Thousands of Sudanese refugees are now stranded without food or drinking water in South Sudan’s Upper Nile State after fleeing fighting between the Sudanese Armed Forces and armed groups in neighbouring Sudan.
Why are we there?
- Armed conflict
- Endemic/epidemic disease
- Healthcare exclusion
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In early 2005, a peace agreement was signed between North and South Sudan. This agreement ended a prolonged civil war of more than 20 years.
In January 2011 South Sudan decided, after a referendum, to secede from the North. This led to the formal independence of the Republic of South Sudan on 9 July 2011.
Despite this Africa’s newest country is still facing a humanitarian crisis. Diseases, malnutrition and displacement are rife. The health system is extremely weak and under resourced and many regions are still facing ongoing violence.
Historical
Activities 2011
The Republic of South Sudan only came into existence on 9 July 2011, but the country has already faced multiple crises.
According to the UN, some 350,000 people returned home to South Sudan between November 2010 and the end of 2011, while violence displaced around 300,000 people. Médecins Sans Frontières/Doctors Without Borders (MSF) continued to focus on emergency response.
MSF works in South Sudan as well as in the transitional area of Abyei, providing a range of medical services, from maternal healthcare and nutrition programmes, to surgery and treatment for tuberculosis (TB), malaria and kala azar.
In September, MSF started negotiations with the authorities to construct a hospital in Juba, the capital city. The intention is to provide paediatric and surgical care and emergency obstetric services.
Jonglei conflict
Since 2009, violent, intercommunal cattle-raiding has become more intense in the eastern state of Jonglei, and entire villages have been destroyed.
In the last week of December 2011, the MSF hospital in the town of Pibor was looted and ransacked, and MSF’s clinic in Lekwongole was burned, with only the walls and roof left standing.
Refugees fleeing Abyei during the fighting between North and South Sudan, one month prior to South Sudan's independance. © Corentin Fohlen
Attacks on MSF
Among the many people killed were an MSF watchman and his wife. MSF treated 108 people for violence-related wounds in the first weeks after the attack. Many frightened people hid in the bush for weeks on end and MSF consequently saw an increase in the number of patients suffering from malnutrition and malaria.
MSF is the only provider of healthcare for the 160,000 people who live in Pibor county, as the nearest alternative health services are over 150 kilometres away. In 2011, the team carried out around 12,500 consultations in Pibor, and more than 11,800 in the villages of Lekwongole and Gumuruk.
Staff treated approximately 2,500 patients for malaria, 1,000 children with severe malnutrition, and 500 people with violence-related injuries.
Further north, the MSF clinic in Lankien serves around 127,000 people. With outreach sites in Pieri and Yuai, teams provide all kinds of medical care, from treatment for respiratory tract infections to spear wounds. In 2011, they treated more than 74,600 outpatients.
In August, there was a raid on Pieri and 12 surrounding villages; MSF treated over 100 people for injuries and referred another 57 to hospitals in Leer and Nasir. The majority of the victims were women and children with gunshot wounds.
One MSF staff member was killed, along with her entire household. The raiders looted MSF’s compound and clinic in Pieri and burned down parts of it.
In early December, teams expanded their outreach activities in Lankien, Pieri and Yuai in response to an increase in the number of people suffering from malaria. Staff treated 3,160 patients for malaria in just one month, when the average is usually 300 to 400 cases a month.
MFS treat refugees in Agok, South Sudan, June 2011. © Corentin Fohlen
Emergency response in Abyei
The area of Abyei, contested by Sudan and South Sudan, was the scene of violent clashes in May. The MSF hospital in Agok, 40 kilometres south of Abyei, received 42 wounded in less than 48 hours and treated at least 2,300 patients in the first two weeks of the fighting.
As most people had fled with just the few belongings they could carry, MSF distributed medical supplies and basic relief items such as shelters, plastic sheeting, mosquito nets and soap.
Staff also set up a rehydration point in Agok hospital. Mobile teams attended to the wounded and displaced in several small villages outside Agok. In 2011, MSF carried out a total of 26,000 outpatient consultations at the hospital.
A nutrition assessment in November prompted MSF to start offering supplementary food for all children under five years old. The first batch was distributed to 10,200 children in December.
Sudanese refugees
In late November, MSF launched an emergency response when thousands of refugees fled from Blue Nile state in Sudan to several locations in Maban county, Upper Nile.
By the end of 2011, around 35,000 refugees had arrived in Doro and Jamam camps, and the number would swell to over 90,000 by April 2012. As well as setting up a field hospital in Doro camp, MSF teams provided urgently needed healthcare for refugees arriving at the border-crossing point at El-Fuj, carried out measles vaccination campaigns and distributed emergency supplies of food.
MSF water specialists also took steps to ensure a minimum amount of safe water was available and lobbied water organisations to implement more permanent solutions.
In December, MSF began providing medical assistance to some 20,000 refugees who had arrived in Yida, Unity state, just south of the border with the extremely volatile Sudanese state of South Kordofan.
Maternal healthcare
Despite the eruption of violence along the northern border with Sudan, Northern Bahr El Ghazal remained relatively stable. In 2011, MSF handed over its basic healthcare activities and paediatric outpatient services at its hospital in Aweil to the Ministry of Health so that staff could focus resources and expertise on specialist maternity and paediatric care and nutrition.
In 2011, over 1,200 children were enrolled on the nutrition programme and almost 3,800 children were admitted to the paediatric ward. Staff assisted more than 3,400 births in the hospital.
In Western Bahr El Ghazal, staff supported the maternity, paediatric and surgery departments of Raja civil hospital, carrying out more than 12,000 paediatric consultations and admitting over 1,600 children to the hospital for treatment.
In Western Equatoria state, MSF tended to some 24,000 patients in Yambio state hospital – working in the maternity and paediatric departments as well as treating malaria and malnutrition – and conducted outreach activities among people displaced by violence.
MSF has been working in South Sudan since 1983.
Patient story
Wathou, displaced from Lekwongole
“They started shooting and I tried to run away, but I fell over and hurt my back. It is still not OK now. When I sleep, I have no blankets or things to cover me; I just sleep in these clothes I’m wearing.
"And I am hungry; I have had no food, nothing to eat. My mother is old and cannot walk, so she has to be carried. But she is still alive. There is malaria attacking children and there are very few mosquito nets here. When children get malaria, we take them to the MSF hospital.”
