Nearly 700 dead as South Sudan battles worst cholera outbreak since independence

South Sudan is battling its worst cholera outbreak since gaining independence in 2011, with nearly 700 deaths recorded over the past six months, the United Nations reported on Monday. The crisis has hit children the hardest, with many among the dead.

According to the United Nations Children’s Fund (UNICEF), 40,000 cases of cholera were reported from late September to March 18, 2025, making it the worst outbreak the country has faced in 20 years.

"This is the worst outbreak South Sudan as an independent country has ever faced," said Verity Rushton, a UNICEF emergency specialist speaking from Juba.

Children under 15 make up half of the reported cases, while a third of the deaths are children under 14, UNICEF stated.

Despite having vast oil resources, South Sudan has long struggled with instability and economic hardships.

Ongoing clashes between forces allied to President Salva Kiir and his longtime rival, First Vice President Riek Machar, have displaced tens of thousands of people, worsening the humanitarian crisis.

Nine of the country's 10 states have been affected by cholera, with Jonglei in the east recording the highest number of cases, according to Rushton.

Regional crisis

The outbreak is part of a larger crisis affecting eastern and southern Africa. Alongside South Sudan, Angola has reported more than 7,500 cholera cases and 294 deaths between January 7, 2025 and March 18, 2025. UNICEF has warned of a high risk of further escalation.

Medical charity Doctors Without Borders (MSF) said on Monday that cholera is spreading rapidly as people flee violence in search of safety.

MSF has treated 400 cholera patients in one county alone in Upper Nile State and warned that the disease has already reached neighbouring Jonglei, where it operates a 100-bed treatment unit.

"With cholera spreading rapidly and violence ongoing, the need for medical care in Upper Nile State is more critical than ever," said Zakaria Mwatia, MSF's head of mission in South Sudan.

The worsening situation comes amid a surge in violence in Upper Nile State, where 50,000 people have been displaced since February, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA).

The crisis forced the closure of a cholera treatment unit in Nasir County, with 23 humanitarian workers forced to leave.

South Sudan has seen a steady increase in cholera cases over the past three years. The disease, which causes severe diarrhoea and dehydration, can be deadly if left untreated but is manageable with antibiotics and hydration.

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The country’s last major outbreak, between June 2016 and December 2017, claimed 436 lives.