<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META http-equiv=Content-Type content="text/html; charset=iso-8859-1">
<META content="MSHTML 6.00.2800.1458" name=GENERATOR>
<STYLE></STYLE>
</HEAD>
<BODY bgColor=#ffffff>
<DIV><FONT face="Verdana Ref" size=4><A
href="http://www.latimes.com/news/nationworld/world/la-fg-disease4aug04.story"><FONT
size=3>http://www.latimes.com/news/nationworld/world/la-fg-disease4aug04.story</FONT></A><FONT
size=3> </FONT>
<H1>Water Offers Deadly Relief in a Blistering Iraqi Slum</H1>
<H2>Typhoid and hepatitis E run rampant because sewage has tainted nearly the
entire supply.</H2>By Ashraf Khalil<BR>Special to The Times<BR><BR>August 4,
2004<BR><BR>BAGHDAD — The price of bicycle pumps has more than quadrupled in
Sadr City, for reasons that have nothing to do with cycling. Residents of
Baghdad's worst slum use them to coax water from the district's battered supply
lines. It's either that or use their mouths as though they're siphoning
gas.<BR><BR>But there's a problem — the water is making them
sick.<BR><BR>Typhoid and hepatitis E are running rampant through Sadr City this
summer, as residents rely heavily on a sewage-tainted water supply to endure
temperatures of 115 degrees and up. The outbreak has strained local healthcare
facilities and left Health Ministry officials able to only guess at the scope of
the problem.<BR><BR>The increase in typhoid (known as "tee-pho" here) is a
regular summer occurrence in Iraq because of increased water consumption, but
officials say this year's infection rates are much higher than usual. Hepatitis
E, although present in the country for decades, is more rare.<BR><BR>"We would
read about it in books," said Dr. Qassim Nuwesri, director of Sadr City's Ali
bin Abi Talib Hospital.<BR><BR>Sadr City's aging water system was crumbling
before last year's U.S.-led invasion to oust Saddam Hussein. But the postwar
looting of a sewage treatment plant brought the crisis to a new level. Broken
water lines allow raw sewage to seep into the regular water supply. Frequent
electrical shortages stop the municipal water pumps, and innovative means of
pumping water from the dry pipes end up bringing in extra sewage.<BR><BR>"It's
always been bad, but now it's getting worse every day," said Faliha Ahmed, 32, a
scrawny typhoid patient in the hospital's crowded infectious disease ward. "What
can we do? We're thirsty."<BR><BR>At least four people have died from hepatitis
E, and the number of reported cases of the disease in the first half of 2004 —
about 12,000 — has already surpassed the amount for all of 2002. Faced with a
shortage of diagnostic kits, the government's communicable disease center sent a
team to test a limited sample of patients at Sadr City health centers. Twelve of
16 people tested positive for hepatitis E.<BR><BR>As the brutal Baghdad summer
heads toward its traditional August peak, health officials and Sadr City
residents expect the infection rate of both diseases, and the death toll, to
keep rising.<BR><BR>Both diseases are characterized by high fever and
gastrointestinal ailments. Typhoid is treatable with antibiotics, unlike
hepatitis E, which is also characterized by jaundice, is particularly dangerous
for pregnant women and has no known vaccine.<BR><BR>Other parts of the country
are bracing for a disease-ridden August. The United Nations has warned of a
humanitarian crisis in the southern city of Basra, also because of high
temperatures and a suspect water supply.<BR><BR>In Sadr City, a packed and
squalid urban landscape filled with more than 2 million impoverished Shiite
Muslims, the crisis is already in full swing.<BR><BR>Marked by standing pools of
raw sewage, the district "has every condition you could ask for" to prompt an
outbreak, said Dr. Atallah Salmany, a hepatitis expert at the communicable
disease center.<BR><BR>The cause is as plain as the solution is seemingly
distant.<BR><BR>"Improve the services, improve the drinking water, fix the
sewage network," said Nuwesri, the hospital director.<BR><BR>But U.S. Army
commanders in the area acknowledge that almost no serious reconstruction has
been accomplished in Sadr City. Contractors, they say, have been scared off by
frequent attacks by members of the Al Mahdi militia.<BR><BR>Residents are left
with a revolting water supply.<BR><BR>"If I showed you the water in our house,
you would not believe it," said Taiha Abdel Reda, 45. "We turn on the tap and
the water has a foul smell and we see threads of [human waste] in
it."<BR><BR>Those who end up hospitalized don't fare much better.<BR><BR>Nuwesri
said his hospital often uses water that's "just as contaminated as the water in
the homes."<BR><BR>Even that tainted supply has been known to disappear for up
to 18 hours. Several times, Nuwesri said, he's had to appeal to local fire
stations to provide the hospital with emergency water tankers.<BR><BR>The
hospital director shrugs off the irony of serving tainted water to patients made
sick by tainted water. A 35-year resident of Sadr City, Nuwesri shares his
neighbors' sense of helpless resignation.<BR><BR>"We can't even get contaminated
water!" he said. "Let's first get some and then we'll worry if it's
hygienic."<BR><BR>Health officials, meanwhile, admit there's little to be done
in the short term but chronicle the scope of the outbreak — and even that is
hampered by a lack of facilities.<BR><BR>"Since 1991, we've had no studies, no
programs," said Salmany of the communicable disease center.<BR><BR>Salmany's
office has worked with the World Health Organization to distribute 48,000
20-liter water jugs and 2 million purification tablets to residents.<BR><BR>But
the efforts have made little impact in District 74, a Sadr City neighborhood
that health officials regard as an infectious disease hotbed.<BR><BR>"The water
we drink is the same as this," said Khadar Abbas, pointing to an open sewer
outside his home. He had only vaguely heard of the purification pill
distribution program.<BR><BR>The Abbas family draws water from an outdoor spigot
with a bicycle pump and stores it in a yellow plastic barrel, boiling a portion
each morning for drinking. The barrel is now discolored with brown and green
streaks, and the boiling hasn't prevented one of Abbas' sons from contracting
hepatitis E.<BR><BR>Down the street, a funeral banner hangs for Amal
Kadhim.<BR><BR>"The condition started with vomiting. At first I was happy
because I thought she was pregnant," said Kadhim's widower, Qassim Wussfy. She
died three days after checking into a hospital, heavily jaundiced and gasping
for breath.<BR><BR>Municipal officials offer little short-term
hope.<BR><BR>"We're not just sitting here," said Jaleel Abaidy, a spokesman for
the Baghdad Municipality, which is responsible for city public works
efforts.<BR><BR>A new project, scheduled to begin this month, will provide 33
million gallons of clean water to Sadr City, he said.<BR><BR>But that will take
nine months, at best, to complete, and Abaidy acknowledged that there's little
to be done to help Sadr City's residents bear the rest of the summer.<BR><BR>"We
inherited an existing problem," he said. "The whole system has
expired."<BR><BR><I>Special correspondent Caesar Ahmed contributed to this
report.</I></FONT></DIV></BODY></HTML>