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>Iraq’s 2008 Cholera Outbreak Appears To Be Over

>Cholera outbreaks are an almost annual event in Iraq. In August 2008 the latest one began. The first case was found in Baghdad, but it soon spread to southern Iraq, which was hit the hardest. Incompetence by local officials made the situation worse. By November 2008 900 people were affected. That month the government stopped reporting on cases, fearing the bad publicity. The latest report by the United Nations’ World Health Organization however found that the outbreak is largely over.

On August 18, 2008 the first confirmed case of cholera was found in Baghdad. Later that month Babil and Maysan reported cases. The outbreak then spread to Diyala, Wasit, Anbar, Basra, Najaf, Karbala, and Qadisiyah the next month. Eventually thirteen of Iraq’s eighteen provinces were affected, including Dhi Qar, Irbil, and Muthanna. On September 22 the most cases were detected in one day at 79. The numbers then declined until October 14 when a second wave was detected. Most of these new cases were found in Qadisiyah that has received 33% of the total. This new outbreak seemed to scare Baghdad. In November, the Health Ministry said that they would no longer report on the epidemic because of concern over the media, and families affected. After October 22 however, the number of cases tapered off. The last seven incidents have all been in Babil, which has had 32% of the cases overall.

Total Cases By Province as of December 21, 2008
Diyala 1 case
Dhi Qar 1 case
Irbil 2 cases
Wasit 3 cases
Maysan 3 cases
Anbar 8 cases
Muthanna 21 cases
Najaf 41 cases
Karbala 61 cases
Basra 64 cases
Baghdad 109 cases
Babil 294 cases
Qadisiyah 317 cases

Compared to the last cholera incident, this one has been rather mild. Since August there have been a total of 925 cases. 476, 53%, were children five years or younger. In August 2007 an outbreak began in Tamim, and spread to nine other provinces. There were over 3,000 cases that year, and 14 deaths. In 2008 eleven have died so far.

The main cause of the cholera outbreak in 2008 was the decrepit water system, and incompetence by officials in Babil. According to Iraq’s Health Ministry 17% of the country’s water pipes are in bad condition. The International Red Cross reported in October 2008 that 40% of the population does not have access to clean water. Many Iraqis, especially the poor, displaced, and those in the country rely upon untreated water from rivers and wells, which greatly increases the likelihood of diseases like cholera spreading. In the summer, a drought hit Iraq, which made the water situation even worse. In Babil members of the Supreme Islamic Iraqi Council also used chlorine that they knew had passed its expiration date to clean the water supply. Until December Babil was the center of the cholera outbreak as a result.

Like almost everything else, Iraq’s infrastructure has been degraded by three wars, international sanctions, looting after the U.S. invasion, along with the fighting caused by the insurgency and sectarian war. The country still needs billions of dollars in reconstruction. The problem is that the U.S. led effort is ending, while Baghdad is facing budget cuts because of the declining price of oil. Together this has left Iraq a rather poor and broken country despite its huge petroleum reserves. The yearly cholera outbreaks are just one sign of the depleted situation Iraq finds itself in.

SOURCES

Balarkrishnan, Angela, “Millions of Iraqis at risk from contaminated water, says Red Cross,” Guardian, 10/29/08

Cockburn, Patrick, “Corruption blamed as cholera rips through Iraq,” Independent, 10/10/08

IraqSlogger.com, “Health Ministry Stops Releasing Cholera Numbers,” 11/18/08

IRIN, “Health threat posed by aging water supply networks,” 10/23/08

World Health Organization, “Ministry of Health Iraq and the WHO Representative’s Office Iraq,” 1/2/09

>United Nations Humanitarian Report On Iraq

>At the end of October 2008, the United Nations Office for the Coordination of Humanitarian Affairs released its latest report on Iraq. The study covered the cholera outbreak, security, refugees and their return, the drought, and Iraq’s budget.

