South Sudan: Children with cholera die on three-hour walk for treatment after aid cuts shut local health clinics

JUBA, (April 9, 2025) – At least five children with cholera in South Sudan have died on an arduous journey to seek medical treatment, after aid cuts forced their local health services to close in the middle of a major outbreak of the deadly disease, Save the Children said.

The children from a remote part of Akobo County in the country's east, along with three adults, died on the three-hour walk from their village to seek treatment at the nearest remaining health facility in Akobo town. The group walked in the blazing sun where temperatures reached as high as 104 degrees Fahrenheit (40 degrees Celsius) and had no access to clean water, shade or medicines.  

Earlier this year, these children and adults would have had access to lifesaving treatment in one of the 27 health facilities established and supported by Save the Children, providing free, critical healthcare for conditions like malnutrition and cholera.  

However, due to this year's foreign aid cuts, these services are no longer available, with seven of these health facilities forced to shut completely and the remaining 20 partially closed. Some of these centers are only being run by volunteers, and there is no longer transportation to take severely ill people to the hospital in town.  

Meanwhile, cholera, caused by abnormally heavy rains and flooding, has been surging in Akobo County since mid-February, with 44% of reported cases in children aged 17 and younger.

Floods have also devastated crops and, combined with conflict, have led to families in Akobo County also living with "critical" levels of food insecurity and malnutrition – some of the worst in the country.

Save the Children staff said half the children they see in the clinics still operating across Akobo County are suffering from malnutrition – one of the biggest killers of children worldwide, which damages immune systems and leaves children more vulnerable to diseases like cholera.  

Meanwhile, the area has been swept up in a nationally escalating security situation, with recent airstrikes in Akobo County. The nationwide tensions risk spiraling the country back into conflict seven years after the landmark peace agreement, further jeopardizing humanitarian access in a country where 78% of the population is in need of aid.

In the clinics where Save the Children is still able to provide some services, the aid agency has been supporting a cholera treatment unit and is providing infection prevention and control as well as water, sanitation and hygiene supplies and awareness.

For now, many cholera patients in Akobo County have to make do with dwindling supplies of oral rehydration sachets, usually used for mild cases of diarrhea. If they are unable to get to the clinics that are still functioning, they have resorted back to traditional forms of medicine, such as eating local herbs.  

Sarah*, 24, a cholera patient in a remote community in Akobo County said: "I am sick. My stomach is in pain, and I cannot move. They said I can go to hospital in town, but I am weak and it is far. The doctor is helping his people for free. When Save the Children left, we had no hope, this doctor is only helping and sending us to Akobo to receive medicines. 

"We used to be happy – there were many doctors and enough medicine. We did not suffer much. But we are now suffering. Sick people are being carried to hospital because they cannot walk for many hours."

Micheal, a community health worker who volunteers at the health facility, said: "Since the cuts, the community is really suffering; we don't have good medications. Before we had all medications for various diseases, and patients were treated on time; now we have no choice. We see patients suffering, and we can't help. We can only refer, knowing that it's difficult for some patients to reach the hospital in town in time to be helped since it is almost three hours of walking. 

"Now there is a serious cholera outbreak. We don't have any medications apart from Oral Rehydration Salt (ORS), which is very limited; we only give one sachet per patient."

Chris Nyamandi, Save the Children Country Director in South Sudan, said:  "There should be global moral outrage that the decisions made by powerful people in other countries have led to child deaths in just a matter of weeks.  

"It is critical that the world wakes up to the humanitarian catastrophe unfolding in South Sudan – a country where four out of five people need aid to survive. We must do everything in our power to prevent such deaths from happening again. The first step is to make sure the current tensions in the country do not escalate further. Children and families in South Sudan need peace and stability that will allow Save the Children and other aid groups to rise to this emerging challenge, adapt to the new global reality and do our utmost to put children’s needs first – to ensure this travesty does not happen again."

Save the Children has worked in South Sudan since 1991, when it was part of Sudan. The child rights organization provides children with access to education, healthcare and nutritional support, and families with food security and livelihoods assistance.

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