In March 2025, following the Sudanese military’s reclaiming of Khartoum, the capital city, a wave of returnees flooded back to reconnect with family and assess the state of their homes. However, the relief of returning was overshadowed by the heartbreaking reality of extensive destruction wrought during nearly two years under the authority of the Rapid Support Forces (RSF), a paramilitary group engaged in conflict with the Sudanese Armed Forces (SAF), the entity many Sudanese citizens and the UN recognize as the legitimate ruling authority since April 2023.
In regions where hospitals and supplies of food and medicine had been systematically devastated, many individuals returning to Khartoum quickly found themselves falling ill.
Omdurman Faces Challenges
A large number of returnees gravitated towards Omdurman, one of Khartoum’s three cities, which offered slightly better living conditions, having avoided significant control by the RSF, thus escaping the brunt of violent clashes and looting.
However, Omdurman quickly became overcrowded with “thousands of returnees from Egypt alone,” as noted by Dr. Dirar Abeer, a member of the Emergency Response Rooms in Khartoum, which coordinate relief efforts across Sudan.
This influx of people led to a swift increase in cholera cases, a severe and highly transmissible diarrheal disease endemic to Sudan that can be deadly without prompt treatment.
“There are many decomposing bodies near or even in the Nile in southern Omdurman, contributing to the infection spread,” disclosed Badawi, a local volunteer who chose to remain anonymous due to security concerns in the conflict-affected area.
Cholera has manifested as a widespread epidemic in Sudan, affecting multiple states including White Nile and Gadarif, claiming hundreds of lives in just a fortnight.
Similar to the situation in Khartoum, the unchecked spread was exacerbated by overcrowding and inadequate essential services.
Fazli Kostan, project coordinator for Doctors Without Borders (MSF), emphasized that halting the waterborne disease is feasible through basic sanitation and provision, although he expressed skepticism about current capabilities. “It’s quite challenging at the moment,” he told Al Jazeera, highlighting the collapse of Omdurman’s electricity infrastructure post-RSF drone strikes on May 14, which devastated power stations.
With no access to safe drinking or bathing water, residents are left with no choice but to consume contaminated Nile water or capture rainwater from the ground, Badawi added.
According to the SAF-led Ministry of Health (MoH), there has been a significant rise in cholera cases in the capital region from May 15 to May 25, with at least 172 fatalities reported between May 20 and May 27.
The UN indicated a staggering increase in daily cholera cases, surging from 90 to over 815 in late May.
Patients Lining Hospital Streets
Those affected by the disease quickly flock to the nearest healthcare facilities, further overwhelming an already beleaguered health sector. Local volunteers reported that many individuals may not exhibit severe symptoms, suggesting that home isolation may be a better approach.
“Hospitals are inundated with patients, and we lack sufficient medication or medical supplies to cope with the influx,” remarked Kareem al-Noor, a medic at al-Nao hospital in Omdurman. “Currently, we’ve reached full capacity, leaving some patients waiting for treatment outdoors,” he continued.
Dr. Abeer criticized the SAF-backed health authorities for their insufficient response to the crisis, suggesting that while the RSF significantly damaged the health infrastructure, more could be done by current authorities.
Al Jazeera reached out to Dr. Montasser Towarra, the MoH spokesperson, for insights regarding the ministry’s initiatives to aid volunteers and supply necessary provisions, but received no reply before publishing.
Food Insecurity Aggravates the Situation
Sudan is grappling with a severe food crisis, laying waste to the livelihoods of millions due to failed harvests, rampant looting of food aid, and widespread destruction of homes and businesses.
The UN reports that around 25 million people—over half the country’s population—currently face extreme food insecurity.
Hunger can severely diminish health and rise the likelihood of acquiring contagious diseases, as pointed out by Alex De Waal, a Sudanese famine expert. He warns that children, in particular, suffer higher mortality rates from diseases when faced with starvation.
“We could potentially witness excess deaths reaching hundreds of thousands over the imminent year due to these intertwined crises,” De Waal cautioned.
The UN also warns that without immediate intervention, as many as one million children could perish from cholera.
Addressing the burgeoning health crisis depends on restoring basic services like electricity and sewage systems to enhance sanitation, asserted De Waal, but he implored that it seems the army, the new de facto authority, does not prioritize such repairs.
Al Jazeera sent inquiries to SAF spokesperson Nabil Abdullah regarding the army’s plans for restoring vital infrastructure, like ruined power grids. Abdullah deferred responsibility, stating, “These questions should be directed to the Ministry of Health.”
Towarra of the MoH likewise did not provide feedback to those inquiries.
De Waal speculated that the military’s focus primarily remains on combat operations against the RSF. “My impression is that the army is financially and organizationally overextended, with little bandwidth to address anything but the ongoing conflict,” he concluded.