On September 23, the Al Qaeda-occupied area in Idlib Province reported the first confirmed case of cholera in the last terrorist-controlled area in Syria. The deadly outbreak has claimed 39 lives in Syria, with thousands of suspected cases across the country. In areas under the Ministry of Health in Damascus, 23 deaths were reported recently, 20 of them in Aleppo, and at least 253 cases.
In the northeast region of Syria controlled by the US-backed SDF, a Kurdish militia with ties to the outlawed terrorist group the PKK, are a reported 16 deaths and 2,867 cases since September 5. The US occupation forces there are controlling the main oil fields in Syria to prevent the Damascus government from using the oil to provide electricity for people's homes, water-pumping stations, and gasoline for their cars.
The cases were reported in several provinces, including Aleppo with 676 cases, Raqqa in the north with 17 cases, Latakia on the Mediterranean coast with 4 cases, Hama with 2 cases, Al Hasakeh with 38 cases, and Deir Ez Zor along the border with Iraq with 201 cases. There were two cases in Damascus, but the patients had just come from Aleppo.
This marks the first cholera outbreak since the conflict began in March of 2011, with the last outbreak recorded in 2009.
The source of the outbreak is the river
The Euphrates River runs for almost 2,800 kilometers (1,700 miles) across Turkey, Syria, and Iraq.
During the rainy winter season, and fed by spring snow melt-offs in Turkey, the river runs full entering Syria from the Turkish border and then running in a diagonal towards Iraq.
Climate change has brought steadily rising temperatures combined with drought, and during this long and very hot, dry summer the river has sunk to its lowest point. So low that ancient antiquities once buried on the river bed have been suddenly revealed, but government reports warn the river could go completely dry by 2040.
Health authorities tested the Euphrates and found the bacteria causing cholera. The river is polluted by raw sewage and oil spills from the US-occupied oil wells at Deir Ez Zor. If the river can be replenished this winter the contamination might be mitigated.
Over five million Syrians rely on the Euphrates for their drinking water, which is pumped to them without filtering or sterilization. Farmers use irrigation pipelines to pump water out of the river onto their crops. Syria is self-sufficient in ground crops, but using contaminated water to grow food is what has spread the outbreak.
Residents of the northeast who rely on the Euphrates know that it is polluted but are faced with no other choice or immediate solution.
The treatment plan and prevention
On September 19, Ahmed Al-Mandhari, the World Health Organization's regional director, said that medications and other supplies had landed in Damascus. The second shipment arrived on September 23 to fight the cholera outbreak.
The Syrian Ministry of Health advised people to make sure they drink water coming from "a secure source" and if that is not available people should boil water, then preserve it in a clean and closed-gallon container.
Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. People can get sick when they swallow food or water contaminated with cholera bacteria. The infection is often mild or without symptoms, but can sometimes be severe and life-threatening.
Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution (ORS), a prepackaged mixture of sugar and salts that is mixed with 1 liter of water and drunk in large amounts.
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