Cholera is a serious intestinal water-borne illness that can reach epidemic proportions, especially when the water supplies in an area are contaminated or suspect. Hence, it often follows where war and social disintegration occur. In 2003, there was an outbreak in the Basra area. An even more serious contagion has emerged recently in northern Iraq and is moving south.
While an Associated Press article on the spreading cholera epidemic in Iraq headlines it is "contained", the article belies such spin by noting that the vicious intestinal disease has spread to three provinces now. The New York Times own article covers the story in more depth, and notes the danger:
A cholera epidemic in northern Iraq has infected approximately 7,000 people and could reach Baghdad within weeks as the disease spreads through the country’s decrepit and unsanitary water system, Iraqi health officials said Tuesday. [emphasis added]
Bush's Rapture = Four Horsemen of the Apocalypse
Like all would-be prophets, Bush feels very certain of himself. He has long had the support of fundamentalist evangelicals, who, according to a Glenn Greenwald article last year, "believe the Rapture is what is driving (and justifying) not just our current, but also future, conflicts in the Middle East.
Is fighting in order to bring about the Rapture -- whereby "believers will spontaneously disappear from their homes and workplaces and be carried to heaven" -- really all that different from 72 virgins awaiting martyrs in heaven? And much of that language is how the President publicly describes his view of the Middle East.
Then, there was the famous quote by Bush reported in the Guardian UK a few years into the Iraq War:
One of the delegates, Nabil Shaath, who was Palestinian foreign minister at the time, said: "President Bush said to all of us: 'I am driven with a mission from God'. God would tell me, 'George go and fight these terrorists in Afghanistan'. And I did. And then God would tell me 'George, go and end the tyranny in Iraq'. And I did."
But, as Greenwald pointed out, the press studiously avoids questioning Bush about his messianic beliefs, especially as they relate to the Iraq War. My question to Bush would be (and David Gregory, are you listening?): President Bush, given that you believe God has sent you on a mission in your war on Iraq, and given the support you receive from those who believe the Second Coming is at hand, would you interpret the appearance of a cholera epidemic in Iraq to presage the appearance of the fourth, pale green horse of the apocalypse, as marking the imminence of the success of the surge? Or do you wish to announce the coming of Christ right now?
While the bacterium Vibrio cholerae is the material agent of choleric infection, the efficient causal agent is the war itself (to utilize Aristotelian categories of causation). The New York Times article explains how the cholera epidemic begun in the northern regions of Kirkuk and Sulaimaniya, where almost a dozen have died, and thousands stricken, has spread to the provinces of Erbil and Nineveh. What follows is a description of how the contagion has been exacerbated by the actions taken to stem the insurgency:
“The water system represents the main problem,” [Dr. Cerko Abdulla, chief of the Sulaimaniya health directorate] said. “The disease can spread widely through water, and that’s a very serious matter.”
... Dr. Adel Mohsin, said that he was not aware of any cases on the Diyala border. But he said that further spread of the epidemic was “very likely” unless government agencies followed strict guidelines on water testing and maintaining sufficient levels of chlorination, which kills the bacteria.
In a chilling reminder of how difficult it may be to maintain those levels, Dr. Mohsin said that chlorine imports had been severely curtailed as a result of recent insurgent bombs that had been laced with chlorine, which in concentrated form can be deadly.
This is what cholera looks like:
The clinical description of cholera begins with sudden onset of massive diarrhea. The patient may lose gallons of protein-free fluid and associated electrolytes, bicarbonates and ions within a day or two. This results from the activity of the cholera enterotoxin which activates the adenylate cyclase enzyme in the intestinal cells, converting them into pumps which extract water and electrolytes from blood and tissues and pump it into the lumen of the intestine. This loss of fluid leads to dehydration, anuria, acidosis and shock. The watery diarrhea is speckled with flakes of mucus and epithelial cells ("rice-water stool") and contains enormous numbers of vibrios. The loss of potassium ions may result in cardiac complications and circulatory failure. Untreated cholera frequently results in high (50-60%) mortality rates.
Untreated? But surely there are plentiful hospitals and good medical care in Iraq. Sadly, the medical system in Iraq has all but collapsed, according to an article by David Wilson.
Destruction of Health System Another U.S. War Crime
Wilson notes that the Fourth Geneva Convention, Article 56, states:
To the fullest extent of the means available to it, the Occupying Power has the duty of ensuring and maintaining, with the cooperation of national and local authorities, the medical and hospital establishment and services, public health and hygiene in the occupied territory with particular reference to the adoption and application of the prophylactic and preventive measures necessary to combat the spread of contagious diseases and epidemics.