In 2008 the United Nations and non-government organizations (NGOs) increased their activities within Iraq due to the improved security situation. Together they have formed a Consolidated Appeals Process to fund humanitarian assistance to Iraqis. In 2008 this fund had $164,675,584, but it asked for $271,371,554. This money went towards refugees, health, shelter, water, sanitation, schools, and food aid. Overall, the U.N. believes that the situation within Iraq is moving from a country in crisis to fragile stability where violence is down and refugees are slowly returning.

Health

The first major issue the report covered was the health situation, namely the on-going cholera outbreak. The first case appeared in Maysan province in August 2008. Since then it has spread to twelve of Iraq’s eighteen provinces, including Anbar, Babil, Baghdad, Basra, Qadisiyah, Diyala, Irbil, Karbala, Muthanna, Najaf, and Wasit. The number of cases peaked on September 22 with 79 then decreased, only to pick up again in mid-October. The disease is a regular occurrence in the country with an average of 600 annual cases. As of November 4, there were 738 confirmed cases. By November 18 the Iraqi Health Ministry reported that number had increased to 900, but said it will no longer provide statistics because of concerns with the media, other ministries, and victims. There have also been eight deaths as a result. As reported earlier, the majority of cases have occurred in Babil. The major causes have been inadequate and deteriorating infrastructure, and official incompetence.

The United Nations and the Iraqi government have tried to respond to the crisis. The World Health Organization has provided support to Baghdad as well, which has set up 950 centers to monitor the outbreak. The Ministry of Health also has a Cholera Preparedness Plan at work. By November 13, they claimed that 99% of the cases in Babil and Qadisiyah had been cured.

Cholera Cases In Iraq As Of 11/4/08
Diyala: 1 district affected, first-last case 9/9/08 – 9/9/08, 1 case
Wasit: 1 district affected, first-last case 9/30/08 – 9/30/08, 2 cases
Irbil: 2 districts affected, first-last case 10/14/08 – 10/14/08, 2 cases
Maysan: 1 district affected, first-last case 8/7/08 – 8/28/08, 3 cases, 1 death
Anbar: 2 districts affected, first-last case 9/7/08 – 10/1/08, 8 cases
Muthanna: 1 district affected, first-last case 10/14/08 – 11/1/08, 10 cases
Najaf: 3 districts affected, first-last case 9/17/08 – 10/28/08, 33 cases, 5 under investigation
Karbala: 3 districts affected, first-last case 9/5/08 – 10/27/08, 55 cases, 4 under investigation
Basra: 5 districts affected, first-last case 8/18/08 – 10/6/08, 58 cases, 1 death, 2 under investigation
Baghdad: 12 districts affected, first-last case 9/20/08 – 11/3/08, 92 cases, 1 death, 1 under investigation
Qadisiyah: 4 districts affected, first-last case 8/28/08 – 11/2/08, 207 cases, 2 deaths, 44 under investigation
Babil: 4 districts affected, first-last case 8/7/08 – 11/3/08, 267 cases, 3 deaths
Totals: 39 districts affected, first-last case 8/7/08 – 11/3/08, 738 cases, 8 deaths, 56 under investigation

Security

The U.N. reported that the number of deaths in Iraq has decreased from September to October. In October there were 294 civilian deaths and 726 wounded compared to 332 killed and 867 wounded in September. The number of deaths is higher if unidentified bodies found on the streets are included. Most of the violence is concentrated in northern and central Iraq.

Casualties – October 2008

Iraqi Civilians: 294 killed, 726 wounded
Iraqi Security Forces: 79 killed, 195 wounded
Iraqi Officials: 8 killed, 8 wounded
Unidentified Bodies: 70
Insurgents/militiamen: 75 killed, 9 wounded
Awakening/Sons of Iraq: 8 killed, 5 wounded
TOTAL: 534 killed, 943 wounded

