Borderlines are not borders

Yes, that is the setting we seem to forget at times. You look at google Maps, look at the country/location and at times you forget that one country is not limited to the borderline you witnessed. Some will Google ‘boobies’ and ‘bikini’ and look in amazement on how good thing seem to be North of the border. Yet, we forgot that there is still a trap. That it is for the most an imaginary line. Birds never seem to see one and diseases notice it even less, so as we got exposed to Cholera this week, we see “RIYADH: Saudi Arabia confirmed one cholera case and said three others were suspected in an area bordering Yemen, where an epidemic has killed more than 2,000 people, Saudi state TV said, citing a health ministry official” (at https://www.channelnewsasia.com/news/health/saudi-arabia-reports-cholera-infection-in-southern-province-10727266), yet do we comprehend the danger that is evolving? You see, we can rely on numerous sources and accept: “Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae“, we seem to forget too often that ‘infectious disease‘, ‘leads to dehydration and even death if untreated‘. The treatment is actually simple. We are also given: “you can protect yourself and your family by using only water that has been boiled, water that has been chemically disinfected, or bottled water“, that part is important right now. You see, antibiotics ‘reduce the duration of diarrhoea by half and also reduce the excretion of the bacteria, thus helping to prevent the spread of the disease‘, yet the true treatment is Hydration and that is where the problem starts. Yemen is in a state of famine and shortage, so not only is there almost no water, there is in addition no way to boil that water, continuing a cycle of symptoms and a spread of the bacteria (and so the disease). At that point, dehydration becomes the killer leaving death in its wake and in Yemen that is unlikely to be mere dozens or hundreds; it will be killing thousands of people. So they are not too fearful of bombs and war slaughter, cholera is much more certain to kill them and do it at a slower pace, ensuring that suffering is maximised. So even as one case is found in Saudi Arabia, it is in my personal view running rampant in Yemen where more than 2,000 people have died of cholera at present and the estimated 5.2 million children that are in danger of dying of hunger, measles, or diphtheria are at present more than likely on the death list of cholera. Making the Battle of Al Hudaydah not merely an essential one, but making it imperative that it is won by the Saudi-coalition as soon as possible.

As we see the outspoken lies of the Houthi’s claiming that they are defending Yemen from a ‘US backed invasion’. That whilst they are knowingly, willingly and intentionally letting the Yemeni population die in the most horrible way imaginable, we need to wonder how much humanity we need to show the Houthi’s in all this. You see, the alleged Houthi in the image, an image merely 16 hours old (if the source it to be believed) does not seem to look that hungry, making the issue of who gets fed more important, and beyond that, if the Cholera treatment (hydration) is not made openly available Yemen could become the biggest graveyard in history. It is there that the setting of the Battle of Al Hudaydah is clearly shown and it is about to get worse. You see, as more and more refugees flee Yemen into Saudi Arabia with their malnourished and dehydrated children and babies, they will also push Cholera into Saudi Arabia. Even as we know that Antibiotic treatments for one to three days shorten the course of the disease and reduce the severity of the symptoms, and therefor lessen the dehydration, the setting is now also that there are sources that have given view that resistance against antibiotics have been reported, making matters less easy to resolve and therefor more water is needed to remain hydrated, and that is not even including of the backlash of other diseases in younger children because of the Cholera impact. DA Sack, RB Sack, GB Nair, and AK Siddique in their January 2004 paper in The Lancet “Cholera” give us the frightening part: “If people with cholera are treated quickly and properly, the mortality rate is less than 1%; however, with untreated cholera, the mortality rate rises to 50–60%“. Here we have the larger setting, you see cholera does not give a hoot about borders and now that the first cases have been reported, we see not merely the danger of the disease, we see the dangers that if any of these refugees would make it to a city like Khamis Mushait they would have passed half a dozen smaller places like Al Masgi, that is if they even maker it that far. For me 80 Km is a stroll, for a lot of others it is a mountain and refugees, even if given assistance, caring Muslims, giving them a ride on their trucks towards a decent hospital, or even trying to treat these people (especially when it was not clear that it is Cholera) might see a larger problem evolve. Even as we accept that Cholera is rarely spread directly from person to person, which is a good thing. I wonder how dangerous the disease is when we accept that bodies are working in a state of lowered hydration. You see the Arabian continent has dealt with water shortages for the longest of times. Over generations these people learned to deal with less hydration (personal assumption), yet in that light does cholera not become a lot more dangerous and could that optionally make these people more susceptible to cholera? I am not stating that this is so, I a merely asking (as I never qualified for a medical degree).

