Reliefweb publishes latest Situation Overview on cholera in Sudan
16 Jan 2025 by The Water Diplomat
The latest Situation Overview produced by Relief web on the cholera situation in Sudan was published on January 2nd of this year, showing recurrent outbreaks in Sudan as far back as 2017. In that year, disrupted health services and poor sanitation led to approximately 700 deaths and 22,000 infections in two months. During the subsequent 2019–2020 outbreak, heavy rains and flooding contaminated water supplies, leading to hundreds of cases across several states. The outbreaks are, in addition to conflict, driven by environmental factors and inadequate WASH and health infrastructure. Cholera spreads primarily through contaminated water, with poor sanitation making many areas in Sudan highly susceptible to outbreaks.
Since the start of the war in April 2023, numerous outbreaks have been reported but numbers are unreliable due to challenges in accessing and reporting data (relative lack of communications network, with limited network availability), as well as limited access to and slowed community referrals to health facilities. According to the Assessment Capacities Project ACAPS, an objective and evidence-based information provider that works with Reliefweb, outbreaks across the country took place in July 2023, July 2024, followed by the latest outbreak in October 2024. Reported cases have increased by 33.3% from October to November. By 16 December, the highest number of reported cases were in Aj Jazirah (11,179), Al Qadarif (9,745), Kassala (7,364), White Nile (6,646) and River Nile (5,824) districts, caused mainly by flooding due to an unusually heavy rainfall season. The number of casualties from the last outbreak amounts to more than a thousand deaths.
The Relief web Situation Overview shows that particularly Internally Displace Person (IDP) populations are at risk for cholera, due to the conditions in the overcrowded displacement sites and settlements without adequate water and sanitation facilities, clean water, and sanitation. Over 70% of cholera cases are occurring in infants and adults up to age 50, with a higher mortality rate in individuals aged 70 and above (14.56%), closely followed by ages 60-69 and 20-29 (12.09%). In October of last year UNICEF warned that over 3 million children in Sudan are at heighted risk of cholera and other deadly diseases in Sudan. The high mortality rate may be attributable to weakened immune systems, preexisting conditions such as cardiovascular or kidney diseases, which worsen dehydration, and limited access to timely healthcare, which delays treatment.
According to Reliefweb’s 2024 Review, displacement dynamics in Sudan were caused by 389 incidents during 2024, as reported by DTM Early Warning Flash Alerts. These included attacks and conflict (226), floods (130), and fire (31). The effect of flooding is mostly negative when it impacts on human settlements, causing damage to infrastructure such as sewerage, wastewater and electricity. A secondary effect of flooding is the contamination of floodwater with chemicals and sewerage, causing a severe threat to the health of people contracting waterborne diseases, such as cholera, diarrhoeal diseases, shigella, typhoid, hepatitis A and E, and poliomyelitis. Fires in displaced persons settlements are leading to death, burn injuries, displacement, and destruction of shelters.
In a Relief web HYBRID National Health Cluster Coordination Meeting on November 13, presentations underscored the fragile state of health systems in the region, the challenges posed by communicable diseases, and the inadequacies of current reporting mechanisms and disease surveillance systems. 70-80% of health facilities in areas worst affected by the conflict are not functioning. Violent attacks on healthcare facilities have intensified, with 116 incidents reported since the outbreak of hostilities on 15 April 2023, resulting in 188 deaths and 140 injuries.
In the meeting a renewed commitment was made to strengthen coordination at both field and municipal levels, with action points identified for scaling up efforts and integrating various services: deploying mobile clinics and supplying health, nutrition, and WASH resources as well as Cholera Vaccines (OCV).