Security Incidents – October 2008
Kurdistan: Small Arms Fire: 1, Indirect Fire: 3, IED: 2, found: 1, TOTAL: 7
North: Small Arms Fire: 117, Indirect Fire: 4, RPG: 5, Hand Grenades: 23, IED: 165, VBIED: 7, Found: 73, TOTA: 394
North Central: Small Arms Fire: 79, Indirect Fire: 22, RPG: 7, Hand Grenades: 12, IED: 124, VBIED: 4, Found: 112, TOTAL: 360
Baghdad: Small Arms Fire: 50, Indirect Fire: 21, RPG: 1, Hand Grenades: 14, IED: 150, VBIED: 7, Found: 120, TOTL: 363
West: Small Arms Fire: 28, Indirect Fire: 5, Hand Grenades: 1, IED: 32, VBIED: 3, Found: 12, TOTAL: 92
South Central: Small Arms Fire: 28, Indirect Fire: 1, IED: 22, Found: 17, TOTAL: 68
South: Small Arms Fire: 14, Indirect Fire: 7, Hand Grenades: 1, IED: 16, Found: 16, TOTAL: 54
TOTAL: Small Arms Fire: 316, Indirect Fire: 60, RPG: 13, Hand Grenades: 51, IED: 509, VBIED: 21, Found: 361, TOTAL: 1338

Refugees

The third issue that the U.N. report dealt with was that of Iraq’s refugees. The latest mass exodus occurred in Mosul when Christians were attacked. Twelve were killed and approximately 2,465 families fled as a result. The Christians received leaflets, letters, text messages, messages painted on walls, and even announcements on loud speakers all telling them to leave. Several houses were destroyed, and 19 were robbed. Because some of these incidents happened in the middle of the day there is strong suspicion that the Kurds were behind the attacks. The fact that they occurred right after Christians began protesting the exclusion of an article in the provincial election law that would have given minorities a quota on provincial councils also adds a political element to the incident. The Christians in Mosul are caught between the Muslim Arabs and the Kurds who are vying for control. The Christians are a swing vote in the city and province, with both sides trying to gain their loyalties or intimidate them. There are reports that up to 500 families have come back to Mosul because of jobs or school, although on November 12 two Christian sisters were assassinated at their home.

In terms of the larger refugee crisis, the U.N. notes that the process of returning has begun. Although the number of families coming back is small, it is increasing. The government fully supports this and has launched a refugee program based upon encouraging Iraqis to go back to their residences. On September 1, 2008 Maliki issued Order 101 that said all squatters must vacate their premises. The order also set up refugee centers in Baghdad to assist with returns. Any family that registered with the authorities would receive one million dinars to help with their move. The centers are also supposed to help with any property disputes. The International Organization for Migration reported that 16,782 families (100,692 people) have gone back to Baghdad. Another 11,986 families have returned to other parts of the country, with 8,691 going back to Anbar and Diyala provinces. 92% of those are internal refugees. Some are not able to go back to their homes because they are occupied or destroyed, leading to further displacement. In Maysan province for example, 100% of returnees were not able to return to their homes, only to their original neighborhoods, while in Karbala it was the exact opposite. There 100% of families were able to get back into their houses. In Baghdad, which has seen the greatest displacement and returns, 91% were able to go back to their homes. In Diyala that number was 96% and in Anbar 97%. Many of these families still face large obstacles such as finding jobs, food, and shelter.

Iraqi Government Figures On Internally Displaced
Note: This is the number of families and people that have registered with the government. The actual numbers are probably higher.

