Darfur Relief and Documentation Centre
Darfur Relief and Documentation Centre (DRDC) is alarmed that since mid-August 2016, many parts of Sudan have been facing a growing cholera epidemic. Currently the deadly disease spread into hitherto unaffected regions, including the national capital Khartoum and its twin cities Omdurman and Khartoum North (Bahri). Since the outbreak of the disease in August 2016, at least 12 of Sudan’s 18 States were severely affected. The epicentre of the pandemic is the White Nile, Khartoum, North and South Kordofan, River Nile and Northern States.
In his address at Sudan’s National Assembly “Parliament” on 1st June 2017, the Federal Minster of Health stated that over the last ten months some 14,659 cases of “acute watery diarrhoea” were reported all over Sudan and that 265 mortalities were reported during this period. DRDC believe that these figures are conservative and do not reflect the reality, however, the case fatality rate deduced is over 1.8% of confirmed cholera cases. This mortality rate is above the threshold to declare cholera epidemic in a country. According to independent medical practitioners in Khartoum and elsewhere in Sudan the numbers of confirmed cases of cholera are much higher and that the mortality rate in some affected areas has reached over 10% of the declared cases.
Despite these facts, the government of Sudan (GoS) remained indifferent for a long time and its response has been disproportionate with the gravity of the situation. The GoS refused to declare the existence of cholera in the country for several months and until 4 June 2017 when Sudan’s Minister of Health informed journalists that “acute watery diarrhoea” occurred in some parts of the country thus referring to the symptoms of the disease without naming it. GoS unwillingness to declare the cholera epidemic severely affected internal and external mobilization efforts to rescue the victims. In addition, there were reports that GoS – at Federal and State levels – obstructed the work of local volunteers. On 8 June 2017, the governor of White Nile State informed local volunteers that they should use the term “watery diarrhoea” instead of cholera for the government to support them hinting that objectors risk to face legal proceedings. Punitive measures were reportedly used against officials who expressed independent views about the nature of the pandemic. Dr. Hussein Gasim Abu-Aker, head of medical emergency service at Omdurman Hospital had been dismissed from his post because he refused to conceal the existence of the cholera epidemic. On 7 June 2017, the security forces arrested and detained three activists (Mr. Ahmed Abu Zaid, Adil Hadatha and Eyman Ali Ismail) while they were taking part in an awareness raising campaign against cholera in Haj Yusuf residential area in Khartoum Bahri.
DRDC believes that Sudan is a cholera-endemic country and that all the factors for a large-scale pandemic exist. As a least developed country, Sudan is facing complex emergencies and is particularly vulnerable to cholera outbreaks. The size of the population at risk is considerable due to poor access to clean water and food sources, sane environment and optimal sanitation facilities. The rainy season risks transforming the situation into a human tragedy of high proportion in case the epidemic finds its way to the conflict-ridden regions of the country such as Darfur, Blue Nile and the Nuba Mountains, where millions of internally displaced persons and other vulnerable war-affected groups live in miserable conditions deprived of the necessary facilities to cure, control and prevent the outbreak of the disease.
Because of the GoS apparent reluctance and unwillingness to declare cholera epidemic and seek international support during the last ten months, DRDC believes that GoS will not be in a favourable position to intervene to save lives in case of cholera outbreak in regions affected by armed-conflict such Darfur, the Nuba Mountains and Blue Nile States. The ongoing situation places the burden of addressing the cholera pandemic in Sudan on intergovernmental and non-governmental actors, including the UN Security Council and specialized agencies.
DRDC calls on GoS to:
Declare in no ambiguous terms the existence of cholera pandemic in the country without regard to any political or economic incentives or any considerations other than saving the lives of millions of rightful citizens and preventing further spread of this deadly disease.
Invite the World Health Organization and other international agencies and relief organisations to develop emergency plans for timely intervention to curb the ongoing cholera epidemic in the country taking into consideration the special needs of regions of the country that witness concentration of vulnerable groups in densely populated makeshift settlements with extremely poor health service and sanitation such as Darfur, where habitats and environmental and health infrastructures are being destroyed systematically.
Allow international agencies and relief organisations free and unhindered access to the affected regions and to provide the necessary medical service directly to the victims.
Provide the necessary funding to and declare a general mobilization for awareness building on prevention and control strategies to arrest the pandemic using different means such as the national public and private media outlets particularly through radio transmission, schools, advocacy groups and places of worship etc.
Support the local volunteer groups and independent professional associations such as Sudan’s Central Doctors Committee and the Independent Doctors Union and remove all administrative obstacles that hinder the ability of such groups to access the victims and provide them with medical assistance and to launch public awareness and prevention campaigns as well as disease control strategies, including in the field of epidemiological surveillance and reporting to concerned national and international partners.