Cholera outbreak threatens the lives of children in Syria

Ferial Salim is the mother of four children, with whom she lives poorly in the informal settlement of Yawnani, in the city of Raqqa, in northeastern Syria.

“One of them was sick for three days, with diarrhoea.

I did not know what he had, "laments this 30-year-old woman in statements collected by Unicef, the United Nations Children's Fund.

What her son has is anger.

And his is one of the thousands of children's lives hanging by a thread in Syria, as recently warned by the international humanitarian aid organization World Vision and confirmed by Unicef.

Cases of this disease have almost doubled since the Ministry of Health declared the outbreak on September 10.

So far, more than 2,500 people have been infected in the north of the country, of which 611 are under the age of five, according to the NGO.

Children, especially those suffering from chronic and acute malnutrition, are at high risk of developing severe symptoms or even dying.

Without timely treatment, cholera can cause death within hours in between 25% and 50% of cases, according to the World Health Organization (WHO).

Eloisa Molina, spokesperson for World Vision, adds: “Diarrhea like that caused by cholera, treated immediately, can reduce the number of deaths to 1%.

But it can end the life of a malnourished minor in a very short time, and even more so in a country like Syria, where after ten years of conflict, access to medicine and health care are not guaranteed.”

General living conditions of children residing in the informal settlement of Yawnani, in the city of Raqqa, northeast Syria.© UNICEF/UN0710285/Souleiman

Now, thanks to the information provided by the volunteers in Yawnani, Salim already knows that cholera is a bacterial disease caused by ingestion of contaminated food or water, causing acute watery diarrhea and vomiting leading to dehydration.

Mild cases are treated with oral rehydration salts.

However, severe ones require intravenous fluids and antibiotics quickly, according to the WHO.

Additionally, access to a safe water supply is imperative to slowing the spread.

Despite knowing all this, Salim does not have many options.

“Most of the time, when there is no water at this site, we bring it from the river.

It's not clean, but this is the only source we have,” he laments.

According to WorldVision,

only 22% of people living in informal settlements have sufficient water resources in the affected areas, and the vast majority of IDPs (95%) cannot afford treatment for this ailment.

“Even when they have public health facilities.

The urgency of the situation could not be more serious,” says the NGO's director of response.

Because right now?

In Syria, there has not been a cholera outbreak like this since 2009. Molina clarifies what is happening now: “A series of cases come together that make the situation horrible.

First, ten years of conflict have destroyed the national water infrastructure, which is why at the moment the population is accessing it in the most rudimentary way, through the Euphrates or through boreholes created by the communities themselves, which may be contaminated with anger.

Second, the northeast of the country is suffering the worst drought in the last 70 years, according to the UN.

It is not that there is no drinking water, it is that there is no water.

Neither underground nor in the river.

If it rains, at least reservoirs or other water retention mechanisms could be produced.

And third, this drought, together with the rise in wheat prices due to the conflict in Ukraine,

Ten years of conflict have destroyed the national water infrastructure.

At this time, the population is accessing water in a rudimentary way, through drilling carried out by the communities themselves.

For all this, a dramatic increase in mortality is imminent in the coming weeks, warns World Vision, which has been delivering emergency water and sanitation supplies to displaced and host communities in Syria since 2013. “In 2009, the situation in the country was not so dramatic.

Now, the health system is decimated, and medical treatment and the capacities to respond to the outbreak are scarce”, laments Molina.

And she makes an appeal: “We ask all governments and international donors to expedite support with additional funds for water disinfection materials, health medicines and cholera treatment equipment.

In short, that the world includes Syria among its priorities.”

The funds required for the three-month plan to respond to this outbreak amount to 34.2 million dollars, according to the WHO request at the end of September.

Attacks on water and sanitation are attacks on children

Blanca Carazo, head of UNICEF Spain Programs, explains that the United Nations Children's Fund is also working in various areas to try to help, in a coordinated response with the WHO, the Syrian Ministry of Health and partners on the ground .

“Chlorination activities to disinfect water are being intensified and dosage rates are being increased in fragile and highly vulnerable communities to slow the spread of the disease.

Clean water is also being transported to the affected places.

In addition, religious leaders, community chiefs and local volunteers have been mobilized, as well as organizations to encourage good hygiene practices and help refer suspected cases to health centers, ”she details.

This is critical information on the causes, symptoms and prevention of #cholera.

Disseminating it on community level is an integral part of the ongoing response, supported by @UNICEFinSyria and @WHOSyria, to curb the spread of the disease in #Syria.#ForEveryChild @OCHA_Syria https://t.co/yTOEqVOUKe

— UNICEF in Syria -يونيسف سوريا (@UNICEFinSyria) September 23, 2022

To finish, Carazo sentences: "Attacks on water and sanitation are attacks on children."

Because when a community's water supply is cut off, children and their families are forced to rely on unsafe water or leave their homes in search of a new source.

This may mean, at times, having to reduce or ration their supplies, and at other times, having to drink water that is clearly contaminated and dangerous.

“For children, the consequences can be deadly”, he ends, not without first reminding that Syrian minors have known nothing but the conflict.

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