Dohuk: Families: 18,706, Individuals: 104,824, 7% of total
Irbil: Families: 10,304, Individuals: 52,007, 4% of total
Sulaymaniya: Families: 14,585, Individuals: 80,935, 5% of total
Total North: Families: 43,595, Individuals: 237,766
Ninewa: Families: 19,100, Individuals: 106,623, 3.7% of total
Tamim: Families: 7,911, Individuals: 43, 623, 4.8% of total
Anbar: Families: 9,179, Individuals: 55, 716, 3.6% of total
Baghdad: Families: 90,731, Individuals: 550,099, 7.5% of total
Diyala: Families: 22,784, Individuals: 136,891, 8.5% of total
Salahaddin: Families: 7,790, Individuals: 45,614, 3.7% of total
Total Center: Families: 157,495, Individuals: 938,566
Babil: Families: 12,677, Individuals: 77,197, 4.5% of total
Basra: Families: 5,989, Individuals: 35,509, 1.8% of total
Qadisiyah: Families: 3,858, Individuals: 25,186, 2.5% of total
Karbala: Families: 10,921, Individuals: 70,709, 7.7% of total
Maysan: Families: 6,792, Individuals: 46,523, 5.5% of total
Muthanna: Families: 2,457, Individuals: 18,331, 2.9% of total
Najaf: Families: 10,087, Individuals: 57,716, 5.2% of total
Dhi Qar: Families: 7,066, Individuals: 47,423, 2.8% of total
Wasit: Families: 12,306, Individuals: 75,457, 6.9% of total
Total South: Families: 72,153, Individuals: 454,051
Grand Total: Families: 273,243, Individuals: 1,630,383

Drought

Iraq is facing the greatest water crisis in at least ten years. The northern provinces of Diyala, Ninewa, Dohuk, and Irbil have been affected the most. In the north, many farms rely upon rain for their crops. Wheat and barley production is estimated to be 51% lower than 2007 numbers as a result. Electricity and fuel shortages along with deteriorating infrastructure are also hampering the government’s response. Families in four districts have been displaced from mountainous regions because of the drought as well because they cannot support themselves. The Kurds have set up a special committee to deal with the problem, and five million dinars have been allocated to help with wells, pipes, etc. Water shortages in Sulaymaniyah have also led to many diarrhea cases, but no cholera so far. Iraq has seen a recent spate of rain, which might alleviate the situation.

Budget

The last issue covered is Iraq’s budget. The 2009 budget was just approved on November 12 and totals $67 billion. This is a decrease from the original proposal of $80 billion. The major reason for the cut is the rapidly declining price of oil. The budget will likely run a deficit as it was based upon a $62 a barrel price for oil, when world prices are currently around $50 a barrel. $52 billion of the budget will go to operational costs such as bills and salaries, with only $4.1 billion going towards the capital budget, which is used for investment in infrastructure. The budget cut will have an affect on humanitarian assistance provided by the government as well.

SOURCES
Alsumaria, “99% of cholera cases healed in Babel,” 11/13/08
- “Iraq Cabinet approves 2009 budget,” 11/12/08
Associated Press, “Iraq plans to cut 2009 budget by $13 billion,” 10/31/08
Azzaman, “Iraqi Oil Exports Receding by 100,000 Barrels a Day Every Month, Former Minister Says,” 11/19/08
Reuters, “Gunmen Kill Two Christian Sisters In Iraq’s Mosul,” 11/12/08
United Nations Office for the Coordination of Humanitarian Affairs, “Iraq Humanitarian Update,” October 2008

>Chart On Spread of Cholera Across Iraq

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The above graphic is from the World Health Organization and charts the spread of cholera across Iraq. It shows the slow growth of cases in mid-August 2008, with a dramatic rise in September to its highest point yet from September 19-23 when 52, 62, and then 79 cases were confirmed. The number of new reports then dramatically dropped, and authorities believed they had the upper hand, when they again began to take off in mid-October. As reported earlier, the outbreak started in the south in Maysan, and has hit Babil the most. The latest cases have been in Baghdad, Basra, and Muthanna provinces. Political incompetence, deteriorating water infrastructure, along with the worst drought in years have been the main cause of the disease spreading.

SOURCES
Balarkrishnan, Angela, “Millions of Iraqis at risk from contaminated water, says Red Cross,” Guardian, 10/29/08
Cockburn, Patrick, “Corruption blamed as cholera rips through Iraq,” Independent, 10/10/08
World Health Organization, “Situation report on diarrhoea and cholera in Iraq, 29 Oct 2008,” 10/29/08

>Cholera Spreading Rapidly Across Iraq

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50% of the cholera cases and 50% of the deaths from it have been of Iraqi children 5 years old or younger. (Source: IRIN)

The latest report by the World Health Organization notes a rapid spread of cholera. (1) As of October 29, there were 644 confirmed cases of cholera, and 62 others under investigation. On October 20, there were 531 cases. That was an increase of 113 cases in just nine days. Previously, it took two weeks for that many cases to occur that month. In late September there was another surge in cases, but then it seemed to wane, only to increase again at the end of October.

