Cholera outbreaks threaten children’s survival in the Middle East

Statement by Bertrand Bainvel, UNICEF Deputy Regional Director for the Middle East and North Africa

24 October 2022
Amer, 9, learned how to wash his hands well during a session by a health and nutrition mobile team in Hawaij village, Deir-ez-Zor governorate, Syria, on 4 October 2022.
Amer, 9, learned how to wash his hands well during a session by a health and nutrition mobile team in Hawaij village, Deir-ez-Zor governorate, Syria, on 4 October 2022.

AMMAN, 24 October 2022 – “The fast pace of the cholera outbreak in Syria and Lebanon is alarming and the risks of the disease further spreading to other countries in the region call for immediate action. Urgent support is needed to respond and contain the spread of the disease.

“The acute epidemic in Syria has left over 20,000 suspected cases with acute watery diarrhoea and 75 cholera-associated deaths since its start [1]. In Lebanon, confirmed cholera cases reached 448 in just two weeks, with 10 associated deaths [2].

“Several neighbouring countries are already affected with a high number of acute watery diarrhoea cases and may be at risk of cholera.

“Cholera outbreaks and acute watery diarrhoea add to children’s struggles in these countries. Malnourished children are more vulnerable to developing severe cholera disease, and the cholera outbreak is yet another blow to already overstretched health systems in the region.

“Cholera doesn’t know borders and lines of control, and spreads along population movements, including displacements. In hard-hit countries, the spread of the disease is fueled by weak water and sanitation systems, poor water management, increased poverty, climate change, and conflicts – all of which make safe water more and more scarce for families and their children and reliance on unsafe water exposes them to the risk of contracting the water-borne disease.

“Since the start of the outbreak, UNICEF has been delivering lifesaving health and water, hygiene, and sanitation supplies and services to affected areas, while helping families improve their hygiene practices. Simultaneously, preparedness and response efforts are being stepped up in neighbouring countries.

 “UNICEF urgently needs US$40.5 million[3] to expand its emergency cholera response in Syria and Lebanon alone. This includes support in health, water, hygiene and sanitation, risk communication and community engagement in the next three months.”


Notes to editors: 

In Syria, UNICEF:

  • Is distributing 7 million water treatment tablets to 350,000 people in affected governorates.
  • Distributed 408 tons of sodium hypochlorite during the first two weeks of October to increase chlorine dosages and concentration. Since the beginning of the cholera response, a total of 1,095 tons of sodium hypochlorite have been distributed, providing 13.5 million people with safe and clean water.
  • Delivered acute watery diarrhoea (AWD) kits to support treating an estimated 12,700 moderate cases and 11,700 severe AWD cases and distributed 244 kits in affected governorates.
  • Trained 438 health care workers and hygiene promotion teams, 160 religious leaders and 161 school health education officers on Interpersonal communication and community mobilization skills to prevent cholera outbreak. The social behaviour change outreach teams have engaged 159,000 people through community dialogues with influential leaders, community health workers and volunteers and 71,000 children through health education sessions in schools, while 93,161 people were reached via door-to-door visits with key messages and actions on cholera prevention in Aleppo, Deir Ezzor, Al Hasakeh, Al Raqqa, Damascus city and Damascus Rural.

 In Lebanon, UNICEF:

  • Distributed 98,800 litres of fuel to water pumping stations and waste-water treatment stations in locations with confirmed and suspected cholera cases
  • Procured emergency medical supplies including 150,000 Oral Rehydration Salts (ORS) and 40 Cholera Treatment Kits to support the treatment of 5,000 cholera cases and symptoms including moderate to severe diarrhoea
  • Delivered Chlorinated Trucked water, wastewater desludging and ensuring disinfection in informal settlements with suspected or confirmed cases.
  • Trained over 4,369 frontline workers and partners on cholera awareness, including transmission, symptoms, treatment, prevention and referral mechanisms.
  • Scaled up safe water deliveries and increased desludging to over 250,000 people living in informal settlements.

In Iraq, UNICEF:

  • Supported capacity strengthening of laboratories with water testing and sampling instruments to reach 1 million people, as well as scaling-up on-site chlorine generation, and advocate for the establishment of local factories for chlorine.
  • Distributed 1.5 million units of ORS in affected governorates.
  • Trained over 700 frontline workers on issues ranging from water, sanitation and hygiene infection, prevention and control measures to cholera prevention messages.
  • Has been conducting social mobilization on the ground in the areas with high cases, as well as the airing of awareness-raising messages across TV, radio, social media and SMS, with over 14 million people reached so far.

[1] WHO, Syria, as of 15 October 2022.
[2] Ministry of Public Health, as of 21 October 2022.
[3] US$11.14 million in Syria and US$29.38 in Lebanon. 

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