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[casi] 'Grave danger' of cholera epidemic



Not a drop that's safe to drink

By Jonathan Duffy
BBC News Online, in Nasiriya
Wednesday 23rd April 2003

War-ravaged Nasiriya is caught is a deadly cycle: with no electricity to
pump water, locals are breaking into the underground pipes, allowing raw
sewage to seep into the system. That points to one thing - a cholera
outbreak.

Eight-month-old Ali Hussein is too young too know anything about the war,
but he is feeling the effects now, in his stomach.
For the past week, Ali has suffered from vomiting and diarrhoea, leaving him
badly dehydrated. Now doctors have prescribed him a simple antibiotic and
his mother, Zahra, hopes he will soon be on the mend. For Ali has been
diagnosed with gastroenteritis, cases of which have risen sharply in
Nasiriya in recent days.

Since the third day of the war, the city's electricity supply has been out
of action. The combination of bombing raids by the coalition forces and the
counterattack by the Iraqi army destroyed Nasiriya's infrastructure.

Without power there is nothing to pump the water. And without running water,
the locals are turning to untreated supplies which they can't afford to boil
because of the soaring price of fuel.

The electricity shutdown has also brought the sewage pumps to a halt, so
that much of this city of half a million people is sitting on a bed of stale
human waste. In places it has started to seep up to ground level.

Filthy pool

Outside the clinic where Ali had been taken for treatment, the sewage has
settled into a pool which runs the length of the dusty street before
spreading out over a traffic junction. It's hard to sidestep and impossible
to avoid getting a sniff of it.

The big fear is the two problems will combine into a single, lethal one.
Across the city, locals desperate to tap into a ready water source have
split open the municipal pipes.


['We are in grave danger of a cholera epidemic by the summer - that will
sweep through the population and kill thousands' - Field worker Mary
McLoughlin]

Now sewage is seeping through the punctured holes of those pipes, so that
even when the electricity is restarted, and water begins to flow freely
again, it will carry potentially deadly bacteria.
With temperatures rising as summer approaches, Nasiriya could find a cholera
epidemic on its hands, says one highly experienced aid worker.

Clean water, or the lack of it, is more of a problem than anything else in
Nasiriya. There is no shortage of food. The central distribution system set
up under the Oil for Food programme ensured everyone here had enough rations
to last them through to August.

Fatal consequences

In some medical practices, 80% of patients seen are suffering from some sort
of water infection. Dr Abdul Al-Shadood says his Al-Meelad clinic is seeing
an average of 22 gastroenteritis cases a day, compared to one or two before
the war.


"If this is not diagnosed and treated quickly in children, they will die,"
says the doctor. That has already started to happen. The doctor refers
severe cases to the city's children's hospital - itself working at only half
capacity after a stray missile attack - and says the illness has claimed
young lives.
Another worry is the lack of medicine available to treat these relatively
simple maladies. The central medicine store that used to serve all medical
practices in the area was seized by the Iraqi army as a battlement and
subsequently wiped out in bombing raids.

Dr Shadood's clinic has run out of the most basic treatment - oral
rehydration solution. Instead, he is prescribing an antibiotic called
Flagyl. But he has only a few days' stock left and no deliveries are
scheduled.

Again there are complications. Like many western countries, Iraq's fondness
for handing out simple antibiotics to treat sickness has raised resistance
among many locals.

Dirty water

Only now are humanitarian relief agencies starting to get a handle on what
help they can offer. The Irish humanitarian agency Goal arrived in Nasiriya
last week and is one of only a small group of aid organisations here.


Field worker Mary McLoughlin says it's "no exaggeration" that if the water
and sewage situation is not mended soon, Nasiriya will see a "major
humanitarian crisis".
"Cholera is endemic in southern Iraq, but we are in grave danger of a
cholera epidemic by the summer. That will sweep through the population and
kill thousands," she says.

"The water and sewage pipes were already crumbling before the war, because
of years of neglect. But now people are breaking holes in them to get the
water, the real danger is of cross contamination between sewage and water.

"It's such a massive construction task to repair the years of neglect, I
doubt whether they can fix the pipes by the time the really high
temperatures come, which is when cholera becomes a real fear."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/world/middle_east/2969283.stm

Published: 2003/04/23 10:16:13

© BBC MMIII




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