What caused the cholera epidemic in Sudan?

More than 350 cases of cholera have been reported in a new outbreak in Sudan in just a few weeks.

Difficulties in reaching and registering victims during the ongoing humanitarian crisis caused by the country’s civil war have led experts to speculate that many more people than these may have been infected.

The health minister, Haitham Mohamed Ibrahim, said at least 22 people had died from the disease and declared a cholera epidemic after several weeks of heavy rain, which contaminated drinking water.

The cholera epidemic is the latest crisis for Sudan, where the war between the army and the Rapid Support Forces (RSF), a paramilitary group, has been spreading around the country since April 2023.

Cholera is not new to Sudan. In 2017, the last outbreak killed at least 700 people and infected nearly 22,000 in less than two months.

Apart from this latest outbreak, the World Health Organization (WHO) has reported 78 cholera deaths between the beginning of this year and July 28 in Sudan, with around 2,400 people infected. throughout the country as a whole.

But what caused this latest epidemic, and how widespread is it? Here’s what we know so far:

Where did cholera originate?

Sudan’s health department first reported the latest outbreak two weeks ago, when 17 people died of the disease and 268 cases were reported in Kassala, El Gezira and Khartoum. This has increased to 22 deaths and 354 cases.

Sudan has been experiencing the heaviest rains of the season since June, with floods that have killed many people. According to the International Organization for Migration (IOM), more than 20,000 people have been displaced by floods in 11 of Sudan’s 18 regions since June.

Water supplies are also contaminated with cholera due to flooding mixed with sewage.

WHO spokesman Tarik Jasarevic told the Associated Press that the data show that most of the cases detected are in people who have not been vaccinated against cholera.

He added that WHO is working with the Sudanese health authorities and its partners to implement a vaccination campaign across nine regions in five provinces where the disease has been reported.

What is cholera?

Cholera is a disease caused by bacteria and is usually spread through contaminated water. It is spread when people drink contaminated water, when people with open wounds come into direct contact with contaminated water, and, sometimes, when they eat raw snails.

It cannot be passed from one person to another, so mere contact with a person suffering from this disease is not dangerous.

The disease causes severe diarrhea and dehydration. If left untreated, cholera can kill within hours – even in previously healthy people.

Although the disease may not cause illness in everyone exposed to it, infected people can still pass the bacteria on to their stools, contaminating food and water. This is a particular problem where there are no effective sanitation facilities.

How is cholera treated?

Treatment for cholera involves rehydration to replace lost fluids.

According to the Mayo Clinic, a medical center in the United States, without rehydration, “half of the people suffering from cholera die. With treatment, the incidence drops to less than 1 percent”.

Other treatments include intravenous fluids, antibiotics and zinc.

Children under five have the highest rates of infection, but all age groups are at risk, especially those who are malnourished, immunocompromised or need a first injection.

Why is cholera spreading in Sudan?

Sudan’s war has damaged and destroyed much of the country’s public infrastructure, including sewage and water systems, and has turned many areas, including the capital, Khartoum, into war zones.

Many hospitals and medical centers have been forced to close their doors as they have little or no equipment.

Although the number of dead people caused by the war is still uncertain, some estimates, according to the US ambassador to Sudan Tom Perriello, are higher than 150,000 people so far.

In June, IOM reported that more than 10 million people have been displaced from Sudan by the war. Cholera spreads rapidly as populations move and sanitation and hygiene are poor, making war zones ideal climates for the disease to spread.

On top of this, according to the World Food Program (WFP), the season of heavy rains has worsened the already dire situation, making it difficult for aid convoys to pass through the roads. muddy, flooded.

The WFP reported on Monday that the organization initially planned to reach half a million people, but the convoys “are now stranded on the Chad side, with heavy rain making it impassable – the trucks some have been stuck for up to two weeks”.

“Preventable diseases [are spreading] urgently in areas where essential services, such as clean water and sanitation systems, have been damaged by conflict and overcrowded displacement camps,” WFP said.

Will Sudan’s cholera epidemic worsen?

According to the WFP, the heavy rain is expected to continue until September.

Some reports warn that “the flood could exceed the historic floods of 2020 that hit Khartoum,” the organization said.

Although the WFP has warned of the dire humanitarian situation in the country, the war continues.

On Sunday, the army said it would send a delegation to meet US officials in Cairo after US pressure to intervene in ongoing peace talks in Switzerland, aimed at ending the conflict and humanitarian crisis. that followed.

The director of the John Hopkins Center for Public Health, Paul Spiegel, also told Al Jazeera that cholera “thrives in times of conflict and forced migration”.

“These conditions make it very difficult to control cholera outbreaks, leading to rapid transmission and dire consequences for affected communities,” he said.

Spiegel added that while operational conflicts make traditional methods of disease control difficult, health workers “must be flexible and innovative, and take advantage of different situations.” ” within Sudan to reduce the spread of disease.

Are some diseases increasing in Sudan?

On Friday, WHO official, Margaret Harris, said that dengue and meningitis infections are also increasing in Sudan due to poor living conditions due to the 16-month war.