Gorilla’s Guides has an important report this morning on a very serious outbreak of cholera in Sulaymaniyah Province, which is located north of Diyala Province. The report, by the World Health Organization, is available as a .pdf file at http://emro.who.int or on the Guides page.

Pattern Of Transmission In Sulaymaniyah Province

As of 1st of September, the outbreak, since reported on 23 August, has spread to four out of eleven districts in the province (Please see the map below) exposing over 1,502,009 people at great public health risk. No surveillance system for diarrhoeal diseases existed in the province before the outbreak started on 23 August. Only recently with support from WHO Office of Iraq, the provincial health authority has started collecting surveillance data on cases reported to the health centres and hospitals. Therefore, due to inadequacy of reporting and other limitations of the surveillance system, the cumulative number of cases of cholera reported so far from the province may be grossly underreported and may not represent the true burden of the disease.

Cholera is the result of inadequate sewage and water purification facilities, either because they were destroyed and never repaired, or improperly repaired by people more interested in their contracts than in doing the work.

Such an outbreak might not be unusual a few months after an initial conquest, but to find such a situation four years afterwards is normally only seen in places conquered by barbarians.

UPDATE: Mark from Ireland reports that cholera as also shown up in Arbil, as well as Sulymaniyah. "As of Friday morning there were 4 confirmed cases. Local authorities said on Friday that they believed those 4 had contracted it on trips to Sulaimaniya and that there were as yet no further incidences reported."