A rapidly spreading waterborne disease outbreak in southern Sudan has resulted in at least 24 deaths and hospitalized over 800 individuals within the past three days, according to Doctors Without Borders (MSF) on February 22.
The outbreak occurred in White Nile state following a drone strike on the Um Dabakar power station—located 275 kilometers (170 miles) south of Sudan’s capital, Khartoum—which disrupted access to clean drinking water in Kosti.
Sudan’s healthcare system is already severely weakened due to the ongoing civil war, which has claimed tens of thousands of lives and displaced over 12 million people. MSF reported that the most likely cause of the outbreak is contamination from the river, as many families resorted to collecting water using donkey carts after the power outage cut off regular supplies. In response, authorities have now prohibited this practice and are working to improve chlorination in the region’s water distribution system. Many restaurants and the market in Kosti have temporarily shut down as a precautionary measure.
The outbreak has overwhelmed the cholera treatment center at Kosti Teaching Hospital, where patients are exhibiting symptoms such as severe diarrhea, dehydration, vomiting, and sunken eyes. Dr. Francis Layoo Ocan, MSF’s medical coordinator in Kosti, expressed deep concern over the crisis, stating that the situation is spiraling out of control. “We’ve run out of space, and now we are admitting patients outdoors, treating them on the floor due to a lack of beds,” he explained.
Escalating Crisis
MSF, which has been assisting with cholera treatment in the region since October, reported a sharp rise in patient admissions starting Wednesday night, with 100 new cases arriving at the treatment center. By Friday afternoon, the number had exceeded 800. So far, at least 24 people have died, including one individual who was deceased upon arrival, while 48 others have been discharged. “The number of cases is continuing to increase, making it difficult for our team to keep a precise record,” MSF stated.
Sudan has been embroiled in conflict since April 2023, as a power struggle between army chief Abdel Fattah al-Burhan and Rapid Support Forces (RSF) leader Mohamed Hamdan Daglo has plunged the country into turmoil. The fighting has severely impacted the nation’s healthcare infrastructure, with official reports indicating that 80% of medical facilities in conflict-affected areas are no longer operational.
Last year, Sudan officially declared a cholera epidemic, recording nearly 25,000 cases and 699 deaths by October, according to government statistics. The World Health Organization (WHO) warns that cholera can be fatal within hours if left untreated, although most cases can be managed with oral rehydration therapy and antibiotics.
The International Committee of the Red Cross (ICRC) recently raised concerns about repeated attacks on civilian infrastructure, including power stations, further worsening conditions for millions already suffering due to the conflict.
White Nile state, which extends from south of Khartoum to the border with South Sudan, has witnessed escalating violence in recent days. A three-day assault by RSF forces on villages approximately 200 kilometers north of Kosti earlier this week resulted in over 200 deaths.