The outbreak has also spread to all parts of the country. The first case was found in Maysan in the south on August 7. It then spread to Baghdad and Babil that month. It then moved to central and western Iraq in September, reaching Irbil in northern Kurdistan by October 7. The newest cases have occurred in Wasit and Diwaniya, both on October 18, and in the capitol on October 29. There have been a total of eight deaths as a result. Half of the victims have been children under five years old. Babil has been hit the hardest with a total of 255 cases. Diwaniya is next with 158.

The outbreak has spread because of a mix of incompetence and deteriorating infrastructure. Cholera is a disease contracted from drinking contaminated water. As reported earlier, Babil has had the most cases because of the negligence of Supreme Islamic Iraqi Council (SIIC) officials who rule the province. They decided to use expired chlorine that was purchased from Iran to purify the water supply. Across the rest of the country, the major cause has been the lack of access to clean water. The United Nations Agency In Iraq (UNAMI) and Iraqi ministries reported in mid-October that the water supply in Iraq had dropped. In Baghdad for example, the demand was for 3.25 million cubic meters, while only 2 million cubic meters of water was supplied. Overall, the Red Cross estimated that 40% of the population, especially in the rural and suburban areas, does not have access to purified water. Many people use rivers and wells for their needs, while others can’t afford the price of bottled water. There is also a drought hitting northern and central Iraq, which has made the situation worse, as people are even more desperate to find water, whether it is clean or not.

This has happened despite billions of dollars appropriated for rebuilding and improving the country’s water system since the 2003 invasion. In total, the U.S. has spent almost $2.38 billion on water and sanitation. In 2008, the Iraqi government appropriated $375 million for infrastructure in the sector, but as of June 2008 only $113 million had actually been spent. In August, Baghdad added an additional $241 million for the Water Ministry in its supplemental budget. These huge sums have obviously net met demand in Iraq.

The 2008 outbreak is not as large as the 2007 one that affected over 3,000 people. The government is attempting to address the problem by handing out chlorine tablets, and providing public information. There have been times when it seemed like the outbreak had been contained, and the number of new cases slowed, but now they are increasing again.

Spread of Cholera Across Iraq In 2008

August 7 – 1st case detected in the country in Maysan
August 18 – 1st case detected in Baghdad
August 28 – 1st case detected in Babil, 7 total cases, 174 suspected cases
September 5 – 1st case detected in Karbala
September 6 – 2 deaths
September 7 – 4 deaths, 1st case detected in Anbar
September 9 – 1st case detected in Diyala
September 10 – 22 cases, 5 deaths
September 13 – 68 cases
September 14 – 1st case detected in Basra
September 16 – 107 cases
September 17 – 1st case detected in Najaf, 161 cases total
September 20 – 1st case detected in Diwaniya, 172 cases total
September 27 – 327 cases
September 30 – 1st case detected in Wasit
October 5 – 418 cases, 6 deaths
October 7 – 1st cases detected in Irbil and Muthanna
October 14 – 479 cases, 8 deaths
October 20 – 531 cases
October 29 – 644 cases, 62 under investigation, last case detected in Baghdad, 255 in Babil, 158 in Diwaniya, 84 in Baghdad, 58 in Basra, 43 in Karbala, 23 in Najaf, 8 in Anbar, 3 in Maysan, 7 in Muthanna, 2 in Irbil, 2 in Wasit, 1 in Diyala

For more on the cholera outbreak see:

