South Sudan’s humanitarian needs have increased rapidly in the last few months, even before the eruption of fighting in Juba in July. More than 1,500 cases of cholera, including 25 deaths, have been reported across the country since June. With renewed violence in Juba, many of the city’s residents were unable to access clean water, leading to an outbreak in some parts of the city. Although the outbreak has stabilized over the last month, largely due to efforts by aid agencies, the crisis is far from over.
“Oxfam is working closely with community leaders to identify the most important issues,” says Kenyi Alison, Oxfam’s Emergency Response Officer. “We can’t go everywhere and cover all the needs in South Sudan, but we have identified the most vulnerable people to help first and, at the same time, involve many other organizations that can make this impact bigger.”
Since the beginning of the outbreak in Juba, Oxfam has worked to contain the disease by focusing its response on improving access to clean water and sanitation for affected communities. Oxfam is also working with Community Health Promoters to spread messages about good hygiene practices including hand washing and cleaning of water storage facilities.
Clean water is paramount in stopping the spread of cholera but for most South Sudanese, this most basic of resources is expensive and, at times, inaccessible. Most Juba residents rely on private sector suppliers such as water trucks and bicycle vendors, or on town boreholes. Others collect water directly from the Nile or connected streams where the safety of the water is not guaranteed.
Helen Gune is a mother of seven who lives in the Gudele neighborhood of Juba, the scene of much of July’s fighting. Helen knows that having good access to clean water helps prevent the spread of disease, and ensures that her family is protected.
“My husband and I work very hard to keep our children safe but it’s hard, especially now when security in Juba and the rest of the country is very bad. I wash everything before giving it to my children and I don’t allow them to drink the water from the river or the rain,” she says. “Now our biggest challenge is to overcome the expensive prices in the market.”
In July, South Sudan recorded the world’s highest rate of inflation — at 661%. Across the country, families are struggling as food prices and living expenses rise. Many South Sudanese are resorting to desperate measures such as drinking dirty water in order to survive. The high cost and scarcity of clean water puts people at much greater risk of deadly yet preventable diseases like cholera.
“It is really challenging protecting ourselves from cholera in Juba as we are continuously exposed to it,” says Clara, who lives in Munuki, one of the areas most affected by the cholera outbreak. “We are ten family members at home, and we normally use the rain water to drink. Water purifiers are very expensive and without help we can’t afford them.”
Oxfam is carrying out public awareness campaigns on cholera prevention and treatment, but as Clara says, prevention must start with the individual. “At the end of the day, it’s our hands to stop cholera from spreading. Changing human behavior is the only way to improve health.”
Ramadan Juma is a Sultan on the island of Gondokoro on the Nile River. At 62, he was one of the island’s first settlers, taking up residence in 1964.
“Gondokoro is very secure, but also very far. We’re just one hour away from Juba by boat, but being separated by a river makes it difficult to reach us. Help doesn’t arrive easily,” says Ramadan. “We have learned to survive with the little we have.”
Gondokoro was not immune from the cholera outbreak that spread rapidly across parts of Juba. According to Ramadan, at least ten cases were declared on the island in July but with the nearest hospital hours away, the cost of travel made treatment impossible.
“People here are very well aware about this disease,” said Ramadan. “Our biggest problem is that we don’t have a choice but to drink water directly from the river.”
Oxfam is repairing boreholes on Kondokoro, distributing soap, buckets and water treatment tablets as well as conducting public awareness campaigns on cholera prevention and treatment.
With support from European Civil Protection and Humanitarian Aid Operations (ECHO), Oxfam has reached over 20,000 people in Juba with Cholera prevention and treatment messaging and improved access to clean water and sanitation.