Wilson continues, reporting on the disaster that is the Iraqi medical "system":
The Iraqi Health Ministry estimates that, as of October 2005, 25% of Iraq's 18,000 physicians had left the country since the invasion in 2003. Earlier this year MEDACT reported that "doctors and other health workers were being attacked, shot at, threatened, kidnapped, and told to leave the country or die"....
Hospitals, their staff and patients have also come under attack from Coalition forces. In the US attack on Fallujah in 2004 the General Hospital was not the place to be for better health and security. Its services and those of clinics throughout the city were obstructed by US Marines with US snipers targeting medical facilities and ambulances....
Iraq's hospitals were once the envy of the Middle East....
Power supply is a major problem for most Iraqi hospitals.... Many hospitals do not have fully functioning backup generators because they lack funds to have them repaired. In many cases, spare parts are unavailable.
Al-Yarmouk, the largest emergency hospital in Baghdad, lacks medicines, disinfectants, surgical requirements, bed sheets, cleaning aids and personnel.... A medical aid worker in Basra informed MEDACT that most hospitals there have limited - and in some cases no - supplies of IV fluids, IV cannulae, antibiotics and oxygen.
Chuwader General Hospital in Sadr City, one of two hospitals covering an area of nearly two million people, has a shortage of most supplies with the lack of potable water the major problem. Chief manager, Dr Qasim al-Nuwesri has said: "of course we have typhoid, cholera, kidney stones but we now even have the very rare Hepatitis Type-E and it has become common in our area". He added that they had not faced these problems before the invasion of 2003.
Meanwhile, in order to further their war aims, the U.S. and their Iraqi partners cut off crucial supplies of chlorine, endangering many thousands with water-borne plague. Why was General Betray Us, I mean Petraeus (so there Faux News!) not questioned by this in the pro-war on terror Congress?
From the Times article again:
“If the water has low chlorination, Vibrio cholerae will go through the central supply,” Dr. Hakki said, and the disease will spread “like a fire in a haystack.”
Dr. Burhan Omar, deputy director of Kirkuk General Hospital, said that because of such problems, water purification plants themselves could be contaminated with the bacteria....
In fact, if those plants are contaminated, the epidemic could hopscotch all the way to Basra, in the south, Dr. Omar said....
The major human displacement caused by the Iraq conflict — people being driven from their homes or simply choosing to leave — is likely to be driving the epidemic, officials say.
Fadela Chaib, a spokeswoman for the World Health Organization, said: “Frankly speaking, it’s possible that cholera will spread to neighboring provinces and even to Baghdad, because there is a lot of people movement.
End the War Now! No to U.S. Occupation of Iraq!
The U.S. invasion of Iraq, backed by their British junior partners, and facilitated by token forces from "allied" countries that drool after U.S. foreign aid and military assistance, has turned Iraq into a hellhole of misery, war, and death. Bush strides not like Christ, but like Antichrist, bringing chaos, disease, and torture wherever his forces tread. (And I use the terms Christ and Antichrist metaphorically, and with irony, unlike the way Bush and his minions treat these matters -- such true believers, such maniacs.)
Osama bin Laden, who has reappeared like a ghost in videos transmitted in the Arab world (but not in America), speaks in populist terms of the evils of capitalism. But we have nothing to offer the poor and displaced and oppressed peoples of the Middle East, Africa, and Southern Asia, except more exploitation at the hands of multinational corporations seeking cheap natural resources and even cheaper labor to fuel their quest for super-profits.
Rebellious youth in that part of the world have been attracted to Islamic fundamentalism because of its populist, quasi-socialist rhetoric; but only after the U.S. and their third-world allies destroyed the small progressive forces in those countries who fought for democracy, and often for socialism itself. We are watching the same drama unfold in Pakistan today, where a U.S.-backed dictatorship is quashing democratic institutions and imprisoning or banning government opposition. With no other pole of progressive attraction, the youth of that country are being drawn to the Islamic fundamentalists, who promise, as the mullahs in Iran did in the last days of the Shah, more economic equality and a caring approach toward the poor, but delivering social oppression and a religious form of totalitarianism.
We are in deep trouble because what passes for the democratic left in this country is frozen with paralysis and fear. If the Bush regime is not brought down through social protest and impeachment, then the war party will be the stronger for it. And we will await the Fifth Horseman, presumption and hubris, whose task it will be to bring the entire sad affair down around our heads. We must not wait for such a deadly and tragic denouement.