Cholera outbreak in Iraq

Cholera cases multiplying

Latest United Nations Numbers On Cholera Epidemic

Political Intrigue and the Cholera Outbreak

Latest United Nations Numbers On Cholera Epidemic – Updated

SOURCES
Agence France Presse, “Iraqi province on alert for cholera outbreak,” 9/8/08
Alsumaria, “Babel declares state of emergency for cholera outbreak,” 9/9/08
Babylon & Beyond Blog, “IRAQ: Lots of rivers, not enough water,” Los Angeles Times, 9/7/08
Balarkrishnan, Angela, “Millions of Iraqis at risk from contaminated water, says Red Cross,” Guardian, 10/29/08
Cockburn, Patrick, “Corruption blamed as cholera rips through Iraq,” Independent, 10/10/08
Health and Nutrition Sector Outcome Team, “Situation Report on Diarrhea and Cholera in Iraq,” World Health Organization, 9/17/08
IRIN, “Cholera cases reach 172, health ministry says,” 9/21/08
- “Cholera claims five lives,” 9/11/08
- “Cholera continues to spread in the south,” 9/14/08
- “Cholera deaths rise to eight as disease spreads,” 10/15/08
- “Confirmed cholera cases exceed 100,” 9/17/08
- “Number of cholera cases nearly doubles,” 9/28/08
- “Over 400 confirmed cholera cases so far,” 10/6/08
- “Two more cholera cases confirmed,” 9/8/08
Najm, Hayder, “water shortages, jobs and cholera,” Niqash,” 10/23/08
Special Inspector General for Iraq Reconstruction, “Quarterly and Semiannual Report to the United States Congress,” 10/30/08
World Health Organization, “Cholera in Iraq,” 9/10/08
- “Situation report on diarrhoea and cholera in Iraq, 20 Oct 2008,” 10/20/08
- “Situation report on diarrhoea and cholera in Iraq, 29 Oct 2008,” 10/29/08

>Latest United Nations Report On Cholera Epidemic

>The following commentary originally appeared on Musings On Iraq

On October 20, the World Health Organization (WHO) released its latest report on Iraq’s cholera outbreak. It recorded 531 confirmed cases of cholera. That was up from 479 cases on October 14, and 418 on October 5. The first case was reported on August 7, 2008 in Maysan province. Since then it has spread across 37 districts in 12 of Iraq’s 18 provinces. 56% of the cases have been children under five years old, and half of the eight deaths have been from the same age group.

Most of the cases have been in southern Iraq, but it has spread to northern and western provinces as well. After starting in Maysan, that currently has three cases, and one death, it spread to Baghdad that has 78 cases, one under investigation, and one death. On August 28, the first case was detected in Babil, which has 236 confirmed cases, with fifteen under investigation, and three deaths. As reported earlier, Supreme Islamic Iraqi Council members used expired chlorine to clean the water system there, which is responsible for the higher number of victims in that province. In September Karbala (40 cases), Anbar (8 cases), Diyala (one case), Basra (one death, 50 cases), Najaf (16 cases), Diwaniyah (two deaths, 93 cases), and Wasit (2 cases) were hit. The latest instances have been found in Muthanna (2 cases) and Irbil (2 cases). Those numbers still pale in comparison to the 2007 incident in which over 3,000 Iraqis were affected, and fourteen died.

Spread of Cholera In Iraq

  • Maysan 8/7/08 first case, 1 district affected, 1 death, 3 confirmed cases
  • Baghdad – 8/18/08 first case, 10 districts affected, 1 death, 1 under investigation, 78 confirmed cases, 15% of total
  • Babil – 8/28/08 first case, 4 districts affected, 3 deaths, 15 under investigation, 236 confirmed cases, 44% of total
  • Karbala – 9/5/08 first case, 3 districts affected, 3 under investigation, 40 confirmed cases, 8% of total
  • Anbar – 9/7/08 first case, 2 districts affected, 8 confirmed cases
  • Diyala – 9/9/08 first case, 1 district affected, 1 confirmed case
  • Basra – 9/14/08 first case, 5 districts affected, 1 death, 2 under investigation, 50 confirmed cases, 9% of total
  • Najaf – 9/17/08 first case, 3 districts affected, 5 under investigation, 16 confirmed cases
  • Diwaniyah – 9/20/08 first case, 4 districts affected, 2 deaths, 22 under investigation, 93 confirmed cases, 17% of total
  • Wasit – 9/30/08 first case, 1 district affected, 2 confirmed cases
  • Muthanna – 10/7/08 first case, 1 district affected, 2 confirmed cases
  • Irbil – 10/7/08 first case, 2 districts affected, 2 confirmed cases

