Those admitted have symptoms of acute watery diarrhea, dehydration, vomiting, and sunken eyes, though the exact waterborne infection causing these symptoms has not yet been determined.
“The situation is really alarming and is about to get out of control,” said Dr. Francis Layoo Ocan, MSF’s project medical referent in Kosti. “The cholera treatment center keeps receiving patients in critical condition. We've run out of space, and we are now admitting patients in an open area and treating them on the floor because there are not enough beds.”
Massive influx of patients overwhelms health facilities
On Wednesday night, the first 100 patients arrived at the cholera treatment center. By Friday afternoon, there were over 800 admitted patients. At least two dozen people died at the center, and at least one was dead on arrival. So far 48 people have been discharged. The numbers continue to rise and keeping a detailed tally has become difficult for the team responding.
MSF has been supporting cholera-related responses in Kosti and Rabak Hospitals since October, though the patient numbers had been decreasing before Wednesday. Some days, staff saw fewer than 20 patients at the center.
With this massive influx, there are too many patients to treat in the MSF-built cholera treatment center in Kosti Hospital, so some are being treated in the hospital’s adult and pediatric emergency rooms. The MSF team is collaborating with the Ministry of Health staff from Kosti Teaching Hospital and additional medical staff from Rabak Hospital to respond to this huge number of patients.
“We are mobilizing our resources and have been able to manage so far,” Dr. Ocan said. “But we are worried that if the situation continues like this over the next few days, we will run out of medical consumables that treat acute dehydration and are keeping patients alive—not to mention that the medical teams would be completely overwhelmed.”
MSF is calling for other actors to step up and help respond to this emergency.
“We urgently need other organizations to help respond to this emergency with staff and supplies for managing patients,” Dr. Ocan said. “People need water, and it’s vital that outreach activities start to stem this crisis at the source.”
Identifying ways to stop the spread of disease
MSF is supporting the White Nile state Ministry of Health in managing the patients while assessing the causes of this surge and identifying ways to reduce and stop the spread of the disease. The most likely source of infection is the river, where many families have been collecting water using donkey carts after a major power outage in the area. Local health authorities have banned collecting water from the river by donkey carts and requested reinforcing chlorination in the water distribution system. The market and most restaurants are currently closed.
Many people in White Nile state are living there after fleeing war in Sudan—primarily in camps with inadequate access to food, shelter, health care, and water and sanitation.
