Over the past week in just the Darfur region, Doctors Without Borders/Médecins Sans Frontières (MSF) teams treated over 2,300 patients and recorded 40 deaths for cholera at facilities run by the Ministry of Health. MSF is calling for an urgent and scaled-up international response to provide health care, improve water and sanitation services, and begin cholera vaccination campaigns in affected areas.
Facilities are overwhelmed with cholera patients
Across Darfur, cholera is affecting people already struggling with water shortages that have made it impossible to follow essential hygiene measures, such as washing dishes and food. The situation is most extreme in Tawila, North Darfur state, where 380,000 people have fled to escape ongoing fighting around the city of El Fasher, according to the United Nations.
By the end of July, after one month of responding, MSF teams treated over 2,300 cholera patients in collaboration with the Ministry of Health in Tawila. The cholera treatment center at Tawila Hospital, officially equipped with 130 beds, had to accommodate 400 patients during the first week of August, overwhelming the facility and forcing staff to add extra mattresses on the floor to cope.
In Tawila, people survive with an average of just 3 liters (less than a gallon) of water per day, which is less than half the emergency minimum threshold of 7.5 liters needed per person per day for drinking, cooking, and hygiene, as stipulated by the World Health Organization (WHO). As cholera cases rise and resources run out, clean water and sanitation services are urgently needed to prevent more deaths.
Samia Dahab, MSF patient in Nyala
“The health centers are full, and they only operate until noon"
I felt sick yesterday at 4:00 p.m. I started vomiting and had diarrhea, but I’m feeling better now. On Friday, we bought some food from outside, and the next day we all had diarrhea and vomiting. My five children also got sick. Three of them have recovered, but two are still receiving treatment.
When the symptoms started, I waited two hours until my husband returned from work. He came with a motorcycle and took us to the hospital. They treated me immediately, and I began to feel better. The distance was very far. I first went to Nyala Teaching Hospital, and then they transferred me to the cholera treatment center at Al-Nahda Hospital. They treated all of us and also provided food. Today I feel much better.
People are drinking contaminated water due to shortage
“In displacement and refugee camps, families often have no choice but to drink from contaminated sources and many contract cholera,” says Sylvain Penicaud, MSF project coordinator in Tawila. “Just two weeks ago, a body was found in a well inside one of the camps. It was removed, but within two days, people were forced to drink from that same water again.”
About 60 miles from Tawila, cholera was reported in Golo, Central Darfur state, on July 13. MSF opened a 73-bed cholera treatment center in Golo hospital. This center was quickly overwhelmed, with 137 patients arriving on August 3 alone. Five oral rehydration points were set up around Golo to manage mild cases and prevent deterioration, but our teams see that the outbreak is still spreading fast. In early August, cholera reached Zalingei and Rokero in Central Darfur state, and Sortony in North Darfur state.
Heavy rains are worsening the crisis by contaminating water and damaging sewage systems. Cases are continuing to rise in South Darfur state as well, where MSF, in coordination with the Ministry of Health, has expanded the cholera treatment center in Nyala to 80 beds. Health workers are in urgent need of cholera vaccines and dealing with a severe shortage of water purification tablets.
As people move around to flee fighting, cholera is spreading further, in Sudan and into neighboring Chad and South Sudan. In Damazin, Blue Nile state, Sudan, MSF and the Ministry of Health expanded the Damazin Hospital cholera treatment center from 50 to 250 beds in July to cope with an influx of returnees from South Sudan. At this center, our teams are seeing a deadly combination of cholera and malnutrition. Between August 3 and 9, six cholera patients who died were also suffering from acute malnutrition.
“The situation is beyond urgent,” says Tuna Turkmen, MSF’s head of mission in Sudan. “The outbreak is spreading well beyond displacement camps now, into multiple localities across Darfur states and beyond.”
“The international response must have an outbreak emergency coordination mechanism able to provide health care, improve water and sanitation services, and begin cholera vaccination campaigns in affected areas at a pace that matches the urgency this catastrophic situation requires,” says Turkmen. “Every day of delay costs lives. MSF stands ready to collaborate with the Ministry of Health, UNICEF, and WHO to launch mass vaccination campaigns across Darfur. Survivors of war must not be left to die from a preventable disease.”
