United Nations Resident and Humanitarian Coordinator in Syria, Imran Riza, statement on the outbreak of cholera in Syria, 12 September 2022 [EN/AR]

The United Nations Resident and Humanitarian Coordinator in Syria, Imran Riza, expresses serious concern over the ongoing cholera outbreak in Syria.

On 10 September, the Syrian Ministry of Health (MoH) declared an outbreak of cholera in Aleppo Governorate following 15 confirmed laboratory cases, including one death. Between 25 August and 10 September, the surveillance data showed that a total of 936 severe acute watery diarrhea cases were reported in Syria, including at least eight deaths. Most of the cases were reported from Aleppo (72.2%, 676 cases), Deir-ez-Zor (21.5%, 201 cases), Ar-Raqqa (1.8% 17 cases), Al Hasakeh (4.1%, 38 cases), Hama (0.2%, 2 cases) and Lattakia (0.2%, 2 cases). The number of confirmed cholera cases so far is 20 in Aleppo, four in Lattakia and two in Damascus (people coming from Aleppo).

Based on a rapid assessment conducted by health authorities and partners, the source of infection is believed to be linked to people drinking unsafe water from the Euphrates River and using contaminated water to irrigate crops, resulting in food contamination. Cholera remains a global threat to public health and an indicator of inequity.

This outbreak is also an indicator of severe shortages of water throughout Syria. The United Nations have been sounding alarm bells on this issue for some time.1 With the Euphrates levels continuing to decrease, drought-like conditions and the extent of destruction of the national water infrastructure, much of the already vulnerable population of Syria is reliant on unsafe water sources, which may lead to the spread of dangerous water-borne diseases, particularly among children. Water shortages are forcing households to resort to negative coping mechanisms, such as changing hygiene practices or increasing household debt to afford water costs.

A closely coordinated water, sanitation and hygiene (WASH) and health response is underway, led by the MoH, with support from WHO and UNICEF, working with a wide network of partners on the ground to respond. Since late August, health partners have been actively working to strengthen preparedness and response capacity for potential outbreaks in all affected governorates. Early warning surveillance has been intensified in areas where the outbreak has been reported and other high-risk areas, including in camps hosting internally displaced persons. Four thousand rapid diagnostic tests have been delivered to support the work of rapid response teams deployed to investigate suspected cases. Intravenous fluids and oral rehydration salts have been also delivered to health facilities where confirmed patients are admitted.

Partners have mobilized health and WASH supplies in the affected governorates. Chlorination activities to disinfect water are being scaled up and dosing rates are being increased in fragile and highly vulnerable communities to curb the spread of the disease.

Clean water is also being trucked to affected locations. Partners are similarly engaging with local authorities to begin periodic, focused water testing procedures and support the collection of water samples. Information on where to locate the nearest drinking water pumping station is being provided to affected communities without sustainable access to drinking water.

Religious leaders, community heads and local volunteers have been mobilized to encourage good hygiene practices and help refer suspected cases to health facilities.

Orientation sessions with health care workers, door-to-door household visits and community dialogues are part of the community-based awareness raising efforts to provide families with accurate information and to improve reporting symptoms and seeking treatment.

The outbreak presents a serious threat to people in Syria and the region. Swift and urgent action is needed to prevent further illness and death. UN agencies and non-governmental organizations partners are coordinating closely with health authorities to ensure a timely and effective response.

The UN in Syria calls on donor countries for urgent additional funding to contain the outbreak and prevent it from spreading. We urge all concerned parties to ensure unimpeded and sustained access to affected communities, as well as the support of neighbouring countries to expedite the necessary approvals to ensure the timely delivery of life-saving medicines and medical supplies.

For further information:

Olga Cherevko, Spokesperson, OCHA Syria, Damascus, cherevko@un.org