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Lack of medical care and poor water quality in Syria exacerbate cholera outbreak

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Poor access to clean water has exacerbated a cholera outbreak sweeping war-torn provinces in Syria, with local authorities struggling to contain the spread with chlorine tablets and vaccines.

More than 35,000 suspected cases of cholera have been reported across the country, according to the United Nations children’s agency. UNICEF said only about 2,500 have been tested, of whom nearly half have tested positive.

“Finding a single case of cholera means you have an outbreak,” said Zuhair al-Sahwi, head of communicable and chronic diseases at the Syrian Ministry of Health.

He said the curve had largely flattened, with the number of new confirmed cases daily slowing.

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Sahwi said the ministry recorded 46 deaths as a result of delays in accessing medical care and requested cholera vaccines from the World Health Organization.

According to the WHO, the Syrian cases are linked to a devastating outbreak that began in Afghanistan in June and then spread to Pakistan, Iran, Iraq, Syria and Lebanon.

Cholera is usually spread through contaminated water, food, or sewage. It can cause severe diarrhea and dehydration, which can be fatal if left untreated.

Syria’s water pipes and pumping stations have been ravaged by more than a decade of war, and a drought this year left levels particularly low in its main river, the Euphrates.

Nabbough al-Awwa, an eye, nose and throat doctor in Damascus, said dumping solid waste into standing water had contributed to the spread.

Syria’s poor water supply and lack of medical care are exacerbating the cholera outbreak in the country’s provinces. Pictured: Nurses monitor cholera patients in the cholera ward of Al-Rahma Hospital in the city of Darkoush.
(Anas Alkharboutli/Image Alliance via Getty Images)

“If the river is running, that’s fine. But when the water levels dropped due to rising temperatures in many countries around the world, these bacteria started to proliferate and spread,” Awwa told Reuters.

As farmers relied on untreated river water, vegetables quickly became contaminated and the virus spread to cities, he said.

Stores and restaurants in the capital have modified their menus to protect their customers.

“We stopped using green leafy vegetables for the sake of public health,” said Maher, who runs a falafel shop in Damascus.

The capital remains relatively sheltered, according to WHO data, with the highest case numbers recorded in the vast desert province of Deir Ezzor in the east and Raqqa and Aleppo in the north, which depend more on the Euphrates.

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United Nations agencies have been mainly trucking water to affected communities and distributing sterilization tablets.

But to continue its efforts, the UN children’s agency says it still needs about $9 million in funding to make it to the end of the year.

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