A cholera outbreak in the Abyei Special Administrative Area is at risk of spreading further if water and sanitation conditions are not urgently improved.
South Sudan has been grappling with a widespread cholera outbreak since September 2024, with cases reported across multiple states including Unity, Jonglei, Upper Nile, and Central Equatoria, which hosts the capital, Juba. Since the start of the outbreak, more than 75,000 cases and over 1,300 deaths from cholera had been reported nationwide according to the World Health Organization, as of June 27, 2025.
Doctors Without Borders/Médecins Sans Frontières (MSF) has been responding to the crisis, treating patients with symptoms consistent with cholera such as acute watery diarrhea at its 20-bed cholera treatment unit set up at Ameth Bek Hospital since April 11. A total of 333 suspected cholera cases were treated between June 2 and 28.
Displacement is fueling the spread of disease
Many people in Abyei, whether they are displaced or from host communities, are living in overcrowded areas with limited access to basic services. The situation is particularly concerning in informal settlements like Amiet market, where over 50,000 people who fled the war in Sudan live with limited access to safe drinking water and sanitation infrastructure such as latrines. Many are forced to defecate in the open due to a lack of latrines, increasing the risks of further spread of diseases.
“The situation in Amiet is critical,” says Stéphanie Dongmo, MSF project coordinator in Abyei. “The patients admitted with cholera to Ameth Bek Hospital in Abyei town confirm an active outbreak. The risk of spread to Abyei town is high, especially with the return of the rains, extremely poor hygiene conditions, and the continued increase in the number of people arriving from Sudan coming into an already overcrowded space.”
Upcoming rainy season poses increased threat
While medical response efforts are ongoing, the onset of the rainy season poses an immediate and severe threat. Ensuing floods are likely to cut off access to care, complicate logistical movements for aid, and accelerate the spread of waterborne diseases.
“MSF calls for the urgent rollout of cholera vaccines and vastly improved water, sanitation, and hygiene programs by all relevant actors in affected areas,“ Dongmo adds. “Immediate and comprehensive actions—including deploying water trucks to provide clean water, [providing] soap, constructing more latrines, and improving the drainage systems—are critical to mitigate the crisis. These immediate actions are crucial to save lives and prevent further escalation of this critical public health emergency in Abyei.”
