SULAYMANIYA, IRAQ — A cholera outbreak in northern Iraq, where thousands of people have sought refuge from sectarian violence, is overwhelming hospitals and has killed as many as 10 people, health officials said Friday.
The outbreak in Sulaymaniya and Kirkuk is seen as the latest example of the displacement and deterioration of living conditions caused by the Iraqi conflict.
The water-borne disease has struck more than 80 people in the two cities, which are about 100 miles apart, said Claire Hajaj of the U.N. Children's Fund, or Unicef. She said cholera had been confirmed as the cause of five deaths and was suspected in five others.
Local officials said more than 2,000 people had been affected.
Aid agencies had warned of the possibility of a cholera outbreak as blazing summer heat settled in Iraq, where the infrastructure is shattered by war and neglect. The disease tends to appear in the summer because, as the temperature rises, Iraq's chronic electricity shortages make it difficult to operate pumps at sewage and drinking-water treatment plants, which leaves many people without clean water.
That was evident Wednesday at a squalid encampment outside Sulaymaniya, where several hundred people live in makeshift tents that are little more than worn blankets draped over wooden frames. Girls and women lined up to fill containers from a tanker distributing water.
"We drink from this water, whether it's drinkable or not," Zahra Jabbar Kadhim said.
"In this tent, we bathe, cook and sleep," she said, pointing to the canvas she shares with her husband, Abdullah Ahmed, and four children.
Ahmed, a Sunni Arab, said they fled Baghdad after a Shiite militia threatened to kill him.
Lamia Karim Shaalan ended up at the camp after she sold everything she had, including her shop, to pay a $60,000 ransom to kidnappers who took her 10-year-old daughter in Baghdad's Dora neighborhood.
"We live in this handmade tent on the sand and in the middle of heat and snakes," she said.
A Shiite man whose wife gave birth in their tent a week ago said they fled to Sulaymaniya from the Sadiya neighborhood in southwest Baghdad seven months ago after Shiite militiamen discovered his wife was Sunni and ordered him to divorce her.
A nurse with the Kurdistan Health Organization, Abdul Karim, said the camp, which has neither garbage disposal nor a sewage system, is a breeding ground for disease.
The International Organization for Migration, in its latest assessment of Iraq's internal displacement problem, says that more than 70,000 Iraqis have fled to the northern region this year, most of them to escape violence. Such people increasingly are living in camps or camp-like settings because of the scarcity of affordable housing, it says.
In Kirkuk, Dr. Sabah Amin, director of the provincial health department, announced measures to curb the disease, including the closure of public swimming pools, a ban on street vendors selling food and drinks, and testing at ice and soft drink factories.
The number of patients arriving at health facilities with cholera symptoms, which include severe diarrhea, has increased to the point that hospitals have stopped testing everyone.
"They simply can't test them all," said Hajaj, of Unicef. "They're just assuming that if it looks like cholera, they have cholera."
Northern Iraq has not been immune to violence, but it has not been as deeply affected by the war as have Baghdad and nearby Diyala and Anbar provinces. This has made the northern area a destination for tens of thousands of people seeking security.
"This tent is my heaven," said Marwan, a man who fled Anbar for the camp in Sulaymaniya.
Still, violence Friday in Kirkuk was a reminder of the dangers across Iraq. Police said gunmen killed a barber in his shop in a northern part of the city. It was the ninth slaying of a barber in the city this year by Islamist militants who oppose Western haircuts and grooming styles.
In Anbar, police reported a fierce battle between Sunni Arab tribesmen and suspected insurgents near the town of Haditha, 130 miles northwest of Baghdad. They said the tribesmen, who have turned on the insurgents and have been cooperating with U.S. forces, tried to fight off an attack. Three tribesmen and six insurgents were reported killed in the two-hour battle.
U.S. military and political leaders are expected to cite Anbar province as a success story when they present their assessment of the war to Congress this month. Violence has dropped overall, though attacks by militants who the U.S. says are loyal to Al Qaeda in Iraq continue.
The military said Friday that a U.S. Marine and a soldier were killed Wednesday in fighting in the province. It gave no details of the incidents, but said U.S. forces had killed 12 suspected Sunni insurgents in Anbar in an assault that day.