Although health officials in the semi-autonomous region of Iraqi Kurdistan say they’re not going to announce an official public health emergency, there is no doubt that locals have felt like they’ve been having one for the past fortnight. In particular the people of Sulaymaniyah are concerned - their city is the one most affected by a new cholera outbreak.
Official figures from Iraqi Kurdistan’s Ministry of Health indicate that there are more than 1,800 cases of patients with diarrhoea and vomiting being treated in Sulaymaniyah’s hospitals. By Oct. 8, local hospitals themselves confirmed 202 definite cases of cholera out the potential 1,800 cases, with a suspected four deaths resulting.
The cholera outbreak, the second in five years in the region, seems to have started with patients in Sulaymaniyah presenting symptoms on Sept. 26. Other cases have since been reported in cities further away such as Kirkuk, where there are around 15 cases.
Cholera bacteria are spread through contaminated food or water and the disease usually spreads further when infected faeces get into drinking water. Once infected, patients die of dehydration due to sudden and copious vomiting and diarrhoea.
In Iraqi Kurdistan, Lake Dukan, about 60km west of Sulaymaniyah is suspected to be the cause of the spread of cholera. Lake Dukan is one of the biggest lakes in Iraq and its reservoirs provide drinking water for more than 1.5 million people in surrounding areas. Some water purification plants in Kirkuk also use Lake Dukan’s water.
And as the outbreak began, an announcement by the chief of Sulaymaniyah’s Health Department, Miran Mohammed, confirmed that cholera bacteria had been found in samples taken from the lake.
Additionally almost all of the sewage from surrounding areas ends up in Lake Dukan. Water department officials say that all the lake water that is pumped back to Sulaymaniyah’s householders is treated and has chlorine added to sterilize it.
“But some people also use water from local wells alongside water from Lake Dukan,” Amanj Jalal, a spokesperson for Sulaymaniyah’s water department told NIQASH. “We cannot rule out the possibility that the wells are the source of the outbreak. We’re ensuring that the water we provide is sterilized and we’re also adding more chlorine to the water.”
“We have also asked people not to consume raw vegetables at the moment because there’s higher risk of getting infections there too,” added health chief, Mohammed; raw vegetables and shellfish are also known to harbour cholera bacteria.
And while this week, Mohammed continued to say that the situation is under control, the figures don’t really add up as dozens head to local hospitals with cholera symptoms daily.
This is not the first time that Iraqi Kurdistan has had to deal with a cholera outbreak. An initial outbreak occurred in 1998, the second in 2002 and the most recent in 2007. The latter was the worst with around 12,000 patients admitted to hospital, 4526 confirmed to have cholera and 19 deaths as a result.
Even back then health experts were warning that Iraqi Kurdistan’s dirty water was to blame and that there would be further outbreaks if the problem wasn’t solved somehow.
“Locals have drilled around 13,000 wells in and around the city of Sulaymaniyah,” the region’s Minister of Health, Rekawt Hama Rashid, said. “Some of these wells might be the source of the disease and they should be put under government control.” Lake Dukan’s waters also needed further scrutiny, he added.
Additionally the sewage systems were also to blame for the outbreak. “But reorganizing the sewage systems in Iraqi Kurdistan’s cities requires an investment of around US$2 billion and a lot of time,” Rashid said at a special session of Iraqi Kurdistan’s Parliament held 12 days after the cholera was first detected. The session was heavily criticised for coming so late after the outbreak started.
Other local officials also blamed farmers who they suspected of irrigating crops with untreated water in some areas around Sulaymaniyah.