Charity blames US aid cuts for fatal cholera claiming children's lives
7 Min Read
In South Sudan’s worst cholera outbreak in decades, clinic closures caused by US aid cuts have forced patients to walk for hours in extreme heat, leading to preventable deaths along the way.
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A Somali internally-displaced (IDP) child sits outside makeshift homes in Maslah camp, Mogadishu, Somalia, on April 9, 2025 (AP)
At least 5 children and 3 adults have died from cholera in South Sudan while trying to reach medical care amid recent US foreign aid cuts. According to Save the Children, these lives were lost following the shutdown of essential healthcare services.
The cholera outbreak, which began in 2024, has already infected tens of thousands across South Sudan. However, the country’s ability to respond has been severely hindered by funding cuts and a weakened healthcare system. The fatalities occurred in the eastern part of the country, where the outbreak has been especially intense and where many health centers have been forced to close due to a lack of support.
Many Cholera deaths in South Sudan are going unreported. The true scale of the disaster is being hidden due to the lack of resources and access to accurate reporting mechanisms. The lack of data and oversight also makes it harder to mobilize the international community.
📢 South Sudan: Children with cholera die on three-hour walk for treatment and patients left with just Oral Rehydration Salts after aid cuts shut local health clinics - @SCSouthSudan
— Save the Children Canada (@SaveChildrenCan) April 9, 2025
Spokesperson available.
News Release: https://t.co/UNnLDzo6BP pic.twitter.com/DhmRBl6ecn
Those who died had to walk for hours under the scorching sun to reach the nearest health facility still in operation—many of which are overwhelmed and lacking in supplies. Their deaths highlight just how vital accessible healthcare is, especially during major health crises. The brunt of these aid cuts is being borne by the most vulnerable—people who simply cannot manage the dangerous journey to get the help they need.
Grueling journey for treatment
The victims of cholera, all from the eastern regions of South Sudan, endured a painful and lengthy journey in search of medical care. These individuals were part of a larger group left with no choice but to try to reach treatment after many health clinics were shut down.
Cholera spreads rapidly in areas with poor sanitation, and its dangers are heightened when treatment is delayed. The disease causes severe dehydration and can kill within hours without proper medical intervention.
"While emergency lifesaving programmes continue, we will not, in good conscience, ask the American taxpayer to provide assistance that effectively subsidises the irresponsible and corrupt behaviour of South Sudan’s political leaders," a US State Department spokesperson said.
Save the Children has described the situation as becoming increasingly critical, with many people being in desperate need of care and unable to access any medical help. The charity stressed that the shortage of aid and health facilities has significantly worsened the risks for people in South Sudan. What was once a situation that could be managed with timely treatment has now escalated into a deadly crisis.
Impact of US aid cuts
In January, these cuts forced 7 out of 27 health facilities supported by Save the Children in Akobo County to shut down completely. Meanwhile, 20 other health centers were forced to cut down their operations, exacerbating an already dire health crisis.
Some remaining clinics are operating with severely limited resources and are now managed by volunteers, many of whom lack the training and supplies needed to handle large numbers of patients effectively.
A devastating consequence of these cuts is the inability to transport patients to hospitals in a country already struggling with inadequate infrastructure and limited healthcare. The country is currently on the brink of civil war amid the ongoing health crisis.
Christopher Nyamandi, Save the Children’s country director for South Sudan, recounted his visit to a clinic in Akobo County shortly after the aid cuts were implemented. He observed that tents meant to accommodate 25 patients were packed with hundreds, forcing many individuals to sleep outside. This overcrowding significantly heightened the risk of additional health issues for those already suffering.
Many cholera patients, who were already dealing with severe dehydration, had no choice but to sleep outside, exposed to the intense heat and the threat of mosquito-borne diseases. The overcrowding, lack of proper shelter, and limited medical care created a hazardous and unsanitary environment for those in need of treatment.
Nyamandi explained that health workers on the ground were overwhelmed and unable to manage the large influx of patients, forced to make difficult changes.
Challenges for healthcare workers
Healthcare workers in South Sudan are facing unprecedented challenges as they try to manage the cholera outbreak with dwindling resources.
Exciting innovation!
— WHO South Sudan (@WHOSouthSudan) April 11, 2025
Amid dwindling funding for health, communities in remote locations in #SouthSudan are leveraging local resources to boost the cholera response.
Residents of Thargueng, Jur River innovatively are constructing a cholera treatment centre using local materials. pic.twitter.com/DjPAAJ8aUK
In some areas, clinics are left to care for patients without even the most basic equipment, such as IV fluids, which are essential for treating cholera-related dehydration. Despite their best efforts, health workers are unable to provide adequate care due to these shortages. This results in many patients not receiving the necessary treatment in time, which contributes to the rising death toll.
Nyamandi spoke to the emotional toll this has taken on the healthcare workers. In the face of overwhelming demand and scarce resources, they are often forced to make impossible decisions. “When somebody dies,” Nyamandi said, “the workers can only try to protect the children from seeing that scene.” These workers are not only tending to the sick but are also confronting the emotional and psychological weight of the situation.
Cholera is a highly contagious disease that can kill within hours if left untreated. It spreads through contaminated food and water, posing a serious threat in areas with poor sanitation and overcrowding. In South Sudan, where conflict and instability have displaced many into camps with limited clean water, the risk of outbreaks is especially high.
While cholera can be treated easily and cheaply with oral rehydration salts, the real problem is access to healthcare, which has long been a problem in Sudan, even prior to the aid cuts.
In March 2025, the United Nations Children’s Fund (UNICEF) reported that South Sudan is facing its most severe cholera outbreak in 20 years. Since September 2024, over 47,000 suspected and confirmed cases have been recorded. With ongoing aid cuts and limited resources, the outbreak is expected to worsen as the country struggles to mount an effective response.
Changes to US foreign aid structure
The reduction in US aid is part of a broader change in American foreign policy under the Department of Government Efficiency, headed by Elon Musk. This new department has overseen major cuts to the US Agency for International Development, the main agency responsible for American foreign aid. These cuts have had serious consequences, especially for countries like South Sudan that depend heavily on international support.
By mid-August, the State Department is expected to take over the remaining duties of USAID. This transition has sparked concern about the future of US foreign aid—particularly in crisis-prone regions like South Sudan, where American funding has been crucial for health and humanitarian efforts.
The restructuring has created uncertainty about how effective future aid programs will be. As funding is reduced or shifted, many nonprofits and local agencies are struggling to fill the gaps left behind. This policy shift is likely to have a lasting impact on global humanitarian efforts.
