GENEVA — U.N. agencies are scaling up cholera prevention and treatment programs to get on top of a new, deadly cholera outbreak in Sudan that threatens to further destabilize communities suffering from hunger and the ill effects of more than 16 months of conflict.

The recent cholera outbreak has resurged after several weeks of heavy rainfall and resulting flooding,” Kristine Hambrouck, UNHCR representative in Sudan, told journalists Friday in Geneva.

Speaking on a video-link from Port Sudan, she warned, “Risks are compounded by the continuing conflict and dire humanitarian conditions, including overcrowding in camps and gathering sites for refugees and Sudanese displaced by the war, as well as limited medical supplies and health workers.”

She expressed particular concern about the spread of the deadly disease in areas hosting refugees, mainly in Kassala, Gedaref and al-Jazirah states.

“In addition to hosting refugees from other countries, these states are also sheltering thousands of displaced Sudanese who have sought safety from ongoing hostilities,” she said.

The United Nations describes Sudan as the largest displacement crisis in the world.  Latest figures put the number of people displaced inside Sudan at more than 10.7 million, with an additional 2 million who have fled to neighboring countries as refugees.

Additionally, the UNHCR says Sudan continues to host tens of thousands of refugees from countries such as Ethiopia and Eritrea.

Sudan’s health ministry officially declared a cholera outbreak on August 12. In the one month since the first suspected cases were reported, the World Health Organization says 658 cholera cases and 28 deaths have been reported by five states, “with a high case-fatality ratio of 4.3%.”

Kassala has reported the highest number of cholera cases at 473, followed by Gedaref with 110 cases, and al-Jazairah with 51 cases. Two other states, Khartoum and River Nile, have reported fewer numbers.

“These cases are not linked to the previous cholera outbreak, which had been declared in September 2023,” said Dr. Shible Sahbani, the WHO representative to Sudan, noting that the outbreak “technically ended” in May 2024 after no cases were reported for two consecutive incubation periods.

Speaking from Port Sudan, Sahbani described the situation in Kassala as very worrisome. He said the state’s health system already was under stress because of the large number of displaced people and refugees living there. “So, the health system is not able to cope with the additional influx of refugees and IDPs [internally displaced persons].”

“But in addition to that, it puts a big burden on the WASH system — the water, sanitation, and hygiene system. So, this makes the situation more complicated in favor of the spread of cholera,” he said.

Besides the dangers posed by cholera, UNICEF representative Hambrouck also warns of an increasing number of cases of waterborne diseases, including malaria and diarrhea, which also need to be brought under control.

“Constraints in humanitarian access are also impacting response efforts. Violence, insecurity and persistent rainfall are hampering the transportation of humanitarian aid,” she said.

She noted that more than 7.4 million refugees and internally displaced Sudanese living in White Nile, Darfur and Kordofan states are having to do without “critical medicines and relief supplies” because of delays in delivery.

The WHO and UNHCR are working closely with Sudan’s Ministry of Health to coordinate the cholera outbreak response. Among its many initiatives, UNHCR says it is working with health partners to strengthen surveillance, early warning systems and contact tracing in affected locations.

“Disease surveillance and testing are ongoing, and awareness-raising and training on cholera case management for health staff are also being conducted,” said Hambrouck.

For its part, Sahbani said the WHO has prepositioned cholera kits and other essential medical supplies “in high-risk states in anticipation of the risks associated with the rainy season.”

He said the WHO was spearheading a cholera vaccination campaign, noting that “a three-day oral cholera vaccination campaign in two localities of Kassala state concluded Thursday.”

He said the campaign already has used 51,000 doses and “the good news is that we got the approval of an additional 155,000 doses of cholera vaccine. So, this is the good news in the middle of this horrible crisis.”

One dose of the vaccine, he said, would protect the population against cholera for six months, while two doses would provide protection for up to three years.

“So, this is really good news because this will help us to contain the outbreak,” he said.  Without more funding, however, he warned the good news will quickly evaporate, noting that the WHO has received just one-third of its $85.6 million appeal.

“This will indeed limit our capacity to launch a robust response to reach a larger segment of the people in need,” he said.

His UNHCR colleague, Hambrouck, echoed the sentiments.

“With the humanitarian situation and funding level already precarious prior to this latest cholera outbreak, funds are desperately needed to support the provision of health care and other life-saving aid,” she said.
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Port Sudan — For the second consecutive year Sudan is in the grip of a cholera outbreak that has left at least 28 people dead in the last month as rains fall in areas crammed with those fleeing the country’s 16-month-old war, officials said.

Since July 22, when the current wave began, 658 cases of cholera have been recorded across five states, World Health Organization (WHO) country director Shible Sahbani told Reuters in Port Sudan.

With much of the country’s health infrastructure collapsed or destroyed and staffing thinned by displacement, 4.3% of cases have resulted in deaths, a high rate compared to other outbreaks, Sahbani said.

