KAMPALA, UGANDA/NEW YORK, JUNE 20, 2017—Nearly one million South Sudanese refugees have fled to Uganda to escape the violence in their country, yet the international aid response is failing to meet their basic needs for food and water, raising the risk of a medical emergency, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today, ahead of an international summit to raise funds for Uganda's refugee response.
"The international community has failed to help resolve the conflict in South Sudan and is now failing to adequately help South Sudanese refugees in the region," said Dr. Leon Salumu, MSF program manager. "Refugees are being put in an unimaginable position—to go without food and water, or risk their lives in a conflict just so they can eat."
Governments and international organizations are meeting in Kampala on June 22 and 23 to raise funds for Uganda's refugee response. The country currently hosts 950,562 refugees—the largest number of any country in Africa—and receives about 2,000 new arrivals per day, the vast majority of whom are fleeing violence in South Sudan.
Wealthy countries that have shamefully introduced restrictive migration policies and sought to limit the arrival of refugees at their borders have promised instead to support refugees closer to their countries of origin. Yet they have not delivered on this promise in Uganda, where the aid response is only 17 percent funded. MSF is not raising funding for its own operations at the summit, but MSF is warning that inadequate resources in the larger aid response, coupled with poor water and sanitation conditions and a shortage of food rations, could quickly lead to a medical emergency.
Many South Sudanese refugees who live in Ugandan settlements rely on a handful of borehole wells and water trucks and receive just seven liters of water per person per day. Access to water in the settlements is dependent on water trucking, a hugely expensive system often made more complicated by poor road conditions.
In Palorinya, a settlement of 170,000 refugees where MSF provides medical care, MSF is providing 80 percent of the population with their entire supply of treated water. A more sustainable solution must be found.
"Even though we are pumping and treating record amounts of water in Palorinya, it's always only just barely enough for the population," said Tara Newell, MSF operations manager for Uganda. "Without a longer term and more cost-effective solution, people's ability to cope, as well as their health, will deteriorate."
After monthly food rations from the World Food Program were recently cut, the number of people critically short of food in the settlements is also a major concern. MSF is seeing refugees registering in multiple settlements because they are desperate for food rations and water, and there are reports of inconsistent or incomplete distributions of basic relief items in the settlements.
Refugees have cited food insecurity as a major concern, and MSF teams have heard stories of refugees who returned to South Sudan because of a lack of food in Uganda, only to be killed.
"I'd rather get shot in South Sudan than starve in Uganda," one refugee told MSF.
Keeping pace with the growing refugee population is increasingly difficult, stretching the Ugandan government. Some refugees have been moved to sites far from water sources or farmable land, such as the Ofua zone in the western part of Rhino settlement. Better site planning, which maximizes access to services such as water, sanitation and health care, is needed to ensure the basic needs of refugees are met.
Health interventions have also been complicated by the time-consuming nature of regular importation procedures for medical supplies. For example, for two months this year, MSF was unable to offer medical services such as safe deliveries or treatment for eye or skin diseases because of the lengthy bureaucratic requirements for importing medical supplies. MSF requests that the government of Uganda expedite pending importation requests and fast-track medical importations for emergency health kits and medical supplies to facilitate an increased emergency medical response.
In addition to its operations in South Sudan, MSF has been responding to the humanitarian crisis in Uganda since July 2016, with medical and water and sanitation activities. MSF is currently working in four refugee settlements in the northwest—Bidi Bidi, Imvepi, Palorinya and Rhino—providing inpatient and outpatient medical care, sexual and gender-based violence and mental health care, maternity care and nutritional care, and conducting community health surveillance and water and sanitation activities. MSF also responded to an influx of refugees into Lamwo, on the border with South Sudan, after an attack in Pajok, Eastern Equatoria, but has since handed over these activities to other organizations.
In addition to responding to the refugee influx, MSF runs programs in Uganda providing reproductive health services for adolescents in Kasese, HIV/AIDS care for the fishing communities on lakes George and Edward, and HIV viral load monitoring services in Arua regional hospital.