Cholera continues to spread in the south

The Iraqi Ministry of Health continues to fight a recent outbreak of cholera as it spreads through Iraq's southern provinces, bringing the total number of confirmed cases to 68, a health ministry spokesman said on 13 September.

"So far we have diagnosed 68 cholera cases in Baghdad and other southern provinces: Babil 40 cases; Baghdad 22 cases; Karbala four cases; Najaf one case; and another in Maysan," Ihssan Jaafar, director-general of the public health directorate and spokesman for the ministry's cholera control unit, told a press conference in Baghdad.

"The Ministry of Health's teams and institutions are working 24 hours a day and seven days a week to check all areas and to treat any cholera case immediately to avoid fatalities. The ministry recently imported 540 million water tablets and we have already distributed tens of million of them," Jaafar said.

Jaafar said that five people had died from the disease but all in the early days of the outbreak, in late August, as the victims had not gone to any hospital quickly enough.

"Now, awareness [of cholera] among the people has risen and they have started to go immediately to the nearest health institutions and that has helped prevent more fatalities. We call upon all the people to make sure that they are using safe water for drinking," he added.

Government criticism

However, some experts have criticised some of the health authorities’ hygiene recommendations.

Ismaiel Mohammed, a sociology professor at the University of Babil, said the government's recommendations to residents will add to their economic burden as they will have to pay more money for fuel to boil water or for buying bottled water.

It [cholera] is an endemic disease and there must be real solutions that go to the roots of it and not only immediate measures whenever the disease emerges. By this we are only cutting off the octopus' arms and not killing it.

“It [cholera] is an endemic disease and there must be real solutions that go to the roots of it and not only immediate measures whenever the disease emerges,” Mohammed told IRIN. “By this we are only cutting off the octopus' arms and not killing it.”

Mohammed urged the government to begin rehabilitating the country’s dilapidated water networks or at least its small purification and sanitation plants in urban areas where people are most vulnerable to the disease.

He also said that there must be cooperation between all the government's concerned departments to supervise and upgrade existing water and sanitation plants rather than “only adopting the traditional and temporary measures of sending tankers of drinking water or distributing water tablets in the affected areas”.

WHO’s long-term strategy

On 11 September, the Iraqi health ministry and the World Health Organization (WHO) blamed the country's rundown water and sanitation infrastructure for the cholera outbreak and called for immediate measures to remedy them.

"Experience has shown that long-term prevention of cholera depends on access to safe water and adequate sanitation to prevent exposure and interrupt transmission," WHO said in its statement.

"Improving water and sanitation infrastructures is therefore a long-term goal of WHO and its partners in Iraq and, in times of outbreaks, it is essential that immediate measures - such as water treatment at household level, health education and proper case management - are implemented rapidly," it added.

Cholera is a gastro-intestinal disease typically spread by contaminated water. It can cause severe diarrhoea, which, in extreme cases, can lead to fatal dehydration. It can be prevented by treating drinking water with chlorine and by improving hygiene conditions.

sm/ar/ed