October 17, 2017

Jez Goeldi knew something was wrong when the chaotic buzz of the nearby market suddenly disappeared, leaving him and his colleagues engulfed by an eerie silence. The team was inside the Doctors Without Borders/Médecins Sans Frontières (MSF) medical facility in Aburoc, in the White Nile region of South Sudan. "The donkeys and chickens were gone, and that told me that the population had yet again been forced to flee," says Goeldi, the 36-year-old deputy logistics coordinator for MSF.

Moments later, the silence was shattered by the pounding of artillery fire. Outside, thousands lined the muddy roads, fleeing with whatever belongings they could carry, not knowing whether they would return.

Massive Displacement

Four million citizens of the world’s youngest nation share a similar story: half have fled to neighboring countries amid the violent civil war that has lasted for more than three and a half years. For many in South Sudan’s northern Greater Upper Nile region, being forced to leave behind their homes and communities is more than just one isolated traumatic event. It is a story they have relived time and time again since the conflict began in December 2013.

Situated along the country’s White Nile Basin in the northeast, the village of Aburoc and its surrounding areas have become a temporary home to an estimated 15,000 people. Many of those who live in Aburoc have had to flee multiple times.

When Malakal, once the "second city" of South Sudan, was attacked, many of the people there fled to the town of Wau Shilluk. When Wau Shilluk was attacked at the start of this year, the whole town was forced to flee north to the small villages of Kodok and Aburoc. People took to the road yet again when Kodok was attacked, gathering in Aburoc.

As the availability of water and other vital humanitarian services started to deteriorate, some 20,000 people decided to make the long and dangerous journey northward, toward Sudan, while others remained in Aburoc in hopes that peace might return to their home communities.

Living conditions in and around the settlement in Aburoc are terrible. People live in temporary shelters near a swamp, which, during the rainy season, divides the camp in two and leaves much of the terrain a muddy mess. Water from the swamp, even when properly treated, remains a murky yellow color. Because clean water supplies are so limited, many people drink directly from the swamp, raising the risk of deadly waterborne diseases such as cholera.

“This Is Part of Our Evacuation Plan: To Move with the Community Where They Go”

In Aburoc, MSF runs a clinic with maternity and pediatric wards, inpatient and outpatient departments, an isolation ward, and a 24-hour emergency room. According to Martino, a 35-year-old MSF electrician, the facility was built with mobility and adaptability in mind. "We moved our clinic after the clashes earlier this year, as we were following people who left Wau Shilluk and then, afterwards, also left Kodok," he explains.

"This is part of our evacuation plan: to move with the community where they go," adds Goeldi, the deputy logistics coordinator.

So when the first shots rang through the air in Aburoc in early September, both MSF staff and the local community knew what was in store. This time, however, the despair seemed palpable.

"An older man came and dropped to the ground on his knees," Goeldi remembers. "He did not know what to do anymore. He just wept, in the middle of the group, like he had run out of hope."

Over the next 24 hours, MSF teams evacuated the hospital, and the people in Aburoc fled into the bush as fighting erupted in and around the settlement. But this was only temporary. Realizing that the fighting was short-lived, people soon began to return, and MSF medical operations resumed.

Despite being largely spared from the latest round of violence in Aburoc, the long-term consequences of the conflict are evident. "Each time people are forced to flee, they are left in a more vulnerable situation than before," says Jaume Rado, MSF head of mission in South Sudan. "The fighting has put both the general population and our patients at risk. Many were cut off yet again from accessing much-needed medical care and other humanitarian aid."

The people in Aburoc remain highly vulnerable and completely dependent on humanitarian assistance.

Read More About MSF's Work in South Sudan

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