Doctors Without Borders (MSF) calls for a quick response and unrestricted access as cholera poses the latest peril in Sudan's war. Cholera in Sudan is gripping central and eastern Sudan, bringing yet more risk, death and misery to people already bruised by the country’s brutal war. MSF emergency teams are supporting by treating patients and providing water and sanitation services.
Ongoing war, floods and now cholera
In August, Sudanese authorities declared a cholera outbreak, which is currently heavily affecting the states of Kassala, Gedaref and River Nile, followed by Al Jazirah and Khartoum. According to the Ministry of Health, over 5,000 cases of cholera and 191 deaths have been reported. In the second half of August, the weekly cases of the disease were multiplied by four.
Cholera cases are not uncommon in Sudan, but this is the second year since the start of the war in April 2023 that the country is faced with outbreaks of the disease. For the past two years, our teams have been actively engaged in emergency responses to mitigate their impact.
“The menacing mix of heavy flooding and torrential downpours with woeful living conditions and inadequate access to drinking water that millions have today, particularly in crowded camps for displaced people, have created the perfect storm for the spread of this often-deadly disease,” says Esperanza Santos, MSF emergency coordinator for Sudan.
In Kassala, for instance, heavy rains and river floods have destroyed water and sanitation infrastructure and put both internally displaced communities and Eritrean and Ethiopian refugees in even more appalling living conditions.
Cholera adds yet another challenge to the crisis in Sudan and to the decimated health system, already struggling with increasing child malnutrition, high numbers of war wounded and regular cases of preventable diseases. Regularly obstructed by both warring parties, the humanitarian response remains far below what is needed.
Case management and water and sanitation
MSF teams in Khartoum, River Nile, Kassala, and Gedaref have mobilized to support the Ministry of Health in responding to the situation by setting up and running cholera treatment centres and units (CTCs and CTUs) or providing support to existing overwhelmed treatment facilities in some of the most affected areas and in hard-to-reach places where cases are upsurging.
From the end of August to September 9, we provided treatment to 2,165 patients in our supported facilities. Cholera, a water-borne intestinal infection, is transmitted through contaminated food or water, or through contact with fecal matter or vomit from infected people. It can cause severe diarrhoea and vomiting, leading to rapid, often fatal outcomes within hours if left untreated. However, cholera is easily treatable through rehydration.
“One adult male was unconscious [upon arrival to the facility]. Dehydration causes the body to go into shock. When the body reaches that point after a few minutes it’s already too late. Doctors were resuscitating him, squeezing liters of fluids in his veins for about five minutes,” recalls Angela Giacomazzi, a Human Resource coordinator in Tanedba, about a patient who fortunately survived. “His face and his breathing were really showing so much panic.”
MSF teams are setting up oral rehydration points, trucking drinking water, constructing handwashing points and latrines, distributing hygiene kits, and promoting health in the affected communities.
In Darfur, where no cases have yet been registered, MSF teams are helping to improve preparedness.
Unrestricted rapid access for staff and supplies
People are dying from cholera right now; hence, we plead with the UN and international organisations to fund and scale up activities, particularly water and sanitation services, which are crucial to stopping the lethal spread.Frank Ross Katambula, MSF medical coordinator
“People are dying from cholera right now; hence we plead on the UN and international organizations to fund and scale up activities, particularly water and sanitation (watsan) services, which are crucial to stop the lethal spread,” says Frank Ross Katambula, MSF medical coordinator.
After nearly 17 months of challenges and obstructions around providing humanitarian assistance in Sudan, MSF also calls on warring parties to allow unhindered access to medical staff and supplies to all the areas in need across Sudan to enable a quick and coordinated response and prevent avoidable deaths.
“There is a risk of running out of essential supplies such as cholera kits in a moment when scaling up the response is urgently needed. We call on the authorities to fast-track and facilitate the delivery of supplies and drugs, as bureaucratic obstacles remain a major challenge,” says Katambula.
