Cholera Epidemic in Sudan Now Reaches Darfur: As the rainy season begins in earnest, the implication

What we know from previous reporting about cholera in Sudan and the country’s collapsing medical system:

“The collapse of the health services in the country requires intervention by international organisations to help eradicating the epidemic, and that can only be done if the government officially declares the cholera outbreak,” Sarah Abdeljaleel, Media Secretary of the Sudanese Doctors’ Union in the United Kingdom and Ireland told Radio Dabanga last week. (Radio Dabanga, June 25, 2017)

Disgracefully, the UN’s Office for the Coordination of Humanitarian Affairs in Sudan (OCHA) has yielded to the Khartoum regime and refuses to use the word “cholera,” even as laboratory tests have confirmed the presence of the bacterium Vibrio cholerae; the disease has also been confirmed by independent health officials (see below):

The same is true of the UN’s World Health Organization (WHO):

As these are the first reports of cholera infections in Shangil Tobaya, the World Health Organization (WHO) has not yet issued an update… The WHO and the Sudanese Ministry of Health do not refer to the disease as cholera, but the less severe “acute watery diarrhoea (AWD).”

WHO has not replied to Radio Dabanga’s latest request to comment on the spread of cholera. (Radio Dabanga, June, 23, 2017)

The UN is content to ignore what was reported by Radio Dabanga in January of this year:

Medics: “Cholera spreading in Sudan” | Radio Dabanga | January 22, 2017 | KHARTOUM | https://www.dabangasudan.org/en/all-news/article/medics-cholera-spreading-in-sudan

According to laboratory results, the diarrhoea cases spreading over various parts of Sudan since September last year are caused by cholera. The Central Committee of Sudanese Doctors reported 53 such cases in Red Sea and El Gezira states on Friday.

Dr Mohamed Naji El Asam, Member of the Doctors’ Executive Committee, told Radio Dabanga in an interview broadcast on Friday that the results of laboratory tests on acute diarrhoea samples conducted in the Ahmed Gasim Hospital in Khartoum proved that it was cholera.

The doctor criticised the federal Ministry of Health for keeping silent about the disease in spite of the confirmation by laboratories.

Cholera bacteria under a microscope

Sudan Tribune also reported in January 2017 that the epidemic in Sudan was cholera:

Eight dead in suspected Sudan cholera outbreak: report | Sudan Tribune | January 16, 2017 (KHARTOUM) | http://www.sudantribune.com/spip.php?iframe&page=imprimable&id_article=61409

Eight people have died and 342 infected at several Sudanese states in a second wave of a suspected cholera outbreak within five months, said a report by the independent Central Committee of Sudanese Doctors. The report, which was seen by Sudan Tribune on Monday, said the preliminary tests of diarrhea samples proved they were cholera cases, pointing such cases are usually confirmed by a reference laboratory and announced by the Department of Epidemiology at the Health Ministry.

It pointed that a number of cases have been reported in Khartoum, Gazeera and Red Sea states, saying “such cases must be handled with utmost seriousness to ensure the safety of patients and curtail the spread of the epidemic.” The report demanded the authorities to apply the scientific universal measures in dealing with such cases and announce the results with full transparency, saying the disease is highly contagious.

Indeed, the warnings had come early and often, and yet no action was taken by Sudan or the UN’s humanitarian agencies. The Khartoum regime still refuses to call the rapidly spreading epidemic cholera, and UN agencies defer to Khartoum. The results of this policy of denial and acquiescence are now terrifyingly clear:

“Three die of cholera in South Darfur’s Kalma camp” | Radio Dabanga, June 25, 2017 | KALMA / SHANGIL TOBAYA / EL TADAMON / BLUE NILE / KHARTOUM https://www.dabangasudan.org/en/all-news/article/three-die-of-cholera-in-south-darfur-s-kalma-camp

On Friday, three residents of Kalma camp for the displaced near Nyala, capital of South Darfur died of cholera. With the spread of cholera to South Darfur, 14 Sudanese states are now affected. Hussein Abusharati told Radio Dabanga that three other Kalma camp residents are infected as well.

“The South Darfur health authorities and staff of health organisations working in the state rushed to the camp, and allocated two emergency sites in the camp to receive the patients,” he said. “The organisations directed us to immediately report any suspected cases.” Kalma, hosting more than 120,000 displaced, is one of the largest camps in Darfur.

In the Naivasha camp for the displaced near Shangil Tobaya in North Darfur’s Tawila locality, a girl died on Friday. “This brings the number of cholera deaths to 12 in a week,” a Naivasha camp elder reported to this station. “With eight new cases last week, 96 camp residents are being treated for the disease.” The elder complained about the poor health care in the makeshift isolation centre, the overcrowded ward, and the lack of medical staff in the camp clinic.

He said they have called on the North Darfur health authorities to urgently provide adequate treatment and medical staff, and to organise awareness campaigns about the importance of hygiene and sanitation.

“Watery diarrhoea”

The health unit in the area of Um El Kheirat area in South Kordofan’s El Tadamon locality received two new cases of cholera on Friday. The head of the unit reported that two older cases are still being treated.

The Blue Nile state Minister of Health, Abdelrahman Bilal, reported last week that at least 40 people in the state are suffering from “acute watery diarrhoea.” The first cases were recorded in Blue Nile state in August last year. The federal Health Ministry initially neglected the reports. A few months later, after the disease spread to neighbouring states, medical doctors began to mention cholera.

Sudan’s security authorities, however, refused to call the disease by its real name and instead continue to refer to it as “watery diarrhoea.” On 1 June, the Sudanese Minister of Health reported to the federal parliament that between August 2016 and May 2017, 14,659 people were infected with “watery diarrhoea.” 292 patients died.

The UN Office for the coordination of Humanitarian Affairs (OCHA) in Sudan reported it its bulletin of 5-18 June that according to the federal Ministry of Health and the World Health Organization, about 16,600 suspected cases of “Acute Watery Diarrhoea” were reported in the country, including 317 deaths.

Health management

“The collapse of the health services in the country requires intervention by international organisations to help eradicating the epidemic, and that can only be done if the government officially declares the cholera outbreak,” Sarah Abdeljaleel, Media Secretary of the Sudanese Doctors’ Union in the United Kingdom and Ireland told Radio Dabanga last week. This week, Sudanese university professors have appealed to the federal cabinet and parliament to restore “the former health management mechanism” in Sudan. In a press statement, they pointed to the nation’s “successful experience in managing the health system before the federal system came into being.” They further urged the revision of the Constitution and laws governing the health system in the country.

Cholera victim (Zimbabwe)

“Cholera cases in North Darfur, Khartoum, eastern Sudan,” Radio Dabanga, June 23, 2017 | SHANGIL TOBAYA / KHARTOUM / KOSTI / DELLING | https://www.dabangasudan.org/en/all-news/article/cholera-cases-in-north-darfur-khartoum-eastern-sudan