Fleeing war, seeking hope: The struggle for survival in Renk county, South Sudan

Rumors of war turned into a terrifying reality

Sadah Adam is one of nearly 40,000 people living in Atam. Seated in the waiting area of an MSF-run mobile clinic, she cradles her 3-month-old baby Yahin, recalling the day they fled their burning home in Bur, Sudan. “When the fighting came closer, we heard rumors about the war,” she says. “We hid in the bush for two days. After we returned home, the fighters were already there, so we had no choice but to run again.”

While they found peace in Atam, their needs far outstrip the limited humanitarian aid available. “The most urgent need we have is water,” Sadah says.

Masha Arbanat, another refugee from Sudan, also fled intense fighting near her home. Like many others, she crossed the border with nothing. “Our house was completely destroyed, and we had to leave everything behind,” she shares. “When we got to Atam, we had nothing—no pots, no utensils, not even water containers. It was only after MSF gave us some essentials like jerrycans and cooking pots that we started to feel a little relief.”

The experiences of Sadah and Masha reflect the ongoing struggle for survival faced by people who have fled the violence in Sudan. In settlements like Atam, where thousands live in overcrowded conditions, securing basic needs—food, clean water, and shelter—remains an ongoing challenge.

“The overwhelming number of people, combined with the scarcity of resources, has created a dire humanitarian crisis, leaving many without access to the essential aid they desperately need,” says Zakaria Mwatia, MSF head of mission in South Sudan. “Some of those fleeing are even taking dangerous trips back into Sudan just to find basic supplies, exposing themselves to further risk. With health care and basic services limited, overcrowding is causing diseases to spread quickly, and outbreaks are a real threat.”

Time is running out to act before rainy season

MSF teams make trips each morning and evening to Atam and Girbanat, and up to three times a week to Gosfami, providing medical care to the people living in these settlements. Over the last month, MSF has provided an average of 200 medical consultations daily across all three informal settlements, mainly treating conditions such as malaria, diarrhea, and malnutrition. MSF has distributed relief items to 7,000 families, with a focus on those with children. In Atam alone, our teams supply up to 6,075 gallons of water each day, but much more is needed to meet people’s needs.

“With the rainy season rapidly approaching, time is running out to act,” Zakaria warns. “The rains will cut off access to these areas, making it even harder to deliver aid. Donors must release funds now to stop this crisis from worsening, and more actors are needed in the informal settlements. Humanitarian organizations and South Sudanese authorities must urgently ramp up efforts in water, sanitation, health care, shelter, and food assistance to protect lives and prevent further devastation.”

Bridging gaps in access to medical care

While MSF provides medical care, there are limited options to refer patients with severe cases who need further treatment. MSF ambulances take patients to Renk County Hospital, where MSF and the International Committee of the Red Cross (ICRC) treat patients, but the two-hour journey along treacherous roads is arduous and risky. This will become even more difficult with the approaching rainy season.

“There is an urgent need to set up public health facilities closer to the informal settlements and ensure they are adequately staffed and equipped,” Zakaria adds. 

MSF also works at Renk County Hospital, running pediatric and nutritional wards, providing pre- and post-operative care for people wounded in the war, and supporting secondary health care, including maternal health services. Renk County Hospital serves as a crucial referral center for patients from other parts of Renk county, including from both formal and informal settlements.

MSF teams have seen a significant rise in the number of patients, including children, with malnutrition since an influx of refugees arrived in December. In response, we have set up 17 additional medical tents to accommodate the increasing number of patients.

Immediate need for food assistance 

People arriving in South Sudan are entering areas already facing severe food insecurity. Immediate food assistance is urgently needed at informal border entry points, where it has been lacking, and it's crucial to maintain food distributions across the country for both host communities and those arriving from Sudan. Amid adversity, people continue to support each other and keep hope alive. 

“We have no water, we have no food, but at least there is peace,” says Musa Yhaia, a displaced person. “I used to be a businessman in Bur, but I lost everything. Now friends of the family are helping us because we have no source of income.” 

The crisis has placed a heavy strain on local communities, stretching scarce resources and intensifying the suffering of people who were struggling even before the crisis. Including these communities in humanitarian efforts is crucial to prevent the situation from deteriorating.