Nearly two weeks after the destruction of the Kakhovka dam in southeastern Ukraine, the floodwaters are receding, but local officials are grappling with a new concern: the potential for outbreaks from waterborne disease.

On Saturday, local officials in Kherson and Mykolaiv, the two regions most affected by the flooding on the Dnipro River unleashed when the dam collapsed, outlined plans to ensure safe drinking water. And doctors in hospitals across those regions have been warned to prepare for the potential for an outbreak of disease.

“Currently, trucks carrying essential medical supplies for infectious diseases such as cholera are being unloaded,” Oleksandr Chebotarov, the medical director at the Kherson City Clinical Hospital, said in a phone interview on Saturday. “As of today, we have not had any reported cases of illness, but we are actively preparing.”

The full scale of the disaster, which drained a giant reservoir used for drinking water and irrigation, is only beginning to come into focus. Hundreds of residential areas are still underwater, including some under Russian occupation. International humanitarian organizations have shared concerns about widespread pollution and the potential for illness, but the Ukrainian health authorities maintain that they are vigilantly monitoring for any signs of a disease outbreak.

The potential for widespread disease comes as Ukraine’s forces are fighting in the early stages of a counteroffensive, trying to wrest back control of Russian-occupied areas. Hanna Malyar, a Ukrainian deputy minister of defense, said late Friday in a statement on the Telegram messaging app that Kyiv’s forces were “gradually moving forward” in the country’s south, and that in the east they were up against Russian efforts to “make every effort to stop the offensive actions of the Ukrainian troops.”

As that heated military campaign ramps up, civilians in areas near the front line now face not just the threat of fighting but also the threat of illness. Floods can increase the transmission of communicable, waterborne diseases like typhoid, cholera, leptospirosis and hepatitis A.

Jarno Habicht, the head of the World Health Organization’s country office in Ukraine, said the risk of an outbreak of such waterborne diseases was his agency’s primary concern.

The organization provided cholera kits to people in the Kherson region and neighboring areas “as a preventive measure” in the spring, before the dam was destroyed, he said in a statement to reporters this week.

But Dr. Habicht cautioned that the situation was still evolving and said that hundreds of thousands of people were in need of drinking water. The W.H.O. and partners in the field were also monitoring the long-term effect of the release of hazardous chemicals into the water, he added.

Ukraine’s Ministry of Health encouraged people in flood-affected areas to drink only bottled water and said that water monitoring had been stepped up in those areas.

The ministry also has tamped down fears about the potential for a cholera outbreak, saying that there were no registered cases or suspicions of cholera infections in Ukraine as of Wednesday. Samples from both environmental sources affected by the flooding and from patients with signs of acute intestinal infection had been studied and found to be negative, it said in a statement.

Viktor Lyashko, Ukraine’s health minister, said that the area downstream from the Kakhovka dam was heavily polluted and unsuitable for any use, including swimming or fishing. People and animals should not drink the water, he said in an interview with the BBC, adding that even bathing in the water could lead to illness.

“The treatment facilities have switched to emergency disinfection modes,” he said in the interview. “Monitoring of the water quality in the water supply network has been intensified to prevent an outbreak.”

In both Russian-occupied and Ukrainian-held areas affected by the dam break, combating any outbreak could prove challenging. Local officials on the Ukrainian side must respond to both the still-present flooding and the threat of disease.

Oleksandr Prokudin, the head of the regional administration in Kherson, said on Saturday morning that despite a drop in water levels, dozens of residential areas remained flooded.

In a video message, he said that the local water company had started monitoring the quality of water daily to ensure it remains safe for use, and that two powerful water treatment systems were arriving on Saturday to provide clean water for thousands of people. Similar efforts were underway in the Mykolaiv region, the local water authorities said by phone.

Thousands of people have had to be evacuated because of the flooding. Oleksandr Khorunzhyy, a spokesman for the State Emergency Service, said in a Friday afternoon briefing that rescue and recovery operations were still continuing.

Even in areas that escaped the effect of flooding, the potential for disease remains. In the Black Sea port of Odesa, household garbage, mines, plastic, branches and dead animals have been washing up along the city’s famed coastline after the dam disaster.

The Odesa City Council on Saturday banned residents from swimming in the region, saying in a statement that dangerous pathogens that pose “a real threat to the life and health of the population” had been found in the local waters.

Here’s what else is happening:

  • Deadly Strike: A Russian anti-tank missile hit a civilian car in the Kharkiv region of northeastern Ukraine, killing two people, the head of the regional military administration, Oleh Syniehubov, said in a Telegram statement. He posted images of a burning, mangled car and said that the “direct hit” killed a 42-year-old man and a 53-year-old woman.

  • African Delegation: President Vladimir V. Putin of Russia is meeting on Saturday in St. Petersburg with a delegation of African leaders as part of the group’s peace mission to Russia and Ukraine, according to the Kremlin spokesman, Dmitri S. Peskov. He said that Mr. Putin will hold a separate meeting with President Cyril Ramaphosa of South Africa, the Russian news agency Tass reported. The African delegation visited Kyiv the day before, where they had tense exchanges with President Volodymyr Zelensky of Ukraine over how to end the war.

Daria Mitiuk contributed reporting.


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