Some 200,000 are at high risk of falling ill, he said.

The war between the army and the paramilitary Rapid Support Forces (RSF) has created one of the world’s largest humanitarian crises and displaced more than 10 million people inside Sudan and beyond its borders.

The country is dealing with a total of five concurrent disease outbreaks include dengue fever and measles.

The RSF has advanced across swathes of Sudan, where people have been cut off from aid as the army has withheld access and RSF soldiers loot supplies and hospitals. Efforts to deliver aid to the western region of Darfur have been complicated by rains.

International experts have determined that there is a famine in Darfur’s Zamzam camp, an area flooded in the rains and highly susceptible to cholera.

About 12,000 cases and more than 350 deaths were registered in the previous cholera wave between October 2023 and May 2024, health minister Haitham Mohamed Ibrahim said, adding that there had been no major outbreak in the nine years before the war.

The current outbreak is centered in Kassala and Gedaref states, which host 1.2 million displaced people.

In Gedaref, a Reuters reporter filmed pools of water attracting insects and large ponds of stagnant rain water mixing with refuse. A local official said that the vast majority of diseases were caused by insects, poor water quality, and sewage.

Many people fleeing raids by the RSF shelter in crowded, makeshift displacement centers, where lavatories have overflowed as heavier-than-usual rains continue to fall. Cholera is transmitted from food and water contaminated with infected feces and thrives in such conditions.

Sahbani said that states like Khartoum and Gezira, largely controlled by the RSF, had also seen cholera cases, while states in the Kordofan and Darfur regions could likely see outbreaks.

“The challenge is getting supplies to the areas we need them. Due to the rainy season many roads are not usable now, but also there are security constraints and bureaucratic constraints,” he said.

On Friday, he told reporters in a virtual briefing that the International Coordinated Group for vaccine allocation (ICG) had approved delivery of 455,000 cholera vaccine doses to Sudan, some “good news in the middle of this horrible crisis.”

Ibrahim said the army-aligned government had used “unorthodox measures” including air drops to try to get vaccines and supplies into those RSF-controlled areas as well as isolated army-controlled areas.

Both officials emphasized that the need in Sudan far outweighed the aid effort, particularly as the U.N.’s humanitarian appeal for Sudan is only about one-third funded.

 
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BERLIN — The Berlin Zoo announced Friday that longtime resident giant panda Meng Meng has given birth to twins — for a second time.

The cubs were born on Thursday, the zoo said in a statement. They were born only 11 days after ultrasound scans showed that Meng Meng, 11, was pregnant. Their sex has not yet been determined “with certainty.”

“Now it’s time to keep your fingers crossed for the critical first few days,” the zoo said. The cubs are tiny, weighing just 169 grams and 136 grams respectively, and are about 14 centimeters long.

As with other large bears, giant pandas are born deaf, blind and pink. Their black-and-white panda markings only develop later.

“I am relieved that the two were born healthy,” zoo director Andreas Knieriem said. “The little ones make a lively impression and mom Meng Meng takes great care of her offspring.”

The zoo said that giant pandas usually only raise one cub when they give birth to twins, so it will “actively support” Meng Meng’s cub care in cooperation with two experts from China’s Chengdu Research Base of Giant Panda Breeding who are in the German capital.

“With around 20 births a year, they have much more experience and are better able to assess development,” panda curator Florian Sicks said.

The cubs will alternate being with their mother every two to three hours to drink milk and are otherwise being cared for in an incubator donated by a Berlin hospital.

Meng Meng and male panda Jiao Qing arrived in Berlin in 2017. In August 2019, Meng Meng gave birth to male twins Pit and Paule, also known by the Chinese names Meng Xiang and Meng Yuan, the first giant pandas born in Germany.

The twins were a star attraction in Berlin, but they were flown to China in December — a trip that was contractually agreed from the start but delayed by the COVID-19 pandemic. China gifted friendly nations with its unofficial mascot for decades as part of a “panda diplomacy” policy. The country now loans pandas to zoos on commercial terms.

Giant pandas have difficulty breeding and births are particularly welcomed. There are about 1,800 pandas living in the wild in China and a few hundred in captivity worldwide.

Meng Meng was artificially inseminated on March 26. Female pandas are fertile only for a few days per year at the most.

The new arrivals and their mother won’t be on show to the public for the time being — but visitors can still see Jiao Qing, 14, as male pandas don’t get involved in rearing cubs.
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COPENHAGEN, denmark — A volcano in southwestern Iceland erupted on Thursday, the meteorological office said, spraying red-hot lava and smoke in its sixth outbreak since December.

“An eruption has begun. Work is under way to find out the location of the recordings,” the Icelandic Met Office, which is tasked with monitoring volcanoes, said in a statement.

