Health authorities in Sudan’s West Kordofan have declared a public health emergency after a cholera outbreak killed at least 40 people and infected 228 others, according to figures released Tuesday. The disclosure comes as Sudan’s already fragile health infrastructure buckles under more than two years of brutal conflict between the Sudanese Armed Forces and the Rapid Support Forces paramilitary.

Alaa Nugud, spokesperson for the RSF-aligned Sudan Founding Alliance, identified En Nahud locality as the epicentre of the outbreak, accounting for 215 of the 228 confirmed cases. Smaller clusters were reported in El Fula (5 cases), Wad Banda (4 cases), and single cases each in Dibebad in South Kordofan and Ghubeish.

“The conditions for an outbreak of this magnitude were sadly predictable,” said Dr. Youssef Ramadan, a regional health coordinator with Médecins Sans Frontières. “When whole localities are cut off from running water, when water-treatment infrastructure is deliberately destroyed, and when displaced populations are crowded into areas with no sanitation, cholera is almost inevitable.” He said MSF teams were working around the clock to supply oral rehydration salts, intravenous fluids, and chlorination tablets, but access remained deeply restricted by ongoing fighting.

The humanitarian situation in the broader region continued to deteriorate in parallel. Emergency teams operating in East Darfur reported a separate surge in suspected measles cases inside a refugee camp hosting South Sudanese refugees, compounding the pressure on already overstretched aid agencies. The Red Cross, Solidarity International, and the Humanitarian Aid Commission were also working to disinfect water sources and distribute hygiene kits in the hardest-hit areas.

The West Kordofan outbreak is the latest in a series of public health crises that have multiplied since the war between General Abdel Fattah al-Burhan’s forces and the RSF under General Mohamed Hamdan Dagalo erupted in April 2023. A United Nations report published last month warned that 19.5 million Sudanese — nearly 40 percent of the country’s population — are now facing acute hunger, with five million people classified at emergency hunger levels and 135,000 living in areas at imminent risk of famine.

International donors have pledged support for water and sanitation projects in conflict-affected areas, but ground-level access has been inconsistent. Health workers inside West Kordofan said the cholera strain identified in laboratory tests was consistent with water contaminated by raw sewage — a condition that worsens whenever bombardment disrupts local infrastructure or displaces residents from their homes.

Authorities in En Nahud have urged residents to boil all drinking water and report symptoms — particularly acute watery diarrhoea and vomiting — to the nearest health centre immediately. Local mosques and community organisations have been mobilised to spread the warning across rural areas where mobile phone coverage is limited or non-existent. Community leaders in El Fula and Wad Banda have called on both warring parties to grant a temporary humanitarian corridor to allow aid workers to reach the sick without risking being caught in crossfire.

The outbreak adds further strain to an already dire situation in Sudan, where the International Criminal Court is separately investigating recent events — particularly in El Fasher — for alleged atrocities bearing “hallmarks of genocide,” according to a United Nations assessment released last week.

Amara Osei is a breaking news correspondent for Media Hook covering Africa. He can be reached for tips and corrections at amara.osei@mediahook.com