Rains, food crisis and a continuing conflict: South Sudan battles with a cholera outbreak

Published: 30 July 2014 12:30 CET

By Henry Makiwa, British Red Cross Society

Alfred Lati Joseph has the butt of his cigarette tightly pinched between his thumb and index finger, his face animated as he makes his point.

“I am young, strong and fit, but what about the babies, the young and the old?” he queries no one in particular. “Cholera will kill them first because there are weaker. This disease is worse than cancer and AIDS combined, because it takes you in a matter of hours. And that is the truth,” says Alfred, who is today donning a T-shirt nestling the image of the messiah with the legend: “I am the Way, the Truth and the Life”.

Tens of villagers from Gurei township on the outskirts of South Sudan’s capital city, Juba, are gathered here to receive life-saving advice from Red Cross volunteers. The good news for Alfred and his community is that the combined efforts of the Red Cross, local authorities, aid agencies and the villagers themselves has seen a sharp drop of cholera cases in the area.

In fact, the two reported cases at the nearby 100-bed cholera Gudele 2 treatment centre are from further outside Juba.

Run by Médecins Sans Frontières, the treatment centre is fenced in a distance away from the residential areas. It’s a gated quarantined zone that is highly sanitized and secured to prevent the spread of the epidemic.

“South Sudan Red Cross (SSRC) volunteers have visited over 25,000 homes in this area, teaching people the right health practices and providing water treatment tablets and soaps,” says John Marial Mayom, public relations and fundraising coordinator of the SSRC.

“Since the cholera outbreak was detected in May, we have only had one death out of 300 cases here. It’s helped a lot that we have partnered with local authorities and had our organization included in the government taskforce to fight the epidemic. This means we can spread messages of cholera prevention on local radio stations and recruit more volunteers to raise awareness of the disease,” Mayom explained.

Cholera is a severe infection caused by the bacterium Vibrio cholerae, which primarily affects the small intestine and is treatable if detected in time. It occurs in places with poor sanitation and is a fast-moving infection which causes diarrhoea in its victims, leading to severe dehydration and possible death. Experts say contaminated food or water are the main agents of the spread of the disease.

Although the disease appears to have been stemmed in the capital there are concerns that it may spread to other remote areas where it is difficult to get health care. Since May, cholera outbreaks or alerts have been reported in nine of South Sudan's ten states.

Red Cross experts are concerned that the epidemic may escalate across the country with the onset of the rainy season as stagnant floodwaters provide the perfect conditions for the rapid spread of cholera. The continued fighting and heavy rains - which usually make roads impassable across South Sudan this time of year - may also hinder efforts to get support and life-saving drugs to those who desperately need them.

“Our teams have noted an escalation of infections in the town of Torit, averaging 40 cases a day. This latest spread is extremely concerning, especially coming on top of a food crisis. We are also mindful that there are thousands of people still living in overcrowded and often unsanitary settlement areas where they have found safe havens from the fighting. Red Cross staff and volunteers are intensifying the treatment and education outreach, providing hygiene and sanitation kits as well as food aid in some cases,” explained Mayom.

Before the Red Cross teams depart from Gurei for another township post on the outskirts of Juba, Alfred and his neighbours line up in an orderly queue to receive soaps from the back of the trucks.