Cholera outbreak worsens humanitarian crisis in South Sudan

• Refugee camps are already crowded and humanitarian agencies had warned outbreaks were likely.
• Since fighting erupted in Khartoum, in April 2023, more than 745,000 people have crossed the frontier.

At least 23 people have died due to a cholera outbreak in 18 counties across South Sudan, the National Ministry of Health has reported.

In an emergency meeting chaired by Hussein Akol, the the Vice President for Service Cluster, Acting Health Minister Hoth Mai confirmed that the ministry has recorded 1,745 cases since the outbreak was declared on October 28.

“It’s alarming. We call on the public to observe good hygiene and sanitation. Most of our people get water from rivers sometimes. We urge them to always boil it,” said Hoth.

Two weeks ago, the National Ministry of Health declared a cholera outbreak in Renk, Upper Nile State, following reports of 44 suspected cases and six laboratory-confirmed cases on October 23.

Officials in South Sudan admit the mounting humanitarian crisis in the country may be frustrating efforts to keep hygiene.

South Sudan, which already has two million people displaced by war has now received more than 160,000 refugees from Sudan.

This number includes South Sudan returnees who had fled their country earlier due to civil war in the south but have been forced back after conflict erupted in the north.

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The camps hosting these refugees are already crowded and humanitarian agencies had warned outbreaks were likely.

“An immediate scale up of activities, including accelerating a vaccination campaign, is needed to contain the outbreak and prevent further suffering,” said medical charity group MSF in South Sudan on Sunday, admitting the rising cases had put a strain on available services at clinics.

The first suspected case was identified on September 28 when the County Health Department received a report of a potential cholera case at a point of entry in Renk, Upper Nile state, a border town between Sudan and South Sudan.

But the new wave began proper last month in the same place, before spreading like wildfire to other states.

In response, the Ministry of Health, in collaboration with the World Health Organization (WHO), UNICEF, and other partners, said they were taking steps to manage the outbreak, according to Health Minister Awel Deng.

“The Ministry of Health is aware of the difficult conditions refugees and returnees face, such as overcrowding and poor water and sanitation, which can lead to outbreaks; however, the Ministry is working with health and water sanitation and hygiene cluster partners on the ground to ensure that the risk of the outbreak spreading is minimised,” said Deng.

“The Ministry of Health and WHO have taken steps to properly manage cases reported, ensuring that every contact on the ground is followed. We urge communities to practice good and safe behaviors, such as consistent hand washing, use of latrines, and proper food handling throughout the outbreak season,” added Deng.

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Dr Humphrey Karamagi, WHO Country Representative in South Sudan, commended the Ministry of Health for its timely declaration of the outbreak.

“The announcement enables the public to take prevention measures, helps health partners take the necessary steps to contain the outbreak, and unlocks the required resources for fighting the outbreak,” said Karamagi.

He noted that WHO has pre-positioned essential medical supplies for cholera management in Renk and Malakal, Upper Nile State, and reaffirmed the organization’s support for South Sudan’s government and partners in controlling the outbreak.

Dr Karamagi reiterated WHO’s commitment to supporting the Ministry of Health in enhancing disease surveillance, improving response coordination, and ensuring the availability of medical supplies.

The South Sudanese border town of Renk, the epicenter of the cholera outbreak, serves as both a home to local host communities and a critical entry point for hundreds of people fleeing the war in Sudan each day.

Since fighting erupted in Sudan’s capital, Khartoum, in April last year, more than 745,000 people have crossed the frontier. Over half a million of these are returning South Sudanese who had fled to Sudan for safety years ago when the south was engulfed in conflict.