HIGHLIGHTS
- By 29 November, 1,178 suspected cases of cholera and 13 deaths were recorded from 17 counties across six states.
- As of November 30, over 887,991 individuals, including 446,367 children, entered South Sudan fleeing the conflict in Sudan.
- 1.4 million people in 44 counties and Abyei Administrative Area have been affected by floods including 379,000 people displaced.
- The Humanitarian Action for Children (HAC) remains underfunded at 66 per cent, limiting the ability of UNICEF to reach individuals with life-saving assistance.
SITUATION OVERVIEW AND HUMANITARIAN NEEDS
In November, South Sudan faced a rapidly escalating cholera outbreak following its declaration in late October by the Ministry of Health with 6.8 million individuals at risk and a caseload of 550,000 individuals, assumed at an attack rate (AR) of 8 per cent. The disease spread swiftly across multiple counties, exacerbated by the country's already fragile health and WASH (Water, Sanitation, and Hygiene) infrastructure and struggling health care system. The outbreak unfolded against the backdrop of ongoing crises, including widespread flooding and the significant influx of refugees and returnees from Sudan, which further strained limited resources and increased vulnerabilities. By the end of the month, over 1,100 suspected cases had been recorded in 17 counties across five states including ten deaths with a case fatality ratio of one per cent. Malakal and Renk, Upper Nile State, Rubkona, Unity State and Juba, Central Equatoria State have been, to date the most affected counties. Oral Cholera Vaccination (OCV) campaigns were planned, with early December roll-out dates to complement WASH interventions and curb the spread of cholera in the most affected areas. The overall situation underscored the urgent need for strengthened health systems, improved WASH services, and enhanced humanitarian support to address overlapping emergencies and protect the most at-risk populations.
The country also continued to face multiple public health emergencies including measles and anthrax. Malaria remains the leading cause of morbidity, while Mpox, though still a public health concern, reported no positive cases in the country. A persistent Hepatitis E outbreak was recorded in Bentiu, Unity State particularly among individuals aged 15 to 44 years (43 per cent). There continued to be reports of snake bite cases in Warrap, Northern Bahr el Ghazal, Pibor, Lake, Jonglei, and Unity States linked to widespread flooding in these states.
The month of November recorded a total of 33,131 individuals crossing into South Sudan from Sudan which was a slight increase from that of October at 32,160 individuals. This brings the cumulative of 887,991 people returnees and refugees, including 446,367 children. The majority of these individuals continued to arrive in dire need of immediate lifesaving humanitarian support. Many of them continued to remain in the main transit centres and nearby towns further placing additional strain on local economies and basic services. With escalating tensions and potential increased fighting along border areas of Sudan, the number of new arrivals is expected to rise by the end of the year, compounding the existing humanitarian crisis.
The effects of flooding continued to be experienced countrywide in the reporting month. As of 29 November 2024, the number of people who remained affected by floods stood at 1.4 million and 379,000 people displaced. While heavy rains have declined and floodwaters are receding, many communities remained highly vulnerable to the prolonged impacts of flooding, which have devastated basic services and infrastructure.
Despite the harvest season providing some relief from acute food insecurity in parts of South Sudan, the latest assessments indicate that food insecurity in South Sudan remains critical, with IPC levels showing that a significant portion of the population continues to face crisis or emergency conditions. Fourteen counties are expected to remain in Emergency (IPC Phase 4), while households in Malakal (Upper Nile), the Abyei Administrative Area, and areas with high numbers of returnees—particularly those in transit—are likely to continue experiencing Catastrophe (IPC Phase 5). This dire situation is further compounded by the ongoing cholera outbreak, which disproportionately affects children—the same group already grappling with acute or severe malnutrition. The overlap of these crises is particularly concerning, as malnutrition weakens immunity, increasing vulnerability to cholera, while cholera exacerbates malnutrition, creating a dangerous cycle.
Flooding, climatic shocks, and economic instability have further strained livelihoods, leaving smallholder farmers unable to produce sufficient food. The country’s heavy reliance on expensive imports has pushed basic necessities out of reach for many, forcing millions to depend on humanitarian aid. With the dual burden of disease outbreaks and food insecurity worsening conditions, there is an urgent need for coordinated efforts to address these interconnected challenges and protect the most vulnerable populations.
UNICEF's AIMs platform recorded ten incidents, a slight increase from October, that directly impacted UNICEF-supported activities. These included floods affecting health facilities, harassment of staff by known individuals, and armed conflicts. Notable incidents included intra-Dinka clashes in Tonj North, armed attacks in Tambura and Tonj East (including an ambulance attack), and the hijacking of a chartered aircraft delivering vaccines. These events disrupted operations, displaced people, and forced temporary halts in affected areas. The overall security and access situation in South Sudan continued to pose significant challenges for humanitarian operations, with persistent dangers impacting the delivery of life-saving assistance. In the reporting period, a total of 35 incidents were recorded, 16 of which involved violence, including robberies and ambushes targeting humanitarian actors. Additionally, six incidents were related to bureaucratic impediments, further hindering operational efficiency. These challenges significantly affected the ability to provide timely and effective aid to vulnerable populations in many areas, underscoring the urgent need for improved security measures and streamlined access for humanitarian efforts.