A deadly outbreak of cholera has killed hundreds of people fleeing conflict in South Sudan. The country's Ministry of Health has recorded more than 7,000 cases of cholera, and at least 229 deaths due to the disease. Children and young adults under 30-years-old are the worst affected, accounting for more than 70% of cases.

South Sudan cholera
A child suffering from cholera drinks water at a specialised hospital located near the Mingkaman Internally Displaced People campAFP

The cholera outbreak will "intensify and spread during the upcoming rainy season due to continued conflict," a UN humanitarian report said. Roughly 3.5 million people have been displaced due to South Sudan's civil war, and about one million are on the brink of starvation, said the report. Crowded living conditions and poor sanitation in refugee camps put people at an increased risk of contracting the disease.

Marcus Bachmann, South Sudan head of mission for the medical charity Médecins Sans Frontières (MSF), told Reuters: "With so many people squeezed in one place, the risk of an outbreak of cholera is extremely high. It puts the exhausted population at highest risk of death."

South Sudan cholera
A man with cholera is treated moments before his death at a temporary specialised hospital in Mingkaman, a camp for internally displaced people in South SudanAFP
South Sudan cholera
Relatives mourn the death of a family member due to the cholera crisis at a temporary hospital in Mingkaman, a camp for the Internally displaced people in Eastern Lakes state, South SudanAFP

Cholera is caused by the bacterium Vibrio cholerae, which causes the cells lining the intestine to produce large amounts of fluid, leading to violent diarrhoea and vomiting. The disease is spread via food or water contaminated with the faeces or vomit of someone carrying the disease, a particular risk in overcrowded areas such as refugee camps. Its victims can die an agonising death.

South Sudan cholera
A South Sudanese patient suffering from cholera rests on a bed at a specialised hospital located near the Mingkaman Internally Displaced People (IDP) campAFP
South Sudan cholera
A child suffering from cholera rests at a specialised hospital located near the Mingkaman Internally Displaced People (IDP) campAFP
South Sudan cholera
A man suffering from cholera is treated at a specialised hospital located near the Mingkaman Internally Displaced People (IDP) campAFP
South Sudan cholera
A Dinka boy, suffering from cholera and severe malnutrition sits on the floor of a tent converted into a temporary field hospital near the village of DorAFP
South Sudan cholera
A malnourished woman suffering from cholera waits for treatment at a temporary field hospital near the village of Dor in Awerial countyAFP
South Sudan cholera
Patients suffering from cholera receive treatment inside a tent converted into a temporary field hospital near the village of DorAFP
South Sudan cholera
A cholera-stricken woman showing signs of malnutrition sits with fellow patients outside a temporary field hospital near the village of Dor in Awerial countyAFP
South Sudan cholera
A mother sits by her child suffering from cholera in a tent converted into a temporary field hospital near the remote village of Dor in Awerial county in Lakes State, central South SudanAFP

Famine was declared in two counties of South Sudan in February 2017, but aid workers have repeatedly been blocked from delivering food aid by government and rebel forces. "The guns have to fall silent ... (or) the humanitarian situation will continue to deteriorate," said Eugene Owusu, the top UN humanitarian official in South Sudan.

Main conflict zones

SUDAN

High emergency area

Internally displaced camps

Refugee camps

Malakal

Bentiu

Aweil

Main conflict

ETHIOPIA

and high

famine areas

Wau

Rumbek

C.A.R.

Bor

Juba

KENYA

CONGO

UGANDA

Main conflict zones

SUDAN

High emergency area

Internally displaced camps

Refugee camps

Malakal

Bentiu

Aweil

Main

conflict

and high

Wau

famine

areas

Rumbek

Bor

Juba

CONGO

The disaster is part of an arc of hunger and violence threatening 20 million people as it stretches across Africa into the Middle East. It extends from Nigeria in the west, where Boko Haram's six-year jihadist insurgency has forced two million people to flee their homes, to Yemen in the east, where warring factions block aid while children starve. Between them lie Somalia's parched sands and the swamps of oil-rich South Sudan, where starving families fleeing three years of civil war survive on water-lily roots.

South Sudan cholera
15 March 2017: A severely malnourished child waits to be processed into a Unicef-funded health programme in Baidoa, the capital of Bay region of south-western SomaliaTony Karumba/AFP
South Sudan cholera
15 March 2017: A malnourished child is weighed by an aid worker for a Unicef-funded health programme catering to children displaced by drought, at a facility in Baidoa in south-western SomaliaTony Karumba/AFP