JUBA/NEW YORK, November 15, 2024—The displacement crisis brought on by the 19-month-old war in Sudan is increasing humanitarian needs across the border in South Sudan, where more than 800,000 people have fled.
In the South Sudanese border town of Renk, in Upper Nile state, a cholera outbreak is putting people who fled Sudan at risk and is also affecting the host community.
Doctors Without Borders/Médecins Sans Frontières (MSF) has set up a 20-bed cholera treatment unit (CTU) at the Renk Civil Hospital in response to the cholera outbreak declared by the Ministry of Health (MoH) on October 28. MSF calls on all organizations in Upper Nile state to help prevent the spread of the disease within the state and beyond.
The MSF-supported CTU has so far received and treated 45 cholera cases, including two deaths. Most of the patients are people arriving from the war in Sudan, where a cholera outbreak was declared in August 2024. However, 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.
“Given the inadequate, overcrowded living conditions and 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 improve the water, sanitation and hygiene situation to prevent further spread of the disease,” said Emanuele Montobbio, MSF’s coordinator for the Renk emergency program. “In the past weeks, up to 800 people are entering Renk daily from Sudan, fleeing from the war in the country.”
Cholera response in Malakal
In Malakal, less than 185 miles 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, whether they stay in Malakal or 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 November 12, less than a week after opening, 65 patients have been admitted to the facility. MSF is also conducting health education initiatives to help curb the further spread of the disease.
Given the increasing number of patients, MSF has established a cholera treatment center (CTC) in Assosa, less than 6 miles away from Malakal Town Hospital, with a capacity of up to 100 beds. MSF teams are treating patients from Malakal’s protection of civilians (PoC) site, which hosts thousands of people in close proximity, heightening the risk of rapid spread.
MSF urges other organizations to quickly establish treatment facilities within the PoC to prevent loss of life.
Risk of spread
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 a wider crisis, as soon as possible,” said Montobbio. “An immediate reactive vaccination campaign is crucial.”
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