A South Sudan Red Cross volunteer speaking about cholera prevention

A South Sudan volunteer speaking about cholera prevention – ©BritishRedCross/HenryMakiwa

Alfred Lati Joseph pinches his cigarette butt between his thumb and index finger, his face animated as he speaks. 

“I am young, strong and fit, but what about the babies, the young and the old?” he asks.

“Cholera will kill them first because they are weaker. It can take you in a matter of hours, and that’s the truth.”

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Dozens of villagers from Gurei, a township on the outskirts of South Sudan’s capital, Juba, have gathered together. They’re here to receive life-saving advice and relief items from Red Cross volunteers.

Alfred and his neighbours line up in an orderly queue to receive soap from the back of an aid truck.

The good news for Alfred and his community is that the combined efforts of the Red Cross, local authorities, aid agencies and the villagers have seen a sharp drop in cholera cases in the area.

Alfred Lati Joseph

Alfred Lati Joseph – ©BritishRedCross/HenryMakiwa

In fact, the two reported cases at the nearby 100-bed cholera Gurei treatment centre are from outside of Juba.

The centre is fenced off some distance away from residential areas. It’s a gated, quarantined zone that is highly sanitised and secured to prevent the spread of the disease.

“The South Sudan Red Cross (SSRC) volunteers have visited over 25,000 homes in this area teaching people the right health practices and providing water treatment tablets and soaps,” says Marial Mayom Riak, fundraising co-ordinator of the SSRC.

“Since the cholera outbreak was detected in May, we have only had one death out of 300 cases [in Gurei]. It’s helped a lot that we have partnered with local authorities and been included in the government taskforce to fight the epidemic.

“This means we can spread messages of cholera prevention on local radio stations and recruit more volunteers to raise awareness of the disease,” Marial explains.

Cholera symptoms and treatment

Cholera is an acute diarrhoeal infection, which leaves the patient dehydrated and nauseous. It can kill within hours if left untreated.

It is, however, easily treatable by oral rehydration salts or intravenous fluids in the case of severely dehydrated patients.  

The virulent disease occurs in places with poor sanitation and infection spreads quickly. Contaminated food and water are the main sources of the disease.


Children in a camp for people displaced by fighting in South Sudan – ©NetherlandsRedCrossSociety/MerlijnStoffels

Although infection rates have slowed in the capital, cholera has spread to remote areas of South Sudan where it is difficult to administer health care.

Cholera outbreaks or alerts have now been reported in nine of South Sudan’s ten states.

There’s concern that the epidemic may escalate across the country with the onset of the rainy season. Stagnant floodwaters provide the perfect conditions for the rapid spread of cholera.

Unsanitary conditions

As of July 9, more than 3,150 cases of cholera had been recorded across the country. Seventy people have died.

The continued fighting and heavy rains make roads impassable across South Sudan at this time of the year. This has hindered efforts to get support and life-saving drugs to those who desperately need them.

A Red Cross volunteer holds a satchet of chlorine water purifiyer

A Red Cross volunteer holds a satchet of chlorine water purifiyer – ©BritishRedCross/HenryMakiwa

Mayom says: “Our teams have noted more infections in the town of Torit (130 miles south east of Juba), averaging 40 cases a day. This latest spread is extremely concerning, especially coming on top of a food crisis.

“We are also mindful that there are thousands of people still living in overcrowded and often unsanitary camps, where they have found safe havens from the fighting.

“Red Cross staff and volunteers are intensifying the treatment and education outreach, providing hygiene and sanitation kits as well as food aid in some cases.” 

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  • Find out more about the South Sudan crisis

This post was written by Henry Makiwa, British Red Cross press officer, while on a recent trip to South Sudan.