Cholera spreads in Iraq and beyond

Friday 13/11/2015
Iraqi child getting vaccinated for cholera in Baghdad

BAGHDAD - Days after flash floods in Iraq killed 60 people, injured dozens and dis­placed hundreds, the country is grappling with a cholera outbreak that has infected at least 2,200 people, killed six and expanded beyond its borders.
In Bahrain, the Health Ministry reported 55 confirmed cases of chol­era, saying the infected individuals had been in Iraq. Kuwait reported five cases, also saying all those with the disease had visited Iraq.
Syria, which has been devastated by war, has several confirmed cases, though there are no exact numbers or details on how cholera was con­tracted there.
Bahrain, Kuwait and Syria have significant Shia Muslim communi­ties. At least 7 million pilgrims con­verged on Iraq in October to take part in rituals at a Shia shrine in Karbala.
Concern has been increasing that more pilgrims will contract cholera during a Shia holiday celebrated in Iraq in December. Millions are expected in Karbala for Arbaeen, a religious ritual marking the end of mourning for the Prophet Moham­mad’s grandson Hussein.
“Iraqis are jinxed,” joked engi­neering student Karrar al-Ameri, 22, a Shia.
“It’s been one disaster after the other, militants and explosions, sec­tarianism and killings, unbearable summer heat, electricity cuts, gov­ernment corruption and protests, floods and now cholera.”
Cholera can lead to death by de­hydration and kidney failure within hours. It was first detected west of Baghdad in mid-September and has since spread to other Iraqi prov­inces, including cities controlled by Islamic State (ISIS) militants.
There was no immediate word on conditions in ISIS-run areas but the Iraqi Health Ministry said there were cholera cases there as well.
The outbreak can be traced to several factors, primarily low water levels in the Euphrates and flood­ing that contaminated the river and shallow wells with sewage water.
Near Baghdad, extensive flooding caused sewage systems to overflow, affecting 65,000 residents in camps for people displaced by Iraq’s ongo­ing violence.
The war against ISIS is also a fac­tor in the cholera outbreak. It has displaced 3.1 million Iraqis, with many of them now living in squalid and muddy camps where condi­tions are conducive to the spread of the disease.
UNICEF, a UN agency tending children worldwide, warned on November 6th that “given the scale of the outbreak in Iraq, the risk of cholera spreading across Iraq’s bor­ders remains high”.
It did not elaborate but UNICEF’s representative in Iraq, Peter Hawk­ins, told The Arab Weekly that the outbreak has a regional dynamic and the “risk of that can only be in­creased by people from all over the region coming into Iraq”.
One in five of the confirmed cases in Iraq is a child and in large parts of the country the start of the school year was delayed by a month as a precaution, according to UNICEF’s statement.
In response to the outbreak, UNICEF said it was providing bot­tled water, oral rehydration salts and installing community water tanks but, as with most humanitar­ian operations in Iraq, it is severely underfunded.
With concern rising that the disease could spread due to re­cent rains and ongoing insecurity, UNICEF — alongside the World Health Organisation — is supporting the response led by the Iraqi Health Ministry. It is delivering and secur­ing clean water supplies, providing treatment for people showing chol­era symptoms and undertaking a national communication campaign to help people protect themselves against the disease.
“There is unfortunately a high risk that cholera will reach more ar­eas of Iraq, affecting marginalised and displaced children, women and their families in particular,” Hawk­ins said. “So we have to act fast.”
Hawkins said a significant part of UNICEF’s effort is to “help commu­nities protect themselves against cholera”, by using water only from a protected source, by treating wa­ter they store at home and by call­ing for medical help when a family member develops diarrhoea or oth­er symptoms.
UNICEF has provided Iraqi health authorities with 820,000 sachets of oral rehydration salts used to treat patients suffering from dehydra­tion, the organisation’s statement said.