The total length of the fissure was about 3.9 kilometers (2.42 miles) and had extended by 1.5 kilometers (.93 mile) in about 40 minutes, it said.

Livestreams from the volcano on the Reykjanes peninsula showed glowing hot lava shooting from the ground.

Studies had shown magma accumulating underground, prompting warnings of new volcanic activity in the area just south of Iceland’s capital, Reykjavik.

The most recent eruption on the Reykjanes peninsula, home to 30,000 people or nearly 8% of the country’s total population, ended on June 22 after spewing fountains of molten rock for 24 days.

The eruptions show the challenge faced by the island nation of nearly 400,000 people as scientists warn that the Reykjanes peninsula could face repeated outbreaks for decades or even centuries.

Since 2021, there have been nine eruptions on the peninsula, following the reactivation of geological systems that had been dormant for 800 years.

In response, authorities have constructed barriers to redirect lava flows away from critical infrastructure, including the Svartsengi power plant, the Blue Lagoon outdoor spa and the town of Grindavik.

Flights were unaffected, Reykjavik’s Keflavik Airport said on its web page, but the nearby Blue Lagoon luxury geothermal spa and hotel said it had shut down and evacuated its guests.

Volcanic outbreaks in the Reykjanes peninsula are so-called fissure eruptions, which do not usually disrupt air traffic as they do not cause large explosions or significant dispersal of ash into the stratosphere.

Iceland, which is roughly the size of the U.S. state of Kentucky, boasts more than 30 active volcanoes, making the north European island a prime destination for volcano tourism.
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Harare, Zimbabwe — The United Nations said Thursday it is working with governments and health officials in Eastern and Southern Africa to contain the outbreak of mpox there.

UNICEF, the World Health Organization and the Africa Centers for Disease Control and Prevention, along with local partners, are responding to the spread of the new mpox clade 1b variant, said Etleva Kadilli, UNICEF’s regional director for Eastern and Southern Africa.

Kadilli said in a statement that more than 200 confirmed cases have been detected in five countries: Burundi, Kenya, Rwanda, South Africa and Uganda.

Dr. Francis Kasolo, director and head of the WHO at the African Union and U.N. Economic Commission for Africa, told a joint WHO-Africa CDC meeting, “Our collaboration has been instrumental in enhancing surveillance, laboratory capacity and effective deployment of technical capacity to countries. Together we are making progress.”

But, he said, there is still much to be done.

It is imperative that we remain vigilant and proactive in our efforts to combat mpox. This means not only addressing it in the immediate needs, but also investing in long-term strategies that will build resilient health systems capable of withstanding future outbreaks and shocks,” Kasolo said.

Last week, the WHO declared mpox a public health emergency of international concern following a surge of mpox in the Democratic Republic of Congo and a growing number of other African countries.

An earlier emergency was declared in 2022. The U.N. agency said that one was declared over in May 2023.

Botswana and Zimbabwe are now screening for mpox after their neighbor, South Africa, recorded three deaths from the new strain. Zimbabwe is screening for the viral ailment at all ports of entry.

“We have said all those who present [high fever] and rash should be thoroughly investigated — where they are coming from and for how long they have been there and possible contact with people who have monkey pox,” Zimbabwean Health Minister Douglas Mombeshora said, referring to mpox’s previous name.

“We have kits to do tests for monkey pox,” he said. “So yes, we are on a very high alert. … I know there was a scare a few days ago. Some people were reporting on social media that there were people who had presented with some rash. They thought it was monkey pox. We did not take it for granted. The patient was said to have tested negative.”

Dr. Norman Matara of Zimbabwe Doctors for Human Rights said that given the country’s poor health care system, keeping mpox out is better than trying to contain it after cases appear.

“It saves the nation a lot of money because treatment is always expensive,” he said. “It also prevents us from unnecessary lockdown restrictions of movements … like what we saw with COVID-19.”

For now, he said, there is no need to panic.

“At the moment we have not recorded any case of mpox. … We just need to increase our health surveillance so that anyone with symptoms can be isolated and they can be screened and any case can be easily identified and minimize the virus spreading in the country,” Matara said.

Dr. Matshidiso Moeti, the WHO regional director for Africa, told VOA this week that the Democratic Republic of Congo was the “epicenter” of mpox. She said front-line health workers in affected areas should be given priority on vaccinations against the ailment.

“The issue of access to vaccines is something which we are working on collectively at the international level,” she said. “This is really a case of negotiating with pharmaceutical companies that are able to produce the vaccine to ensure they scale up their production and increase availability of vaccines.”

Besides a rash, other symptoms of the viral infection can include lesions, muscle aches and swollen lymph glands. Most people fully recover, but some become very ill and die.
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A green revolution is sweeping Pakistan as consumers switch to generating their own solar electricity. But as VOA Pakistan bureau chief Sarah Zaman reports, the move to the increasingly affordable, green option may also cause a crisis for the national grid. Videographer: Wajid Asad
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BANGKOK — Thailand has detected an mpox case in a European man who arrived from Africa last week and is awaiting test results to determine the strain, a disease control official said on Wednesday.  

