South Sudan: Hope and the world’s worst cholera outbreak, 14 years after independence

As part of the response to the cholera outbreak in South Sudan, Government and World Health Organization staff conduct water quality testing and chlorination at key water points in Abyei. Photo: WHO
As part of the response to the cholera outbreak in South Sudan, Government and World Health Organization staff conduct water quality testing and chlorination at key water points in Abyei. Photo: WHO

By Tapiwa Gomo

Anna Nyaguir Tiyen and Nya Luide Gatkueth Chap, of Rubkona County, Unity State, were just four years old when South Sudan gained independence, on 9 July 2011.

South Sudan is currently facing its worst-ever cholera outbreak and the world’s deadliest outbreak so far this year. But like many adolescents, Anna and Nya remain hopeful.

“We feel happy when we are in school,” said Anna. “We learn so much.”

Anna aspires to be a pilot; Nya hopes to be a medical doctor. But both girls worry whether their families will be able to financially support their higher education.

The girls, who are among South Sudan’s 2 million internally displaced people, also dream of a life where their families no longer have to struggle for basic needs, such as education, sanitation, food and clean water.

Fourteen years after gaining independence, South Sudan is again facing a humanitarian emergency of staggering proportions. The country teeters on the edge of renewed conflict, while millions of its people endure acute hunger, disease and displacement.

Nyanene's two-year old son, Tuach get being tested for malnourishment at the WFP-funded Wichpoul nutrition site located in Kuerguini Payam in Rubkona County, Unity State. Photo: WFP
Nyanene's two-year old son, Tuach get being tested for malnourishment at the WFP-funded Wichpoul nutrition site located in Kuerguini Payam in Rubkona County, Unity State. Photo: WFP

Cholera outbreak

As of 7 July, more than 80,000 cholera cases and more than 1,400 associated deaths were reported across the country. Health partners warn of a sharp rise in new infections and deaths due to the onset of the rainy season – projected to be above average and likely to cause widespread flooding – combined with declining immunity levels.

But South Sudan’s fragile health system is collapsing. In a recent statement, aid agencies warned that lack of access and the closure of projects have reduced the chances of early intervention and treatment.

“In addition, the cholera outbreak has added to an already difficult situation, putting young lives in a precarious fight for survival,” said Noala Skinner, UNICEF’s Country Representative in South Sudan. “Now more than ever we need continuity and scale-up of services for prevention and treatment of malnutrition.”

In response to the severity of the situation, the United Nations Central Emergency Response Fund allocated US$10 million in May to help sustain humanitarian operations, mitigate the impact of conflict and cholera, and support early action for anticipated flooding.

However, funding shortfalls continue to hamper humanitarian partners’ ability to scale up the response. By midyear only 21 per cent of the $1.69 billion required for the 2025 Humanitarian Needs and Response Plan had been received. Additional funding is urgently needed.

Nyanene carries her monthly food rations from the WFP-funded Babanusa food distribution site in Unity State to her home nearby. Photo: WFP 
Nyanene carries her monthly food rations from the WFP-funded Babanusa food distribution site in Unity State to her home nearby. Photo: WFP 

Worsening food insecurity

Growing food insecurity is making people more susceptible to disease outbreaks. Some parts of South Sudan are now on the brink of famine, with more than 83,000 people facingcatastrophic levels of food insecurity, particularly in Malakal, Nasir, Pibor and Ulang Counties, due to ongoing conflict and displacement.

Today, more than half of the country’s population – about 7.7 million people – is enduring high levels of acute food insecurity. At the same time, the country’s nutrition crisis is deepening. Overall, 9.3 million people need humanitarian assistance this year.

Teetering on the edge

Meanwhile, violence has surged across multiple regions, most notably in Malakal and Upper Nile. Hostilities escalated in March, displacing more than 50,000 people. That same month, reports of air strikes and political tensions shook the already fragile peace established by the September 2018 agreement. In May, the bombing of a hospital run by a non-governmental organization in Fangak, which killed seven civilians and injured dozens, underscored the growing disregard for international humanitarian law.

Narrow window

There is still a narrow window to prevent widespread famine and a major humanitarian catastrophe, but only if urgent, coordinated action is taken now.

OCHA is calling for sustained funding to be restored to avoid further deterioration in healthcare, food security and essential services. Violations of international humanitarian law, including attacks on vital infrastructure such as hospitals, must not be ignored. Accountability is critical to protect civilians and uphold the rule of law.