Sudan's worst cholera outbreak in years has been linked to the deaths of over 2,470 people, with nearly a 100,000 suspected cases, in the past year the Doctors Without Borders (MSF) humanitarian organization said on Thursday.

The outbreak was first declared by Sudan's Ministry of Health a year ago.

Cholera cases are especially widespread in the western Darfur region, where MSF said it has treated over 2,300 patients and recorded 40 deaths in the past week alone.

Cholera hits those already struggling with water shortages, MSF said, as the lack of water makes it impossible to stick to essential hygiene standards.

In North Darfur state's town of Tawila, MSF reported an especially extreme situation with the disease. Some 380,000 have fled to town, escaping the ongoing fighting around the city of El-Fasher, according to United Nations figures.

Fighting in Sudan between the army and the paramilitary Rapid Support Forces has been ongoing since April 2023, creating one of the world's worst humanitarian crises.

Darfur Governor Mini Arko Minawi, in an interview with DW, blamed the RSF militia for failing to care for those affected by the cholera outbreak.

"Those suffering from cholera are located outside the government's service areas, with most of them living in areas controlled by the so-called 'Rapid Support Forces' which have taken over these areas but are unable to provide services there,' Minawi told DW. "These forces and their commanders have no knowledge of how to provide services or how to govern."

What else do we know about the cholera outbreak in Tawila?

Residents of Tawila have to make due with barely three liters of water per day. The World Health Organization stipulates that the absolute bare minimum threshold per person per day for drinking, cooking and hygiene is 7.5 liters.

Apart from the water shortages, MSF also reported a shortage of treatment facilities.

Tawila Hospital's cholera treatment center is equipped with barely 130 beds. During the first week of August, it had to accommodate 400 patients, which overwhelmed the facility, forcing staff there to treat patients on mattresses on the floor.

"In displacement and refugee camps, families often have no choice but to drink from contaminated sources and many contract cholera," said Sylvain Penicaud, MSF project coordinator in Tawila. "Just two weeks ago, a body was found in a well inside one of the camps. It was removed, but within two days, people were forced to drink from that same water again."

Where else has cholera spread in Sudan?

MSF reported that the outbreak was spreading elsewhere in Sudan, and fast. A 73-bed cholera treatment center that opened in July in Central Darfur's Golo was quickly overwhelmed, with 137 patients arriving on August 3 alone. Golo lies some 100 kilometers (62 miles) from Tawila.

In early August, the outbreak also reached more areas in Central Darfur state, Zalingei and Rokero, as well as Sortony in North Darfur state.

The organization warned that heavy rains were exacerbating the crisis, as it contaminates water and damages sewage systems.

"The health centres are full," MSF quoted Samia Dahab, a resident of Otash displacement camp in Nyala, as saying. "Some areas have water, others have kiosks that are far or empty. Some water is salty, and we drink it unboiled, unsure if it's safe."

As people flee the fighting into neighboring countries, the outbreak spreads with them. MSF reported cases were spreading to Chad and South Sudan.

"The situation is beyond urgent," says Tuna Turkmen, MSF's head of mission in Sudan. "The outbreak is spreading well beyond displacement camps now, into multiple localities across Darfur states and beyond."

Additional reporting by Youcef Boufidjeline

Edited by: Alex Berry