Human Rights Watch has found evidence of a likely large harmful algal bloom along the Shatt al-Arab in the middle of the city of Basra that may have been related to the health crisis in the summer of 2018. The algal bloom appears to have been present in the river from as early as March 2018 until as late as November 2018. Satellite image date September 26, 27, 28, 2018. 

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