In recent weeks, fighting in the Greater Upper Nile region has left the town of Wau Shilluk deserted, and now thousands of vulnerable people who fled the violence are in urgent need of humanitarian assistance. Until recently, Doctors Without Borders/Médecins Sans Frontières (MSF) ran a hospital in Wau Shilluk, but when the fighting approached, the organization was forced to evacuate the facility. MSF has now launched an emergency medical operation to support the thousands of displaced persons settled north of the town of Kodok, in Aburoch, and in the more sparsely populated areas south of the town.
Since late January, nearly 30,000 people have fled fighting around Wau Shilluk and moved to Aburoch town and the bush areas south of Kodok. "The humanitarian needs of those that fled are vast and are not being met," said Abdalla Hussein Abdalla, MSF deputy head of mission for South Sudan. "Most of the people who fled left all their belongings behind. They walked for days to escape the violence, and now they are in dire need of water, food, shelter, and medical attention."
Responding to Urgent Needs
MSF responded to the urgent medical needs of this displaced population by opening a field hospital with inpatient, outpatient, and emergency services in Aburoch, where up to 15,000 people have settled. Two mobile clinics also operate south of Kodok, where another portion of the displaced population has settled. Over the last two weeks, MSF provided an average of 300 consultations a day, six times the number provided in the Wau Shilluk hospital before the evacuation.
The displaced people who settled in these areas have very little to survive on. For weeks they have only received an average of two liters of clean water per person per day, far short of the recommended minimum of 15 liters. While the situation has improved slightly in recent days, the amount provided is still well below the guideline. Among the families visited by MSF teams, over 90 percent lacked basic supplies such as plastic sheeting to protect them from the sun or the cold at night, jerry cans to collect clean water, and cooking pots.
"Our doctors see many cases of respiratory infection and of acute diarrhea, which is partly explained by the terrible living conditions," Abdalla said. "Children, pregnant women, and the elderly are especially vulnerable in this situation. If more latrines are not constructed soon, and access to water is not improved, the risk of communicable diseases spreading through the population will increase."
This is not the first time many of the people now arriving from Wau Shilluk have been forced to flee their homes. Many previously lived in Malakal town but were displaced by fighting. Some have relatives in the Malakal Protection of Civilians site, the camp established by the United Nations Mission in South Sudan (UNMISS), but are unable to inform them of their present situation.
Protection of Civilians
MSF is concerned about the insufficient humanitarian assistance available in the area and reiterates its call for all those involved in the fighting to guarantee the safety of civilians. "Many people don’t know where to settle because they are afraid the fighting will force them to flee again," Abdalla said. "It is essential that they are spared from any more violence, and that assistance is provided to them where they choose to settle."
MSF managed to visit Wau Shilluk at the end of February and again in early March, when the team assisted 47 people who remained in and around the town, mainly elderly and disabled people who were unable to leave. Thirty-eight of them have since been taken to the Malakal Protection of Civilians site on their request. The remaining civilians in the town are in clear need of assistance and protection. Humanitarian workers should be allowed to provide them with the help they require.
MSF Reiterates Its Call for Respect of Medical Facilities and Staff
During the most recent visit, MSF was able to return to its hospital in Wau Shilluk and survey the condition of facility. "Wau Shilluk was looted of all medicines, including lifesaving drugs and essential supplies," Abdalla said. "We have called on those fighting to respect the protected status of medical facilities. Unfortunately, our hospital is in terrible condition. Medication for the treatment of tuberculosis, HIV/AIDS and kala azar are now all gone. If medical facilities are not able to operate safely, the whole community will suffer."