Basra problems run deep

By Jane Peel BBC News, Basra

Restoring security may be the only way to prevent a cholera epidemic

You have to give credit to the people of the southern Iraqi city of Basra. If there is a problem, they have a way to deal with it. It might not be legal or good for them, however.

Water, for example. Although supplies are almost back to pre-war levels, some homes are still not connected.

With some ingenuity, people have been adapting water pipes they have somehow "acquired" and connecting them up to any nearby water supply.

It might be the Shatt al-Arab waterway, or a stagnant pool. It might be a mains water pipe that has inexplicably been smashed, its water conveniently gushing out.

CHOLERA

Bacterial illness

Endemic in Iraq, particularly in hot months

Caused by drinking or bathing in or eating food washed in contaminated water

Incubation period of 2-5 days

Attacks intestine, causing diarrhoea and vomiting, and dehydration as a result

Can be fatal if untreated

Medical notes

The trouble is, the water they are getting is often contaminated with sewage or rubbish left uncollected in the post-war chaos that is afflicting local government. That brings diseases.

Cholera is endemic here. There were 250 cases in the Basra area in 2002.

There has, though, been a sudden increase. Nineteen cases have been identified in the city's hospitals in two days.

Most of the victims are young children, but the most recent two are a 70-year-old woman and a 25-year-old woman.

Car-jacking on the rise

Dirty water is being blamed for this outbreak and a dramatic rise in other diarrhoea-related illnesses.

Gastro-enteritis is proving a problem and there are concerns about hepatitis too.

The lack of security is the biggest worry of every Iraqi I have met here.

Doctors are having to cope in ill-equipped hospitals, but say there are enough drugs and intravenous fluids to treat the victims, if, that is, they are not too frightened to take themselves to hospital.

Like every other public building, hospitals are constantly being targeted by thieves and armed robbers these days.

There is no security to stop them seizing whatever they can.

Car-jacking is a crime taking off here too. Go out in anything resembling a decent car and you might be walking home - if you are lucky.

This is why the World Health Organisation representatives in Basra expect the number of actual cholera cases in the local population to be 10 times the figure reported by the hospitals.

If that is the case and sufferers fail to get help, they could die. Up to 80% of cholera patients die if they do not get treatment.

Security fears

An emergency meeting of health and water officials, the Red Cross, the WHO and the British Army who are in control of southern Iraq addressed these problems on Thursday.

There has been widespread looting in Basra

One of the key developments was the commitment by the army to provide an armed guard force and police force from people they have recruited and trained to protect key installations such as hospitals and water pumping stations.

The force should start work on Saturday, 10 May. There are some here who say about time too. The lack of security is the biggest worry of every Iraqi I have met here.

Only when there is security will the infrastructure be restored. Then, perhaps, civic society can begin to re-emerge.

Part of that will be to renew public health education programmes. If all that can be done swiftly, then maybe the threatened cholera epidemic can be averted.