Water Pollution Aborts Missan Women’s Dreams of Motherhood

Missan – Fatima Neama and Tamara Emad

Shahlaa Hassan, from Missan Governorate, 344 kilometers from Baghdad, never expected that drinking water would cause her to lose the baby she had waited years for.

In her eighth month of pregnancy, Shahlaa experienced severe abdominal pain and fever. When she went to the hospital, the doctor informed her of the need for an early delivery to remove the fetus before it was too late, due to inflammation in the placenta “which could cause a stop in oxygen flow to the fetus.”

Several hours after leaving the operating room, doctors told her that the fetus had died due to blood contamination, while Shahlaa’s health continued to deteriorate. Tests revealed that she had typhoid, and the reason – as doctors told her – was due to drinking contaminated water from the Al-Butaira River that flows through several areas in Missan.

This report documents the rise in miscarriage and premature birth rates among women in the southern Missan governorate due to drinking water contamination. According to the annual statistical report of the Iraqi Ministry of Health, the rate of unspecified miscarriages among women in Missan governorate reached 83.7 percent of the total miscarriage cases in the governorate.

On the other hand, the deteriorating situation is exacerbated by the lack of hospitals compared to the population, as the number of government and private hospitals within the governorate reached 10, according to the Central Statistical Organization.

Drinking Water Mixed with Sewage

The suffering of Hirsh Muhammad’s late father with chest diseases is still vivid in his memory: “My father suffered from chest allergies and asthma, and remained confined to his home sick. Whenever I took him out to breathe fresh air, his condition worsened due to the pollution in Bazian’s air.” Dr. Salih Najib Majeed explains that wind direction plays a role in transporting factory pollutants, and the closer pollution sources are to residential areas, the higher the density of residents’ exposure to these pollutants.

According to satellite images, cement and iron factories are located close to residential areas; the cement factory is about 200 meters away from residential units.

The cement industry produces clinker dust that travels through the air and affects the respiratory system of those who inhale it.

Despite the multiple cases of serious chest diseases in “Bazian,” the Environment Department in Sulaymaniyah Governorate does not have any statistics on disease incidence rates in Bazian district.

The absence of estimates does not prevent Chai Awat Abdul Qadir, head of the Awareness and Media Department in the Environment Department in Sulaymaniyah Governorate, from confirming that factory emissions and their waste negatively affect the health of the area’s residents.

Last November, the Missan Governorate Environmental Directorate issued a report on tests conducted on two river water samples taken from different locations. The sample reveals high levels of hardness and turbidity, and sodium, phosphate, and potassium levels above the standard levels set by the Ministry of Environment. A report we obtained warns that mixing sewage with drinking water affects the health of the governorate’s residents.

Pollution and Miscarriage

A document issued by the Communicable Diseases Unit in one of the governorate’s hospitals indicates 120 miscarriage cases in 2018. Another document issued by the Statistics Department in the same hospital showed an increase in miscarriage cases to 150 in 2020, and 140 in the first half of 2021.

According to Central Statistical Organization data, the infant mortality rate per 1,000 live births in Missan Governorate for 2019 and 2020 was 14.1 and 13.7 respectively, while the maternal mortality rate per 100,000 births was 46.3 percent in 2020. Doctors in the governorate’s hospitals attribute miscarriage cases to high water pollution levels, explaining that water pollution is a source of diseases and germs that negatively affect the health of women and their fetuses.

Dr. Sarah Hussein, an obstetrics and gynecology specialist in one of the hospitals, with experience in scientific research on the effects of contaminated water on women’s health and reproductive health, says that water pollution in the governorate causes a range of health problems for women, such as reproductive system infections, diarrhea, and food poisoning. As water pollution contributes to the transmission of diseases like cholera and typhoid, health experts point to the seriousness of these conditions and their impact on women’s health.

