In a country already buckling under the weight of war, economic collapse, and mass displacement, Sudan now faces another brutal foe—cholera. Over the weekend, health officials in El Geneina, the capital of West Darfur, confirmed six new cases of cholera, including two fatalities. These may seem like small numbers, but the emergency health coordination committee is warning of something far more ominous: a widening outbreak that could spiral out of control in the absence of urgent international aid.
The re-emergence of cholera in Sudan is a grim but predictable outcome of more than a year of fighting between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF), whose battles have shredded public health infrastructure, decimated water sanitation systems, and displaced millions. While the cholera bacterium—Vibrio cholerae—may thrive in contaminated water, it’s conflict that lays the groundwork for its flourishing.
Medical responders on the ground are already on edge. “There are definitely more cases than the six we’ve confirmed,” says a member of the El Geneina Emergency Room, the civil response body trying to coordinate limited medical relief. “People are dying in their homes. Others are too afraid to go out looking for help.”
The six confirmed patients were taken to the El Zahra school, a makeshift medical center hastily repurposed into a cholera isolation ward. Humanitarian organizations, including Médecins Sans Frontières (MSF) and the International Medical Corps, are rushing to deliver chlorine, rehydration salts, and IV fluids. But they are facing an uphill battle. Trucks carrying supplies have reportedly been delayed at checkpoints, and some routes are still under the control of paramilitary groups or looters.
One of the tragic ironies of Sudan’s plight is that the war has turned even the act of finding clean drinking water into a potentially lethal endeavor. In El Geneina and many surrounding towns, municipal water services haven’t operated in months. Locals resort to fetching water from makeshift wells, streams, or storage tanks long contaminated by sewage or corpses. This environmental collapse has combined with the collapse of government to create ideal conditions for cholera—a disease that is, in theory, entirely preventable.
Historically, cholera has always been a disease of inequality. It thrives in communities without functioning sanitation systems and punishes the already vulnerable. In 2023, Sudan endured another outbreak, with thousands infected and hundreds killed. But this time is different. “We had some semblance of a health system then,” says Dr. Amani Idris, a Sudanese epidemiologist now working in exile from Cairo. “Now we’re operating in freefall.”
The World Health Organization (WHO) and UNICEF have issued joint alerts in response to the outbreak, but international focus on Sudan remains minimal, eclipsed by other crises, such as the war in Gaza, tensions in the Taiwan Strait, and the economic meltdown in parts of Europe. Funding gaps persist. The UN Humanitarian Response Plan for Sudan in 2025 is only 18% funded, and most of the allocated resources are going toward food aid, not public health emergencies like cholera.
What’s worse, the fighting has fractured Sudan into warlord-run zones where access for NGOs is spotty and often politicized. In Darfur, particularly West Darfur, the RSF and its allied militias are accused of targeting humanitarian convoys, looting hospitals, and weaponizing starvation. This means any public health intervention, such as mass vaccination campaigns or clean water distribution, may become entangled in political rivalry or armed conflict.
A temporary ceasefire in parts of Darfur earlier this year had raised hopes for a more coordinated humanitarian push, but those hopes were dashed after renewed clashes last month. Now, health experts worry that by the time peace returns—or even temporary access corridors are secured—it might be too late to contain the outbreak.
Sudan is no stranger to suffering, but cholera adds insult to an already bleeding nation. This is a country where over 10 million people are internally displaced, where bread costs more than many people earn in a day, and where entire cities have been reduced to ruins. Yet the quiet cruelty of cholera—its ability to kill quickly, humiliate thoroughly, and spread invisibly—makes it especially terrifying.
For Sudanese families already trapped between warlords and economic collapse, the question isn’t just where the next meal will come from—it’s whether the water they drink today will kill them tomorrow. That’s the cruel paradox of cholera: it exploits life’s most basic necessity and turns it into a silent weapon of mass destruction. As international headlines move on and donor fatigue sets in, the people of El Geneina and beyond wait for a lifeline that, if not extended soon, may come too late. Cholera doesn’t knock when it arrives; it kicks the door down. And in Sudan, every door has already been left swinging open.
