South Sudan: Displaced and in danger

A photographer joins our team in South Sudan, taking an MSF plane to treat people fleeing from conflict

12 Apr 17
Siegfried Modola British Photo Editor South Sudan

Our plane lands on a dusty, windy space of open bush.

Thaker, South Sudan is a scene of desolation. At a distance are several tukuls (mud huts), but few people can be seen.

Just two weeks prior to our arrival, skirmishes had erupted here between different armed groups. We are told that most young men left with the cattle for security reasons.

The plane takes off - MSF has few planes operating within the country, so they run on a tight time schedule. Every extra minute spent on the ground is wasted somewhere else.

Minutes after our arrival we are told there is a woman with serious pregnancy complications inside a hut close by.

Pippa Pett, an MSF doctor, examines the woman, who is heavily pregnant. She has been in labour for two days, the baby is stuck, and she hasn't felt it move for over 24 hours.

"She needs to be referred to our hospital in Bentui," says Pippa.

The plane that flew off moments before is called back by radio, and the woman is flown to the MSF hospital in Bentiu for emergency treatment.

That evening, we receive wonderful news - the mother is alive and well, and the baby has been born.

A hot, inhospitable place

It is a hot, inhospitable place. It must be over 35 degrees Celsius in the middle of the day.

It feels incredibly dry. The wind burns the skin. I am constantly thirsty.

It is not a place where one can afford to become sick. I wonder how all these mothers and children cope in such a hostile environment. 

Patient after patient approaches the clinic.

A woman arrives with her daughter who shows signs of severe malnutrition. The baby looks much younger than her real age. 

An old woman arrives – she walks slowly, supported by a relative. Some of the people I meet have come a long distance for the chance to receive medical treatment. 

Another woman lies on the ground in the queue to be seen; she is too weak to sit up straight.

A pregnant woman is stabilised after becoming unconscious.


Out of all MSF personnel, MSF staff are the ones who face the most danger. They are targeted by armed gangs, believing they carry a lot of money for working for an international organisation.

James, 33-years-old, is an MSF community area supervisor who's been with us for one year.

"It is a dangerous job that we do as health workers," he explains. "We follow the population wherever they go.

"Once I spent eight hours with others in the swamps to hide from gunmen. Five people were shot and died around me during this time. I remember seeing a mother holding her child, trying to breastfeed him. She didn’t know the child had died.

"Nevertheless, I love this job. I love serving my community. People need medical care. They need us to be here to help them.

"Many are dying because they can’t reach a hospital in time. Many children are dying because of malnutrition and because they don’t have the appropriate vaccines."

Keeping safe

In the field, the situation can change from one moment to the next, and the MSF team needs to be prepared to act accordingly.

The priority is to minimise the risks of danger from armed groups.

MSF staff are not usually a target in such conflict scenarios. However, the unpredictability of the situation means that things can go wrong. 

On the afternoon of 22 March, five days into our assignment, we hear reports from local people of troop movements in the area, and rumours of a possible attack in the vicinity. 

MSF’s project coordinator in Juba makes the decision to pull the international team out the following day, to minimise their risk of being caught in the crossfire of the conflict. 

“I have worked for MSF in over eight countries but South Sudan has proven to be a very hard place to operate," says my colleague Georg, our team leader in this assignment. "I can clearly see the great needs of people here. They need food, medicines. 

"However, accessing such areas of great insecurity can be a real challenge. 

"I am responsible for my team. I need to keep them safe.”

On the morning of 23 March, after setting up our second clinic in Gier, a few kilometres from Thaker, we make our way back to the original drop-off point to wait for the same MSF plane to take us out of the area.

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MSF in South Sudan

The airport in South Sudan's captial is a hub of humanitarian activity: numerous aid organisations are there to support the country's population, who have lived through a conflict which has made food and medical care almost non-existent.

Three years of fighting has forced millions to flee their homes, split people along ethnic divides, and paralysed agriculture - leaving the country facing famine. At least one quarter of South Sudanese people have been displaced from their homes. 

In particular, the southern part of the former Unity State (where Leer county is located), has been greatly affected by longstanding clashes between the government's Sudan People's Liberation Army (SPLA) and the Sudan People's Liberation Army-In Opposition (SPLA-IO).

Entire villages have been burnt to the ground, and there are continual reports of gross human rights violations perpetrated by armed groups in the area.

In September 2016, MSF set up a network of community healthcare workers, community health promoters and women's health promtoers - themselves part of the affected population - who are able to stay side by side with people in need.

If the community needs to flee, they go with them, thus continuing to provide healthcare in these difficult times.

our work in south sudan >