Lack of clean drinking water and poor sanitation has led to 5,000 people in northern Iraq contracting cholera.
The outbreak is among the most serious signs yet that Iraqi health and social services are breaking down as the number of those living in camps and poor housing increases after people flee their homes.
"The disease is spreading very fast," Dr Juan Abdallah, a senior official in Kurdistan's health ministry, told a UN agency. "It is the first outbreak of its kind here in the past few decades."
Doctors in Sulaimaiyah in Iraqi Kurdistan have appealed for help because of the rapidly increasing number of cases, saying there is a shortage of medicines. Although the city has been less affected by fighting than almost anywhere in Iraq, Unicef says that mains water is only available for two hours a day and many people have dug shallow wells outside their homes.
"There is a shortage of medicines to control the disease and the focal point [the source of the disease] hasn't been identified yet," Dr Dirar Iyad of Sulaimaniyah General Hospital told the UN news agency Irin. Ten people have already died and he expects more deaths to occur "over the next couple of days as victims are already in an advanced stage of illness."
The number of Iraqis fleeing their homes has risen from 50,000 to 60,000 a month, the UN High Commission for Refugees reported earlier this week.
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"My two children, husband and mother have been affected by cholera because we weren't able to get purified water and one of my children is very sick in hospital," said Um Abir, a 34-year-old mother. "We have been displaced since January and we have to camp near a rubbish tip which, according to the doctor, might be the reason for all of the family being affected." The number of Iraqi refugees stands at 4.2 million of whom two million have been displaced within Iraq. Many live in huts made out of rubbish and have no fresh water supplies. In addition to Sulaimamiyah, the cholera has spread to the oil city of Kirkuk.
"The bad sanitation in Iraq, especially in the outskirts of cities where IDPs [internally displaced person] are camped, has put people at serious risk," said Dr Abdullah. "In Sulaimaniyah and Kirkuk, at least 42 per cent of the population don't have access to clean water and proper sewage systems." Unicef says that local reports suggest that only 30 per cent of people in Sulaimaniyah have clean drinking water.
Most of Iraq outside Kurdistan is flat so water and sewage need to be pumped, but this has often become impossible due to a lack of electricity. The water in the Tigris and Euphrates rivers is highly polluted and undrinkable.
In central and southern Iraq, the Mehdi Army, commanded by the nationalist Shia cleric Muqtada al-Sadr, has so far obeyed his surprise instruction to suspend their activities for six months after clashes with police and rival militiamen in Kerbala left 52 dead and hundreds wounded. Checkpoints that normally protect the Sadrist bastion in Sadr City in Baghdad were unmanned yesterday.
Militia leaders say they will fight if provoked. "It will be hard to stand still with our hands tied when we are attacked or arrested by the Americans," said Abu Hazim, a Mehdi commander. Ahmed al-Shaibani, an aide of Mr Sadr, said the suspension might only last a week if arrests continued.
© 2007 The Independent