SOURCES
IRIN, “Cholera deaths rise to eight as disease spreads,” 10/15/08
- “Over 400 confirmed cholera cases so far,” 10/6/08
- “Two more cholera cases confirmed,” 9/8/08
World Health Organization, “Situation report on diarrhoea and cholera in Iraq, 20 Oct 2008,” 10/20/08

>Political Intrigue and the Cholera Outbreak

>The following commentary originally appeared on

There have been 230 cholera cases in Babil (10), 73 in Baghdad (1), 61 in Diwaniya (9), 50 in Basra (6), 39 in Karbala (11), 9 in Najaf (12), 8 in Anbar (13), 3 in Maysan (5), 2 in Irbil (16), 2 in Muthanna (8), 1 in Wasit (4), 1 in Diyala (3)

As of October 14, 2008, there have been 479 confirmed cases of Cholera in Iraq. That is up from 418 on October 5. The worst hit province has been Babil with 230 cases, followed by 73 in Baghdad, 61 in Diwaniyah, 50 in Basra, 39 in Karbala, nine in Najaf, eight in Anbar, three in Maysan, two in Irbil, two in Muthanna, one in Wasit, and one in Diyala. The outbreak has been concentrated in the south, but has recently spread west to Anbar and north to Irbil. The first cases were reported in August 2008. There have been a total of eight deaths so far.

Babil has been at the center of the outbreak since the beginning. The blame seems to be due to the actions of several Supreme Islamic Iraqi Council (SIIC) officials in the province. The Health Ministry bought $11 million worth of chlorine from Iran to purify the water in Diwaniyah, Karbala, and Babil to prevent cholera. Officials in Diwaniyah and Karbala noticed that the expiration dates had passed, so they did not use the chlorine. SIIC officials in Babil did anyway. Hence, the most cases have been found there.

Police moved in and arrested several officials in Babil as a result who were members of the SIIC’s Badr Brigade militia. The SIIC demanded their release, but Prime Minister Nouri al-Maliki refused. Frustrated, members of the Badr Brigade then forced local police in Babil to release one of the SIIC officials.

This is not the first, nor worst cholera outbreak in Iraq, but it does show the continued power of the political parties over law and order. In 2007, Iraq had a much worse cholera situation that affected over 3,000 people. Although more widespread this time, the 2008 outbreak has not affected nearly as many. More important is the fact that it has spread in Babil due to the incompetence of local SIIC officials. To make things worse, the Badr Brigade then intimidated the police into releasing one of their arrested brethren. After the 2005 elections, the victorious parties doled out government positions to their followers, creating a vast patronage system. Many officials were chosen for their connections rather than capabilities, and the councils and ministries were treated like personal fiefs. The SIIC-Babil incident shows that some parties still see themselves as above the government, and feel like they have the right to set their own rules and ignore laws and procedures when they see fit.

SOURCES
Babylon & Beyond Blog, “IRAQ: Lots of rivers, not enough water,” Los Angeles Times, 9/7/08
Cockburn, Patrick, “Corruption blamed as cholera rips through Iraq,” Independent, 10/10/08
IRIN, “Cholera deaths rise to eight as disease spreads,” 10/15/08
- “Over 400 confirmed cholera cases so far,” 10/6/08
- “Two more cholera cases confirmed,” 9/8/08
Ucko, David, “Militias, tribes and insurgents: The challenge of political reintegration in Iraq,” Conflict, Security & Development, October 2008
World Health Organization, “Cholera in Iraq – Update,” 9/29/08
Xinhua, “Iraq reports more than 400 cholera cases,” 10/6/08