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In Wad al-Hulaywah alone “we’ve counted 150 cases so far, among them seven dead” since late July, local health official Adam Ali told the AFP news agency.

Before the start of the war between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), the UN had said that about 40 percent of Sudanese did not have access to clean water. Conditions have since worsened.

“Our problem is drinking water,” said Ali.

Most residents of Wad al-Hulaywah “drink water directly from the river – polluted water”, he said.

During the rainy season, large amounts of silt are washed into the Setit river, which begins in neighbouring Ethiopia, increasing pollution levels, the health official added.

Near the local hospital, workers spray insecticide to fight the proliferation of flies, which Ali said was a symptom of poor sanitation.

Dam construction in 2015 on the Setit river had displaced “entire villages”, he said, and their inhabitants “dug makeshift latrines, which attract flies because they are not maintained”.

Access to clean water has been hampered across the country, in areas under either the SAF or the RSF, both fighting for control of Sudan.