Ukraine readies for waterborne disease outbreak from dam floodwaters

KYIV — Ukraine’s health ministry is preparing for an outbreak of waterborne diseases such as cholera following the huge release of water caused by the destruction of the Nova Kakhovaka dam in the country’s Kherson region, Ukraine’s Health Minister Viktor Lyashko has told POLITICO.

Ten days since the dam of the Kakhovka hydroelectric plant was destroyed, floodwaters are receding and people who did not leave their homes have started to clean up the surrounding areas.

But the health threat is not over.

In a speech on June 8, two days after the dam’s destruction, Ukrainian President Volodymyr Zelenskyy warned that water could be contaminated by the flooding of fuel storage facilities, warehouses with chemicals and fertilizers, and animal burial grounds — including two where the animals had died from anthrax. Sewage in the water is also a concern.

“We inform people that it is now dangerous to swim or take animals to rivers and lakes,” Lyashko said. “These all are effective ways to prevent outbreaks of cholera, anthrax and other diseases.” “We are regularly testing water and food products and getting ready for more work when the water goes away.”

Last week, the World Health Organization also expressed concern about the health impact, with WHO Director General Tedros Adhanom Ghebreyesus saying that the effect on the “region’s water supply, sanitation systems, and public health services cannot be underestimated.” He added that the WHO had rushed in to work on preventative measures against waterborne diseases.

At the same briefing, the WHO’s Teresa Zakaria said that while there hadn’t been human cases of cholera since the war began, the disease was present in environmental samples, meaning that the risk is there for it to spread to humans. She added that the WHO has been working closely with the Ukrainian health ministry to ensure that mechanisms are in place to import vaccines if they are needed.

“So far the epidemiological situation is stable,” Lyashko told POLITICO. “We only have isolated cases of intestinal diseases caused by the consumption of unwashed fruits and vegetables.”

Preparing for worse

Nevertheless, preparations for an outbreak are underway. Lyashko has just returned from the Kherson region, where, he said, the Ukrainian government has prepared over 220 beds for possible infected patients and supplied hospitals with all the needed medicines and vaccines to treat patients in case the outbreak happens.

The Ukrainian government has also allocated €36 million for the construction of alternative water supply chains for the affected regions, he said, and increased financing to more than seven hospitals in Kherson, Dnipropetrovsk, Mykolaiv, and Odesa Oblasts ­— regions most affected by the flooding. 

Dozens of doctors are getting ready to work in the affected regions to replace burned-out colleagues during a possible outbreak, while scientists and epidemiologists are testing local waters every four hours for all possible types of contamination, including radiation. So far nothing is exceeding the norm, Lyashko said.

On Thursday, Ukraine’s Deputy Minister of Health and Chief State Sanitary Doctor Ihor Kuzin told journalists that it is now forbidden to drink water from individual wells in the flooded regions, as well as swim and fish in the Dnipro River and the Black Sea.

“Now we see signs of fecal contamination of the water. Escherichia coli, enterococci, salmonella, astroviruses and enteroviruses were found in the water surface in the Odesa region,” Kuzin said. “Each of them can provoke the development of intestinal infections in the case when a person swallows dirty water or eats with unwashed hands after bathing.”

Lyashko hopes that the alternative water supplies for Kherson, Mykolaiv and Dnipropetrovsk regions will be constructed as soon as possible to help minimize threats to the local population.

But he warned that even when the water goes away, Ukrainian healthcare professionals will face new challenges. “The soil will begin to dry; dust will begin to rise into the air and spread. It is necessary to see what is in this dust, and what toxic substances it may contain. This is one of the forecasting options,” the minister added.

Ashleigh Furlong contributed reporting.