On 30 May, two people died in Sudan's capital, Khartoum, from cholera, which the government denies exists in the country and refers to it as “acute watery diarrhoea” since an outbreak began in August 2016 in 10 states. According to a parliamentary statement 1 June, there are more than 14,000 cases of “acute watery diarrhoea” and 272 deaths so far. Minister of Health Bahar Idris Abu Garda insisted in front of parliament that the cause of the outbreak is polluted drinking water. His ministry urged citizens to wash vegetables and fruit before consuming them, wash hands, drink clean water and prevent children from being close to rubbish dumps. The government arrested a journalist in April for publishing articles about a cholera outbreak in eastern Sudan. There is disagreement between the federal Health Ministry, local health offices and medical sources about characterising the disease. “The government believes cholera is a stigma, but raising citizen awareness about the disease, its causes and how to deal with it is vital to overcome and vanquish the epidemic,” a Sudanese doctor based in Britain told the opposition Radio Dabanga (headquartered in the Dutch capital Amsterdam). Several reports said that medical tests based on WHO (World Health Organisation) standards indicated the outbreak is cholera and not “acute watery diarrhoea”. General Bakri Hassan Saleh, first vice president and prime minister, directed his government to take all necessary measures and provide essential assistance to confront “acute watery diarrhoea”, according to a cabinet statement. At the end of last week, the US Embassy in Khartoum warned US nationals in Sudan that there are confirmed reports of a cholera outbreak in some areas, including Khartoum, that has claimed lives. Minister of Health in the state of Khartoum Maamoun Hemeida said there are 120 cases of “acute watery diarrhoea” and two deaths. Several hospitals in the capital, such as Bahari Medical School and Ibrahim Malek Hospital, received 30 cases daily in January according to medical sources speaking to Reliefweb. The Website added that hospitals in the capital and Al-Jazira state, the most urbanised province, documented hundreds of cases. The embassy statement added: “This is a reminder about the need to follow instructions for washing hands, and consuming safe food and water.” It asked its nationals “who will be far from medical services to take with them at least three packs of oral rehydration salts (ORS) and water purification tablets. According to government reports, the states worst affected are White Nile state south of the capital where more than 4,000 fell ill and 75 died since the outbreak there in May. White Nile state Governor Abdel-Hamid Moussa Kasha suspected the epidemic has reached more than 129 villages in his province. According to Abdel-Rahman Al-Siddik, a civil society activist, 19 new cases were documented in Aba Island region (the stronghold of Al-Ansar sect led by former prime minister Al-Sadik Al-Mahdi). Al-Sidik explained that cases are documented daily in hospitals and quarantine centres in the state. One child and one adult died in the River Nile state north of the capital, while 57 people fell ill especially in the town of Almatama and surrounding villages. A medical group called the Central Committee of Sudanese Doctors (CCSD) urged the government to admit there is a health disaster in White Nile state, and follow international measures for quarantine. Kasha responded to medical calls to declare the state a medical disaster zone that it is not within their powers. According to CCSD, locals in the state held two demonstrations to force authorities to announce the truth about the outbreak, whether it is cholera or acute watery diarrhoea, but to no avail. White Nile state is home to 122,000 refugees fleeing the war in South Sudan housed in eight refugee camps, as well as 50,000 others in other parts of the state. They are all more susceptible than others to contract cholera, according to Radio Dabanga. In North Kordofan in central west Sudan, new cases are admitted on a daily basis. Doctor syndicates recorded dozens of cholera cases. A medical team in North Kordofan began investigating why the epidemic spread in the state. One person died in South Kordofan state, and the local government decided to add more chlorine at the water plant and ban the sale of cooked and uncovered foods in markets. According to medical sources, lack of quarantines forced authorities to use schools as quarantine centres, which “could be a major catastrophe and a threat to neighbouring areas”. The outbreak coincides with the collapse of the national economy after losing oil revenues following South Sudan's independence in July 2011. This forced Khartoum to support the Arab coalition's bombing of Yemen in the hope it would receive Gulf aid to shore up the economy. The outbreak comes at a bad time for President Omar Al-Bashir's new government headed by Saleh, one that includes several opposition parties. The goal of the new cabinet was to reduce civil war tensions in Darfur in the west and South Blue Nile and Nuba Mountains in the south, but this has not yet happened. At the same time, Sudan currently has strained relations with Egypt whereby the success of the Egypt-backed Libyan army could impact the situation inside Sudan. There are dozens of Sudanese combatants fighting alongside rival Libyan groups. Meanwhile, South Sudan is suffering dire humanitarian conditions that could develop into famine for millions, according to the UN. This is certain to negatively impact Sudan. Simultaneously, Bashir is progressively under siege especially after the US blocked him from attending the Arab-Islamic-American Summit in Riyadh last month, under the pretext he is wanted by the International Criminal Court (ICC) for war crimes in Darfur. The call by South Africa for African countries to withdraw from the ICC failed, and the government of South African President Jacob Zuma is under international and African political pressure, as well as facing protests for economic reasons. If the Sudanese government admits to a cholera outbreak, this would cast a long political and social shadow on Khartoum that will compound its dilemma and further complicate the economic situation.
