In May 2003, the World Health Organization warned of the risk of an epidemic of diarrheal disease, including cholera, in Iraq due to “...the lack of access to clean, safe water and the problems with security...” The WHO reported 18 confirmed cases of cholera in Basra (in southern Iraq), and warned that the disease could spread throughout the war-torn country. Fortunately, the outbreak subsided.
Cholera is caused by a bacterium, Vibrio cholerae, which is endemic (present all the time at low levels) in many areas of the world. The pathogen, which causes a severe, watery diarrhea resulting in life-threatening dehydration, is spread mostly through contaminated water. Crowded living conditions, poor sanitation and inadequate clean water supplies can also lead to secondary person-to-person transmission.
If the microbe is present in the environment, a cholera outbreak often flares up wherever a natural or man-made disaster strikes. Floods, earthquakes, war and tsunamis are all breeding grounds for cholera, which takes advantage of the crowded refugee camps, contaminated water and general chaos that follow in the wake of disaster to strike down its victims.
The list of countries that have struggled with cholera outbreaks in recent years include, among others, Angola, Afghanistan, Uganda, Sudan, Zambia, Liberia, Somalia and the Congo. It’s no coincidence that these same countries have been decimated by war, famine, floods or drought.
This year, it’s Iraq’s turn again. In September the WHO reported that nearly 300 cases of cholera had been confirmed in the area of Kirkuk, in northern Iraq. By the beginning of October, the number of cases in the north had surpassed 3,000, and the disease had spread to 9 of Iraq’s 18 provinces. Cases were reported in Diala, a province neighboring Baghdad, in Baghdad itself, and in a few other cities - including Basra.
Cholera is the great leveler. It doesn’t discriminate based on race, religion, gender, age or national origin. The tools to defeat it are well known - a clean, adequate water supply and basic sanitation. Isn’t it about time that Iraqi’s had reliable access to these fundamental items that most of us take for granted?