Port Sudan, 11 September, 2024. A cholera outbreak is gripping central and eastern Sudan bringing more, death and misery to people already suffering under the country’s brutal war. Médecins Sans Frontières/Doctors Without Borders (MSF)’s 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, 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 multiplied by four.
Cholera cases are not uncommon in Sudan, but this is the second time 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 the spread of cholera.
“The mix of heavy flooding and torrential downpours, combined with the terrible living conditions and inadequate access to drinking water that people, particularly in crowded displaced camps are facing, have created the perfect storm for the spread of this often deadly disease,” says Esperanza Santos, MSF emergency coordinator for Sudan.
In Kassala, heavy rains and river floods have destroyed water and sanitation infrastructure and left both internally displaced communities and Eritrean and Ethiopian refugees living in even more appalling living conditions.
“People are dying from cholera right now; and we are pleading on the UN and international organizations to fund and scale up activities, particularly water and sanitation services, which are crucial to stop the lethal spread of cholera,” says Frank Ross Katambula, MSF medical coordinator.
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. The humanitarian response, frequently obstructed by both warring parties, 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 to respond to the situation, by setting up and running cholera treatment centres and units (CTCs and CTUs) and providing support to existing treatment facilities, in some of the most affected areas and hard-to-reach places. Between the end of August and 9 September, MSF teams treated 2,165 patients in our supported facilities.
Caused by a water-borne intestinal infection, cholera is transmitted through contaminated food , water, or through contact with faecal matter. Cholera can cause severe diarrhea and vomiting, and rapidly proves fatal, within hours, if untreated. But cholera is very simple to treat – rehydration is key.
“One adult male was unconscious [upon arrival to the facility]. Dehydration causes the body to go into shock. 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.
MSF teams are setting up oral rehydration points, trucking drinking water, constructing handwashing points and latrines, distributing hygiene kits and doing health promotion in the affected communities.In Darfur, where no cases have yet been registered, MSF teams are helping to improve cholera preparedness.
Unrestricted rapid access for staff and supplies
After nearly 17 months of challenges and obstructions around the provision of humanitarian assistance in Sudan, MSF calls on the warring parties to allow unhindered access for 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, MSF’s Medical Coordinator.
MSF Australia was established in 1995 and is one of 24 international MSF sections committed to delivering medical humanitarian assistance to people in crisis. In 2022, more than 120 project staff from Australia and New Zealand worked with MSF on assignment overseas. MSF delivers medical care based on need alone and operates independently of government, religion or economic influence and irrespective of race, religion or gender. For more information visit msf.org.au