Amidst circumstances that seemed “very favourable” for the spread of a deadly outbreak in war-torn Syria, the cholera re-spread in early September, more than 13 years after the last cholera infection recorded in 2009.
There is no indication on the horizon that the government will be able to find permanent solutions that prevent the spread of the disease or the development of the situation into an epidemic or pandemic that threatens neighbouring countries. At the same time, the emergency measures were limited to prevention advice first, then temporary solutions to lessen the outbreak.
Cholera knows no borders
According to the latest statistics issued by the Early Warning and Response Program for Epidemics (EWARN) in Syria, as of Saturday evening, 24 September, the number of cholera cases in northeastern Syria reached 2,821, while the number of deaths as a result of the disease reached 15 deaths.
In northwestern Syria, one infection has been recorded since the outbreak began, according to data released by the program.
The regime’s health ministry said on Monday, 26 September, the cholera outbreak in several regions of Syria has killed 29 people in what the UN has called the worst outbreak in the war-torn country for years, according to Reuters.
Rapid assessment testing confirmed 338 cases since the outbreak was first recorded last month, with the bulk of deaths and cases in the northern Aleppo province, the ministry said in a statement.
It said 230 cases were in Aleppo province, where 25 people were confirmed dead. The rest were spread across the country.
Cholera is an acute diarrhoeal infection caused by ingesting food or water contaminated with the bacterium Vibrio cholera. Cholera remains a global threat to public health and indicates inequity and lack of social development.
Cholera may be endemic to Syria
Dr. Aula Abbara, a consultant in infectious diseases in London and co-chairs the Syria Public Health Network, told Enab Baladi via email that given the bad situation concerning water in Syria due to the conflict, drought, lack of rainfall, and the damage to the water infrastructure, this raises concern that cholera will turn into an epidemic. It may extend beyond the borders of Syria.
Abbara added that the conditions associated with the armed conflict in Syria, the forced displacement of millions of people, and the damage to water and electricity, in addition to targeting health facilities and stopping water treatment plants, contribute to the aggravation of the health situation that could lead to an epidemic.
The director of the vaccine program at the Support Coordination Unit in Syria, Dr. Mohammad Salem, said, in turn, that Syria is facing a “large wave” of a “cholera outbreak,” adding that as the infection continues to spread and move to new areas, the situation will worsen.
Salem warned, in an email to Enab Baladi, that in light of the current infrastructure conditions, it is expected that we will be facing a case of “cholera endemicity” in Syria, meaning that it could turn into an endemic disease.
Who opened the door to cholera?
During the war years, many Syrian cities and towns, with different forces and parties controlling them, experienced a drinking water crisis.
The most important reasons were the pollution and poor quality of water transmission pipes, the mixing of some drinking water with sewage water, in addition to the destruction of the infrastructure of water networks, and the damage and them being out of service.
The water crisis resulted in great damage, starting with the population, who were exposed to many diseases and epidemics, and damage to crops and animals.
Many people inside Syria depend on unclean water sources, which may lead to the spread of dangerous diseases transmitted by polluted water, in addition to the shortage and scarcity of water, which forces the people to resort to mechanisms and solutions that are not subject to the minimum elements of control and safety.
Will a vaccine reach Syria? – SYRIA TV (Opposition website)
What are the chances of the vaccine being available in northern Syria, in light of the weakness of the medical system?
The director of health programs at the Syrian Interim Government’s Ministry of Health, Dr. Rami Kalzi, said that the cholera vaccine is not available in northern Syria, and there are no current plans to secure it.
Speaking to Al-Souria Net, Kalzi explained that the World Health Organization has made it clear from the beginning that securing vaccines is “very difficult” at the current stage. Therefore, other alternatives must be sought to contain this accelerated spread of cholera.
For his part, the director of the vaccine program at the Early Warning Network, Dr. Mohammed Salem, said that the cholera vaccine is not available throughout the Syrian territory. He spoke of a plan currently being worked on to provide the vaccine, but it has not been translated into practical steps on the ground.
Salem added that the office of the World Health Organization in the Turkish city of Gaziantep has asked the office of the organization in Jordan (the office responsible for Syria) to secure the vaccine. The request is still under study, and there has been no progress in this regard to date.
According to Salem, if available, the vaccine will primarily target children aged one year and older. It will be an oral vaccine given directly through the mouth. He added: “But it is currently unavailable and efforts to provide it remain poor.”
Salem urged the activation of model treatment centers for this disease in northern Syria, and then the provision of the vaccine, especially in light of the weakness of the health system necessary to respond to cholera.
The cholera vaccine is not one of the routine vaccines that babies are vaccinated with from birth in northern Syria, according to Salem.
The latest statistics released by the Early Warning Network indicate that the total number of cholera infections in northwestern Syria reached 58 cases, without registering any deaths. The infections in the “Peace Spring” area reached 50 cases, without registering deaths either.
In regime-controlled areas, 338 cases have been recorded to date, of which 29 have died, according to the regime’s Ministry of Health.
In northeastern Syria, the epidemic is spreading remarkably and rapidly, with 4,357 cases recorded, of which 18 have died.
This article was edited by The Syrian Observer. The Syrian Observer has not verified the content of this story. Responsibility for the information and views set out in this article lies entirely with the author.