Hospitals in north struggle to contain cholera outbreak

Doctors in the northern city of Sulaimaniyah have asked for more help to cope with the rapidly increasing number of cholera cases.

“We need urgent medical support as the disease is spreading. We didn’t expect an outbreak in this area,” said Dr Dirar Iyad of Sulaimaniyah General Hospital.

“There is a shortage of medicines to control the disease and the focal point [source of the disease] hasn’t been identified yet… Five deaths have so far been reported here and in Kirkuk, and we believe more could occur over the next couple of days as victims are already in an advanced stage of the illness,” he said.

According Dr Juan Abdallah, a senior official in Kurdistan’s health ministry, over 2,300 cases of cholera have been reported in the area, including Kirkuk over a four-week period.

“The disease spread very fast. It is the first outbreak of its kind in the past few decades,” said Abdallah.

The disease spread very fast. It is the first outbreak of its kind in the past few decades.

According to a report on Al-Jazeera TV on 30 August, which quoted “official sources” at Kurdistan’s health ministry, eight people - seven in Sulaimaniyah and one in Kirkuk - had died of cholera, and a state of emergency had been declared in all hospitals in the cities of Iraqi Kurdistan. The report went on to say there were over 35 cholera cases in Sulaimaniyah and 47 in Kirkuk. A further 350 people had acute diarrhoea and were suspected of having contracted the disease.

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium vibrio cholerae. It has a short incubation period and produces an enterotoxin that causes copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given.

Causes

“The bad sanitation in Iraq, especially in the outskirts of cities where IDPs [internally displaced persons] are camped, has put people at serious risk,” Abdallah said, adding: “In Sulaimaniyah and Kirkuk at least 42 percent of the population don’t have access to clean water and proper sewage systems.”

Cholera is an easily treatable disease and the prompt administration of ORS to replace lost fluids nearly always results in a cure, but without proper assistance and with so many IDPs living in deteriorated conditions in Iraq, the situation might get worse.

The UN Children’s Fund (UNICEF) said the outbreak has due to serious problems with water quality and sewage treatment. It quoted local reports which said that only 30 per cent of the population in Suleimaniyah had an adequate water supply. “Mains water is only available for two hours per day at most in the city. A water quality report on Suleimaniyah in July showed that only 50 per cent of the city’s water was chlorinated,” said UNICEF, adding that many had been reduced to digging shallow wells outside their homes.

UNICEF response

UNICEF, in coordination with the World Health Organization (WHO), which is leading the UN response, has delivered 4,000 cannulae and needles and 15,000 sachets of oral rehydration salts (ORS).

ORS is critical to prevent death from dehydration caused by severe diarrhoea. UNICEF said 4,000 safe water kits were being delivered on 30 August to families in the Suleimaniyah area, where significant numbers of IDPs are also at risk.

“Cholera is an easily treatable disease and the prompt administration of ORS to replace lost fluids nearly always results in a cure, but without proper assistance and with so many IDPs living in deteriorated conditions in Iraq, the situation might get worse,” Iyad said.

According to a press release issued by UNICEF on 29 August, the local authorities said that over 2,000 people had been affected and about 500 hospitalised in the previous two days with severe diarrhoea. UNICEF said 47 cases had been confirmed as epidemic cholera, and this number was expected to grow.

Photo: IRIN

UNICEF is appealing to families in affected areas to ensure their children are kept away from areas contaminated with raw sewage

UNICEF is appealing to families in the affected areas to ensure that children, in particular, are kept away from areas contaminated with raw sewage, that they always wash their hands with soap, and only drink water that has been purified or boiled.

“My two children, husband and mother have been affected by cholera because we weren’t able to get purified water and one of my children is very sick in hospital,” Um Abir, a 34-year-old resident of Kirkuk said.

“We have been displaced since January 2007 and we have to camp near a rubbish pit which, according to the doctor, might be the reason for all the family being affected,” she added.

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