The Associated Press reported in a lengthy report, Friday, that conflicts and crises contribute to the spread of “cholera” in Arab countries, and published a story that reflects the suffering of those afflicted with this disease.
Shadia Ahmed was terrified when the rain flooded her hut one night, drowning her seven children. The next morning, the children developed vomiting, diarrhea, and other symptoms.
After an aid group conducted cholera tests in Ahmed camp for Syrian refugees in the town of Bhanine in northern Lebanon, the youngest of them, 4-year-old Aseel, tested positive.
Cholera has spread to Lebanon, Syria and Iraq, where these countries struggle with poor infrastructure, unrest and harboring large numbers of people displaced by conflict. Last month (October) Lebanon reported its first case of cholera in nearly 30 years.
Bacterial infections have surged globally in dozens of countries this year, with outbreaks in Haiti and across the Horn of Africa as well as the Middle East. Outbreaks of hundreds of thousands of cases due to conflict, poverty and climate change represent a major setback for global efforts to eradicate the disease.
“Cholera thrives in poverty and conflict, but is now exacerbated by climate change. Regional and global health security is at risk,” said Inas Hamam, WHO regional spokeswoman.
Cholera control efforts focus on vaccination, clean water and sanitation. Last month, the World Health Organization announced a temporary suspension of the two-dose vaccination strategy because production could not meet rising demand. Officials are now administering single doses so that more people can benefit from the vaccine in the short term.
Cholera infection is caused by ingesting food or water infected with the bacterium Vibrio cholerae. While most cases are mild to moderate, cholera can cause death if not treated properly.
Ahmed, 33, said of Aseel, her daughter who contracted cholera: “I would spend the whole night taking her to the bathroom, giving her medicines, washing her, and sterilizing her. I couldn’t sleep, and I was up all night just looking at her. I was afraid of the worst.”
Aseel and her siblings eventually got better, and it was the only confirmed case of cholera in the family.
Across the border in Syria, UN officials and agencies announced last month that a cholera outbreak was sweeping the entire country.
According to the United Nations and the Syrian Ministry of Health, the outbreak in Syria is due to people drinking unsafe water from the Euphrates River and using contaminated water to irrigate crops.
In the areas controlled by the Syrian regime, and in the Kurdish-controlled areas in the north-east of the country, nearly 17,000 cases of cholera and 29 deaths were recorded.
In Syria’s opposition-held Idlib province, most of the 4 million people have been displaced by the conflict. They depend on international aid and live in camps.
More than half of Idlib does not have regular water access. Many families use polluted water from wells close to sewage.
3,104 cholera cases and five deaths were recorded in Idlib Governorate. Dr. Abdullah Hamidi, from the Syrian American Medical Association, expects an increase this winter.
“The health care system in the area is weak,” Hamidi said. “Medical organizations and local councils are trying to sterilize the water and they are holding workshops to limit the spread of the disease.”
In Salah al-Din camp in the opposition-controlled countryside of Aleppo, children play near a swamp of sewage water, and activists conduct awareness sessions for the population.
“We are worried about its spread in our camp,” said one resident, Jamil Latvo.
Iraq has been suffering from a cholera epidemic for years. In Lebanon, the disease has been rare for decades.
Three years ago, Lebanon fell into an economic crisis. Most Lebanese now rely on water trucked in by private suppliers and private generators for electricity. Public institutions cannot buy fuel and pump water into homes.
Since last month, Lebanon has reported 2,421 cases and 18 deaths. About a quarter of these cases are children under the age of five. Vibrio cholerae bacteria are found in drinking water, sewage systems, and irrigation water.
The country hosts more than one million Syrian refugees. The Lebanese Ministry of Health said that most cases of cholera have been detected in refugee camps.
In Bhanine, Shadia and her children are crammed between apartment buildings, along with dozens of other Syrian refugees. Families live in weak wooden huts with tarpaulin walls and ceilings. They share three toilets and three sinks.
Like most homes in Lebanon, camp residents purchase trucked water from private suppliers. The state does not test the waters for safety.
“The water was contaminated but we had no choice but to use it. There was no water to drink, let alone water to clean, wash dishes, wash our clothes or take a shower,” said one resident, Ali Hammadi.
UN aid agencies began providing clean water to the camp, while disinfecting walls and doors and holding information sessions. It is also donating fuel to the Lebanese government so that the authorities can pump water again.
“The support we are providing cannot replace the service lines and the national electricity grid, which is basically not working most of the time,” said Ettie Higgins, Deputy Representative of the United Nations Children’s Fund (UNICEF) in Lebanon.
WHO has been working with Iraqi health authorities to help bolster their cholera response, visiting water treatment plants and testing laboratories in Baghdad since last month.
UNICEF said it urgently needs $40.5 million to continue its work in Lebanon and Syria for the next three months.
“These camps are fertile ground for disease outbreaks,” said Hamidi of the Syrian American Medical Society. “We will not be able to properly respond to them unless there is intervention with medical equipment and aid.”