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South Sudan: Cholera cases decline as aid agencies join forces to contain the outbreak

When 32-year-old Rosa Lino arrived at the cholera treatment unit in Gumbo, a neighbourhood in the capital, Juba, with her 22-month-old son Angelo, he had all the signs of severe dehydration and she feared that he might not survive.

“I was so worried because he was very weak and his eyes had sunk in because of the diarrhea that started yesterday,”she said. A few hours later he was significantly better. “You wouldn’t believe this is the same boy I brought in this morning!” she exclaimed, marveling at the speed of his recovery. 

Angelo recovered quickly thanks to the care he received at the cholera treatment unit established by health NGO Medair.

Since June 2015, South Sudan has been facing a cholera outbreak. By 28 August, a total of 1,675 cases and 46 deaths had been reported, the majority of the cases in Juba and Bor. Children under age 5 make up 18 per cent of total cases.

Humanitarian partners’ concerted efforts have paid off, with a downward trend in cases and the case fatality rate dipping from 10 per cent at the onset of the outbreak, to the current 2.75 per cent, although this is still high.

“Excellent coordination of partners through the leadership of the Ministry of Health, supported by the health and water, sanitation and hygiene (WASH) clusters has helped to achieve the two main objectives of the cholera outbreak response, which are to reduce mortality and decrease the spread of the disease,” said Dr. Henry Ilunga Kasongo, Co-coordinator of the Health Cluster in South Sudan.

Cholera treatment centres have been set up in Juba and Bor, as well as eight oral rehydration points in strategic areas around Juba. 

The World Health Organisation has been providing emergency medical supplies, rapid diagnostic test kits and technical support to NGOs involved in the response to ensure all adhere to correct case management protocol.

Effective cholera preparedness and response activities paid off in containing the outbreak, said Dr. Kasongo. Pre-positioning medical and diagnostic supplies to all states across the country, setting up an effective surveillance system and training health workers enabled early detection and timely treatment of cases.

WASH partners have stepped up efforts to improve the provision of safe water, while monitoring water sources and encouraging people to chlorinate their water. Some 400 community hygiene promoters are going to schools and to people’s houses to try to eliminate high-risk behaviours, said Pauline Mwaniki, the WASH Cluster Coordinator in South Sudan.

NGOs have installed hand washing facilities and soap in public places like markets and schools to encourage hand-washing and have installed latrines in schools and health facilities, and well as distributing cholera treatment tablets and water storage containers to at-risk populations.

These efforts are accompanied by radio messaging to communities to recognize the signs and symptoms of the disease. Construction worker, John Taban, said he saved his friend Peter Marko’s life by acting on such radio messages. “I recognized the signs and symptoms of cholera from the radio jingles so I rushed him to the hospital in Juba where he was treated and has recovered,” he told OCHA.

The response has been funded by multiple donors and individual givers, including the Central Emergency Response Fund (CERF), managed by the Office for the Coordination of Humanitarian Affairs (OCHA), which released US$2.6 million.