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Insider Update: South Sudan

A message from MSF-USA Executive Director Avril Benoît

MSF Dr. Kambale Mwendakwabo Ingels talks to Avril Benoît, executive director of MSF-USA, in South Sudan.

Your generosity fuels all of our lifesaving work, including responding to disasters, crises, and emergencies that make international headlines.

In a moment when so many humanitarian emergencies are filling the news, I want to share my recent experience with Doctors Without Borders/Médecins Sans Frontières (MSF) teams in South Sudan—where conflict, corruption, and the growing impact of climate change have plunged an already vulnerable country into crisis. I have seen firsthand the impact of your support in under-reported crises like these.

Blasco Sesebe, Medical Doctor checks on a patient
During his daily round, Blasco Sesebe, Medical Doctor, checks on Nyakuiy Mabor admitted to the adult inpatient ward of MSF medical facility in Leer, Unity.

I traveled to South Sudan to better understand the growing needs of the region as a result of increased displacement of people fueled by conflict and violence and the effects of climate change.

Today, South Sudan is home to one of our largest operations with 13 projects nationwide that assist hundreds of thousands of people. MSF has been working in the region for over 40 years and we have witnessed the challenges escalate: The need is greater than ever.

Since war broke out in Sudan in April 2023, 7.8 million people have fled the violence, including half a million who crossed the border into neighboring South Sudan. Many of those fleeing conflict—up to 2,500 people a day—find refuge at a government-run transit camp in Renk, a settlement near the border. The camp—originally designed only as a temporary stopping ground with capacity for 3,000 people—is now home to more than 20,000. 

MSF Nurse measures Mid Upper Arm Circumference to screen malnutrition of child
MSF Nurse Gatwech Tuoch measures Mid Upper Arm Circumference to screen malnutrition of child, returning with family from Sudan, at the MSF Mobile Clinic in Bulukat, Upper Nile State in South Sudan. The Bulukat transit centre hosts over 5,000 returnees who fled the conflict in Sudan.

Renk has a decrepit water system with limited access to water and functioning sanitation, which combined with the influx of people in the camp, has led to a rise in disease and malnutrition. Adding to these conditions, the local hospital has limited emergency room hours to treat the many in need of medical care. Our teams are responding by working to establish a cholera treatment center to meet the growing need. We are also treating up to 90,000 liters of river water every day to help provide safe drinking water for those living at the camp.

I saw how this emergency extends beyond the border and transit camp. Further south, in a town called Old Fangak, I met a mother named Nyakena at the MSF hospital. She and her children had passed through Renk and continued on to Old Fangak, where Nyakena was now looking for help for her daughter.

Nyakena Mathot and Chudier
Nyakena Mathot's 2-year-old daughter, Chudier, is being treated for malaria and malnutrition in Old Fangak. Nyakena is not from Old Fangak but fled conflict in Sudan with her six children and is now living there with her mother-in-law. Her husband is still in Khartoum.

The family is from Sudan and lived in the capital of Khartoum, which had once been something of a safe haven from violence in the country. When conflict broke out earlier this year between military rivals however, Khartoum became a war zone. Nyakena fled with her children in August after fighting separated her from her husband.

When the family arrived at the transit camp in Renk, Nyakena stood in line for days waiting to register for cash assistance which she never received due to the overcrowding. With nowhere else to turn, she decided to bring her young children to her mother-in-law’s home in Old Fangak—only realizing after arriving that her mother-in-law was visually impaired and needed help herself.

Since 2019, Old Fangak and the surrounding region have been semi-permanently flooded. This prolonged natural disaster has destroyed food crops, driven disease, and blocked access to many aid groups.

Among the millions affected are Nyakena, her children, and her mother-in-law. The family doesn’t have enough to eat, and every evening, when the sun sets, they are swarmed by disease- carrying mosquitos. When her daughter became severely sick, Nyakena brought her to MSF for treatment. Your generosity means she, and countless others, can get the care they need, even in the most challenging circumstances.

In Old Fangak, MSF’s facility has been rebuilt on top of raised platforms to avoid the encroaching flood water—with concrete pathways connecting different wards within the hospital. It’s another example of how climate change is making our work even more difficult and how we are adapting to the changing needs of the people we serve.

Old Fangak flooding
Men dig a dike in Chotbora village near Old Fangak.

A senior official in the Ministry of Humanitarian Affairs who had lived through the region’s violent conflicts told me she feared that the climate crisis is posing an even bigger challenge. “Flood[ing] is worse than war,” she said. “In war, you can hide and hunt in the bush…when there’s water, there’s no bush to hide in.”

Despite the growing need, the South Sudanese government currently funds just 30 percent of the country’s health spending. The rest of the resources must come from outside organizations like MSF—but in recent months, these groups have shifted their focus and funding to other crises. They are overstretched, and delivering aid in South Sudan is incredibly challenging.

That is why your philanthropy is so critical. Your reliable support means MSF can act independently, choosing projects based on the areas of greatest need. That is especially critical in places like South Sudan, which don’t always make the headlines.

MSF speed boat docked
An MSF speed boat docked in Toch has been loaded with boxes of hepatitis E vaccines to be transported to the MSF hospital in Old Fangak, Jonglei State.

I know there are so many emergencies going on right now across the world. And you can rest assured that MSF teams are working around the clock to care for patients in Ukraine, Gaza, and more than 70 countries.

Your continued commitment means we can be there in places like South Sudan—and everywhere else we are needed.

Thank you again for making this work possible. I am honored by your trust in MSF and our teams.

Avril Benoît
Executive Director, MSF-USA