Kai Koang, at the crack of dawn on a Tuesday morning, armed with his loud megaphone tightly held to his mouth and moving from house-to-house stormed site D of the highly populated Bentiu internally displaced persons (IDP) camp passing on good news – on the commencement of the oral cholera vaccination campaign. Kai is a well-known social mobilizer in the camp.

A few minutes later the vaccination site was awash with people ready to receive the vaccine.

"Cholera ‘ee juath mijek....' said Nyamoch Madit, a 27-year-old mother of two in her native Nuer language, literally meaning cholera is a dangerous disease 'I came with my two children, my siblings and cousins to get vaccinated today so that we don't miss out”.

Nyamoch  Madit is among tens of thousands of IDPs from the neighboring Guit County seeking refuge in the Bentiu IDP Camp following the devastating floods which hit their area.

The Ministry of Health with support from the World Health Organization (WHO), IOM, UNICEF, and other partners conducted a pre-emptive oral cholera vaccination campaign in the high- risk floods affected locations with the first round being started on 25 January 2022 in Rubkona and Bentiu Internally Displaced Persons (IDP) Camp in Unity State targeting over 202 000 people.

The second round of the campaign is slated to take place in mid-February 2022 and similar vaccination campaigns will be conducted in the other prioritized floods-affected and cholera hotspot counties in Unity, Jonglei, Upper Nile, Central Equatoria, Eastern Equatoria, Lakes, and Warrap States.  
Rubkona County is one of the counties affected by unprecedented floods in 2021. The floods have caused massive displacement with thousands of affected populations from across the state now living in IDP camps.

“To protect communities, prevent transmission and control outbreaks, all aspects of the national cholera prevention and control plan must be maintained and accelerated so as not to lose momentum, and to consolidate the interventions and gains over the past years”, said Dr John Rumunu, Director-General, Preventive Health Services, Ministry of Health South Sudan. “This requires multisectoral action that prioritizes coordination, rapid response to prevent widespread outbreaks and long-term interventions to prevent cholera transmission in hotspot areas”.

I urge all the health sector stakeholders to ramp up required support including financial resources to put in place all preventive measures to ensure that there are no outbreaks in the flood-affected areas said Dr Rumunu.  

During the flag-off of the vaccination campaign at Rubkona PHCC, the Acting Director-General, State Ministry of Health, Unity State Mr Elijah Makuei said, “the situation is worrying”.  

“Given the current congestion in the displacement sites, inadequate access to safe water, sanitation, and hygiene both in the IDP camps and the town’s chances of diseases outbreaks including cholera are very high”. “Thanks to all our partners especially WHO for all the support including the provision of the vaccines to ensure that our people are vaccinated against cholera".

Dr Fabian Ndenzako, WHO Representative a.i for South Sudan said, “given the humanitarian crises in South Sudan and the several outbreaks of cholera the country faced in the past, the pre‐emptive mass oral cholera vaccination campaigns provide protection to the vulnerable population and are used as a bridge for launching sustainable and long-term interventions”.

With support from Gavi, the Vaccine Alliance, a total 2.9 million oral cholera vaccines have been secured to prevent the risk of outbreaks in cholera hot spot areas of the country. For the vaccine to be most effective people need two doses administered two to four weeks apart.

Since the last half of 2021, the widespread flooding has affected 835 000 people in 33 counties across the country as of the end of December 2021. The hard-hit areas include locations in Unity, Jonglei, and Upper Nile.

Cholera continues to be a public health threat to children, women, and other vulnerable groups in South Sudan. The recurrent outbreaks of cholera since 2014 including the longest and largest (18 June 2016 to 18 December 2017) demonstrate the continued vulnerability of the population to the disease, which is preventable and treatable.

Technical contacts:

Dr Wamala Joseph Francis, Email: wamalaj [at] who.int (wamalaj[at]who[dot]int)