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Severe Cholera cases surge across Middle East amid Economic crisis

BHANINE, Lebanon — Middle-east is facing severe spread of Cholera for last few months. Shadia Ahmed panicked when rainwater flooded her shack one night, drowning her seven children. The next morning, the children were afflicted with vomiting, diarrhea and other symptoms. Lebanon alone reports over 2,000 cases, 18 deaths since last month, as bacterial infection sweeps region

After the aid group tested for cholera at Ahmed’s camp for Syrian refugees in the northern Lebanese town of Bhanine, her youngest, four-year-old Assil, tested positive.

Cholera has swept through Lebanon, Syria and Iraq as the countries struggle with devastated infrastructure, unrest and housing for large populations of people displaced by the conflict. Lebanon reported its first case of cholera in nearly 30 years last month.

The bacterial infection has spread globally in dozens of countries this year, with outbreaks in Haiti and the Horn of Africa, as well as the Middle East. An outbreak of hundreds of thousands of cases driven by conflict, poverty and climate change is a major obstacle to global efforts to eradicate the disease.

“Cholera thrives in poverty and conflict, but is now overwhelmed by climate change,” said Inas Hamam, regional spokeswoman for the World Health Organization. “Regional and global health security is at risk.”

Cholera efforts focus on vaccination, clean water and sanitation. Last month, the WHO announced a temporary suspension of the two-dose vaccine strategy as production was unable to meet rising demand. Officials are now giving individual doses so that more people can benefit from the vaccine in a short period of time.

Cholera infection is caused by consuming food or water infected with the bacterium Vibrio cholerae. While most cases are mild to moderate, cholera can cause death if not treated properly.

“I would take her to the bathroom all night, give her medicine, wash her and sterilize her,” Ahmed, 33, said of Asil, his child who contracted cholera. “I couldn’t sleep and I was up all night just looking at her. I feared the worst.”

Assil and her siblings eventually got better; she was the only confirmed case of cholera in the family.

Across the border in Syria, UN officials and agencies announced last month that a cholera epidemic had gripped the country. According to the UN and the Syrian Ministry of Health, the outbreak in Syria is caused by people drinking unsafe water from the Euphrates River and using contaminated water to irrigate crops.

Since then, there have been roughly 17,000 cases of cholera and 29 deaths in government-controlled areas of Syria and the country’s northeast, held by US-led Kurdish forces.

In Syria’s rebel-held province of Idlib, most of its 4 million residents have been displaced by the conflict. They depend on international aid and live in tent camps.

More than half of Idlib does not have regular access to water. Many families use contaminated water from wells that are close to sewers.

In Idlib province, 3,104 cholera cases and five deaths were recorded. Dr. Abdullah Hemeidi of the Syrian American Medical Society expects an increase this winter.

“The health system in the area is weak,” Hemeidi said. “Medical organizations and local councils are trying to disinfect the water and holding workshops to limit the spread.”

Children play near a drain in the Salaheddine camp in the opposition-held countryside northwest of Aleppo. Community workers hold information sessions for residents.

“We are worried that it will spread in our camp,” resident Jamil Latfo said.

Iraq has been dealing with cholera outbreaks for years. The disease was rare in Lebanon for decades.

Three years ago, Lebanon fell into an economic crisis. Most Lebanese now rely on water imported by private suppliers and private electricity generators. Energy companies cannot buy fuel and pump water to households.

Since last month, Lebanon has reported 2,421 cases and 18 deaths. About a quarter of these cases are children under the age of five. The bacterium Vibrio cholerae has been found in drinking water, sewage systems and irrigation water.

The country hosts more than a million Syrian refugees. The Lebanese Ministry of Health reports that most cholera cases have been detected in refugee camps.

In Bhanine, Ahmed and her children are hidden among residential buildings along with dozens of other Syrian refugees. Families live in flimsy wooden huts with tarpaulin walls and ceilings. They share three toilets and three sinks.

Like most households in Lebanon, camp residents buy water imported from private suppliers. The state does not test the water for safety.

“The water was contaminated but we had no choice but to use it,” resident Ali Hamadi said. “There was no drinking water, let alone water for cleaning, washing dishes, washing clothes or showering.”

UN aid agencies began providing clean water for the camp, disinfecting walls and doors, and holding information sessions. They are also donating fuel to the Lebanese government so authorities can pump water again.

“The support we are offering cannot replace service lines and the national electricity grid, which is basically down most of the time,” said Ettie Higgins, Deputy Representative for Lebanon at UNchildren’s UNICEF.

WHO is working with Iraqi health authorities to help strengthen their cholera response, visiting water treatment plants and testing laboratories in Baghdad last month.

UNICEF said it urgently needs $40.5 million to continue its work in Lebanon and Syria over the next three months.

“These camps are fertile ground for disease outbreaks,” said Hemeidi of the Syrian American Medical Society. “We won’t be able to respond to this properly unless there is an intervention with medical equipment and assistance.”

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