Cholera and violence devastate South Sudan-Ethiopia border
MSF’s South Sudan head of mission warned that the dual crisis could spiral out of control.
By Emmanuel Mandella
A lethal blend of escalating violence and a rapidly spreading cholera outbreak is pushing thousands to the brink of survival along the South Sudan–Ethiopia border, with humanitarian agencies warning of an unprecedented crisis.
Doctors Without Borders/Médecins Sans Frontières (MSF) on Monday sounded the alarm, highlighting the dire consequences of ongoing armed clashes, forced displacement, and a worsening health emergency.
The medical charity warned that if the violence continues unchecked, the region could descend into chaos, leaving an already vulnerable population at even greater risk.
The renewed conflict erupted in South Sudan’s Upper Nile state, where clashes between government forces and armed groups have left scores dead and thousands displaced.
The violence has spilled into Ethiopia’s Gambella region, prompting mass displacement, with the United Nations estimating that at least 10,000 people have fled into Ethiopia since early March.
MSF’s South Sudan head of mission, Zakaria Mwatia, warned that the dual crisis could spiral out of control.
“We have already witnessed how this violence has fueled the spread of cholera in several areas, but a larger, escalating conflict could push the entire country into an unprecedented humanitarian catastrophe. We urgently call on all parties to the conflict to ensure the protection of civilians, health care workers, and medical facilities.”
Cholera, a disease caused by eating contaminated water or food, has spread fast.
MSF teams are responding to outbreaks in Upper Nile and Jonglei states, as well as across the Ethiopian border in Gambella. Since March, over 1,000 cholera patients have been treated in South Sudan alone, while more than 560 cases have been managed in Ethiopia.
In Akobo County, South Sudan, an MSF-run cholera treatment unit has admitted over 300 patients in just two weeks. In Ulang, a survivor of the violence, Ruach Riek Chuol, recounted his ordeal.
“My goods and property were all burned inside the house. Everything was destroyed in the fire, including the house where I was,” he said, lying on a hospital bed with bandages covering his wounds, a stark reminder of the recent violence in his county.
Meanwhile, in Gambella, MSF teams, in collaboration with Ethiopia’s Ministry of Health, have deployed 100-bed cholera treatment centers and oral rehydration points. Yet, with a massive influx of refugees, the needs far outweigh the available resources.
Thousands of South Sudanese are arriving in Ethiopia with only what they can carry, their faces etched with exhaustion and despair. In Burbeiye, a new encampment in Wanthoa Woreda has sprung up overnight, hosting more than 6,500 new arrivals.
A South Sudanese mother who escaped from Nasir described her harrowing journey.
“I came here because back home, people are being killed. There was nothing to eat, and when we arrived at places where we took respite, my kids became sick. There were no health facilities that we could run to.”
Meanwhile, MSF’s Ethiopia head of mission, Joshua Eckley, stressed on the urgency of the situation.
“The displaced people are arriving in Gambella with little more than what they can carry. Our teams are responding to the cholera outbreak and providing care, but without additional support, the situation could worsen.”
Compounding the crisis, humanitarian agencies are struggling to sustain their operations due to dwindling donor support.
The recent USAID funding cuts have forced several organizations to scale down or shut critical services, including mobile health clinics.
MSF’s Zakaria Mwatia warned of the consequences of these funding reductions.
“In places like Akobo, cholera response efforts have been highly impacted by funding cuts. Some organizations that supported cholera treatment units have suspended all activities. This is part of a broader trend across the country.”
South Sudan, already grappling with underfunding and limited medical capacity, is now overwhelmed by a crisis that has spilled over its borders. The arrival of over 1 million refugees fleeing Sudan’s war has also added to the burden.
In a call for urgent action, Humanitarian agencies are appealing for immediate intervention—both in terms of funding and access to critical aid services. With cholera spreading, violence escalating, and refugees pouring into camps with limited resources, the situation demands an urgent response.
MSF is calling for emergency funding to sustain cholera vaccination campaigns, provide safe water, and ensure trauma care for those wounded in the violence. Without swift international support, the border crisis could evolve into a full-blown humanitarian catastrophe.
“Disruptions in cholera treatment services, combined with actors’ reduced capacity to support oral vaccination campaigns, heighten the risk of further spread,” Zakaria added. “We urge donors to allocate emergency funds for South Sudan and Ethiopia to prevent a disaster.”
