Cholera Outbreak in North Blamed on Dirty Water

The Kurdistan Regional Government's health minister has warned that cholera outbreaks in the north could spread if the government does not improve its water supply.



"If the government doesn't fix the dirty water problem, the cholera outbreak will continue and a huge disaster will occur," KRG minister of health Zryan Osman told IWPR.



Osman said that 13 people have died of cholera in the northern provinces of Sulaimaniyah, Erbil and Kirkuk. The minister reported that 430 people in Sulaimaniyah and 270 in Erbil have been diagnosed with the disease. And Salah Ahmed Ameen, a senior health official in Kirkuk, said 450 people are infected with cholera there.



The World Health Organisation, meanwhile, reports that at least 6,900 cases of acute diarrhoea had been recorded.



Cholera is a potentially life-threatening diarrhoeal disease that infects humans through contaminated water or food.



WHO reported that the first confirmed case came from Kirkuk on August 14; that the government has since put in place measures to improve water safety and sanitation; and provincial authorities are chlorinating water in the affected districts.



Osman noted that the spread of the deadly disease appears to be slowing. But he said that health officials are concerned that cholera could emerge in new areas where the water is not clean and basic services are poor.



"The water systems need to be cleaned, and then we can control the disease," agreed Sherko Abdullah, head of healthcare in Sulaimaniyah province. "The problem isn't with the healthcare, it's with the services."



International aid agencies and Iraqi officials have warned for years that Iraq could face disease outbreaks because of poor sanitation and infrastructure.



Health officials in the southern city of Najaf reported five cholera deaths - all of them children - in June, and Iraqi health ministry officials in early July warned that water-borne diseases could spread because of crumbling infrastructure, according to reports by the United Nation's IRIN news agency.



WHO in April said that 80 per cent of Iraqis lack adequate sanitation and 70 per cent do not have regular access to clean water. The organisation's report linked violence and health problems in Iraq. Yet Sulaimaniyah - which has remained relatively immune from the conflict in Iraq - has been hit hardest by the cholera outbreak.



Nine people have died in the province, one in Kirkuk and two in Erbil, said Osman.



People in Iraqi Kurdistan maintain that the government is not providing even basic services despite its relative stability and growing oil revenues. Many argue that the cholera outbreak is an example of how the regional authorities - which have a high level of autonomy from Baghdad - have failed them.



"The government is primarily responsible for my mother's death," said Shadan Mohammed, a 25-year-old student at the University of Sulaimaniyah, whose mother recently died of cholera.



"If we had had clean drinking water, my mother would still be alive."



Mohammed and her family live in a slum in Sulaimaniyah and drink from a well they drilled themselves last year because their neighbourhood is not connected to the state water supply. Another four of Mohammed's family members have cholera, she said, and they are now boiling their water to prevent further disease.



Sulaimaniyah's population has grown significantly since 2003, and officials estimate that more than 30 neighbourhoods built on the outskirts of the city do not have water or sewage systems.



According to the Sulaimaniyah water authorities, of an estimated 35,000 private wells in the province, only 15,000 have licenses, and none have ever been tested to determine if the water is potable.



Ferhad Mohammed, head of water supply services in Sulaimaniyah, maintained that local drinking water is clean.

"Sulaimaniyah has never had such clean drinking water as it does now," he said.



But a video posted on Google that shows a man shovelling large amounts of dirt and sludge out of a huge water tanker in Sulaimaniyah has become popular viewing in the north. Some argue that the video provides evidence that authorities are not properly monitoring and managing the water supply.



"The drinking water sources in the city [of Sulaimaniyah] are so dirty that any disease could come out of them," said Osman. "The drinking water is mixed with sewage."



"The current water system in Sulaimaniyah can provide only 30 per cent of residents with water," maintained Abdullah. "The system is old, the tankers are not regularly cleaned, and not enough chlorine is added to the water."



The KRG, which governs Sulaimaniyah, Erbil and parts of Kirkuk, is in charge of containing the cholera outbreak in Sulaimaniyah and Erbil, and central government has sent medicine to Sulaimaniyah to help treat infected patients, said Abdullah.



Prime Minister Nuri al-Maliki's government has allocated 100 million Iraqi dinar (81,000 US dollars) to aid Kirkuk. President Jalal Talbani is giving 50,000 dollars to Sulaimaniyah and 100,000 dollars to Kirkuk, and aid agencies such as WHO are providing medicine.



The outbreak scared off some foreign companies who chose not to attend Sulaimaniyah’s recent international trade fair, said Baban Ahmed, spokesman for the fair. The KRG-governed territories have been the only bright spot in an otherwise struggling Iraqi economy, and Kurdish officials have worked hard to attract international investment.



"The cholera outbreak is hurting us economically," said Ahmed. "Several companies pulled out because they feared the disease."



Doctors say they are overwhelmed by the flood of patients. Hundreds have crowded into Sulaimaniyah's public hospital, and patients with intravenous tubes stuck in their arms have had to lie on the floor because the facility doesn't have enough beds.



Hemin Sarkawt, a doctor at Sulaimaniyah's teaching hospital, said he has worked day and night since the outbreak late last month.



"We're getting tired, but we need to take care of this," he said. "It's a dangerous situation."



Amanj Khalil is an IWPR reporter based in Sulaimaniyah.