health care facilities.

“In this hospital, because of space constraints, we have to make sure that people can be sent to another place where we can provide better care very fast, so that we can still receive,” hospital manager Francoise Gyrone told The Associated Press.

The disease, mainly spread by fecal contamination of food and water, had never had a confirmed case in Haiti before it appeared in late October along the Artibonite River and spread across the country. The strain is one mainly found in South Asia.

Haitian President Rene Preval led a panel of speakers in a Sunday address to implore citizens to practice good hygiene and proper cooking methods.

But even before a massive earthquake left 1.3 million people living in temporary tent villages, most Haitians did not have access to clean water or reliable sanitation.

“When we go around and give advice about hygiene, they say, ‘Let me have soap, I can’t afford it,’ ” Leonard Doyle, a spokesman for the International Organization for Migration, an agency that is distributing water purification tablets and cleaning supplies, told the New York Times.

The central rural province of Artibonite is the worst-affected, accounting for nearly 600 of the total deaths, Reuters reported. Other affected provinces are Centre, Nord, Nord Ouest, Sud, and Ouest, where the capital Port-au-Prince is located.

The United Nations Friday said $163.9 million in aid is needed over the next year to combat the epidemic, with $89 million going to sanitation and hygiene efforts.