Institute for War and Peace Reporting | Giving Voice, Driving Change

Cholera Epidemic Fears Rise

Officials accused of suppressing news as disease spreads in drought-hit northeast.
By IWPR
Reports of hundreds of cases of cholera spreading in northeastern Syria have sparked fears of an epidemic in this poor and drought-stricken area, Syrian analysts and media reports said.



Four people - three of them children - have died from the disease so far and the numbers of those estimated to be infected in the past three weeks with the bacteria that causes cholera vary between 200 and 1,000, according to media reports.



The source of the infection is believed to be pollution of the Euphrates River and smaller rivers that it feeds, which constitute the main source of drinking water and irrigation for northeastern villages.



The area, which relies mainly on agriculture, has suffered many environmental, social and economic problems since a severe drought started four years ago.



One unnamed local health official told a pro-government website, Syria News, earlier this month that tens of severe cases of diarrhoea were reported in June around the villages of Mayadeen and Deir Ezzor close to the Euphrates.



A health ministry official working in the northeastern province of Raqqa told IWPR that there were 321 cases identified as cholera in the province in recent weeks. He added on condition of anonymity that one of those infected had died and 45 others were in a critical condition.



He said that medics at the public hospital in Raqqa are sealing off some sections of the hospital because the disease is spreading very fast.



The hospital was registering cholera patients as suffering from severe intestinal infection, he said. The authorities had given no orders to distribute vaccines against cholera.



Although Syrian authorities have tried to downplay the scale of the crisis, local journalists have raised fears that the disease could become an epidemic.



The health minister, Rida Saeed, issued a statement on August 21 denying that there were any cases of cholera in northeastern Syria. He said that there were only cases of "severe diarrheoa" in the areas of Raqqa and Deir Ezzor but that they were all being treated and this form of diarrheoa was common in summer.



A high-ranking official from the ministry, Ghassan al-Rab, head of the local health departments, denied that there was a cholera epidemic.



He told reporters that a dozen patients were suffering from normal diarrhoea only because they ate unwashed fruit and vegetables and the vast majority of the cases had been cured.



Official media have not reported any deaths related to cholera in northeastern Syria.



Meanwhile, a prominent tribal leader from the area said that more than 170 people from the rural Mayadeen and Boukamal areas were taken to hospital with cholera symptoms. He spoke to IWPR by telephone on condition of anonymity.



"The denial is making rumours circulate and making people panic," he said in reference to the situation in the areas said to be affected.



According to local media reports, the government has taken a number of steps to deal with the crisis by opening emergency health centres in small villages and increasing capacity in hospitals in the area.



The health ministry also sent officials to monitor the situation closely and test the drinking water.



In addition, the government sponsored awareness campaigns in northeastern areas to persuade citizens to wash produce thoroughly and use chlorine to decontaminate the water.



A Damascus-based agricultural engineer who preferred to remain anonymous said that the Euphrates was probably contaminated because sewage and waste from hospitals and factories had spilled into it.



He added that the level of pollution had risen recently after Turkey, where the Euphrates originates, reduced the flow of water into Syria. The slower flow of water caused contaminants to accumulate and increase the pollution, he said.



Others experts suggested that the health crisis is the result of a general deterioration of the environmental situation in the northeast area coupled with mismanagement and neglect on the part of authorities.



"It’s the most important area in the country [economically], and yet it receives the least attention from the government,” said an economist in reference to the vast Al-Jazeera area in the northeast, which groups Al-Hassakeh and Deir Ezzor governorates.



Four years of extreme drought on top of four decades of official negligence have negatively affected over one million people in Al-Jazeera, according to reports about the region, said the economist, who asked that his name not be mentioned.



The area, which was traditionally the most important for natural resources and agricultural production, today suffers from high levels of poverty and is far from the main centres of population, he said.



“Family and tribal relations are still dominant," the expert added.



International organisations have indicated that the situation in northeastern Syria has reached dire proportions.



Around 1.3 million people have been affected by drought and more than half a million of them are in Hassakeh province, according to a report issued in July by the International Federation of Red Cross and Red Crescent Societies.



Small-scale farmers and rural households have lost crops and 80 per cent of their animal stock with no alternative sources of income, the report said, stressing that the region was in urgent need of food supplies, clean water, health support and help with living standards.



Around 60,000 families – more than half of them from Hassakeh – have migrated to big cities over the past four years, according to recent reports by United Nations agencies.



The Syrian government along with international organisations deployed a number of measures including the distribution of food rations to improve living conditions. But critics say that these efforts have not been serious enough.

“The area has been suffering from inadequate investment in water resources,” said the economic expert, who added that 40 per cent of the existing wells were drilled illegally and this had led to the exhaustion of the ground water.



He blamed the government for lifting subsidies on oil products, which, he said, was an additional blow to farmers who were already burdened by the heavy drought.



As a strategy to prevent diseases like cholera, he urged authorities to build treatment facilities for sewage and waste water and design sound strategies to stop water pollution.



“There should be a comprehensive plan to achieve economic and social development, instead of dealing with every problem as it comes up," he said.