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South Sudan crisis threatens to derail tropical disease efforts

Since mid-December the nascent South Sudanese state has collapsed into inter-ethnic violence, sparked by a skirmish within the country’s Presidential Guard. At least 1,000 people have been killed and around 200,000 more displaced.

Regardless of the immediate outcome of tentative ongoing peace talks, the violence underlines the country’s fragility and the difficulties of nation building. Independence – less than three years old – has bequeathed a deeply divided and profoundly impoverished society.

There are other bequests: a political elite inexperienced in peacetime governance and severely limited infrastructure and services of every kind. In the current situation, health systems can only further weaken, increasing the risk of health burden and disease.

Many diseases are analogous with conflict. Displaced people have poorer access to basic services and are exposed to more infections. Conflict also undermines key infrastructure such as hospitals. Risk factors for many infectious diseases – poverty, already poor health, overcrowding, poor hygiene, contaminated food, and lack of safe drinking water – are exacerbated and water-borne diseases such as diarrhoea and cholera become immediate problems.