MSF responding to cholera outbreak in Burbeiye Cholera treatment Unit (CTU) that MSF set-up during the early days of the outbreak to handle the influx of patients, and provide lifesaving rehydration therapy, infection prevention, and patient monitoring. (Photo: MSF)

The Médecins Sans Frontières (MSF) has said violence in Upper Nile State is worsening the cholera outbreak as it hinders access to medical care for several remote villages in Akobo County where 1,300 cases have been recorded in just one month.

Violence erupted in Nasir on March 4 between SSPDF and heavily armed local youths, who overran a military base and later assassinated a top commander and a United Nations staff during evacuation efforts.

The incident – which erupted barely hours after a high-level presidency meeting resolved to ease tension in the region – has raised fears that it may derail gains made in the 2018 peace agreement that ended five years of devastating civil war.

In a press statement, the medical charity MSF said thousands of people are being displaced and losing access to healthcare and proper sanitation – a situation that it describes as key factors driving the rapid spread of cholera.

MSF said the armed clashes between the government forces and armed groups in Upper Nile state since February 2025, has led to increased cross-border movements with refugees and injured people fleeing to Ethiopia.

“Violence and new hotspots in South Sudan’s Upper Nile and Jonglei states are pushing hundreds across the border to Ethiopia in search of urgent medical care, where a cholera is rapidly spreading across western part of the country, endangering thousands of lives,” said the statement.

MSF said it is delivering lifesaving care in Malakal, Ulang, and Akobo, supporting the Ministry of Health in containing the disease.

The charity also received 23 patients in Ulang who were wounded in the clashes. MSF added its teams are responding on both sides of the border treating patients, providing clean water, and raising awareness about the disease.

MSF is also distributing thousands of water purification sachets and ensuring access to clean drinking water for affected local communities and those arriving from South Sudan in Ethiopia’s Moan, Burbeiye, and Matar areas.

The charity further said it is expanding its cholera response along the Sobat corridor despite ongoing fighting and access challenges.

“An urgent support to health facilities, provision of safe water and cholera vaccination campaign is needed in the affected areas to stop the spread of the disease,” it said.