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Refugees arrive at the South Sudanese border from Sudan. Rich Wainright

Fears cholera will 'explode' in South Sudan as cases take hold among refugees fleeing war

Last week Niall O’Connor travelled to South Sudan and the Sudan border to report on the forgotten African crisis. This is his first dispatch from the region.

A MAJOR CHOLERA crisis is set to “explode” in South Sudan as cases begin to take hold among refugees crossing the border to flee the war in Sudan, humanitarians in the country have warned. 

Last week The Journal travelled to the South Sudan to report on the forgotten crisis in in the Sub-Saharan country where seven million people have fled the neighbouring country’s war.

Some of those are Sudanese but also others are returning South Sudanese who fled the civil war in that country after its outbreak over a decade ago. 

We accompanied GOAL’s Regional Director John Rynne on a tour of the region – what we found was an aid effort stretched to the point of full capacity. 

We observed, along the border, in a massive holding camp and hospital in the town of Renk, the dire conditions for refugees who have crossed the frontier – some of whom have travelled for days to flee the fighting between the Sudanese Armed Forces and the rival Rapid Support Force.

While there is a large scale humanitarian effort to help the refugees the volume of people arriving is such that aid workers are struggling to meet demand.

Many of the displaced, are living in transit camps, sheltering in makeshift shelters made from flimsy cloth and sticks.

Aid agencies are working to secure the water supply but it was evident that a large stream of fecal matter was running through a low ditch inside the facility.

Humanitarian agencies from a number of different countries, including Ireland’s GOAL, are providing emergency feeding to malnourished refugees.  

On a week-long visit to the region we met with humanitarians as well as local Government officials and spoke to refugees about their experiences. The most stark predictions were from the humanitarians trying to limit the spread of cholera. 

The deadly bacterial disease is spread through contaminated food and water. Once established it can spread rapidly and kills between 25% to 50% of those who contract it.

Rynne, a hugely experienced Irish humanitarian, said that there is great work being done by aid workers to assist the refugees coming across the border but that the effort is “fragile” and close to full capacity.

“There’s cholera now on the border and Renk – almost definitely that’s going to explode over the next number of weeks, which is going to put real strain.

“You saw with me how really maxed-out the services are as it is – if there’s a large sickness load due to the cholera, it’s going to be very difficult to contain. I am worried,” Rynne said. 

1N4A1728 Refugees with water containers next to a stream full of effluent. Richard Wainwright Richard Wainwright

Rynne said that the fragility of the situation for refugees is further complicated by South Sudan’s struggling situation with its own extreme poverty. 

The humanitarian said that such is the fragile nature of South Sudan that any kind of increase in fighting near the border will send thousands of people fleeing south. 

“While a great job has been done since the Civil War kicked off in April last year, you can see that it would be very easy, I think, to overwhelm those services very quickly if there’s a surge in numbers or a surge in sickness,” he added. 

Speaking to The Journal in the frontier town of Renk Joseph Adiomo of UNICEF said he believes that the cholera situation will continue to worsen. 

Adiomo is leading the UNICEF operation in the area – in just two weeks the agency has recorded 107 cases and that figure is expected to keep rising. 

He said that it may be much higher given that the border is so porous and that people are crossing where there is no humanitarian cover.

“At the moment, if you see the trend of the cases, it is going higher. In two weeks, we have reached 107 – this is worrying and it is really too much.

“This is the time that we need to be very aggressive with the response. We shouldn’t wait until we see the peak of the cholera and then we say that we need to respond – we need to deploy now.

“We need to strengthen our preparedness in the community, in the transit camps and at the border we are working to try to contain it.”

1N4A2097 (1) Refugees arrive at a transit camp onboard a truck from South Sudan. Richard Wainwright Richard Wainwright

Adiomo said that given funding is a struggle for many humanitarian organisations given the number of other crises across the globe and that that there is limited bed space to deal with the predicted increase in cholera cases. 

The situation in the region is driven by a war raging for the last year in Sudan where two opposing factions the Rapid Support Force and the Sudan Armed Forces are battling for control of the country.

South Sudan itself is also gripped in a crisis at the moment – massive flooding along the course of the White Nile has displaced hundreds of thousands of people. In 2013 a bloody civil war established South Sudan.

A mix of climate change effects on food security and access to clean water and a major instability caused by the war has plunged the region’s citizens into disaster.

The country itself, which is the world’s youngest, is ranked 161 out of 163 for the Global Peace Index

As many as 50% of the population lack water and it has a massive maternal death rate of 1,223 out of 100,000 births.

The State also has 7.1 million people trapped in food insecurity – 70% of a total population of 12 million people. 

The Government in South Sudan has delayed holding elections in a political quagmire and all while the country is gripped in a staggering 250% inflation on the local currency. 

Last week Niall O’Connor travelled to South Sudan and the Sudan border to report on the forgotten African crisis. This is his first dispatch from the region – we will also look at the struggling medical system and the close to capacity refugee holding centre.

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