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    Bilharziasis is widespread in thirteen countries of the Eastern Mediterranean Region - including Iraq - and represents one of its major public health problems.

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    Background: Bilharziasis is widespread in thirteen countries of the Eastern Mediterranean Region - including Iraq - and represents one of its major public health problems. Of the 180 million population of the Region, at least 56 millions, it is estimated live under the threat of this disease, and 20 millions actually suffer from bilharziasis infection. This was stated, this morning, by Dr. M. Farooq, WHO's bilharziasis adviser for the Eastern Mediterranean, when representatives of the thirteen countries at the WHO Regional Committee for the Eastern Mediterranean now being held in Baghdad, started their technical discussions on this subject.

    This meeting, which was held under the Chairmanship of Dr. N. Ayyad, (Egypt) gave the opportunity to the delegates to study reports submitted by various experts in the field of bilharziasis control.

    Bilharziasis represents a problem of growing seriousness in the Eastern Mediterranean as development schemes increase the areas under irrigation and give new scope to its development and spread. The severity of this disease in irrigation projects as compared with the old-established endemic areas is well known and the chief danger lies in what may happen in countries, like Iraq, where the extension of such schemes plays a vital part in their economic development.

    The assistance provided by World Health Organisation (WHO) to various countries facing this chronic debilitating infection, which is passed to man through contact with irrigation water, was considerably increased in order to control this disease, which is ranking next to malaria in importance among the parasitic diseases of man in this Region.

    Bilharziasis is caused by several kinds of tiny parasites, part of whose life-cycle is passed in certain species of fresh-water snails, which act as intermediate hosts. The infections is passed to man through contact with water, often in irrigation ditches, in which the snails live.

    Through daily contacts with this fertilizing water that man is continuously exposed to the disease, which tens to extend to new areas with the present development of irrigation.

    In Iraq, according to a report submitted at this WHO Meeting, cultivation in the valley of the twin rivers (Tigris-Euphrates) has been largely dependent upon perennial irrigation and bilharziasis has in all probability been endemic in the area for many thousands of years. Since the destruction of the original irrigation system in the thirteenth century it has been a health problem of relatively minor importance until the present century, when first the military operations during the First World War and then the progressive restoration of the irrigation system, brought it once more into prominence.

    The extent and gravity of the bilharzia problem in this area today is immensely increased by the progress of plans for the construction of vast new irrigation systems which will inevitably lead to the spread of infection unless exceptionally vigorous measures of prevention are undertaken.

    Some fifty separate new irrigation projects are under way in Iraq.

    In the northern valley of the Tigris conditions are marginal and small foci have flared up sporadically only to become spontaneously extinct, but in the middle and lower valley of the twin rivers prevalence and intensity of the disease are heavy, especially towards the south.

    The overall bilharziasis incidence in Iraq is about 20%. In certain areas, however, the infection rises much higher. In Tel Mohammed, near Baghdad, it is 80%; in the area surrounding Baghdad city the incidence of bilharziasis has risen from less than 10% to over 25% during the last thirty-five years, owing to the great increase of lift-irrigation by pumps. It is estimated that there is at least a total of one million individual infected in Iraq.

    Bilharziasis occurs extensively in marshes, swamps, irrigation channels and drains in central and southern Iraq, principally along the courses of the Tigris and Euphrates Rivers, and in a few limited foci in the northern part of the country. In the southern part of the country it does not occur nearer the Persian Gulf than the region of the Khandaq Canal in Basrah. This species has never yet been recorded from the Tigris or Euphrates Rivers or from their major tributaries in Iraq.

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