The Minister of Health in Jonglei State, Angok Gordon, said that so far more than 70 people have died of Cholera in Duk County.
“The number reported in the facilities up to last evening is actually 97 cases,” he said on Monday, April 3. He added that “22 have died”, 65 are still being treated at the health facilities and the rest was discharged.
“You know that people are scattered,” Gordon said, adding that some are in cattle camps and others hide in the swamps. Therefore, he explained, many communities are unable to provide accurate figures. “They are talking of about 54 death cases,” out of 127 cholera infected people.
It is estimated that 30,000 to 40,000 people reside in the swamp areas during dry season. However, due to widespread food insecurity, more people have been driven into the swamps, according to the minister.
“You know people in the swamps drink the same water, bath in the same water and even sometimes defecate in the same. So it is really a challenge if you are on those islands […], you cannot even dig a borehole,” Gordon said.
The Ministry of Health in Jonglei State is working on an intensified awareness campaign in the areas affected, mainly the swamps and cattle camps, where hygiene and sanitation practices are poor.
Africa Arise Initiative for Development (AAID), a local organisation operating on one of the islands, scales up activities to promote hygiene and sanitation.
“We are going today (Monday, April 3) to the island to provide them with hygienic kits. We have hygiene promoters there whom we have trained on those islands,” AAID’s Garang Kuol said.
Although cholera is highly infectious, it is also highly preventable and manageable. Therefore, organisation like AAID promote basic guidelines like washing hands regularly with clean water and soap (or ash), drinking only boiled water and cooking all food consumed.
Cholera risk factors are contaminated water sources (shallow wells, river water, unprotected water sources), lack of adequate latrines and open defecation.
Dead bodies are also highly infectious therefore some burial practices increase the risk. These risk factors are common across South Sudan and are aggravated by the rainy season.
The majority of cholera infections are mild, resulting in no visible symptoms and with only about one in 20 people becoming critically ill.
However, infected persons can carry and transmit the bacteria one to four weeks after first becoming infected, and a few carry the bacteria for several months.
The classic symptom of cholera is an acute, watery diarrhoea that looks like rice, or maize-meal water, sometimes accompanied with frequent vomiting.
Some communities believe that diarrhoea is caused by an excess of water in the body and therefore deny water to anyone suffering from diarrhoea.
Contrary to this, managing cholera (and diarrhoea in general) requires the patient to continuously drink a water solution containing oral rehydration salts or a salt and sugar mix to replace what is lost in the body, until all the bacteria is washed out of the body and the diarrhoea stops.
While the spectre of a cholera epidemic looms large with every rainy season in South Sudan, years of violent conflict have hampered progress in implementing a systematic cholera prevention strategy.
Photo: A woman takes an oral cholera vaccine in a camp for internally displaced people in South Sudan. (WHO/Ali Ngethi)