Peru's cholera epidemic spreads to its neighbours .sx Malcolm Coad reports from Santiago that the continent's river systems may be infected .sx AFTER decades free of cholera , a three-month epidemic centred on Peru has established South America as a world focus of the disease .sx Experts in the region talk of it becoming endemic for at least 15 years and warn that it could soon advance towards the borders of the United States .sx The death toll in Peru has reached nearly 1,000 , with more than 140,000 infected , and the first cases were confirmed this week in Chile and Brazil .sx In both countries the cases appeared to indicate what is most feared :sx that the continent's river systems are now infected , making the spread of the disease extremely difficult to control .sx In Ecuador , the country's Medical Association said 100 people had died of a total of 5,000 cases , and accused the government of suppressing information about the epidemic in the interests of tourism and the country's fishing industry .sx Officially , 59 people have died and 682 more are sick .sx In Colombia , also a neighbour of Peru , one death and 81 cases have been reported in border areas .sx But health ministry sources estimated that if the outbreak takes serious hold it could lead to more than 85,000 cases .sx Cholera thrives where sewage is pumped directly into seas and rivers , vegetable crops are irrigated by untreated water and sanitary systems are fragile .sx Spread by human faeces in water and food , it is easily cured if caught early , but otherwise can kill within hours .sx Latin America has suffered few cases since early this century , and the last serious epidemics were in the 1880s .sx Peruvian experts believe that this outbreak was brought by ship from Asia and spread through miserable local sanitary conditions and fish caught along the country's coastline .sx From fishing and industrial towns on Peru's northern coastline , the disease spread inland to the the country's Amazon region and across the Ecuadorean border , apparently carried by ocean currents and fishermen who work on either side of the frontier .sx " Cholera will remain in Ecuador for about 15 years , and will become endemic , " said Francisco Plaza , the head of Ecuador's Medical Association , echoing similar warnings by Peruvian experts .sx Mr Plaza added that the country's main river , the Guayas , was infected .sx The cases in Brazil , one confirmed and three likely , are in the Amazon town of Tabatinga , where Brazil , Colombia and Peru meet .sx Experts believe that the infection was brought from Peru by the local river , the Solimoes , the main originating branch of the Amazon .sx This , and the presence of hundreds of thousands of illegal gold diggers moving between the Colombian Amazon region and Brazil's main cities , has led the Brazilian authorities to expect a serious outbreak , potentially affecting up to 3 million Brazilians .sx The case in Chile , confirmed in Santiago on Tuesday , also appeared to be due to infection of vegetables by contaminated river water - though the origin is a mystery , given the city's distance from infected countries and lack of direct river connection with them .sx Last weekend , Presidents Jorge Serrano of Guatemala , Rafael Callejas of Honduras and Rafael Calder o n of Costa Rica met in Guatemala to discuss ways of preventing the spread of the epidemic through Central America , where its arrival is expected imminently .sx The three leaders called for urgent aid , especially from the US and Mexico , for regional prevention programmes .sx " With this we will not only prevent disasters from the illness in Central America , but help prevent cholera from spreading to the United States and Mexico , " said President Calder o n. Similar calls for help are likely from Saturday when regional health ministers begin a three-day meeting in Sucre , Bolivia , to discuss the crisis .sx Care threat lifted on abuse case children .sx Peter Hetherington .sx THE nine children at the centre of the Orkney child abuse row will not be taken into care again unless " miraculous new evidence " is produced .sx Rowan MacCallum , the Orkney Islands council's director of administration and legal services , said a court would almost certainly rule further place of safety orders " incompetent" .sx Earlier , Paul Lee , the social work director , had declined to give an assurance that the children , who were taken from their homes six weeks ago then reunited with parents , would not be returned to care .sx Mr MacCallum later clarified the position .sx He said that in theory Mr Lee could begin the process again .sx But he added :sx " For the nine children I do not think there is any danger of them being taken in unless some miraculous new evidence was forthcoming .sx " .sx At a special council meeting yesterday councillors called for a full judicial inquiry into the controversy after categorical denials from Mr Lee that more children had been placed on an " at risk " register .sx Mr Lee , backed by his committee chairman , promised more resources and new policy options to handle allegations of child abuse .sx Councillors heard that the council , unlike other authorities , had no guidelines or procedures for handling abuse cases when the nine children , aged from eight to 15 , were taken from their homes in dawn raids on the island of South Ronaldsay .sx They were reunited with parents two weeks ago after a judge described allegations of ritual abuse as fatally flawed .sx This week the acting administrator of Orkney Children's Panel announced that he would be appealing to Scotland's Court of Session .sx Members yesterday heard that their small social work department , which had to enlist the help of other agencies and mainland social workers to round up the nine children , had been underfunded and under - staffed for a long time .sx The meeting only began after the convener , Jackie Tait , and Mr MacCallum threatened to call police to eject several reporters because the session had been billed as private .sx Eventually the press was admitted and councillors voted to hold part of the meeting in public , against the advice of Mr Tait and Mr MacCallum .sx With some South Ronaldsay parents and their supporters sitting behind councillors , Mr Lee emphasised that there was no list of " 21 or 23 children " believed to be at risk .sx Earlier , one councillor , Spencer