
Juba-Médecins Sans Frontières (MSF) has called on South Sudan authorities and international humanitarian organizations to take urgent action to combat the rapidly worsening cholera outbreak in Malakal of Upper Nile State.
The crisis, which began with the first suspected case on November 5, has escalated significantly, overwhelming the already limited response capacity.
By December 3, the number of reported cholera cases in Malakal had surged to 737, with MSF treating 646 patients—an astounding 87% of all cases.
Albert Stern, MSF emergency response coordinator in South Sudan, said persistent gaps in essential services have created the perfect conditions for the disease to spread.
“In just four weeks, MSF teams in Bentiu have treated over 1210 cholera patients, many of whom arrived in a critical condition due to severe dehydration, and tragically 92 lives have been lost in Unity State,” Stern said in a statement issued on Monday.
He said the cholera outbreak has intensified in Juba’s former Protection of Civilians (PoC) camps, where an estimated 63,000 people live.
He said in the past weeks alone, MSF has treated over 1,700 suspected cases at its cholera treatment centers (CTC) in the camps with 25 dead.
“There is serious concern that the numbers will continue to rise due to the dire sanitation conditions,” he said.
For his part, Mamman Mustapha, MSF head of mission in South Sudan, said, “What we are witnessing is not just a cholera outbreak—it is the result of systemic neglect.”
Mustapha said the camps were overwhelmed with mountains of uncollected waste, which rapidly worsened the cholera outbreak.
“As a result, drinking water has become contaminated, and patients are arriving at our cholera treatment centers in a critical condition—many are at death’s door,” he said.
“Without immediate action to address the dire conditions that people are living in, we expect cholera cases to skyrocket in the coming days and weeks.”
Nyaluak Kuol and her two-year-old son, Tesloach Manah, were treated in MSF’s cholera treatment center in one of Juba’s camps.
“We live in an overcrowded camp where the situation keeps getting worse. For nearly three weeks, there has been a severe water shortage,” says Kuol.
“Today, I’m relieved that my child is being discharged, but deep down, I fear we will be back. No matter how hard I try to keep my home clean, the entire camp is contaminated.”
The outbreak, first declared in Renk on October 28, 2024, has spread beyond Upper Nile State to areas such as Bentiu in Unity State, Aweil in Northern Bahr el Ghazal State, and even the capital, Juba.
The situation in Renk—a key entry point for refugees and returnees from Sudan—has been exacerbated by inadequate living and hygiene conditions, fueling the spread of the disease.