Politicization of water, humanitarian response, and health in Syria as a contributor to the ongoing cholera outbreak. (June 2023)

• Record Type: Journal Article
• Authors: Tarnas, Maia C.; Karah, Nabil; Almhawish, Naser; Aladhan, Ibrahim; Alobaid, Radwan; Abbara, Aula
• Is Part Of: International journal of infectious diseases. Volume 131(2023)
• Page Start: 115
• Page End: 118
• Publication Date: 2023-06
• Subjects: Syria -- Cholera -- Politicization -- WASH; WASH Water, sanitation, and hygiene -- AWD Acute watery diarrhea -- OCV Oral cholera vaccination -- WHO World Health Organization; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2023.03.042
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Politicization across sectors has contributed to cholera's spread in Syria. Interference with water, sanitation, and hygiene infrastructure has created an environment for disease to spread. Politicization in the humanitarian space prevents the provision of necessary aid. Weaponization of health has limited the access to aid and cholera vaccinations. Recent earthquakes will further limit the ability to control cholera in northwest Syria. Abstract: In September 2022, the Syrian Ministry of Health declared a cholera outbreak after a surge of acute watery diarrhea cases. Since then, cases have been reported across Syria, particularly in the northwest. This ongoing outbreak reflects a pattern of politicizing water, humanitarian response, and health throughout the country's protracted conflict. Interference with water, sanitation, and hygiene (WASH) infrastructure has been a key component of this politicization, impeding detection, prevention, case management, and control. Droughts and floods have exacerbated the WASH situation, as have the early 2023 Türkiye-Syria earthquakes. The humanitarian response after the earthquakes has also faced politicization, leading to increased risk of surges in cases of cholera and other waterborne diseases. This has all occurred in a conflict where health care has been weaponized, attacks on health care and related infrastructure are the norm, and syndromic surveillance and outbreak response have been influenced and restricted by politics. Cholera outbreaks are entirely preventable; what we see in Syria is cholera reflecting the myriad ways in which the right to health has been brought under fire in the Syrian conflict. The recent earthquakes are additional assaults, which raise urgent concerns that a surge of cholera cases, particularly in northwest Syria, may now become uncontrolled.