Monday, November 3, 2008

Cholera Spreading Rapidly Across Iraq

50% of the cholera cases and 50% of the deaths from it have been of Iraqi children 5 years old or younger

The latest report by the World Health Organization notes a rapid spread of cholera. (1) As of October 29, there were 644 confirmed cases of cholera, and 62 others under investigation. On October 20, there were 531 cases. That was an increase of 113 cases in just nine days. Previously, it took two weeks for that many cases to occur that month. In late September there was another surge in cases, but then it seemed to wane, only to increase again at the end of October.

The outbreak has also spread to all parts of the country. The first case was found in Maysan in the south on August 7. It then spread to Baghdad and Babil that month. It then moved to central and western Iraq in September, reaching Irbil in northern Kurdistan by October 7. The newest cases have occurred in Wasit and Diwaniya, both on October 18, and in the capitol on October 29. There have been a total of eight deaths as a result. Half of the victims have been children under five years old. Babil has been hit the hardest with a total of 255 cases. Diwaniya is next with 158.

The outbreak has spread because of a mix of incompetence and deteriorating infrastructure. Cholera is a disease contracted from drinking contaminated water. As reported earlier, Babil has had the most cases because of the negligence of Supreme Islamic Iraqi Council (SIIC) officials who rule the province. They decided to use expired chlorine that was purchased from Iran to purify the water supply. Across the rest of the country, the major cause has been the lack of access to clean water. The United Nations Agency In Iraq (UNAMI) and Iraqi ministries reported in mid-October that the water supply in Iraq had dropped. In Baghdad for example, the demand was for 3.25 million cubic meters, while only 2 million cubic meters of water was supplied. Overall, the Red Cross estimated that 40% of the population, especially in the rural and suburban areas, does not have access to purified water. Many people use rivers and wells for their needs, while others can’t afford the price of bottled water. There is also a drought hitting northern and central Iraq, which has made the situation worse, as people are even more desperate to find water, whether it is clean or not.

This has happened despite billions of dollars appropriated for rebuilding and improving the country’s water system since the 2003 invasion. In total, the U.S. has spent almost $2.38 billion on water and sanitation. In 2008, the Iraqi government appropriated $375 million for infrastructure in the sector, but as of June 2008 only $113 million had actually been spent. In August, Baghdad added an additional $241 million for the Water Ministry in its supplemental budget. These huge sums have obviously net met demand in Iraq.

The 2008 outbreak is not as large as the 2007 one that affected over 3,000 people. The government is attempting to address the problem by handing out chlorine tablets, and providing public information. There have been times when it seemed like the outbreak had been contained, and the number of new cases slowed, but now they are increasing again.

Spread of Cholera Across Iraq In 2008

August 7 – 1st case detected in the country in Maysan
August 18 – 1st case detected in Baghdad
August 28 – 1st case detected in Babil, 7 total cases, 174 suspected cases
September 5 – 1st case detected in Karbala
September 6 – 2 deaths
September 7 - 4 deaths, 1st case detected in Anbar
September 9 - 1st case detected in Diyala
September 10 – 22 cases, 5 deaths
September 13 – 68 cases
September 14 – 1st case detected in Basra
September 16 – 107 cases
September 17 – 1st case detected in Najaf, 161 cases total
September 20 – 1st case detected in Diwaniya, 172 cases total
September 27 – 327 cases
September 30 – 1st case detected in Wasit
October 5 – 418 cases, 6 deaths
October 7 – 1st cases detected in Irbil and Muthanna
October 14 – 479 cases, 8 deaths
October 20 – 531 cases
October 29 – 644 cases, 62 under investigation, last case detected in Baghdad, 255 in Babil, 158 in Diwaniya, 84 in Baghdad, 58 in Basra, 43 in Karbala, 23 in Najaf, 8 in Anbar, 3 in Maysan, 7 in Muthanna, 2 in Irbil, 2 in Wasit, 1 in Diyala

For more on the cholera outbreak see:

Cholera outbreak in Iraq

Cholera cases multiplying

Latest United Nations Numbers On Cholera Epidemic

Political Intrigue and the Cholera Outbreak

Latest United Nations Numbers On Cholera Epidemic – Updated


Agence France Presse, “Iraqi province on alert for cholera outbreak,” 9/8/08

Alsumaria, “Babel declares state of emergency for cholera outbreak,” 9/9/08

Babylon & Beyond Blog, “IRAQ: Lots of rivers, not enough water,” Los Angeles Times, 9/7/08

Balarkrishnan, Angela, “Millions of Iraqis at risk from contaminated water, says Red Cross,” Guardian, 10/29/08

Cockburn, Patrick, “Corruption blamed as cholera rips through Iraq,” Independent, 10/10/08

Health and Nutrition Sector Outcome Team, “Situation Report on Diarrhea and Cholera in Iraq,” World Health Organization, 9/17/08

IRIN, “Cholera cases reach 172, health ministry says,” 9/21/08
- “Cholera claims five lives,” 9/11/08
- “Cholera continues to spread in the south,” 9/14/08
- “Cholera deaths rise to eight as disease spreads,” 10/15/08
- “Confirmed cholera cases exceed 100,” 9/17/08
- “Number of cholera cases nearly doubles,” 9/28/08
- “Over 400 confirmed cholera cases so far,” 10/6/08
- “Two more cholera cases confirmed,” 9/8/08

Najm, Hayder, “water shortages, jobs and cholera,” Niqash,” 10/23/08

Special Inspector General for Iraq Reconstruction, “Quarterly and Semiannual Report to the United States Congress,” 10/30/08

World Health Organization, “Cholera in Iraq,” 9/10/08
- “Situation report on diarrhoea and cholera in Iraq, 20 Oct 2008,” 10/20/08
- “Situation report on diarrhoea and cholera in Iraq, 29 Oct 2008,” 10/29/08

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