A worsening cholera outbreak in Sudan’s North Kordofan state has killed 14 people and infected hundreds more, a medical union said on Saturday, warning that a collapsing health system could cause the disease to spread nationwide.

The outbreak is centred in Al-Mazrub, a town west of Bara in an area controlled by the paramilitary Rapid Support Forces (RSF). The epidemic initially spread from neighbouring West Kordofan.

Al-Mazrub Hospital has registered 418 cholera cases, with 61 patients currently isolated, according to Adiba Ibrahim El Sayed, a specialist with the Preliminary Committee of the Sudan Doctors Union. The facility recorded 29 new cases in a 24-hour period.

“The health system is unable to limit the spread of the disease due to deteriorated sanitation, contaminated water sources, damaged sewage networks, and a severe scarcity of safe drinking water,” El Sayed told Sudan Tribune.