Pregnant women are more at risk from water pollution than others, due to the complications it may cause during pregnancy and childbirth, such as premature birth and its effects on fetal growth and development. Hussein mentions the importance of educating pregnant women about avoiding contaminated water sources. On the other hand, she urges governments and health institutions to take serious measures to ensure the provision of safe drinking water and to care for the health of pregnant women. Thus, the harmful effects of water pollution on women and future generations can be reduced.

The United Nations included “Ensure availability and sustainable management of water and sanitation for all” among the Sustainable Development Goals. The UN said in defining this goal, which bears number 6: “While substantial progress has been made in increasing access to clean drinking water and sanitation, billions of people—mostly in rural areas—still lack these basic services. Globally, one in three people do not have access to safe drinking water.” According to World Health Organization statistics, the percentage of individuals using safely managed drinking water services, i.e., services that are available and uncontaminated when needed, rose to 74 percent of the world’s total population, which reached 7.8 billion people in 2020.

Misdiagnosis Compounds the Crisis

In her second month of pregnancy, Shahad Abbas, 22, experienced symptoms of fever, headache, and diarrhea. She went to the health center for tests, which showed she had appendicitis, requiring necessary surgery. The surgery led to the loss of the fetus, and despite several weeks passing since the operation, Abbas’s health condition persisted. She decided to consult another doctor, who recommended several laboratory tests, which ultimately showed that the previous diagnosis was incorrect, and that she was suffering from typhoid as a result of drinking contaminated tap water. Shahad went through a long period of receiving the necessary treatment until she fully recovered.

Dr. Ghasaq Abdul Wahid, an obstetrics and gynecology specialist at Al-Shaheed Al-Sadr Teaching Hospital in Missan, explains the absence of advanced laboratories, especially in hospitals and health centers located in districts and sub-districts on the outskirts of Missan, where the inability to determine the type of germ or fungal condition that the patient suffers from results in not receiving appropriate treatment. Abdul Wahid emphasized that misdiagnosis can lead to “unintended abortion.” This is confirmed by data from the Iraqi Ministry of Health, which indicates that the vast majority of abortion cases (83 percent) in Missan governorate are classified as unspecified abortion cases.

Dr. Rasha Al-Janabi, a specialist in obstetrics and gynecology surgery, explains that there is a difference between spontaneous and induced abortion. Spontaneous abortion refers to the loss of pregnancy before the twentieth week of pregnancy without external intervention, and is usually caused by genetic or health problems related to the mother or fetus. Induced abortion, on the other hand, includes terminating the pregnancy through a surgical procedure or using medications or other means. It turns out that some women in Missan are subjected to induced abortion due to misdiagnosis of their conditions, which led to unnecessary surgical procedures. Al-Janabi points out that appendicitis is a common misdiagnosis among doctors, leading to effects on pregnant women.

Abortion is Part of the Problem, Not All of It

Amid growing concern about the impact of water pollution on health, it appears that abortion is only part of the problem; the risks of drinking contaminated water extend to affecting women’s ability to conceive and lead their daily lives normally.

In her own words, Zahraa Kadhim, a mother of two, points to her harsh experience: “I suffered from a fungal infection, I tried to treat it with traditional methods, but my condition worsened over the days. I felt intermittent bleeding and severe pain, and the doctor told me that this condition could lead to infertility.”

Zahraa adds: “I received many treatments and changed doctors several times. After conducting tests and laboratory cultures to discover the fungus that infected me, the doctor told me that this situation was caused by my exposure to contaminated water.”

Prenatal care provision rates show that developing countries face significant challenges in this regard. In 2020, about 800 women died daily from preventable causes related to pregnancy and childbirth, while a maternal death occurred approximately every two minutes in 2020, according to World Health Organization data.

The suffering of Shahlaa, Shahad, and Zahraa extends to represent a painful pattern shared by thousands of women in “Missan,” who suffer from a variety of complications and urinary tract infections, affecting their health and reproductive capacity, while the sewage treatment water plant remains out of service, throwing its polluted load into the rivers.

This report was produced within the framework of the Our Voices project implemented by Internews.
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