December 8, 2006
Under a thorny acacia tree in the arid countryside of southern Darfur, a few families seek relief from the scorching sun. Men, women, and children are sitting among the meager possessions they were able to rescue when they fled an attack on their home village: plastic jerry cans, a few pots and pans, and some rush mats. They have tied a blanket to the branches above their heads, creating a small patch of shade in the dust.
MSF mobile teams, traveling out of the town of Muhajariya, encounter hundreds of families like these, living outside under bushes and trees, scattered over tens of kilometers of inhospitable terrain. Water is scarce—the dry season has started—and some are forced to drink water from stagnant pools they share with the cattle. During consultations, MSF's doctors and nurses find signs of deprivation and exposure. Diarrhea is increasing rapidly; skin diseases are multiplying; some of the children already have respiratory tract infections because of the cold nights.
At least 50,000 civilians fled to the precarious refuge of the arid countryside after a series of violent attacks in Muhajariya and the surrounding area. For many of them it was not the first time they had to leave—they had been displaced from other regions and were already living under difficult conditions in displaced camps at the edge of town.
MSF found an elderly man lying under trees to the east of Muhajariya with a gunshot wound and an open fracture of the femur. He described how his home in the village of Angabo was attacked on November 13. "Ten people came inside. They asked me who I was and if I had a weapon, then they shot me, took all of my money and burned my house. I was still inside when they set fire to it."
For many, the violence came without warning. "I was in my home when I heard gunfire," a man who fled southwards, told the MSF team. "I stayed where I was and the next thing I knew I was shot! It was my hand that was hit. I saw two vehicles with fighters on the back of them—there must have been fifteen on the back of each vehicle. They were just shooting and shooting at my friends and into our homes."
The violence has been continuing intermittently since the beginning of October. On some occasions people who fled were attacked once again, forcing them to wander the area in a desperate search for security. The MSF-supported clinic in Muhajariya includes surgical services, and is receiving a steady flow of victims who require specialized medical care. Since the start of the clashes 131 people were treated for war trauma; 107 of them with gunshot wounds. One quarter of them civilians. At times, even patients in the Muhajariya clinic feel unsafe. During a bout of fighting and reprisals on October 23, when MSF staff were forced to seek shelter, 15 patients fled from its hospital wards.
Perhaps most worrisome is the way in which this armed conflict has at times split populations along local ethnic lines, enflaming tensions in the region. The ethnic dimension has prompted attacks on villages or displaced camps, meaning that civilians without any relation to the military have been made direct targets. This complicates the already disastrous humanitarian situation, for example making displaced people afraid to return home even though the situation may calm, or forcing MSF to worry that its work may jeopardize the safety of its national staff by bringing them across community divides.
Due to their rapid flight into this harsh environment, with little or no time to assemble and carry provisions, the displaced urgently need assistance. Where they feel safe, they collect water by digging shallow wells in dry riverbeds. The MSF team is increasing the supply to the most vulnerable by trucking water in and repairing local water systems. But water is running out in many places because so many people and cattle are drinking it. "A week, that's how long the water will last. After that we will move on to find more water but I don't know where we will go," said a 16-year-old girl, who fled while attackers burned the village of Muturwed on November 12. She told MSF four of her relatives were killed, and that her family has been living under a tree ever since.
Food is running out as well. The rainy season was good this year so there is promise of a large harvest, but most people are too afraid to return. MSF teams traveling in the area came across fields partially harvested, the rest slowly spoiling. MSF staff have been treating people who were wounded when they went back to till their fields. Due to the continuing insecurity there is a real risk that the harvest will be lost. The United Nations and aid agencies have distributed food, but the shifting situation and peoples' continued movements make it impossible to ensure that all people are getting the food they need.
There are no places where displaced people can seek health care. Their general health status is precarious, and can be expected to worsen given their living conditions. Over the last few weeks MSF has established a clinic in Sileah (36 kilometers south of Muhajariya) in order to provide medical assistance to the estimated 17,000 displaced people who have gathered there, is conducting nutritional assessments, and started a measles-vaccination campaign for children aged 6 months to 5 years old. MSF has distributed 4,500 pieces of plastic sheeting, 7,300 blankets, and more than 1,000 packages of high-energy biscuits. Even counting the efforts of other aid organizations, the United Nations and the Sudanese government, tens of thousands of people still remain in critical need of humanitarian assistance, particularly for basic shelter items, food, and water.
Over the past few days, renewed attacks have intensified the fighting between rival movements, leading to more civilian deaths and threatening the delivery of MSF assistance to areas outside of Muhajariya. Some of the displaced have been forced to return to the town. Assessing the gravity of the fighting is beyond MSF's scope, but the surgical team in Muhajariya treated 59 gunshot wounds alone in the 3 days after November 29.
Whether caught up in this violence or deliberately targeted, these people, especially the ones living in the open, must make life or death decisions about how to keep their families safe, find food or water, and grieve their lost relatives or homes. "What can we do for the woman who smiles from her bed under the tree in the middle of nowhere?" asks Giles Hall, a nurse working as part of the mobile clinic team. The mother proudly showed the bundle in her arms, a 13-day-old baby girl, her age easily remembered because it was 14 days before that she fled her village in fear of the violence that followed soon afterwards. The baby girl was born under a tree and started her life as a displaced person.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)