Millions of Sudanese are weary, facing a war of over two years and an unseen enemy within.

Within the past 48 hours, a cholera outbreak has killed at least 70 people in the capital Khartoum, which now faces a mounting health emergency amidst recent escalation of violence.

“There has been an increase in the number of registered cholera cases in the state, with 1,375 infections recorded on Wednesday,” said Mohamed Al-Tijani, director of Emergency and Epidemic Control at the Khartoum State Ministry of Health.

“The number of deaths has decreased due to medical interventions, with only 23 fatalities recorded on Wednesday,” he added, noting there were 45 deaths recorded on Tuesday.

The surge in infections comes weeks after drone strikes blamed on the paramilitary Rapid Support Forces knocked out water and electricity supplies across the capital.

The city has been a battleground throughout two years of war between the Sudanese army and the RSF.

The deadly combination of war, displacement, destruction of critical services and infrastructure and disease outbreaks has now become a daily reality in Sudan, putting millions of people at risk, especially children under five.

According to the UN children's agency UNICEF, more than one million children are at risk in cholera-affected areas of Khartoum.

On the brink

Cholera is endemic to Sudan, but outbreaks have become worse and more frequent since the war broke out in April 2023.

Health authorities have recorded more than 65,000 cases and over 1,700 deaths across 12 of Sudan's 18 states since August 2024.

Khartoum state alone has seen more than 7,700 cases, upwards of 1,000 in children under five, and 185 deaths since January.

"Sudan is on the brink of a full-scale public health disaster," said Eatizaz Yousif, the International Rescue Committee's Sudan director.

"The combination of conflict, displacement, destroyed critical infrastructure and limited access to clean water is fuelling the resurgence of cholera and other deadly diseases."

Up to 90 percent of hospitals in the conflict's main battlegrounds have been forced out of service by the fighting.

Médecins Sans Frontières (MSF), which had suspended operations in south Khartoum’s Bashair Teaching Hospital in January 2025 after repeated attacks, has resumed services to help deal with the emergency.

“Restarting and expanding critical health services in Bashair Hospital and beyond can't wait – it was needed yesterday,” Slaymen Ammar, MSF medical coordinator for Sudan told TRT Afrika.

“Our team in Bashair Hospital has been working to ensure that the 20-bed cholera treatment unit is ready to receive patients,” Ammar said, noting that the war has had a devastating impact of the war on people’s access to healthcare.

“The population in many localities within the capital, including as South Khartoum, still don't have the needed access to essential, life-saving healthcare,” he added.

Broken down

The army-backed government announced last week that it had dislodged RSF fighters from their last bases in Khartoum state two months after retaking the heart of the capital from the paramilitaries.

Khartoum however remains devastated with health and sanitation infrastructure barely functioning.

MSF says a ban on the transport of surgical supplies to Khartoum in 2023, forced a stop to all surgical activities – including caesarean sections and trauma care – for several months.

When armed men again entered the hospital in January 2025, the international aid organisation made the difficult decision to suspend all activity at Bashair hospital.

Several other hospitals and healthcare facilities have been damaged or closed because of the war and are not fully functional.

“The needs in Khartoum remain immense. The current cholera outbreak is only one of the challenges facing people still living in Khartoum or returning from other parts of the country,” Claire San Filippo, MSF emergency coordinator for Sudan said.

“Humanitarian assistance must be scaled up, access facilitated, and medical care protected to ensure that all those who need it, in Khartoum and in the rest of Sudan, can access healthcare,” she added.

Vaccinations

UN chief Antonio Guterres's spokesman said cholera vaccinations have begun in Jebel Awila, the hardest hit district in Khartoum.

"The World Health Organization has also delivered more 22 metric tons of cholera and emergency health supplies to respond to local efforts," Stephane Dujarric said

Sudanese authorities declared cholera a national epidemic in August 2024, with over 60,000 cases and 1,600 deaths recorded.

The war between RSF and the Sudanese army has killed tens of thousands of people and displaced 13 million since it erupted in April 2023.

At least three million people fled Khartoum state alone, but more than 34,000 have returned since its recapture by the army in recent months, according to UN figures.

Most have returned to find their homes devastated by the fighting, with no access to clean water or basic services.