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people in so many parts of the world, Iraqi citizens face daily challenges
in securing safe drinking water. Both bombs and looters further damaged
drinking water and wastewater treatment systems, already degraded before
the war. In the aftermath of combat, frequent power outages and a shortage
of chlorine threatened to usher in a public health disaster for Iraq's
24 million citizens. A broad-based effort by the U.S. government, the
United Nations, and humanitarian relief organizations has restored basic
water services in many areas, and appears to have headed off widespread
outbreaks of cholera and other waterborne diseases.
establishing a safe and reliable water supply remains long-term task.
Neglected Water Infrastructure Further Damaged by War. Although degraded
by years of neglect in the 1990s, water and sewage treatment services
were largely functional in Iraq before the war. In April of this year,
however, the United Nations Children's Fund (UNICEF) and CARE conducted
a survey of 177 water treatment plants in southern and central Iraq. About
one quarter of these facilities were operating poorly or not at all. Treatment
plants and water distribution systems appear to have suffered less direct
damage than during the first Gulf War, but services were severely undermined
in certain areas. In July, none of Baghdad's three sewage treatment plants
As a result, the city's raw sewage (an estimated 500,000 tons daily) was
discharged directly into the Tigris River, the primary drinking water
source for millions of people. Lack of Safe Water Spreads Disease, Threatens
a Health Crisis. According to UNICEF, Iraqi children suffer from diarrhea
about 14 to 18 times a year, compared to the average of two or three cases
per year in areas with access to clean water. UNICEF reported that in
one three hour period in May, one Baghdad hospital reported 300 cases
of children admitted with diarrhea. In areas where chlorine supplies ran
out, UNICEF reported a "parallel rise in diarrhea." Executive Director
Carol Bellamy stated, "Young children have developing immune systems and
low body weight. Add a bout of diarrhea picked up from dirty water, and
we can lose them very quickly."
the hot summer months, the specter of widespread cholera outbreaks loomed
over the country. Cholera is characterized by profuse diarrhea, which
can lead to severe dehydration and death if left untreated. The World
Health Organization (WHO) reported a total of 73 laboratory-confirmed
cholera cases in Iraq from April 28 to June 4 - 10 times more than WHO
officials found during the same period last year. Most of these cases
were reported in the Basra region. Other waterborne diseases, including
typhoid and dysentery also rose sharply in the spring. With the hottest
summer months still to come, WHO officials warned that massive outbreaks
were yet to occur.
about the Danger of bombs...
effects of Bombing on Disease Occurrence in Baghdad is blunt to say the
least: "Increased incidence of diseases will be attributable to degradation
of normal preventive medicine, waste disposal, water purification/distribution,
electricity, and decreased ability to control disease outbreaks. Any urban
area in Iraq that has received infrastructure damage will have similar
problems." The document proceeds to itemize the likely outbreaks. It mentions
"acute diarrhea" brought on by bacteria such as E. coli, shigella, and
salmonella, or by protozoa such as giardia, which will affect "particularly
children," or by rotavirus, which will also affect "particularly children,"
a phrase it puts in parentheses. And it cites the possibilities of typhoid
and cholera outbreaks.
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politicians, both in the U.S. and in the Middle East have warned and blamed
the United States for public health problems created by the military conflict.
Disease Outbreaks in Iraq rise as conditions are favorable for communicable
disease outbreaks, particularly in major urban areas affected by coalition
bombing. Infectious disease prevalence in major Iraqi urban areas targeted
by coalition bombing (Baghdad, Basrah) undoubtedly has increased since
the beginning of conflict there. Current public health problems are attributable
to the reduction of normal preventive medicine, waste disposal, water
purification and distribution, electricity, and the decreased ability
to control disease outbreaks.
likely diseases occurring are(descending order): diarrheal diseases (particularly
children); acute respiratory illnesses (colds and influenza); typhoid;
hepatitis A (particularly children); measles, diphtheria, and pertussis
(particularly children); meningitis, including meningococcal (particularly
children); cholera (possible, but less likely)." Medical Problems in Iraq
continue as communicable diseases in Baghdad are more widespread than
usually observed and are linked to the poor sanitary conditions (contaminated
water supplies and improper sewage disposal) resulting from the war. According
to a United Nations Children's Fund (UNICEF)/World Health Organization
report, the quantity of potable water is less than 5 percent of the original
supply, there are no operational water and sewage treatment plants, and
the reported incidence of diarrhea is four times above normal levels.
respiratory infections are on the rise. These diseases particularly have
affected children. However, there are indications that the situation is
improving and that the population is coping with the degraded conditions
even though conditions in Baghdad remain favorable for communicable disease