A cholera outbreak in central and eastern Sudan is bringing yet more risk, death, and misery to people already bruised by the country’s devastating war. Emergency teams from Doctors Without Borders/Médecins Sans Frontières (MSF) are treating patients and providing water and sanitation services to people affected by the war.
In August, Sudanese authorities declared a cholera outbreak, which is currently heavily affecting the states of Kassala, Gedaref, 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, weekly cases of the disease increased fourfold.
Cholera cases are not uncommon in Sudan, but the current outbreak is taking place in a country torn by 17 months of war, making it more difficult to prevent cholera and provide lifesaving care.
“People are dying from cholera right now, and we plead with the UN and international organisations to fund and scale up activities, particularly water and sanitation services, which are crucial to stop the lethal spread,” said Frank Ross Katambula, MSF medical coordinator.
After nearly 17 months of challenges and obstructions of the provision of humanitarian assistance in Sudan, MSF also called on warring parties to allow unhindered access to medical staff and supplies to all areas in need across Sudan to enable quick, 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,” said Katambula. “We call on the authorities to fast-track and facilitate the delivery of supplies and drugs, as bureaucratic obstacles remain a major challenge.”
Cholera is a waterborne intestinal infection transmitted through contaminated food or water or contact with faecal matter or vomit from infected people. Cholera can cause severe diarrhoea and vomiting and can rapidly become fatal within hours if not treated. But cholera is very simple to treat—rehydration is key.
MSF teams in Khartoum, River Nile, Kassala, and Gedaref have mobilised to support the Ministry of Health’s response by setting up and running cholera treatment centres and units and providing support to existing overwhelmed treatment facilities in some of the most affected areas and in hard-to-reach places where cases are surging.
In Tanedba, Gedaref state, MSF runs a 50-bed cholera treatment unit in its Tanedba Hospital and supports three primary health care centres in hard-hit villages that provide water chlorination and distribution.
MSF built a 30-bed cholera treatment unit in Gedaref city close to a camp for displaced people, which provides outpatient treatment for mild cases through oral rehydration points in the community, including building emergency latrines, providing potable water, distributing soap, and handling patient referrals.
MSF is providing support to set up and run a 100-bed cholera treatment centre in Atbarah, the most affected town in River Nile state.
MSF is setting up four oral rehydration points in Kassala state, building and desludging 62 latrines. We have distributed non-food items to 500 families, provided drinking water, and created washing points in three displacement camps.
In Kassala, we support the 200-bed cholera treatment centre at the Teaching Hospital, helping with case management and oral rehydration points.
In Wad El Hilu, MSF is helping a rural hospital cope with a surge of cases in the southern part of the district. Between the end of August and September 9, we treated 2,165 patients in facilities we support. In Darfur, where no cases have yet been registered, MSF teams are helping to improve preparedness.
“The menacing mix of heavy flooding and torrential downpours with woeful living conditions and inadequate access to drinking water that millions face today, particularly in crowded camps for displaced people, have created the perfect storm for the spread of this often-deadly disease,” said Esperanza Santos, MSF emergency coordinator for Sudan.
In Kassala, heavy rains and flooding rivers 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 its decimated health system, which is already struggling with increasing child malnutrition, high numbers of war-wounded patients and regular cases of preventable diseases. The humanitarian response is regularly obstructed by both warring parties, and remains far short of what is needed.
“One man was unconscious [upon arrival to the facility],” recalls Angela Giacomazzi, a human resources coordinator in Tanedba, about a patient who fortunately survived. “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 litres of fluids in his veins for about five minutes. His face and his breathing were really showing so much panic.”
MSF teams are setting up oral rehydration points, trucking in drinking water, constructing handwashing points and latrines, distributing hygiene kits, and promoting health in the affected communities.