It also gives us the setting that as cholera cases grow, the issue around the Battle of Al Hudaydah will show to have a nasty aftershock. it will no longer be a mere case of humanitarian aid and treatment, there will be a much larger need to set up emergency treatment posts, especially North of Saada. In my personal view, a place like Baqim is directly connected to Saudi highway 15 after you pass the Saudi port of Warcraft, going directly to both Al Hayat National Hospital as well as AlKhamis Maternity and Children Hospital giving Baqim a possible lifeline for treatment, medication and most important clean water (food too). Even as we accept that antibiotics are essential for the younger children, the reported resistance against antibiotics might become a much larger complication down the line and realising that danger now is important too.

We need to see on how we can stop all the diseases but Cholera is now the most impactful. That is shown when we realise that the WHO reported in 2016 a total of 132 121 cases, with 2420 fatalities. We now see that with the Yemen fatalities, we get to report that close to 50% of all cholera fatalities were in Yemen, how does that go over with you all? That is besides the setting that Yemen alone will be likely the reason that cholera cases will more than double and if something is not done soon, with well over 200% additional fatalities, which is not a good statistic to work with. We can argue on where the treatment needs to be and i merely took a look at the map, yet the idea of getting as many children as far away from Sanaa and Sadah seems to make perfect sense. I am also very accepting of the statement “The WHO said on Monday the origin of the current cases was not yet known but the outbreak was not expected to spread given Saudi Arabia’s infrastructure“. I get that, Saudi Arabia has a good infrastructure and is equipped for matters like these, especially when you consider the Hajj and the fact that the Kingdom of Saudi Arabia is always prepared for that. Yet, when it is not a mere handful, when the sick refugees are not merely a few, but a few hundred, we will see more complications and moreover an increasing amount of people hiding in fear, fear of disease, fear for their families and fear of others after they witnessed nears of Houthi brutality. Setting up something sooner rather than later on the Yemen side of the border is becoming increasingly pressing as I see it and not merely for the cholera risks. Diphtheria is a much larger problem if it gets a foothold, not merely from the infectious of the disease, the fact that Diphtheria grows its population through coughing, sneezing and sharing water bottles makes it a much nastier issue. It is fatal in 20% of cases in certain age groups, and guess what, children up to 5 are definitely in that risk group making the issue bigger and even as it can be treated with antibiotics, the reports of resistance become a much larger issue at this point. In addition its symptoms are easily mistaken by non-medical professionals as merely a sore throat for too long making matters worse faster than anticipated. with the fact that it spreads easily we get the state where every day not acted is one that is basically too late and we have seen the inactions in this regard for months now making matters not merely worse, it sets the stage where famine is merely the final straw that could get the largest child population in history killed. So at what point did we think that indifferent from the 22nd March 2015 was a good idea?

It makes for the saddest epilogue of the modern era: ‘We merely did not care enough to achieve something in Yemen‘.

So when you see the news and you feel that the EU is doing OK as it talks with Iran via: “Iranian Foreign Minister Mohammad Javad Zarif has urged European countries to take practical steps to keep Tehran in the nuclear deal“, consider that Iran is directly involved and responsible for this by making Yemen a proxy player, arming them and supplying them, prolonging this war, the last missile Iranian sponsored missile was fired by Houthi’s at Jizan city almost 6 hours ago.

You should wonder on how the EU could even contemplate continued talks with Iran under these conditions. Where was the borderline there?

 

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