文章基本信息

标题：The Maladies of Water and War: Addressing Poor Water Quality in Iraq
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作者：Tara Rava Zolnikov
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2013
卷号：103
期号：6
页码：980-987
DOI：10.2105/AJPH.2012.301118
语种：English
出版社：American Public Health Association
摘要：Water is essential in providing nutrients, but contaminated water contributes to poor population health. Water quality and availability can change in unstructured situations, such as war. To develop a practical strategy to address poor water quality resulting from intermittent wars in Iraq, I reviewed information from academic sources regarding waterborne diseases, conflict and war, water quality treatment, and malnutrition. The prevalence of disease was high in impoverished, malnourished populations exposed to contaminated water sources. The data aided in developing a strategy to improve water quality in Iraq, which encompasses remineralized water from desalination plants, health care reform, monitoring and evaluation systems, and educational public health interventions. A LONG HISTORY OF UNSTABLE rule, border disputes, and religious strife has created continuous conflict in Iraq, with wars conducted from the beginning of the 20th century to the present. Iraq took part in World Wars I and II. The Persian Gulf wars had three phases: 1980 to 1988, 1988 to 1991, and 2003 to 2010. 1,2 The American involvement in Iraq and Afghanistan represent the most sustained combat in the world since the Vietnam War. 3 War causes worker shortages, skill-set imbalances, and unreliable distribution of supplies. 4 Unstable leadership, disputed territory, and degradation of land and supplies lead to various public health challenges, which Iraq has experienced throughout the past century. 5 Iraq’s geography exposes inhabitants to significant threats of waterborne and infectious diseases because of the construction of cities along the Tigris and Euphrates rivers and the proximity to neighboring territories that have frequent disease outbreaks. In the mid-20th century, during a hiatus between World War II and the Persian Gulf wars, Iraqis enjoyed comprehensive health care services, including modern hospitals, throughout the country. By 1992, most hospitals were operating at a fraction of their previous level and faced severe medical and supply shortages. Health care access declined and disease proliferated. Malaria, cholera, gastrointestinal diseases, and typhoid fever became prevalent throughout Iraq. Another effect of war in Iraq is infrastructure deterioration. The destruction of Iraq’s water supply system caused widespread failure of water purification and sewage systems. 5 Public health issues became secondary to fundamental human needs; Iraq has become a developing country whose people suffer decreased access to clean water, increased prevalence of malnutrition, and heightened severity of disease outbreaks. Research regarding practical strategies to address Iraq’s water crisis is sparse and outdated. The most recent article on the United Nations (UN) Educational, Scientific, and Cultural Organization’s Web site concerning water in Iraq was published in August 2010. 6 I evaluated water quality issues in Iraq, beginning with a review of historical and current accounts of waterborne disease outbreaks resulting from war. My aim was to amass information on sustainable water quality measures to use in preventing and mitigating disease outbreaks resulting from poor water quality in Iraq. Useful knowledge includes historical and current data on waterborne diseases, best practices for rebuilding war-torn societies, nutritional status of the population, public health infrastructure and awareness, and the country’s overall economic and political state.