Serious sanitation problems persist in Baghdad

For 10 days now, little Muhammad Qasim has been crying in a hospital bed in Baghdad, kept alive by an intravenous drip to counter his serious diarrhoea. He has also received plasma and antibiotics and constant attention from his parents and the doctors at Al-Alwiyah Children’s Hospital. But despite this, Muhammad is losing his battle, and is on the verge of becoming yet another victim of Baghdad’s desperately poor sanitation in the wake of the recent war. Beside him is his twin brother, Ali, flies darting from one to the other as their father waves his hand over them. The twins were born prematurely three months ago, each weighing two kilogrammes at the time. Today, they each weigh three kilogrammes - the normal birth weight of a child. When war broke out, their parents shifted to another area of Baghdad, where they were unable to find good water. The twins have suffered diarrhoea for several weeks now, and while Ali is getting better, Muhammad's body has weakened to critical levels. Their father, Qasim Abbas, said he feared for their lives. Dr Husayn Fadil al-Jawadi, a paediatrician, said the chronic lack of sanitation in the city had created an extremely serious situation. Not only was diarrhoea at the worst level he had ever known, but he feared there could also soon be an outbreak of deadly cholera. "There is no sanitation and no clean water. Even tap water, there is a smell, and when you put it in a glass you can see the material in it," he said. In 1999, doctors had managed to control an outbreak of cholera in Iraq, "but I fear it could be much worse this time". In the wards of Al-Alwiyah Hospital, countless other worried parents clutching weak and wailing babies spill into the corridors and courtyards of the facility, which is stretched far beyond its capacity. Their children are suffering from a collapse of basic services such as sewage disposal, rubbish collection, fresh water and electric power. "There is no authority to turn to for help, we work by ourselves only," Husayn said. One of those trying to help is the project officer for planning of the United Nations Children’s Fund (UNICEF) in Baghdad, Hatim George Hatim. "For some time, Baghdad has been a big factory of bacteria - weapons of mass child destruction," he observed. Contaminated water, uncollected rubbish, flooded sewers, and lack of electricity or gas with which to boil water all served significantly to increase the risk of sickness and death, he said. Added to this was the collapse of the jobs and the subsequent rise in poverty, as well as the barely functioning health system. UNICEF’s staff were trying to cover all areas of need, Hatim said, noting that even small things could make a great difference to hygiene. He gave the example of some hospitals being too stretched to remove rubbish from the wards: by providing them with plastic bags and helping with disposal, their sanitation standards had improved dramatically, he said. Meanwhile, on the streets of Baghdad, mounds of stinking rubbish lie rotting in the heat. Often they smoulder after residents have tried to set fire to them to reduce the health hazard. But some rubbish collections have started. In three of the worst-affected areas, UNICEF has contracted truck owners to clean up the hazard. Fadil Rahim, a driver, said he was surprised by the sheer quantity of the rubbish: by late morning he had already taken two truckloads to a dump. "It’s a big problem, so I have to help getting it away from the people who live in this area." Ahmad Adnan, an area resident, said it was the first time rubbish had been collected from his street in well over a month; prior to the war a truck used to come three or four times a week. With a new son, born in the first few days of the war, he said it was a huge concern that diseases could be caught from the accumulating rubbish. In Baghdad’s northern Al-Adamiyah district, the director-general of the municipality, Hamid Khalif, said maintaining sanitation had now become a major battle. Of the 71 rubbish-collection trucks he normally had on the road, only 35 were currently operating. But even if more trucks were available, getting workers was difficult. With nobody paying wages any more, people were reluctant to go back to work. Workers had not been paid their wages for March and April. At the sewage plant, which he also oversaw, he was worried that if the workers were not paid soon, they would steal vital pumps and other equipment they could sell to survive. A Baghdad Municipality engineer, Nizar Fakhri, said he had given UNICEF a list of badly needed items, such as trucks, front-end loaders, fuel and labourers for the rubbish-collection trucks and sewage plant. The district covered 126 sq km with about 850,000 residents, which meant that the job of maintaining sanitation at present was extremely difficult, he said. He was also worried about security, saying looters were a constant threat, and he had received no protection from coalition troops. "Even in the street there is no protection - any man can shoot and take your car, because there is no police, no security, no government," Nizar said. Back at Al-Alwiyah Hospital, Rida Haydar's face is becoming a familiar sight. The three-month-old boy, admitted a week ago with severe diarrhoea and discharged when his condition stabilised, was back three days later, again with diarrhoea, this time his condition much worse. Haydar, his father, said his family home lacked clean tap water, the supply having been cut off during the war, forcing them to drink river water. He said before the war, cheap bottled water had been available, but now, not only was it too expensive but bottles were filled with tainted water. Moreover, gas was unavailable for boiling water. "The whole situation is bad but the hospital has continued, so at least we have this," he said. Stroking the forehead of his only child, Haydar said there was only one option to stop his son from returning to the hospital yet again: "I have to buy clean bottled water. Even if it is expensive, I have to do it."