Displaced people are sheltering under trees in South Sudan

Moses is one of tens of thousands of people who have been forced to flee their homes due to an escalation of violence between government forces and opposition groups in and around Lankien in Jonglei state, and along the Sobat River in Upper Nile. Many families fled on foot and walked for days to escape attacks and burned villages. In towns like Chuil, where at least 25,000 have sought refuge, people are living outdoors without any shelter, or in makeshift settlements without adequate food, clean water, or health care.

Doctors Without Borders/Médecins Sans Frontières (MSF) is scaling up medical and humanitarian support for displaced people in Chuil and in Ulang county. Our teams are providing primary health care and referrals, donating relief items, and supporting water and sanitation to reduce the risk of disease. Our teams also travel through swamps and rivers by boat to run mobile clinics in nearby Yakuach, Tanakuacha, and Pathiel, and have provided over 1,300 medical consultations while referring some patients for higher-level care.

“This situation is about life and death,” says Nyamai, a mother of three living in an informal displacement site in Chuil. “At one point, we survived by boiling leaves from the trees and eating them. We had nothing else. The needs go beyond hospital care and medicine. We need food, water, and shelter. Without these, survival here will not be possible.” 

Attacks on health facilities push care farther out of reach

The crisis is unfolding in a region where access to health care was already limited and humanitarian access remains limited and irregular. Attacks on health facilities are only worsening the situation: In 2025, the MSF-supported hospital in Ulang was looted and destroyed, and just last month, Lankien Hospital was bombed, resulting in the closure of the two main referral hospitals in the region.

“We are seeing a deeply alarming pattern of attacks on health facilities and health care workers, alongside violence against civilians,” said Tuna Turkmen, MSF emergency project coordinator. “Chuil now hosts a large number of civilians, including women, children, and the elderly, who have fled fighting. It also provides one of the few functioning health facilities in the area, and many aid organizations are coordinating their medical and humanitarian activities from there. It is essential that communities can access these services, and that humanitarian and medical workers can carry out their work safely and without restriction.” 

“In swampy areas around Lankien, thousands remain in dire conditions, still waiting for assistance,” said Turkmen.  “People continue to arrive every day. Displaced MSF medical staff there are doing everything they can, but patients die due to lack of medicine. MSF has requested access from local authorities, so far without success.”

Safe, sustained, uninterrupted humanitarian access must be guaranteed. MSF calls on all parties to the conflict to take all feasible measures to spare civilians from the effects of hostilities. Civilians and civilian infrastructure, including health care, must never be targeted; direct attacks against them constitute serious violations of international humanitarian law. Any further escalation of fighting in or around Chuil would have devastating consequences for civilians sheltering there and severely disrupt lifesaving medical and humanitarian assistance. 

Scaling up support to fill the gaps

More than 70 MSF staff members who were also displaced from Lankien are now supporting the response in Chuil.

Our teams there upgraded the primary health care center, increasing its capacity to 60 beds for emergency care, malnutrition treatment, maternal health services, and trauma stabilization. Since late February, MSF teams have provided 2,200 consultations, admitted 172 patients to Chuil primary health care center, and referred 16 for further treatment.  

Our teams also distributed relief items — including mosquito nets, blankets, soap, jerrycans, sanitary pads, plastic sheeting, and empty sandbags — to more than 1,500 families to help them cope with the harsh living conditions, with more distributions to follow. And to help with water and sanitation services, MSF is building 300 latrines and constructing a water purification plant.  

In the coming weeks, MSF will establish a health post in Tanakuacha while our teams will continue running mobile clinics in Yakuach and Pathiel, providing referrals, mental health activities, outpatient consultations, and sexual and reproductive health services.  

In Minkaman, Lakes state, MSF is providing consultations to new arrivals from Jonglei through mobile clinics. We have also made medical donations to Minkaman primary health care center and are reinforcing their capacity to respond to outbreaks. Our water and sanitation teams have drilled two boreholes, repaired broken hand pumps, and are rehabilitating a surface water treatment plant and constructing emergency latrines. 

Displaced by violence, left without protection

Despite the humanitarian response, major gaps remain, particularly in nutrition and in water, sanitation, and hygiene, raising the risk of cholera and other waterborne diseases. Screenings by MSF in Chuil show alarming malnutrition levels: Of 1,263 children under 5 screened, 54 percent were acutely malnourished, while 21.5 percent of 609 pregnant and breastfeeding women screened were acutely malnourished. Referrals of complicated cases remain a challenge as well.

“Humanitarian organizations are increasing activities in the Chuil area and in Minkaman, but the response still falls short, and many remote communities remain without lifesaving assistance,” said Zakaria Mwatia, MSF head of mission in South Sudan. “We call for an urgent and coordinated scale-up of other humanitarian actors to reach people in the hardest-hit areas — especially those still cut off from aid. Without sustained support, the risk of disease outbreaks and further displacement could rapidly escalate into catastrophe.”