Deadly Pox Outbreak in Rumbek Prisons Sparks Health Emergency in Lakes State

Lakes State 

prison facilities in Lakes State has triggered a major public health emergency, as health authorities confirm that more than 130 inmates have been infected with monkeypox, chickenpox, and smallpox-like illnesses. 

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‎The affected prisons, Rumbek Main Prison and Pachong Prison, are grappling with overcrowding and poor sanitation, making it difficult to contain the spread of the disease.

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‎Since April 17, 2025, health officials have recorded 134 suspected cases, including two confirmed cases of monkey-pox. The situation has prompted urgent intervention from the Ministry of Health and its humanitarian partners

Sparks Health Emergency in Lakes State

‎An outbreak of infectious diseases in two prison facilities in Lakes State has triggered a major public health emergency, as health authorities confirm that more than 130 inmates have been infected with monkeypox, chickenpox, and smallpox-like illnesses. 

‎The affected prisons, Rumbek Main Prison and Pachong Prison, are grappling with overcrowding and poor sanitation, making it difficult to contain the spread of the disease.

‎Since April 17, 2025, health officials have recorded 134 suspected cases, including two confirmed cases of monkey-pox. The situation has prompted urgent intervention from the Ministry of Health and its humanitarian partners.

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‎The Outbreak Unfolds

‎According to Gordon Mayen Kolnyin, Surveillance Officer at the Lakes State Ministry of Health, the outbreak was first reported when several inmates began exhibiting symptoms such as fever, rashes, muscle aches, and swollen lymph nodes. 

‎Initially thought to be chickenpox, further testing revealed that some cases were more severe and consistent with monkeypox.

‎“We initially suspected chickenpox, which is common in congested settings,” Kolnyin said. “However, as more severe symptoms appeared, we sent samples to the national laboratory. Two came back positive for monkeypox.”

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‎Kolnyin said that 29 cases were recorded in Pachong Prison, while the remaining 105 were from Rumbek Main Prison, one of the largest detention centers in the state. The outbreak has exposed long-standing vulnerabilities in the prison system, including unsanitary conditions, lack of medical infrastructure, and insufficient staffing.

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‎Government and Humanitarian Response

‎Following the confirmation of monkeypox, the Ministry of Health, in partnership with organizations such as the World Health Organization (WHO), Médecins Sans Frontières (MSF), and the International Committee of the Red Cross (ICRC), launched an emergency response. This included the provision of essential medical supplies, isolation tents, personal protective equipment (PPE), water basins, and soap to promote hygiene.

‎Health workers have established temporary isolation wards within the prison premises. As of June 20, 24 inmates with severe symptoms are in isolation and undergoing treatment.

‎"We are doing our best to manage the situation, but the environment is very difficult,” said a local health officer working at the prison. “We lack the infrastructure needed for proper isolation and treatment. There's only so much we can do with limited resources."

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‎Monkeypox, Chickenpox, and Smallpox: What’s the Difference?

‎The three diseases involved in the outbreak share similar symptoms, especially in their early stages, but they differ significantly in terms of severity and transmission:

‎Chickenpox is a common viral infection caused by the varicella-zoster virus, known for causing itchy blisters. It’s usually mild in children but can be serious in adults.

‎Monkeypox, caused by the monkeypox virus, is a zoonotic disease that can spread from animals to humans and between humans. It is less contagious than smallpox but can cause severe complications.

‎Smallpox, eradicated globally in 1980, was a deadly disease caused by the variola virus. 

‎Any case presenting smallpox-like symptoms is treated seriously, though no laboratory-confirmed smallpox has been reported in South Sudan.

‎Due to the overlapping symptoms, health workers in South Sudan face challenges in distinguishing between these infections, especially with limited laboratory capacity.

‎“We don’t believe there is a reemergence of smallpox,” Kolnyin clarified. “But some chickenpox and monkeypox cases may present with smallpox-like symptoms, leading to confusion.”

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‎Inmate Conditions Worsen

‎Several prisoners who spoke to this blog under anonymity described dire conditions inside the facility.

