Voice of America (Washington, DC)

4 August 2014

South Sudan: Riverboats Offer Lifeline to Cholera Victims in South Sudan

Photo: Andrew Green/IRIN
Deserted road in Juba.

Geneva — The International Organization for Migration (IOM) this week begins a river transport service for critically ill cholera patients, taking them to treatment centers in South Sudan's Upper Nile State. The boats will pick up patients along a 60-kilometer stretch of the river Nile between the state capital, Malakal, and Kodok.

More than 5,000 cases of cholera have been reported in South Sudan, and nearly 100 deaths. An outbreak in Wau Shilluk in Upper Nile State has claimed about 20 of these lives.

The International Organization for Migration says nearly 1,000 cases of cholera have been reported in small towns and villages along the river between Malakal and Kodok, giving this area one of the highest concentrations of cholera cases in the country.

Cholera is a fast-moving epidemic and IOM health workers fear people in Upper Nile State, including more than 177,000 internally displaced people, may be at risk of getting the disease in the coming months.

In a telephone interview from the South Sudanese capital, Juba, Haley West of IOM's Migration Health Unit told VOA most cholera patients can be successfully treated with oral rehydration therapy. But some patients need more radical care, and getting them quickly to a treatment center is a matter of life or death.

She said road travel during the rainy season is impossible, making river transport the only viable option.

"It is not an ideal situation... However, given the immediate need, we believe that this is a good short-term solution. So, the project will run four to six weeks and it is really aimed at insuring that we are providing life-saving care for those critical patients that need to reach the cholera treatment center as quickly as possible to ensure that we avoid any additional mortality here in South Sudan," said West.

More than 1.5 million people have fled their homes since fighting erupted between the South Sudanese government and rebels in December. More than one million are internally displaced. The rest have sought refuge in neighboring countries.

The cholera epidemic is continuing to spread throughout South Sudan. Bringing it under control is difficult because of the congested and unhygienic conditions of the camps for displaced people. Poor sanitation and lack of safe drinking water are putting many IDP's and local communities at risk.

Cholera causes severe dehydration and can be fatal if not treated promptly.

West said health workers have to be vigilant because new cases of cholera keep popping up.

"The fear is that it will continue to spread northward. There is a lot of population movement along the Nile. So, we just want to make sure that we have the resources necessary to be able to respond in case there is another outbreak. Again, normally, with cholera you see a couple of cases and then it can increase exponentially overnight and then within a week. So, you see a huge spike in cases before you are able to get it under control," said West.

Health workers will go along the river every day canvassing for cholera patients who need emergency care in a treatment center. At the same time, they are running information campaigns in the remote villages and towns to raise awareness of cholera transmission and treatment. The message they are trying to convey is that cholera can be prevented through good hygiene practices.

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