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Diarrhoea still a huge problem for capital's children

[Iraq] Coping with diarrhoea.
Baghdad hospitals are overflowing with diarrhoea cases (Mike White)

Coping with the huge number of diarrhoea cases throughout the capital is putting Baghdad hospitals under pressure. At the Al-Wiyah paediatric hospital, children are being kept two or three to a bed to keep up with the influx. A paediatrician, Dr Abdullah Husayn, said the 168-bed hospital was receiving 200 patients a day suffering from diarrhoea, putting the facility under extreme pressure.

"Our beds are full all the time - they are occupied at least 150 percent," he said. The hospital had appealed to the United Nations Children’s Fund (UNICEF) and other aid organisations to provide 50 more beds, mattresses and medical supplies to cope with the crisis, he added.

The overcrowding was forcing the hospital to send patients home earlier than they would be normally. This raised another problem, that of their then infecting others in the community, Abdullah said. The hospital’s supplies of intravenous fluids were also beginning to run out as the main stores of medical supplies in Baghdad had been looted and burnt.

"This is the 30th year of my work as a doctor, and this is the worst year," Abdullah said. In April 2002, the hospital saw 595 diarrhoea cases. In April this year, it admitted nearly twice that number, despite the huge obstacles for people getting to the hospital during and after the war.

He estimated that the real rise in diarrhoea cases this year would be closer to four times the normal number, observing that there was no doubt children were dying in Baghdad because of it. Even some children who made it to the hospital died, particularly those who were malnourished, as many children in Iraq were, Abdullah said.

"Why should we be in this situation - we don’t understand it?" But the reasons are not difficult to discern. A fellow paediatrician, Dr Ali Shahin, put it succinctly: "We are in a dirty environment now." He said many people had left their homes during the war and shifted to safer places, which had resulted in overcrowding and unhealthy living conditions, under which clean water was often unavailable.

Failure of basic services such as sewage disposal, electricity to keep food safe and a lack of gas to boil water with were also adding to the rise of disease. Abdullah stressed how serious diarrhoea could be, saying it was the biggest killer of children in Iraq. Meanwhile, in spite of the difficulties and the fact that they were not receiving any pay, medical staff were determined to continue their work, he added.

The United Nations says, on average, every Iraqi child suffers 15 bouts of diarrhoea a year, and one in eight children dies before reaching the age of five years.

In the west of Baghdad, Al-Nur General Hospital is suffering a similar large increase of diarrhoea cases in the wake of the war. The hospital’s director, Dr Haqqi Razuqi, said they were treating five times as many diarrhoea cases as normal. Every day they saw more than 200 cases and admitted 50.

He said before and during the war, many people had shifted from Baghdad to rural areas, where they were drinking contaminated river water. Even the water supplied in Baghdad now was not guaranteed to be safe, he said, and there were areas where people were still taking water from polluted wells and rivers.

He said with fuel and transport so expensive, many people without money were unable to reach hospitals, and children were dying unnecessarily as a result; and he believed it would be many weeks before the situation improved.

However, the hospital has received help from UNICEF, the International Committee of the Red Cross (ICRC) and other NGOs, and this means that it is able to cope with the influx.

A UNICEF official in Baghdad, Hatim George Hatim, said UNICEF was bringing in supplies to meet a shortage of oral rehydration sachets, but this would only go part way to meeting pressing needs. It previously did have some supplies stored in Baghdad, but half its emergency medical kits had been stolen when looters stripped the organisation’s building in the capital following the collapse of the regime.

The UNICEF spokesman for Iraq, Geoffrey Keele, said in the Jordanian capital, Amman, that 250,000 oral rehydration sachets had arrived in Baghdad on a UN flight last week, but many more supplies were needed. "Really, we are looking at the tip of the iceberg - there is really a great need," he said. UNICEF had also sent in a convoy of 17 trucks from Amman on Monday carrying high-protein biscuits, water-treatment plants and equipment, and education kits.

Keele said the diarrhoea situation in Baghdad was still very critical, and emphasised that children were dying as a result of the diarrhoea outbreak. "Diarrhoea sounds trivial to people in the West, where it's an inconvenience, but in Iraq you have a situation where water is a killer."

Not only did patients' immediate needs have to be met but the entire sanitation infrastructure would have to be rebuilt. Because of the continuing lack of access to clean water, more children would come down with the disease, he predicted. "And until we can get things up and running, it will continue to be serious. I'm not sure if it has peaked."

Keele said this was a particularly worrying trend given the pressure Baghdad hospitals were already under. Not only were wards filled with diarrhoea-stricken children but outpatient areas were seeing hundreds more victims every day. In many of the capital's hospitals, diarrhoea cases constituted between 70 percent and 80 percent of patients, with the rate being as high as 90 percent in the country's second-largest city, Basra, Keele said.

World Health Organisation (WHO) spokesman Iain Simpson, speaking from Geneva, said that, sadly, it was almost certain that children were dying because of the high levels of diarrhoea throughout Iraq.

Prior to the war, diarrhoea was already one of the country's three biggest killers but the breakdown in security and infrastructure in the wake of the war had made things much worse and cases had increased significantly. Of additional worry was the possibility of cholera emerging in the north of Iraq as well as Basra where it has already been confirmed.

Simpson said that in Mosul, cases of watery diarrhoea among adults had risen from 382 last week to 1665 this week. In children under five, there were 1960 cases this week compared to 1130 the week before.

He said while young children were usually more susceptible to diarrhoea, when there was a large increase in adults patients, it often indicated cholera. Tests were currently being carried out to confirm if this was the case and results would be known in a few days.

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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