Health authorities in Sudan have sounded the alarm as cholera spreads strongly, especially in areas affected by heavy rains and floods.
Authorities have recorded more than 388 deaths and 13,000 infections in the past two months. The disease has been detected in 10 of the country’s 18 states, including Kassala, Gedaref, Red Sea, Northern, and River Nile states. These are areas that have reached the danger stage and require urgent intervention.
The cholera epidemic in Sudan has worsened alarmingly since mid-2024, with the Federal Ministry of Health officially announcing the outbreak on August 12, 2024, following a new wave of cases that began on July 22, resulting in 8,457 cases and 299 deaths in eight Sudanese states by mid-September.
This outbreak comes at a critical time, as Sudan is suffering from multiple crises that are significantly impacting its health infrastructure.
Worsening health crisis
The cholera outbreak coincided with the rainy season and floods, making it more difficult to control the spread of the disease.
According to statements by Sheldon Yate, UNICEF Representative in Sudan, the current situation represents a race against time to prevent the exacerbation of infectious diseases that may spread rapidly as a result of these harsh climatic conditions.
With an estimated 15 million people in 14 states at risk of flooding, and 3.1 million people at risk of cholera between July and December 2024, Sudan is facing a serious health crisis.
The spread of cholera is due to the deterioration of water and sanitation infrastructure, which has been made worse by the war that has been going on for several years.
With national vaccination rates down to 50% from 85% before the war, the most vulnerable groups, especially children under five, are at risk not only of cholera, but also of other epidemic diseases such as measles, malaria and dengue fever.
An estimated 3.4 million children under the age of five are at risk of these diseases due to low levels of immunization.
These challenges come amidst security instability and war that has destroyed more than 70% of hospitals in conflict areas.
This destruction, coupled with months of unpaid health workers, has reduced Sudan’s ability to respond effectively to these health crises. Conflict has also hampered the delivery of vital supplies such as vaccines.
Sudan needs international organizations to intervene to implement cholera vaccination campaigns Warning
Sonali Korde, assistant director of the Office of Humanitarian Assistance at the United States Agency for International Development (USAID), warned of the deteriorating situation in Sudan, telling Alhurra TV that “25 million people are beginning to suffer from hunger, and there are atrocities being committed every day that must stop. Cholera is the latest development we see in this conflict, as we have recorded 11,000 cases, but the actual numbers may be much higher.”
Kurdi explained that the death rate from cholera is “above normal”, while Sudan suffers from food insecurity. She pointed out that women “bear the brunt” of the conflict, and are subjected to “horrific violations”.
Kordi noted that the United States has provided $1.6 billion in humanitarian assistance to Sudan in 2023, but more funding and resources are urgently needed. “We need to allow the movement of aid workers to reach all people, especially children, to provide food, medicine and shelter,” she said.
Kordi pointed out that natural disasters, such as floods, hinder relief efforts, especially in Darfur, in addition to man-made obstacles such as bureaucracy and visas that hinder the entry of relief teams.
Kurdi stressed that the best way to prevent the spread of the disease in Sudan is to provide clean water and health infrastructure in the camps, in addition to providing food, health care and vaccinations, as famine and disease continue to spread in the crowded camps.
The US official called on the actors in Sudan to lift these obstacles immediately, stressing that the majority of these restrictions are man-made and can be removed.
In this context, the United Nations Children’s Fund (UNICEF), in cooperation with the Sudanese Ministry of Health and the World Health Organization, launched a cholera vaccination campaign in Kassala.
The second round of this campaign was launched in September 2024 and will last for five days, and 404,000 doses of oral cholera vaccine were delivered to Sudan.
The campaign includes many other preventive activities, such as distributing home water treatment tablets and establishing oral rehydration centres to ensure that those infected receive appropriate treatment.
In addition to immunization efforts, UNICEF is working to raise awareness in local communities about ways to prevent cholera, through media and awareness campaigns targeting the populations most at risk of infection.
So far, more than 1.9 million people have been supported through chlorination of water sources in affected states.
The effect of floods on the spread of disease
Heavy rains and floods in Sudan have worsened the health situation, with contaminated water helping cholera spread more quickly.
In addition, the ongoing conflict conditions pose a major challenge to delivering medical supplies and humanitarian aid to the most affected areas, further complicating efforts to contain the spread of cholera.
Experts expect Sudan to continue to face the risk of cholera and other epidemic diseases unless urgent action is taken to improve health systems and basic facilities.
Kassala and Gedaref states in eastern Sudan are the most affected by cholera
Sheldon Yate points out the need to invest in health, water and sanitation systems to address these crises, especially with the floods expected to lead to a greater spread of cholera among children and vulnerable families.
The deteriorating nutritional situation also puts children at greater risk of infectious diseases such as cholera.
Amid ongoing conflicts and collapsing infrastructure, improving health and nutrition conditions in Sudan requires broad international cooperation, according to health care experts.
Under these difficult circumstances, international organizations say that Sudan needs coordinated efforts from the international community and humanitarian organizations to control the spread of cholera and other epidemic diseases.
With environmental and humanitarian crises expected to continue, investing in health infrastructure and vaccination campaigns is a critical step to protect children and families from the threat of these deadly diseases.
