Sun, Sep 26, 2004 - Page 6 News List

Deadly hepatitis E highlights water, health ills in Iraq

NY TIMES NEWS SERVICE , BAGHDAD

A virulent form of hepatitis that is especially lethal for pregnant women has broken out in two of Iraq's most troubled districts, Iraqi Health Ministry officials said in interviews this week.

They warned that a collapse of water and sewage systems during the continuing violence in the country is at the root of the outbreak.

The disease, called hepatitis E, is caused by a virus that is often spread by sewage-contaminated drinking water. The officials said that they had equipment to test only a limited number of people showing symptoms, suggesting that only a fraction of the actual cases has been firmly diagnosed.

In Sadr City, a Baghdad slum that for months has been convulsed by battles between a local militia and US troops, officials said up to 155 cases had turned up.

The second outbreak is in Mahmudiya, a town 35 miles south of Baghdad that is known as much for its kidnappings and drive-by shootings as for its poverty, where there are an estimated 60 cases. At least nine pregnant women are believed to have been infected, and one has died. Five deaths have been reported.

"We are saying that the real number is greatly more than this, because the area is greatly underreported," said Dr Atta-alla Mekhlif Al-Salmani of the viral hepatitis section at the Health Ministry's Center of Disease Control.

The WHO is rushing hepatitis E testing kits, water purification tablets, informational brochures and other materials to Iraq, said Dr Naeema Al-Gasseer, the WHO representative for Iraq, who is now based in Amman, Jordan.

But viral hepatitis comes in many forms, and another ominous set of statistics suggests that the quality of water supplies around the country has deteriorated since the US-led war began last year.

In 2003, 70 percent more cases of hepatitis of all types were reported across Iraq than in the year before, he said. During the first six months of 2004, as many cases were reported as in all of 2002.

In another indication of the deteriorating safety of water and food, the number of reported cases of typhoid fever is up sharply this year, said Dr Nima Abid, the ministry's director general of public health and primary health. Hospitals across the country are also full of children with severe forms of diarrhea, Abid said.

These reports come as the US administration has proposed shifting US$3.46 billion in reconstruction money for Iraq to programs that would train and equip tens of thousands of additional police officers, border guards and national guardsmen. The shift, which needs approval by Congress, would gut what had been a program to rebuild Iraq's water and sewage systems.

Last fall, Congress approved US$18.4 billion for Iraq's reconstruction. So far, only about $1 billion of that has been spent.

"The problem is the whole infrastructure," Abid said of the mounting health problems. "Definitely no major intervention has been done in this last one and a half years to repair the problem."

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