Thai authorities were treating the case as if it were the Clade 1 form of mpox, as the person, a 66-year-old European man with residency in Thailand, had arrived on Aug. 14 from an African country where it was spreading, Thongchai Keeratihattayakorn, director-general of the Department of Disease Control, told Reuters.  

“After he arrives from the flight there is very little time frame where he come into contact with others,” Thongchai said. “He arrives around 6 pm and on the next day, Aug 15, he went to see the doctor at the hospital.” 

Thongchai said the man has undergone a test to determine whether the case was a Clade 1 variant, with the result expected by Friday. Authorities are also monitoring 43 people in the country who may come into contact with the patient, he said. 

The director-general did not name the African country the man had been in. He said the man had transited in a Middle Eastern country, which he also did not name, before flying on to Thailand. 

Thailand has detected 800 cases of mpox Clade 2 since 2022, but so far not detected a case of the Clade 1 or Clade 1b variants. 

 
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Palestinian residents of a Jerusalem neighborhood have appealed to the Israeli Supreme Court demanding they be supplied with more water. The 120,000 residents of the area say they receive water only three hours a week. Linda Gradstein reports for VOA from Kufr Aqab. Camera: Ricki Rosen.
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Gaborone, Botswana — Health officials in Botswana have started screening travelers for mpox at the country’s entry points. 

Neighboring South Africa has recorded three deaths as a result of the dangerous strain of mpox, and Botswana is anxious to keep out the rapidly spreading disease.

“Although we have not recorded any case of mpox in Botswana, I want to take this opportunity to assure Botswana that we have significantly enhanced our broader surveillance systems,” the country’s minister of health, Dr Edwin Dikoloti, told the media Tuesday. “We are currently intensifying our surveillance at key entry points, which is borders and airports, focusing on high-risk areas.”

South Africa shares a 1,900-kilometer border with Botswana and as of Aug. 5 had recorded three mpox deaths. In Africa, the disease has claimed the lives of more than 500 people since the beginning of the year.

Botswana Public Health Institute Acting Director Dr. Thebeyame Matsheka says travelers will be required to fill out self-assessment forms at border checkpoints.

“There are sometimes where, through just random checks, we might identify someone who appears not to be well, they will take those travelers aside and investigate further,” Matsheka said.

Meanwhile, Dikoloti said Botswana is engaging with international partners for the supply of vaccines.

According to Africa’s Centers for Disease Control and Prevention, the continent has about 200,000 vaccine doses against a requirement of at least 10 million doses.

Medication to be used for the management of mpox is available at health facilities throughout the country.

“Vaccines exist for mpox but they are not widely available,” Dikoloti added. 

The World Health Organization country representative, Juliet Bataringaya, says the scale of the mpox vaccination will not be broad because the disease affects countries differently.

“We need to have a good understanding of the epidemiology in each and every country, because it is different and to understand the transmission patterns,” Bataringaya said. “These will then guide on the use of vaccines in a more targeted way to have maximum public health impact.”

She said there won’t be the kind of mass vaccination effort implemented during the COVID pandemic because the modes of transmission are different.
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Berlin — A World Health Organization official stressed on Tuesday that mpox, regardless of whether it is the new or old strain, is not the new COVID, as authorities know how to control its spread.

“We can and must tackle mpox together,” said Hans Kluge, WHO regional director for Europe, in a U.N. media briefing.

“So will we choose to put the systems in place to control and eliminate mpox globally? Or we will enter another cycle of panic and neglect? How we respond now and in the years to come will prove a critical test for Europe and the world,” he added.

Mpox, a viral infection that causes pus-filled lesions and flu-like symptoms, is usually mild but can kill.

The clade 1b variety has caused global concern because it seems to spread more easily though routine close contact.

A case of the variant was confirmed last week in Sweden and linked to a growing outbreak in Africa, the first sign of its spread outside the continent. The WHO declared the recent outbreak of the disease a public health emergency of international concern after the new variant was identified.

Kluge said that the focus on the new clade 1 strain will also help in the fight against the less severe clade 2 variety that has spreading globally since 2022, allowing Europe to improve its response through better health advice and surveillance.

About 100 new cases of the clade 2 mpox strain are now being reported in the European region every month, added Kluge.

Mpox transmits through close physical contact, including sexual contact, but unlike previous global pandemics such as COVID-19 there is no evidence it spreads easily through the air.

Health authorities need to be on alert and flexible in case there are new, more transmissible clades or ones that change their transmission route, but there are no recommendations for people to wear masks, said WHO spokesperson Tarik Jasarevic.

 
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