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Juba, South Sudan - South Sudan's government has declared cholera outbreak in the capital city, where at least 18 people died and 171 cases were confirmed.

"After subjecting those [suspected] cases to analysis … we confirm beyond doubt that there is an outbreak of cholera in Juba," Health Minister Dr Riek Gai Kok told journalists in Juba on Tuesday.

The first suspected case was received on June 1 originating from inside the UN 'displaced persons' camp on the outskirts of Juba. Cases have since spread outside the camp to some of the city's most congested neighbourhoods.

Staff are paid for eight-hours [shifts], but they are now working 24 hours

Dr Thomas Wel Maker, in charge of the hospital isolation ward in Juba

There are now 171 confirmed cases of cholera and 18 deaths from the disease, according to the ministry of health.

World Health Organization guidelines indicate that an outbreak should be declared after 10 to 20 confirmed cases.

The health minister was reluctant to explain why the government waited for three weeks before going public. He said "we are not here today to investigate the past … information is not a cure alone ... In the last two weeks we have not been idle".

He said that they have spent the time setting up a treatment ward, increasing surveillance and case management and trying to verify confirmed cases.

"What was lacking was the public declaration, but already we have been taking measures.

"We want to contain it here in Juba. We don't want it to overspill [into other parts of the country," said the minister.

Nurses working overtime 

The cases to date are being admitted to Juba Teaching Hospital – the country's main referral facility – where an isolation ward has been established. Sixty patients are currently being treated after 16 new arrivals on Monday.

"This outbreak is so far small," Dr Thomas Wel Maker, in charge of the hospital isolation ward, told Al Jazeera.

"But we are relieved it has been announced because now we are able to talk to the people," said Dr Maker, the intention being to spread vital hygiene information through Juba's poorer neighbourhoods.

Dr Gai Kok claimed his ministry has the backing of the president and is financially equipped to tackle the outbreak with support from partner organisations and aid groups.

At Juba hospital, Dr Maker said they have enough staff and supplies to operate the small cholera ward for now.

However, nurses are working overtime without additional pay.

"Staff are paid for eight-hours [shifts], but they are now working 24 hours. They are complaining they don't have enough food ... with this extra work, there is no money," Dr Maker said.

Cholera broke out in the capital last year, five months into a civil war that is still ongoing over a year later. That outbreak was devastating infecting more than 6,000 people across 16 counties and resulted in the deaths of 167.

Source: Al Jazeera