Facing cascading crises in South Sudan

Flooding in Unity State

South Sudan 2021 © Sean Sutton

Alert is a quarterly magazine published by Doctors Without Borders/Médecins Sans Frontières (MSF-USA) that features stories and photography from our medical projects around the world. Below is an article from the Summer 2022 issue (Vol 23. No. 2), Life on the move: Calling for a humane response to migration. If you would like to download a print version of this publication, click here.

Doctors Without Borders/Médecins Sans Frontières (MSF) is responding to two compounding displacement crises in South Sudan: One caused by ongoing violence and the other due to unprecedented flooding. These emergencies are adding to already massive needs in the country, where 8.9 million people need humanitarian or protection assistance, according to the International Organization for Migration.

Massive floods have caused widespread displacement

2021 marked three consecutive years of record-breaking flooding in South Sudan, with the most recent crisis affecting more than 835,000 people. In Unity State, the most recent wave of floods damaged cultivated land and wiped out livestock, leaving people without livelihoods or access to food. Clean drinking water is also a dwindling resource, and many people have been left with no choice but to drink contaminated flood water. Tens of thousands who were forced to leave their homes have made their way to Bentiu camp, where MSF runs a hospital for internally displaced people (IDPs).

A majority of the patients MSF sees in Bentiu are children under the age of five suffering from malaria, respiratory tract infections, and malnutrition. Living in the camp, where conditions were substandard even before the latest influx of IDPs, poses its own health risks. Flooding has cut off the sewage treatment system so there are no latrines available in the camp, and waste comes up through open drains. At the same time, receding flood water creates a breeding ground for the mosquitos that carry malaria.

MSF has brought medical staff, water and sanitation advisors, and emergency coordinators to run mobile clinics in Bentiu town, as well as disease surveillance and sanitation support. We are also continuing our programs focused on sexual and reproductive health and sexual and gender-based violence.

“Parents are literally pulling leaves from the trees and cooking them to feed their children because of lack of food.”

Conflict fuels displacement 

In the south of the country, intercommunal violence has created another displacement crisis. In February, conflict in the Abyei Special Administrative Area caused tens of thousands of people to flee. Thirty-three thousand have settled in the open in the six locations where MSF operates in Twic County, and there is an immense need for medical and humanitarian aid.

"The situation in the displacement camps is terrible," said Susana Borges, MSF head of mission for South Sudan. "People are living in makeshift shelters made of sticks and cloth. Parents are literally pulling leaves from the trees and cooking them to feed their children because of lack of food.”

As of April 2022, MSF had distributed 374 metric tons of food and nearly 15 liters of clean water per person per day in multiple locations. We also constructed 135 latrines and distributed relief items such as blankets, mosquito nets, jerry cans, and soap to about 10,000 families. And we’re treating conditions including malaria and cholera at mobile clinics in three sites.

Despite the terrible conditions, it is unlikely that people will be able to return home because of the threat of ongoing violence. "I have seen people that have been shot—people who are innocent—people like me," said Atem, a father of two living in Gomgoi displacement camp. "How can I think of going back again? It is better for me to suffer here."

Non Food Item distribution
An MSF team distributes blankets and jerry cans in Nyin Deng Ayuel displacement camp in Twic County. Thousands of people who arrived here after fleeing violence in Agok have been left without the essentials they need to survive. South Sudan 2022 © Scott Hamilton/MSF

The United Nations Refugee Agency cautions that projected flooding during this spring's rainy season will only be worse, likely causing more displacement and further impacting people already living in camps in Bentiu and Twic County. MSF has called upon the international community and other nongovernmental organizations to support the urgent medical and humanitarian needs in South Sudan.

"The dangerously slow and inadequate humanitarian response to this crisis is putting lives at risk," said MSF operations manager Will Turner. "People simply cannot continue to be forced to live in such undignified conditions, unnecessarily exposed to preventable diseases."

MSF has provided medical humanitarian aid in the area that now constitutes South Sudan since 1983, and our programs within the country remain among our largest worldwide. We will continue responding to emergencies and advocating for the needs of the South Sudanese people.

Alert Summer 2022: Life on the move

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