The disease - spread by bacteria in contaminated water, which can result in rapid dehydration and death - threatens to blunt growing optimism in the Iraqi capital after a recent downturn in violence. Two boys in an orphanage have died and six other children were diagnosed with the disease, according to the Iraqi government. 'We have a catastrophe in Baghdad,' an official said.
The United Nations Children's Fund (Unicef) said 101 cases had been recorded in the city, making up 79 per cent of all new cases in Iraq. It added that no single source for the upsurge had been identified, but the main Shia enclave of Sadr City was among the areas hardest hit.
As Iraq's rainy season nears, its ageing water pipes and sewerage systems, many damaged or destroyed by more than four years of war, pose a new threat to a population weary of crisis. Claire Hajaj, a spokeswoman for Unicef, said: 'Iraq's water and sanitation networks are in a critical condition. Pollution of waterways by raw sewage is perhaps the greatest environmental and public health hazard facing Iraqis - particularly children. Waterborne diarrhoea diseases kill and sicken more Iraqi children than anything except pneumonia. We estimate that only one in three Iraqi children can rely on a safe water source - with Baghdad and southern cities most affected.'
Although US forces in Baghdad have found that security is improving, on daily patrols they face complaints from residents about streets plagued by piles of household waste and fetid cesspools, often near schools and where children are playing. Captain Richard Dos Santos, attached to the 3rd squadron of the 2nd Stryker Cavalry Regiment, said that in the al-Hadar area of south Baghdad sewage pumps were only 30 to 40 per cent operational. 'There is sewage near schools and there is an increased threat of cholera and flu in winter when resistance is low,' he said.
The UN has reported 22 deaths from cholera this year, and 4,569 laboratory-confirmed cases, almost exclusively in northern Iraq where it was first detected in Kirkuk in August. It has now spread to half of the country's 18 provinces, but anxiety is focused on Baghdad.
Unicef said it was providing oral rehydration salts and water purification tablets for families - it distributed three million to the worst hit areas two weeks ago - as well as jerrycans at water distribution points. It is transporting 180,000 litres (47,552 gallons) of safe water per day to Baghdad's worst hit districts.
Unicef issued an urgent appeal to the Iraqi government to clean water storage tanks in all institutions as one preventive measure. Hajaj said: 'Only 20 per cent of families outside Baghdad have access to sewage services, and Iraq's sewage treatment plants operate at just 17 per cent of capacity.'
Cholera is preventable by treating drinking water with chlorine and improving hygiene, but it is estimated that around 70 per cent of Iraqis do not have access to clean water. Many have been too poor or too afraid to go out to buy bottled water, relying instead on tap water, often from polluted sources. Companies responsible for collecting waste and sewage have been reluctant to enter Baghdad's most violent areas.
The government has been trying to educate Iraqis through advertisements on TV and in newspapers and with leaflets handed out at checkpoints. But it admits that six hospitals have unsafe water supplies.
