Idlib, Syria – Abdel Moneim Hamdo rushed his two children, one of whom is a toddler, to a hospital in the northwestern Syrian city of Idlib after they complained of severe abdominal pain that did not seem to go away.
“I took my son and daughter to the hospital to check if they had contracted cholera,” Hamdo said. He and his family – including his eight children – had moved from Atarib near Aleppo to the Al-Iman camp, close to Idlib, after the devastating earthquakes that hit the border region between Turkey and Syria in February.
“But after doing some testing, it turned out they had acute gastroenteritis due to the consumption of contaminated water,” he said, adding that necessities, including access to clean water and sanitary toilet facilities, were lacking in the camp.
Millions of Syrians have been displaced by more than 11 years of war, and difficult living conditions in refugee camps in the area have worsened since the earthquakes. The number of people becoming infected with cholera – a disease caused by eating and drinking contaminated food or water – is on the rise.
And there are concerns that the camp doesn’t have enough resources to deal with an outbreak.
“Having survived the earthquake, we now live in fear of catching contagious diseases that are spreading like wildfire across the camps,” said Hamdo, whose house collapsed in the Feb. 6 earthquakes. “It’s like we escaped death to find death.”
At least two people died of cholera in northwestern Syria last month, while the total number of cholera deaths in the northwestern region has risen to 22 since the outbreak began last year, according to a tweet earlier this week from the Syria Civil Defense, also known as known as the White Helmets.
Fatima Abdelrahman, a doctor at the Cham Humanitarian Foundation’s cholera treatment center in the outskirts of Idlib, said common symptoms in cholera patients include watery diarrhea, vomiting, abdominal pain and difficulty urinating, with some also having a high fever.
“Treatment is given according to the severity of each case. Mild and moderate cases are treated with intravenous or oral solutions to replenish lost fluids, along with antibiotics, antiseptics and antispasmodics,” said Abdelrahman, an internal medicine specialist.
“The danger lies with patients who are delayed in coming to the hospital after the first symptoms start to show. By the time they arrive, they are already showing signs of kidney failure due to prolonged dehydration,” she added.
Al Jazeera tried to talk to cholera patients about their experiences, but they were too sick to answer questions.
Following the deadly earthquakes that killed nearly 6,000,000 people in northwest Syria and displaced tens of thousands more, local health organizations warned of an imminent outbreak of cholera and other communicable diseases, given the severe lack of shelter and clean drinking water.
At least 6,458 new cases of cholera were recorded last month, according to the Early Warning and Epidemic Response Program (EWARN) in northwestern Syria. The EWARN confirmed that two people had died of cholera in February.
“We expect a significant increase in cholera infections due to fragile infrastructure and contamination of water sources with sewage,” Mohamed Salem, director of the vaccination program at the response coordination center, told Al Jazeera.
Salem told Al Jazeera that as most healthcare facilities are focused on treating earthquake victims, cholera patients have become a second priority. He warned that cholera infections would increase and called for the urgent launch of a vaccination campaign in the most vulnerable regions.
“We only have about 1.7 million vaccinations from the World Health Organization, which is not enough to contain the spread of this epidemic in Northwest Syria. To do that, we need about 4.5 million doses,” he explains.
The danger of a cholera epidemic spreading through shelters and camps in northwestern Syria has become a major concern among people living there given the weak humanitarian response following the earthquakes.
“I try to do my best to take care of my children’s cleanliness and hygiene. I want to protect them from diseases. But due to the severe cold and the lack of private showers, I can only wash them once a week with a pot of water in our tent,” says 36-year-old Aisha Abdulkarim.
The mother of nine, who lives with 150 other Syrian families in a shelter set up along the Syrian-Turkish border since the earthquakes, says the situation in the camp is dire.
“I always wash our fruits and vegetables with water and salt. I even forbid my children to eat or drink anything outside the tent,” says Abdulkarim.
“But I’m constantly afraid that one of them will get cholera. We hear about new cases every day.”
Additional reporting by Arwa Ibrahim