MSF: Urgent action needed to address growing cholera outbreak in South Sudan

The Cholera Treatment Unit (CTU) set up by MSF at Renk Civil Hospital. (MSF photo)

Médecins Sans Frontières (MSF) has set up a 20-bed cholera treatment unit (CTU) at the Renk Civil Hospital in Upper Nile State, in response to a cholera outbreak declared by the Ministry of Health on 28 October and appealed to organizations in Upper Nile State to help prevent the spread of the disease.

According to a press statement, the MSF-supported CTU has so far received and treated 45 cholera cases, and recorded among them two deaths. Most of the patients are people arriving from the war in Sudan, where a cholera outbreak was declared in August 2024. However, the MSF teams have also received patients from the local population of Renk.

Contaminated water sources, open defecation, and overcrowded living conditions due to new arrivals from Sudan pose a significant threat to both refugees and the local community, the medical charity said.

“Given the inadequate, overcrowded living conditions and the continued influx of refugees and returnees from Sudan into [the cities of] Renk and Malakal, there is an imminent urgent need for a response to improving the water, sanitation, and hygiene situation to prevent further spread of the disease,” says Emanuele Montobbio, MSF’s field coordinator for Renk emergency program. “In the past weeks, an average of up to 800 people are entering Renk daily from Sudan, fleeing from the war in the country.”

In Malakal, less than 300 km away from Renk, MSF teams have observed a sharp rise in cholera cases. This is an onward travel destination for many returnees and refugees coming from Renk after fleeing Sudan, some of whom stay in Malakal but many others proceed with further travel to other parts of the country.

“The observed rise in cholera cases in Malakal prompted the establishment of a cholera treatment unit at MSF’s Malakal Town Hospital. As of 12 November, in less than a week, 65 patients have been admitted to the facility,” the statement reads in part. “In parallel, MSF is conducting health education initiatives to help curb the further spread of the disease.”

MSF said that due to the increasing number of patients, they have established a Cholera Treatment Center (CTC) in Assosa, less than 10km away from Malakal Town Hospital, with a capacity of up to 100 beds.

“MSF teams are treating cholera patients from Malakal’s protection of civilians (PoC) site, which hosts thousands of people nearby, heightening the risk of rapid spread,” the statement added: “MSF urges other organizations to quickly establish treatment facilities within the PoC to prevent loss of life.”

With people moving across Upper Nile State and other parts of South Sudan, the cholera outbreak poses a risk of spreading beyond Renk and Malakal.

“The current response in Upper Nile does not match the urgency of the situation. We’re calling for stronger, collaborative efforts from all organizations in Renk, and beyond particularly in Malakal, to manage the spread and prevent a further and wider crisis, as soon as possible,” says Montobbio. “An immediate reactive vaccination campaign is crucial.”