Cholera outbreak ravages Gederaf, epidemics spread in Sudan due to war

September 26, 2023 (GEDAREF/PORT SUDAN) – The health crisis in Sudan has worsened considerably, marked by the alarming spread of diseases like dengue fever, acute diarrhoea, malaria, and cholera in the eastern state of Gedaref. A collapsing healthcare system and a severe shortage of medications further compound this dire situation. Additionally, reports of cholera outbreaks have surfaced in Khartoum.

Acting Federal Minister of Health, Haitham Mohamed Ibrahim, declared on Tuesday that 277 cholera cases have been registered, resulting in 19 fatalities, in the Khartoum and Gedaref states.

He disclosed to Sudan Tribune that within Gedaref State, located in eastern Sudan, 264 cholera cases have been documented, with 16 deaths. Concurrently, the emergence of acute diarrhoea was reported in Khartoum State, with 13 cases recorded at Alban Jadid Hospital, including three fatalities.

“Cases of acute diarrhoea were initially reported in Gedaref State toward the end of August 2023. In response, teams were dispatched to collect samples and provide intravenous solutions, while field surveys were conducted in the eastern Qalabat region, bordering Ethiopia,” Ibrahim said.

He underscored that the samples tested positively during rapid examinations, which were subsequently sent for analysis to the public health laboratory in the Red Sea State instead of the Stack laboratory in Khartoum. These laboratory results confirmed cholera cases, which evolved into acute diarrhoea cases across several localities in Gedaref State, encompassing Quraisha and Eastern Galabat.

The minister stressed that cholera treatment primarily involves intravenous fluids and solutions, with antibiotics reserved for severe cases. Collaborating with the World Health Organization, Gedaref State declared cholera cases to facilitate their management and ensure the provision of essential supplies for future immunization efforts, thereby making Sudan eligible for immunization.

Efforts to combat disease-transmitting mosquitoes have been intensified to reduce transmission rates significantly, Ibrahim emphasized. He noted that while acute diarrhoea cases appeared early in South Kordofan State, their incidence diminished after the end of the epidemic phase.

The five-month conflict between the army and the Rapid Support Forces has compounded the healthcare crisis. Most hospitals have become non-operational due to occupation by the Rapid Support Forces, and widespread looting and vandalism have impacted pharmacies and pharmaceutical companies.

Gedaref State, situated in eastern Sudan, is one of the hardest-hit areas grappling with the prevalence of dengue fever and acute diarrhoea. The diseases have affected numerous neighbourhoods, including “Al-Nadir, Deem Al-Nour, Salama Al-Bey, Suakin, and Al-Mufraqa’a,” and villages in the western and eastern Al-Qalabat localities.

Authorities have faced criticism for their sluggish response in curbing the epidemics, with health centres and Gedaref Teaching Hospital confronting a dire shortage of medications as cases continue to surge from affected neighbourhoods.

Osman Gedo, a paramedic in Gedaref State, informed Sudan Tribune that “Gedaref Teaching Hospital and several health centres are still admitting new cases of the dengue fever epidemic.” He estimated the official count of confirmed cases exceeding 750 on Tuesday afternoon.

“The situation in numerous neighbourhoods and shelters housing those displaced by the war is highly concerning, as cases continue to rise steadily,” he added.

A volunteer from the Gedaref Epidemic Protection Initiative, who preferred to remain anonymous, revealed to Sudan Tribune that the number of individuals infected with dengue fever in the state likely reaches thousands. This assessment starkly contrasts with official authorities’ statistics, representing only a small fraction of the infected population.

The volunteer continued, “The state has become an endemic region for dengue fever, with the disease spreading unusually widely. Patients are increasingly being treated at home, owing to the limited capabilities of official authorities, which portends a real disaster.”

He further disclosed the emergence of entities engaged in illicitly selling medicines on the black market, given their complete disappearance from all pharmacies over the past three days.

Moreover, he noted that the Red Crescent had intervened to assist in containing the disease. Still, he lamented, “The situation exceeds our capabilities, as cases have now encompassed all localities in the state.”

Suakin Alhadi, a resident of the Deem Alnur neighbourhood, conveyed to Sudan Tribune, “Dengue fever is rapidly spreading among the neighbourhood’s residents, with a significant number of patients confined to their homes and yet to be transferred to treatment centres.

The authorities’ response to containing the epidemic remains exceedingly weak.”

Government Statistics

In a related development, Federal Minister of Health, Haitham Mohamed Ibrahim, disclosed that the number of dengue fever cases in Gedaref State has risen to at least 700, with eight fatalities.

He explained to Sudan Tribune that the dengue fever epidemic is extending across eight states: “Red Sea, Kassala, Gedaref, Al-Jazira, Sennar, North Kordofan, South Kordofan, and North Darfur.”

Ibrahim elucidated that despite a high mosquito population responsible for disease transmission, severe cases do not surpass 5%, necessitating blood transfusions or hospitalization. Most cases require intravenous fluids or fluid therapy.

He reported the launch of a mosquito control campaign in Gedaref State two weeks ago, supported by the World Health Organization and UNICEF, with the participation of a federal support team within the state.

Ibrahim further divulged the arrival of sufficient supplies from the World Health Organization and the Federal Ministry of Health to Gedaref State, comprising intravenous solutions, blood transfusion bags, and more.

Furthermore, the United Nations World Health Organization (WHO) revealed on Tuesday that cholera and dengue fever outbreaks have been documented in eastern Sudan, where thousands have sought refuge from intensifying clashes between the army and the Rapid Support Forces.

WHO conveyed that 162 suspected cholera cases have been admitted to hospitals in Gedaref State and other areas bordering Ethiopia. It noted that 80 cases have been confirmed, with ten fatalities attributed to cholera, an acute bacterial infection linked to contaminated food or water, causing diarrhoea.

The organization further underscored that more than 500 suspected cases of dengue fever have been reported across all regions in Sudan, primarily concentrated in Gedaref’s urban centres.

It emphasized that this figure represents “the tip of the iceberg,” as the number is significantly higher, given that most patients rely on home remedies and frequently refrain from seeking hospital care.

Malaria surge in North Darfur

A senior official from the Ministry of Health in North Darfur has revealed a concerning surge in malaria cases, surpassing 80,000 in the state.

Ahmed Mohamed Al-Douma, Deputy Director General of the Ministry of Health in North Darfur State, shared with Sudan Tribune that all localities across North Darfur have experienced a notable rise in malaria cases, with the total count now standing at 79,692 cases.

Furthermore, he highlighted that within displaced populations residing in shelter centres in El Fasher, approximately 47 cases of malaria have been reported this week.

In addition to the malaria cases, it has been reported that 25 cases of dengue fever have been recorded, with no associated fatalities.

(ST)