South Sudan: 'People in our community are fearful because this cholera outbreak will cost many lives'
Atong Mark with her daughter Anyang in the cholera clinic at Malek Miir health centre in South Sudan Picture: Eugene Ikol, Concern Worldwide
It is easy to pick out the cholera clinic in this South Sudanese health compound, the only one with white and red tape criss-crossing the front, warning people away.
Yellow cholera prevention tips posters are pasted around, corners curling in the 37 degree heat.
Malek Miir centre saw a surge of cholera patients in mid-February and by the morning of March 12 had treated 178 patients. By evening it was 180.
Among them 15 people had died including a young child the day before the visited.
Atong Mark, aged 37, sat on a pallet-bed watching her 14-year-old daughter Anyang as she lay listlessly on the bed.
“The child got sick yesterday, she was complaining about stomach pain and last night she had watery diarrhea, and this morning she started vomiting so I brought her to the hospital,” she said, through a translator.
The clinic lacks a laboratory but staff have seen so many cases they know what to treat.
Atong has five children including a three-month-old baby but her eldest daughter is the one who helps the most.
"So I’m confused now, what can I do,” she said.
When asked about her husband, she rolled her eyes and explained he is an alcoholic.
This centre is in northern Bahr El Ghazal state which shares a border with Sudan – a country in civil war since April 2023.
Atong is South Sudanese but had been living in Sudan before the fighting.
“On my journey when I came from Sudan we faced a lot of problems,” she said, including losing much.
She added: “What shall I do, shall I stay here or I go somewhere else? I don’t know where I can go, I lived in Sudan but there is a war in Sudan and now I’ve come back from there and I don’t know what shall I do.”
In the next row, 10-year-old Aluth dozed uneasily in her bed, her mother Bavita Nybvol waving her hand to move hot air around her face.
The Irish Aid-supported clinic expects patient numbers to spiral next month.
Cholera is spread through contaminated water, and by hand contact. It is extremely infectious, an outbreak in Ireland in 1832-33 saw 76% death rates in some areas.
Later administrator for the region Ater Deng Akeech explains why water is such a challenge.
“There are no (clean) drinking water sources around here,” he said, although about 10,000 people live in the community. “The residents go to the river to fetch drinking water, some of them also use a shallow well here for drinking.”
Throwing his hands in the air, he said: “The Kiir is not clean water, but there is nowhere to get clean water.”
Unusual severe flooding late in the rainy season during October and November caused widespread damage to wells and bore-holes.
“Even myself now, I am fearful, and people in our community are fearful because this cholera outbreak will cost many lives,” he warned.
Vaccinations – led by the World Health Organisation – are kicking off but globally there is a shortage of this critical vaccine.
Field officer for this state with UN refugee agency, UNHCR, U Aye Maung said: “The health systems in South Sudan are very very fragile.”
Speaking in his office, he explained: “Most of the boreholes were submerged during the floods, so that needs to be fixed.”
Another obstacle is the lack of sewage systems for individual toilets, leaving people dependent on public toilets or outdoors in rural areas.
Civil war-torn Sudan is also struggling with cholera, with 5,479 cases notified to the WHO and 150 deaths during January and February.
Santino Bol Agany, Concern project officer for health and nutrition, said plans are underway to re-build or drill new bore-holes.
“It will be very difficult in the wet season,” he predicted, speaking in their compound near Malek Miir. “When it is the wet season, it will be almost every household affected by the cholera, it will be worse.”
