Cholera has broken out in Syria, with one child having already died after contracting the disease – and the outbreak could constitute an “international threat”.
The break-out, which follows one in Iraq, could spread rapidly, according to Dr Ahmad Tarakji, president of the Syrian American Medical Society (Sams), the largest medical NGO still working in Syria.
Speaking to The Independent, Dr Tarakji said that Syria’s already crippled medical infrastructure, and the lack of access available to aid agencies, meant the disease could spread quickly, both inside the country and across borders.
“It spreads so easily. People are being displaced inside and outside, people are going to Europe,” he said.
There are over four million registered Syrian refugees and nearly eight million internally displaced. A five-year-old boy who died last week in Aleppo province was “very likely” to have been killed by cholera, Dr Tarakji said. In a memo to NGOs working in northern Syria, the World Health Organisation (Who) said it was treating it as a “suspected case” of cholera and that initial tests were positive. “A huge number of people could be exposed,” said Dr Tarakji, as “historically it affects people who are displaced”.
“Nobody would know who has it,” he added, as up to 80 per cent of carriers do not exhibit any symptoms.
In pictures: Syria's escalating refugee crisis
In pictures: Syria's escalating refugee crisis
1/20 Syria refugee crisis
A young Syrian refugee stands near jerry cans used to collect water at Al-Zaatri refugee camp in the Jordanian city of Mafraq, near the border with Syria. The United Nations hopes that political talks between the warring sides in Syria will clinch local ceasefires to allow vital food and medicines to reach millions of civilians
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Syrian refugees transport small stones for their tents at Al Zaatari refugee camp in the Jordanian city of Mafraq, near the border with Syria
3/20 Syria refugee crisis
Representatives of Syrian President Bashar al-Assad, a deeply divided opposition, world powers and regional bodies started a long-delayed peace conference aimed at bringing an end to a nearly three-year civil war
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A Syrian refugee family rests inside their shelter in Hatay, Turkey
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A Syrian refugee family from Aleppo crosses the Bosphorus from Uskudar to the European side of Istanbul
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Syria's air force struck rebel-held areas around Damascus and Aleppo as face-to-face peace talks tentatively began in Switzerland
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Syrian refugees look out from an evacuated house in the Kucukpazar district of Istanbul. Syrians fill houses which have been evacuated for urban development projects. Destitute Syrian refugees who have fled the war in Syria and camps in Turkey are fighting for their lives in different parts of Istanbul
8/20 Syria refugee crisis
Refugees who moved into the houses in Kucukpazar neighbourhood near the historic Suleymaniye mosque, are struggling to live without water and heating
9/20 Syria refugee crisis
A Syrian woman and her child stand inside a building in the Kucukpazar district of Istanbul
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A Syrian boy sits in debris in the Kucukpazar district of Istanbul
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Damaged buildings line a street in the besieged area of Homs
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People sit around a fire along a street lined with debris in the besieged area of Homs
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Children cut wood pieces in the besieged area of Homs. Efforts to get food and medical aid into Homs have become a test case on whether peace talks in Switzerland can produce any practical results almost three years into the Syrian conflict
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Boys walk along a street past damaged buildings and vehicles in the besieged area of Homs
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Syrians stand in a destroyed street following a reported airstrike by government forces on the northern Syrian city of Aleppo
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Rescue teams search for survivors on the rubble of a building following Syrian government air raids in the northern Syrian city of Aleppo
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A graveyard in the northern Syrian city of Aleppo
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A view of destruction in Aleppo's ancient Umayyad mosque, in the UNESCO-listed northern Syrian city. The mosque's minaret was blown up during clashes between opposition and government forces
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Syrians attend the funeral of victims who reportedly died of hunger in the besieged Yarmuk Palestinian refugee camp in southern Damascus
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A man holds the corpse of one-year old baby Adbul Jalil Mohamed Hamis wrapped in shrouds, who reportedly died of hunger in the besieged Yarmuk Palestinian refugee camp in southern Damascus during a funeral ceremony
The water-borne intestinal disease, which mostly affects children, can kill quickly if not treated, and is spread through unclean water and poor sanitation. Within Syria, and especially in areas outside of government control, water purification is increasingly difficult, and on the migrant trail, many Syrians may not have access to proper toilets or clean water, Dr Tarakji warned.
There have already been 1,200 confirmed cases of cholera in Iraq in recent weeks, including six deaths. An immunisation programme is due to start there next week.
With this constant destruction of the health infrastructure, we’re paralysed. We always call on the international community to act, but this is a real threat
Dominique Legros, Who’s cholera chief, expressed concern last week of “a spread towards the Middle East, towards Syria and refugee camps”. But in Syria, any vaccination campaign would be nigh on impossible, Dr Tarakji said. While such a campaign was carried out for polio when it emerged in Syria in late 2013, the country’s medical infrastructure is now weaker.
“Cholera is treatable and preventable… but the basic right to be treated is not accessible by most people,” Dr Tarakji said.
Over recent weeks there have been repeated Russian air strikes targeting hospitals in rebel-held parts of Syria, according to Physicians for Human Rights and doctors on the ground, the latest of which hit a hospital in Hama province on Friday night, leaving four medical staff with major injuries, the Sams president said.
“With this constant destruction of the health infrastructure, we’re paralysed,” said Dr Tarakji. “We always call on the international community to act, but this [cholera] is a real threat.”