MSF Warns of Escalating Cholera Crisis in Abyei Amid Dire WASH Conditions

A fast-developing cholera outbreak in South Sudan’s Abyei Special Administrative Area has raised alarm among health officials and humanitarian agencies, with Médecins Sans Frontières (MSF) issuing a stark warning that the outbreak could escalate further unless urgent improvements are made to the region’s water, sanitation, and hygiene (WASH) infrastructure.

On 11 June 2025, health authorities in Abyei officially declared the outbreak, joining a growing list of South Sudanese states—including Unity, Jonglei, Upper Nile, and Central Equatoria—battling cholera since September 2024. According to the World Health Organization (WHO), the national outbreak has so far resulted in over 75,000 suspected cases and more than 1,300 deaths as of 27 June 2025.

Abyei’s Fragile Humanitarian Landscape

Abyei, a politically sensitive and conflict-prone region straddling the Sudan-South Sudan border, is particularly vulnerable. The area has seen a significant influx of over 50,000 displaced people, mostly fleeing conflict in Sudan, who now reside in precarious informal settlements like Amiet market. With limited access to safe drinking water, sanitation facilities, and healthcare, the area is a high-risk zone for waterborne diseases.

“The situation in Amiet is critical,” says Stéphanie Dongmo, MSF Project Coordinator in Abyei. “The risk of spread to Abyei Town is high, especially with the return of the rains, extremely poor hygiene conditions, and the continued increase in the number of people arriving from Sudan.”

Reports from Ameth Bek Hospital in Abyei Town, where MSF established a 20-bed cholera treatment unit (CTU) on 11 April, confirm the severity of the outbreak. Between 2 and 28 June, MSF treated 333 suspected cholera cases, with numbers rising weekly:

• 80 cases (9–15 June)

• 77 cases (16–22 June)

• 94 cases (23–28 June)

Rainy Season Compounding the Crisis

The arrival of the rainy season has heightened concerns among humanitarian organizations. Flooding is expected to disrupt roads, cut off access to remote settlements, hamper aid delivery, and facilitate the spread of cholera and other waterborne illnesses.

Open defecation, a direct consequence of inadequate sanitation infrastructure, is widespread. In settlements such as Amiet, many people share minimal or no latrines, while safe water remains scarce, forcing residents to rely on contaminated surface sources. Without immediate intervention, health experts warn that the disease will continue to spiral.

MSF’s Response and Urgent Calls to Action

MSF has been on the frontlines, offering free treatment for cholera-like symptoms, including acute watery diarrhoea, and providing community outreach and hygiene awareness campaigns. However, the organisation emphasizes that medical treatment alone is insufficient.

MSF is calling for a coordinated emergency response from government agencies, UN partners, and international NGOs, highlighting five urgent priorities:

1. Rapid deployment of cholera vaccines to affected and high-risk communities.

2. Massive scale-up of WASH interventions, including:

   • Construction of emergency latrines

   • Expansion of drainage and waste disposal systems

   • Distribution of soap and hygiene kits

   • Deployment of water trucks to deliver clean, potable water

3. Improved surveillance and reporting systems to track transmission trends.

4. Community engagement to support behavioral changes around hygiene.

5. Contingency planning for continued access in flood-prone areas.

“Immediate and comprehensive action is critical to mitigate the crisis. Clean water, sanitation, and basic hygiene must be prioritized. These measures are crucial to save lives and prevent the further escalation of this critical public health emergency in Abyei,” said Dongmo.

Cholera in South Sudan: A Persistent Threat

Cholera remains endemic in South Sudan, often flaring up in the wake of conflict, population displacement, and environmental disruption. The latest outbreak, the country’s worst in nearly a decade, reflects the fragile nature of its public health infrastructure.

The Abyei crisis, in particular, demonstrates how decades of underdevelopment, coupled with regional instability, have created conditions ripe for outbreaks. Humanitarian agencies continue to advocate for long-term investment in basic services, beyond short-term emergency responses.

Looking Ahead

The cholera outbreak in Abyei underscores the urgent need for integrated humanitarian and development strategies. As climate shocks intensify and displacement grows across the region, health crises like cholera will only become more frequent and severe unless structural gaps are addressed.

Until those longer-term investments are made, agencies like MSF are left to plug life-threatening gaps, calling upon the global community to support the people of Abyei and South Sudan as they confront this escalating health emergency.