South Sudan refuses to declare cholera outbreak

Juba, South Sudan – South Sudan’s government refuses to declare a cholera outbreak in Juba despite medical officials reporting confirmed and suspected cases from across the capital city.

According to the country’s health ministry, 126 suspected cholera patients have been admitted to Juba’s main hospital since June 12 and there have been seven suspected cholera deaths, including a woman who died on Sunday.

Dr Thomas Wel Maker, in charge of the main isolation ward at Juba Teaching Hospital, said 37 cases of cholera had already been confirmed, but those tests have been sent to Nairobi for secondary confirmation.

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A task force meeting on Monday was called to address increasing cases of acute watery diarrhoea in Juba, with Dr John Rumunu, director-general of preventive health services in the health ministry, stopping short of declaring a cholera outbreak.

Acute watery diarrhoea and cholera present similar symptoms.

“There are cases coming now from almost all directions,” Rumunu said at the meeting.

“A public declaration of [a cholera] outbreak is beyond my responsibility as director-general but according to the case definition, probably we are dealing with a cholera outbreak.”

Health ministry’s stand

World Health Organization guidelines indicate that a cholera outbreak should be declared when there are 10 to 20 confirmed cases, but the South Sudan health ministry is so far refusing to go public.

The majority of suspected cases have been received from the UN’s displaced persons’ camp on Juba’s outskirts and the city’s congested Manga 10 neighbourhood.

However, according to medical officials present at Monday’s meeting, sick people are now coming in from all over the city.

There have been another 85 suspected cholera cases reported across other areas in South Sudan, with nine deaths according to a cholera situation report seen by media on Sunday.

“There is a lack of information,” said Juba Teaching Hospital’s Dr Maker.

“Yesterday we had 14 admissions but people are walking in and out of the isolation ward without any idea … it is also the cases of people who come in too late, then they pass away.”

In 2014, the ministry declared a cholera outbreak in May following confirmation of 18 cases.

By December of that year, the outbreak had spread across 16 counties in five states with more than 6,000 cases and 167 deaths.