By Sarah Easter, David Mutua, and Becca Mountain
In South Sudan, a cholera outbreak is worsening an already dire series of interconnected crises. For displaced families, CARE-supported health centers are a lifeline—but with limited resources, health workers are stretched thin as they fight to save lives.
Tian had been running for days. She and her children fled violence in Sudan, bringing with them only what they could carry. When they finally crossed into South Sudan, exhausted and starving, there was no formal refugee camp to receive them—just a small, overcrowded village on the border.
“We had no food, no water,” Tian recalls. “The children were weak. We kept walking, hoping to find help.”
Like thousands of other displaced families, Tian faced an impossible choice: continue traveling for days to reach a reception center with aid services or stay near the border, clinging to the hope of reuniting with lost loved ones. Many, like Tian, are too weak to journey on.
“Saving lives is teamwork”
Responding to this desperate need, CARE set up a small health center made from tarps, sticks, and corrugated iron. It’s the only medical facility for miles. Here, midwives deliver babies to malnourished mothers, doctors treat children affected with cholera and malaria, and nurses tend to the wounds, both physical and invisible, of those who have survived unimaginable trauma.
“Saving lives is teamwork,” says Kodi Ishmail Arud, a CARE midwife. “We support each other here. When I have a delivery, the pharmacists give me the medicine I need. The doctors help with complicated cases. But we lack so much—medicines, equipment. We can only treat mild cases.”
CARE medical assistant Akuei Samuel echoes this concern. “People arrive weak and malnourished. They’ve traveled far, seen the worst of war. We are the first help they receive, but we are limited in what we can do.” He speaks while preparing an IV for a feverish child named Abdu, just one and a half years old and already battling malaria.
Malaria is the most common reason of death of children under 5 in South Sudan, which has one of the most severe malarial burdens in the world. It is estimated that 7,630 people in the country have the mosquito-borne disease, and that 18 people die from it every day. The median survival time for children with malaria in South Sudan is just three days.
Fighting cholera on the frontlines
Even as health workers fight to care for displaced families, new mothers, and sick patients, another deadly threat is growing in form of cholera.
Cholera is a severe bacterial disease caused by consuming contaminated food or water, and it can be fatal within hours if not treated quickly. When people can’t access clean water, basic sanitation, hygiene, and healthcare, cholera spreads rapidly. This means the disease often flourishes in areas where clean water, sanitation services, and WASH facilities may not exist.
Areas like displacement camps.
Since the day first case was reported in September 2024, over 65,180 cases and more than 1,240 deaths have been reported across 40 counties as of May 20th, 2025.
In the remote village of Gak Dong, deep within Akobo County on the border with Ethiopia, the outbreak has reached crisis levels.
“We receive anywhere from 15 to 50 patients daily,” says Khon Ajith, a mental psychosocial health worker at CARE’s partner organization, the Community Initiative for Development Organization (CIDO). “Some recover, but new ones arrive each day, often carried by family members who have walked for hours to reach for help.”
In partnership with CARE, CIDO has established a cholera treatment unit in Gak Dong, where health workers administer life-saving rehydration treatment. Without it, many patients—especially children—would not survive.
But treatment alone isn’t enough. Stopping cholera means preventing its spread, which requires reliably clean water, stable sanitation access, and ongoing hygiene education.
The urgent need for support
Across South Sudan, CARE has already reached nearly 76,300 people with humanitarian assistance in response to the cholera outbreak, more than half of whom are children under the age of five. The robust relationships CARE South Sudan has established and nurtured with local organizations, in combination with strong supply and logistics systems, means that funding, materials, and staff can efficiently and reliably get to those at risk. CARE South Sudan also has engaged community leaders, influencers, and other trusted sources to help spread factual information about cholera treatment and prevention, address rumors, and maintain open communication.
But resources remain limited, and reaching the most remote communities is a constant challenge. Outbreaks of cholera and malaria continue. Without urgent international attention and funding, health workers fear the worst.
For families like Tian’s, the threat of disease is just the latest in a series of crises. Displacement, conflict, and malnutrition have already taken so much.
Yet, amid hardship, health workers continue their fight. In Gak Dong and at the border, CARE-supported clinics stand as beacons of hope—understaffed, underfunded, but unwavering in their mission.
“We are here to help in any way possible,” says Samuel. “Even when we don’t have enough, we do what we can.”
Every day, families in South Sudan face impossible odds. But with continued support, more lives can be saved.