February 11, 2014

Just under two weeks ago, 240 South Sudanese Doctors Without Borders/Médecins Sans Frontières (MSF) staff left Leer Hospital, fleeing into the bush with several dozen of the most severely injured patients and thousands of local people. The security situation is worsening every day, living conditions are life-threatening, and MSF has now lost contact with two-thirds of its staff.

“Many people from Leer are here,” explains a South Sudanese MSF staff member who is currently hiding in the bush outside the town. “The community is hungry, [and] food and water are a problem for everyone—people are drinking water from a dirty river. We hide during the day, it is safer for us to move around at night.”

“The situation on the ground is chaotic and hostile and it is very difficult to know where the civilians have fled to from Leer,” says Raphael Gorgeu, MSF’s South Sudan Head of Mission. “The sporadic contact we are able to make with our staff paints a desperate picture for them and the unknown thousands living in terrible conditions, vulnerable to disease, dehydration, malnutrition, and attack.”

MSF staff continues to care for patients as best they can, but medicines are running out. Fifteen surgical patients remain under care, but staff is no longer able to change their surgical dressings due to supply shortages.

“The staff who remain in touch with MSF report that worsening security has pushed them further into the bush,” explains Gorgeu. “They have split into smaller groups to decrease the chance of attack and divided their supplies of medicines, which they are saving to treat only the most life-threatening cases.”

One team is reportedly treating at least 45 critically ill patients each day. The most common conditions are watery diarrhea, respiratory tract infections, and malaria—conditions that are directly related to the dire living conditions and lack of shelter and mosquito nets. Staff has also reported alarming cases of sexual violence.

“It is heartbreaking speaking to our staff, hearing their own precarious situation and that their supplies are running out when the little health care they are providing is all that is available in southern Unity State,” says Gorgeu. “We need access to civilians in the area and to resupply our staff with medicines, but it is simply too dangerous given the ongoing fighting. We don’t know how much longer they can hold out.”

MSF has been working in Leer for the past 25 years, providing both in- and outpatient care for children and adults, surgery, maternity, HIV/TB treatment, and intensive care. The last of the MSF staff left Leer Hospital on January 30, 2013, and MSF has no further information on the state of the hospital, which was the only fully functioning secondary facility in all of southern Unity State, serving 270,000 people. MSF is ready to fully return to Leer and southern Unity State to provide medical care as soon as security allows.