People being treated for cholera under a tree at a cattle camp in Akobo. (-)

JUBA (Eye Radio) – Six months after the Ministry of Health declared a cholera outbreak, the country has so far confirmed over 45,000 cases and over 800 fatalities across nine states and two administrative areas – with children being the most affected.

South Sudan first declared the outbreak in October 2024 after recording cases in Upper Nile State – which has become a major transit point for refugees and returnees from Sudan. The crisis has rapidly spread across the country.

Dr. Kediende Chong, Director General for Preventive Health Services and Emergency Response, said the most affected age group are children from 5-14 years and infants from 0-4 years of age.

“We still have cases reported across 9 states out of 10 and two administrative areas. We have so far reached around 45,000 closes to 46,000 cases of cholera countrywide,” he said.

“We have over 800 mortalities across all these 43 counties that have reported cholera outbreaks. And the most affected age group is 5 to 14. Which forms the majority, followed by 0 to 4 years.”

Citing the incident report, he revealed that new epicenters have recently reported decline in cases. He noted that 21 counties have so far completed immunization, while the vaccination campaign is yet to begin in Pibor Administrative Area.

According to him, over four million people from the affected locations have been vaccinated – although it is yet to roll out vaccination in some counties.

He said Nyirol in Jonglei State and Pibor in GPAA recorded the highest cases – while Western Equatoria and Abyei Admirative Area are the only regions still free of cholera since the outbreak.

“We also have more females affected than males. The last counties that have reported higher cases have been Nyirol and Pibor. Luckily, the new cases have also started to decline in those two locations over the last week.”

The World Health Organization (WHO) said the ongoing influx of people fleeing the conflict in Sudan increases the risk of infectious disease outbreaks like cholera and continues to exert pressure on an already fragile health system,

Persistent chronic gaps in healthcare, funding cuts, dire water and sanitation conditions and gaps in other essential services in South Sudan have also created the perfect conditions for cholera to spread, Médecins Sans Frontières (MSF) said.

MSF has added that violence in Upper Nile State is worsening the cholera outbreak as it hinders access to medical care for several remote villages – where people nurse the disease at homes without lifesaving oral rehydration solutions.

Save the Children said on April 9, that five children with cholera were among eight people who perished while on a three-hour difficult journey to seek medical treatment in Akobo County in Jonglei State, following the closure of their local health services over lack of funding.

The UK-based charity said the minors from a remote part of Akobo, along with three adults, died last month while trekking from their village in searing heat to seek treatment at the nearest remaining health facility in Akobo town.

The group walked in the blazing sun where temperatures reached as high as 40 degrees Celsius, and no access to clean water, shade or medicines, the organization said.

Save the Children staff said half the children they see in the clinics still operating across Akobo County are suffering from malnutrition – one of the biggest killers of children worldwide, which damages immune systems and leaves children more vulnerable to diseases like cholera.

It added that the escalating security situation characterized by military confrontations in Upper Nile further jeopardize humanitarian access in a country where 78% of the population is in need of aid.