‎“We sleep close together, almost on top of each other,” said one inmate. “There are no mosquito nets, no clean water, and when someone gets sick, there's nowhere to isolate them.”

‎Prisoners also reported delays in receiving medical attention and a lack of soap or basic sanitation supplies before the outbreak.

‎Human rights advocates have long warned that South Sudan’s prison system is underfunded and overstretched. According to the South Sudan Human Rights Society for Advocacy, overcrowding, poor nutrition, and lack of access to healthcare services are common across the country’s detention centers.

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‎Health Risks Extend Beyond the Prison

‎Experts warn that the outbreak could extend beyond prison walls if not properly contained. Many prison staff members interact daily with the broader community, and if exposed, they could transmit the disease outside.

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‎In Rumbek town, residents are growing increasingly anxious.

‎“I live near the prison,” said Mary Nyachangkuoth, a market vendor. “We hear about the disease spreading inside, but we don’t know if it can reach us too.”

‎Local leaders are urging health officials to extend public health education campaigns into surrounding communities to minimize fear and prevent misinformation.

‎“We want people to be aware but not panic,” said Dr. Santino Mabor, Director General at the State Ministry of Health. “Proper hygiene, early symptom reporting, and responsible behavior can prevent further spread.”

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‎Underlying Structural Issues

‎This outbreak is not just a medical emergency it is also a symptom of larger systemic issues plaguing South Sudan’s health and justice sectors.

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‎Rumbek Main Prison, built decades ago, was designed to hold fewer than 100 inmates. 

‎Today, it houses more than three times its intended capacity. Most cells have poor ventilation, and basic health services are almost non-existent.

‎“This is a time bomb,” said James Maluak, a civil society advocate in Lakes State. “The government must invest in upgrading prisons and integrating healthcare services into the prison system.”

‎South Sudan's National Prison Service has acknowledged the challenges and promised to improve conditions but blames chronic underfunding and insecurity for the delays.

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‎Regional Context and Lessons Learned

‎Monkeypox has been on the rise across several African countries in recent years. In 2022, the World Health Organization declared monkeypox a Public Health Emergency of International Concern (PHEIC), though that status has since been lifted. However, localized outbreaks remain common in areas with weak health systems.

‎South Sudan experienced a similar outbreak in 2021 in Western Equatoria State, but it was quickly contained. Health officials say that lessons from that experience are helping shape the current response.

‎“We now have some experience in handling monkeypox,” Dr. Mabor said. “But we need better diagnostic tools and long-term support to prevent future outbreaks.”

‎Calls for Policy Reform

‎Health experts and human rights organizations are now pushing for reforms that prioritize health in detention centers. They are calling for:

‎Regular health screenings in all prisons and police detention centers.

‎Increased funding for prison infrastructure and medical supplies.

‎Training for prison staff on infection control and hygiene protocols.

‎Collaboration with civil society and international partners to ensure accountability and transparency.

‎Without such reforms, experts warn that disease outbreaks in prisons will become more frequent and more difficult to manage.

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‎Hope Amid Crisis

‎Despite the challenges, there are signs of resilience and hope. Local health workers, many of them volunteers, continue to risk their own safety to care for infected inmates. 

‎Community radio stations have begun broadcasting messages about monkeypox and hygiene, and local youth groups are volunteering to support awareness campaigns.

‎“It’s tough, but we are committed,” said a nurse treating inmates at Rumbek Main Prison. “These are human beings. They deserve care and dignity.”

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‎Conclusion

‎The outbreak at Rumbek prisons is a stark reminder that health crises do not respect prison walls. Infections thrive in environments of neglect, overcrowding, and poverty conditions that define much of South Sudan’s correctional system.

‎As authorities race to contain the current outbreak, the focus must also shift to long-term solutions. This includes investing in prison health infrastructure, improving public health surveillance, and addressing the structural inequalities that make such outbreaks inevitable.

‎Until then, the inmates of Rumbek and many like them across the country remain vulnerable, not just to viruses, but to a system that has yet to recognize their full humanity.

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