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.
“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.
Sadr calls six-month ceasefire to prevent civil war
The Shia nationalist cleric Muqtada al-Sadr suspended the activities of his powerful Mehdi Army militia for six months on August 29 after clashes in the holy city of Kerbala killed 52 people and forced hundreds of thousands of pilgrims to flee.
His spokesman, Sheikh Hazim al-Araji, said in a statement on state television that the aim was to “rehabilitate” the militia, which is currently divided into factions. Significantly, Mr Araji said that the Mehdi Army will no longer make attacks on US and other coalition forces. This may ease the pressure on British troops in Basra, who have come under repeated attack from the Mehdi Army.
The surprise move by Mr Sadr eases fears that escalating battles between Shia militias were turning into an intra-Shia civil war. The Mehdi Army has been battling police and security forces in Kerbala that are largely manned by the Badr Organisation, the military wing of the Supreme Islamic Iraqi Council (SIIC).
In the hours before Mr Sadr’s statement there were widespread attacks on SIIC offices in Baghdad and Shia cities in southern Iraq by Mehdi Army militiamen. They accused the SIIC of being behind attacks on pilgrims who were shouting Sadrist slogans. Another spokesman for Mr Sadr, Ahmed al-Shaibani, denied the Mehdi Army was involved in the Kerbala battles.
Mr Sadr has long blamed factions of the Mehdi Army outside his control for attacking Sunni civilians and Iraqi government forces. Nevertheless his decision to stand down his militia shows he does not want a confrontation with the SIIC and the US at this time. He is also in effect blaming his own militiamen for the fierce gun battles in Kerbala that erupted on Monday as a million or more Shia pilgrims poured into the city to celebrate the birth of Imam al-Mahdi, the last of the 12 Shia imams, in the 9th century. The pilgrimage, along with other ritual events, has normally been a show of unity and strength by the Shia community.
Confusion still surrounds the cause of the fighting, which began as government security forces tried to police the vast numbers of pilgrims trying to visit the shrines of Imam Hussein and Imam Abbas, the founding martyrs of the Shia faith who were killed in the battle of Kerbala in 680. Devout Shia believe that the Imam al-Mahdi will return to earth to overthrow all tyrants and establish justice in the world.
Tight security was in place because of the fear of suicide bombers from al-Qa’ida in Iraq.
The police in Kerbala largely owe allegiance to the SIIC and are accused of shooting at pro-Sadrist pilgrims, who would have been accompanied by Sadrist or Mehdi Army militiamen for their own protection while marching to Kerbala. Security officials say that it was the Mehdi Army that opened fire on government security forces. Hours before Mr Sadr’s statement, an al-Arabiya television correspondent said that there were still many Mehdi Army militiamen deploying in the centre of Kerbala waving their guns in the air.
Earlier, angry crowds had surged through the city streets attacking police and mosque guards and setting fire to two ambulances. Three small hotels were also set ablaze. Militiamen fired automatic rifles, rocket-propelled grenades and mortars. Many pilgrims were trapped inside the shrines.
The Iraqi Prime Minister, Nouri al-Maliki, had rushed to Kerbala earlier to meet local officials and arrange for pilgrims to get out of the city. He blamed “outlawed armed criminal gangs from the remnants of the buried Saddam regime” for the fighting and sacked Major-General Salih al-Maliki, the head of the Kerbala command centre.
The statement from Mr Sadr said: “We declare the freezing [of all action by] the Mehdi Army without exception in order to rehabilitate it in a way that will safeguard its ideological image within a maximum period of six months, starting from the day this statement is issued.” It is not clear what rehabilitation will mean, but presumably Mr Sadr will seek to purge the militia of officers he does not control.
In central and southern Iraq, the Mehdi Army has so far obeyed his surprise instruction to suspend their activities. 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.
In Baghdad, meanwhile, US forces have released eight Iranians, including two diplomats, who were arrested, blindfolded and handcuffed in the Sheraton hotel because their bodyguards were carrying unauthorized weapons. The Iranians were there as part of a delegation holding talks on building a power plant.
PATRICK COCKBURN is the author of ‘The Occupation: War, resistance and daily life in Iraq‘, a finalist for the National Book Critics’ Circle Award for best non-fiction book of 2006.