JUBA, SOUTH SUDAN – 27 FEB 2025 –South Sudan is facing an alarming cholera outbreak, with over 26,800 infections and 455 deaths across 39 counties in eight states. The crisis continues to escalate as new cases emerge every day.
With severe flooding, ongoing conflict and a fragile health system, communities now face the added threat of the rapidly spreading and deadly outbreak.
This recent crisis comes when South Sudan’s health system, critically overwhelmed and reliant on shrinking donor support, is crumbling. A staggering 27% of health facilities in the country are nonfunctional. Moreover, dwindling international financial support has left critical response efforts severely underfunded, at less than 10%, leaving communities dangerously exposed to infection and the threat of death.
“We are witnessing a humanitarian catastrophe,” said Abel Whande, CARE South Sudan Country Director.
“Poor and most cases unavailability of appropriate sanitation infrastructure coupled with a near-collapsed health system has created a catalytic environment for the spread of this deadly disease. In some areas, only seven doctors are serving over 200,000 people. Only 20% of those who fall sick seek hospital treatment, while the overwhelming majority remain at home. As a result, women and girls, as primary caregivers, are exposed to the disease while tending to sick family members. We are battling cholera while fighting for the survival of communities already devastated by hunger and economic hardship, leaving families unable to afford basic necessities or medical care,” he added.
The outbreak was first detected in September 2024 in a border town in Renk state, a major entry point for refugees fleeing conflict in Sudan. Since the conflict started in April 2023, over 1 million people have crossed into South Sudan. Cases have spread rapidly overwhelming a donor-dependent health system that is struggling to respond. With so many health facilities nonfunctional and health workers left unpaid for over 14 months, access to treatment is dangerously limited.
Grave matter
Cecilia who lives in Akobo, where cholera cases are surging, expressed her grave worries about the health of her 13-month-old daughter, Margaret.
“I am so scared because she keeps getting sick,” she said. Margaret had previously been admitted to the hospital for malnutrition and recovered. Now, she is back—this time battling cholera. The lack of clean water in Akobo is fueling the spread of the disease, hitting women and young children the hardest.
Women and girls who face a heightened risk of infection are bearing the brunt of the outbreak. This is due to their roles as primary caregivers and water collectors. Currently, they account for more than half of cholera cases. Those displaced in overcrowded camps are also enduring increased threats of violence, with poorly lit and unsafe sanitation facilities adding to their vulnerability. Pregnant and breastfeeding women are especially at risk, as cholera can lead to life-threatening complications if left untreated.
Unsafe water sources, lack of proper sanitation, and widespread displacement have created the conditions that have allowed cholera to thrive. The outbreak has been further aggravated by severe flooding, which, in November 2024, displaced over 379,000 people and destroyed critical sanitation facilities. With no access to clean water, many people have no choice but to use what is available for drinking and household needs. Some of the water sources were contaminated, further fueling the spread of the disease.
“The cholera outbreak is escalating at an alarming rate, and without urgent funding, more lives will be lost,” said Abel Whande. “CARE South Sudan is calling on donors and the international community to prioritise funding for cholera response efforts and an immediate and significant increase in international funding to support vaccination campaigns and implement comprehensive community-centered interventions. This will ensure communities have access to safe water, sanitation and medical care to prevent further loss of life,”
CARE South Sudan, alongside the Ministry of Health, is combatting the cholera outbreak through emergency health and water and sanitation interventions, including a newly established treatment unit at the Akobo Teaching Hospital. Community engagement, active surveillance.
