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Violence has contributed to the epidemic; aid agencies can’t travel freely and are removing nonessential staff.<\/div>\n

In the wake of renewed violence and insecurity, South Sudan is now also facing a cholera outbreak. But many aid agencies are working with diminished staff and supplies, which could severely hamper efforts to control the epidemic.<\/p>\n

Cholera is spread by food or water contaminated with feces, and can kill within hours if left untreated, according to the World Health Organisation.<\/p>\n

WHO communication officer Jemila Ebrahim says the country’s cholera outbreak is approaching its second month, with 586 cases having been reported.<\/p>\n

But the WHO’s country representative in South Sudan, Abdulmumini Usman, warns that the impending rainy season may bring more cholera cases. “The risk of further spread of the disease is a major concern. With the coming rains, it is realistic to expect an increase in malaria and waterborne diseases.”<\/p>\n

A recent surge of fighting between forces loyal to President Salva Kiir and those aligned to former vice president turned opposition leader Riek Machar has displaced more than 30000 people, the UN Refugee Agency reports. Many aid agencies have had to temporarily withdraw their personnel and only have essential staff in the country.<\/p>\n

Tim Irwin, Unicef’s spokesperson in South Sudan, says there is a security threat to aid workers and many parts of the country remain insecure. “We are unable to access them, and this is a concern.”<\/p>\n

According to Zlatko Gegic, South Sudan country director at the aid organization, Oxfam, providing aid will become logistically impossible if security conditions deteriorate further. “If aid agencies cannot operate fully, the consequences could be catastrophic,” he says.<\/p>\n

The WHO, the United Nations\u00a0Children’s Fund (Unicef) and\u00a0Doctors Without Borders (MSF) have\u00a0set up a cholera treatment center at\u00a0Juba Teaching Hospital in the capital,\u00a0where the bulk of South Sudan’s\u00a0cases have been reported. As an oral vaccination drive strives to inoculate\u00a0more than 14\u00a0000 people against the\u00a0disease in high-risk areas \u2014 such as\u00a0camps housing thousands of people\u00a0displaced by violence \u2014 the organizations have also set up eight centers to treat dehydration among people\u00a0with the diarrheal disease.<\/p>\n

But aid\u00a0supplies \u2014 including vehicles, fuel\u00a0and nutritional supplements \u2014 of\u00a0agencies such as the World Food Program have been looted. With\u00a0only 200km of paved road in South\u00a0Sudan and restrictions on internal\u00a0travel, aid agencies have not been\u00a0able to restock their bases across the\u00a0country. Some regions are impossible\u00a0to get to because even helicopter\u00a0travel has been prohibited.<\/p>\n

WHO epidemiologist Joseph\u00a0Francis Wamala, who is responding\u00a0to the epidemic, says the conflict is\u00a0partly to blame for cholera outbreaks\u00a0that have haunted the country annually\u00a0since 2014.<\/p>\n

“The fact that we had pockets of\u00a0insecurity all these years means that\u00a0you don’t have the time you need to\u00a0build very good water systems and\u00a0very good sanitation systems to handle\u00a0sewage,” Wamala says.<\/p>\n

Decades of conflict have destroyed\u00a0sanitation and healthcare systems\u00a0in the world’s newest nation, which\u00a0gained independence from Sudan\u00a0five years ago. Hunger and malnutrition\u00a0are widespread and 4.8-million\u00a0people \u2014 nearly one in every three\u2014 don’t have enough to eat, according\u00a0to the International Rescue\u00a0Committee.<\/p>\n

The local media is airing prevention\u00a0messages and advertisements\u00a0for a toll-free phone line to report\u00a0cholera cases.<\/p>\n

MSF emergency co-coordinator Anja\u00a0Wolz says people should seek treatment\u00a0urgently if they experience\u00a0more than three bouts of watery diarrhea a day.<\/p>\n

“Our main challenge is making\u00a0sure that people know to protect\u00a0themselves from cholera and what\u00a0to do if they think they have the disease,”\u00a0she says.<\/p>\n

M&G

Violence has contributed to the epidemic; aid agencies can’t travel freely and are removing nonessential staff. In the wake of renewed violence and insecurity, South Sudan is now also facing a cholera outbreak. But many aid agencies are working with…<\/span><\/p>\n