Rosie , who has strongly criticised the social work department , said Orkney had been denied proper local child abuse guidance and procedures involving other agencies although he had raised the question of such an approach two years ago .sx It had not been possible to proceed because the authority had been in dispute with the children's panel administrator , who was suspended last year .sx She is appealing against the decision .sx Mr Rosie wanted assurances that children would no longer be taken from Orkney to foster homes on the mainland .sx Mairhi Trickett , the social work committee chairman , replied :sx " I do not think we will ever be able to make a bland statement that we will not send children outside Orkney .sx " .sx She said that Mr Lee , who took over a year ago , had now got new management and staff - but since November ( when the allegations apparently began ) the department had been extremely stretched and new procedures had to be put to one side " to get the work done .sx " .sx Councillors decided to hold another meeting behind closed doors when representatives from the Royal Scottish Society for the Prevention of Cruelty to Children could give more details .sx Fewer treated from NHS waiting lists .sx David Brindle , Social Services Correspondent .sx FEWER patients are being treated from hospital waiting lists , official figures revealed yesterday as the Government congratulated itself on treating more patients than ever before .sx The fall in the number of people receiving in-patient and day-case care was disclosed in the delayed waiting list figures for England for September 1990 .sx Ministers published the statistics to coincide with a Labour-inspired Commons debate on the National Health Service .sx The figures show a fall in the number of patients waiting for treatment , a total 906,400 , and the number of those waiting longer than a year , 202,700 ; a further 51,200 are not counted because they had deferred their operations .sx However , the totals do not tally with those calculated last December by the Guardian and last February by the Health Service Journal , each of which separately obtained the figures which the 14 health regions said they were submitting to the Department of Health for the September count .sx Both these round-ups showed a rise in the number of people waiting .sx On the same basis as the official figures , both the Guardian and the journal produced totals of more than 940,000 , rising from an official total of 912,800 for March 1990 .sx Comparison of yesterday's statistics with those given to the Guardian shows that 13 of the 14 health regions have had their figures reduced markedly .sx Only Mersey is given the same figures as those it originally announced .sx The department said it was possible the figures had changed during the detailed validation process , ensuring they were all presented on precisely the same terms .sx " We are confident that the statistics are correct .sx " .sx The figures reveal that 138,000 patients were taken off waiting lists in the six months to last September 30 " for reasons other than treatment " , reflecting the drive to clear the lists of 'phantom patients' no longer needing or considered to need operations .sx William Waldegrave , Health Secretary , said the figures showed good progress in cutting waiting times .sx There had been a fall of 2.5 per cent in numbers waiting longer than a year , and provisional returns for the period from last September to February indicated a further fall of 12 per cent .sx However , the statistics show that 12,300 fewer patients were treated from waiting lists in the six months to last September .sx Robin Cook , the shadow health secretary , said the figures were the worst September totals on record .sx " It is breathtaking that ministers should be using today's debate in Parliament to congratulate themselves on their stewardship of the NHS .sx " .sx Dr Jeremy Lee-Potter , chairman of the British Medical Association's ruling council , said :sx " The fact that patients still have to wait 21 weeks to get into hospital for treatment and 12 weeks for day surgery demonstrates yet again that the health service has not got enough money to treat patients in a reasonable time .sx " .sx Oil spill reaches Italian beaches .sx Reuter in Genoa .sx SOUTH-EASTERLY winds yesterday blew thick oil from a sunken supertanker on to Italian Riviera beaches which had previously escaped pollution .sx Hundreds of soldiers , volunteers , hoteliers and fishermen worked frantically to scoop up oily slime from beaches after a sudden weather change pushed floating crude landwards , blackening pebbly shores .sx In Rome the environment minister , Giorgio Ruffolo , said that an all-out effort was under way to contain the pollution caused after the 109,000-ton Cypriot-registered tanker Haven blew up last Thursday .sx " We have avoided a catastrophe .sx What we have is just a grave accident , " the minister told reporters .sx Mr Ruffollo said that anti-pollution vessels earlier this week skimmed off just under a third of the 145,000 barrels of crude oil estimated to have leaked into the sea .sx The tanker , carrying more than one million barrels of crude , sank in the Bay of Genoa on Sunday after a three-day blaze .sx " Until now we believed that most of the crude was still inside the tanker .sx Thanks to underwater pictures , we now know that what is left is less than we estimated , " he said .sx Local authorities are promising that the Ligurian coast will be clean in time for the tourist season .sx Liguria earns $2 billion a year from northern European sun-bathers .sx " We are optimistic everything will be cleaned up .sx We won't sleep until it is , " said Giuseppe Monti , a Savona hotel - owner .sx " It would be a terrible blow if it wasn't .sx " Hoteliers in Savona , one of the towns most affected by the spill , say that 10 per cent of foreign tour groups have yet to confirm their bookings .sx In Genoa , renowned for its fine fish dishes , people have shied away from seafood since the Haven sank , apparently convinced that local fish are polluted .sx Infiltrator kills Israeli farmer .sx An Israeli farmer was shot dead and three others injured in a border settlement yesterday by an Arab infiltrator who crossed from Jordan .sx It was the area's second clash in three days .sx The Arab was also killed , writes Ian Black in Jerusalem .sx .sx