South Sudan: A Dire Health Situation in Malakal

Jacob Kuehn/MSF

The number of patients treated by Doctors Without Borders/Médecins Sans Frontières (MSF) on a weekly basis in the UN Protection of Civilians Camp (PoC) in Malakal, South Sudan, has tripled since June, as overcrowding and substandard living conditions in the camp continue to jeopardize people's health.

Currently, almost 48,000 people are living in the Malakal PoC following an influx of more than 16,000 in July and August. Many came from areas where humanitarian access has been cut off for months by insecurity, forcing thousands to flee from conflict and hunger. Most arrived with nothing.

"The sickness of our patients is directly related to the overcrowded and deplorable conditions in which they are living," said Monica Camacho, MSF program manager for South Sudan. "More space must be immediately allocated for the population seeking shelter and humanitarian actors must urgently improve the provision of basic services and necessities."

Hospital Filled Beyond Capacity

Since June, the number of medical consultations provided weekly by MSF has more than tripled. The number of consultations provided for children under five years old, who are the most vulnerable in these conditions, has increased five-fold. In recent weeks, the MSF hospital has been filled beyond its capacity with children suffering from life-threatening cases of pneumonia, malaria and other illnesses.

Read More: Horrid Conditions for Displaced People in Malakal

The number of patients treated for severe respiratory tract infections has already tripled since September. With the onset of the cold season, pneumonia is a particular concern given the crowded and unhygienic conditions. MSF fears these trends may worsen unless conditions are urgently improved.

Thousands of new arrivals are suffering in the worst living conditions, living in makeshift shelters in swampy areas of the camp not designated for habitation and lacking adequate access to water and sanitation. Children play in filthy mud surrounded by barbed wire and trash.

Too Little Space, Too Few Services

Seven thousand other new arrivals, most of whom are women and children, have been relocated to a contingency area that’s been adapted to accommodate IDPs. In this area, people live in classroom-sized communal tents shared by more than 50 people. These families have less than 4.5 square meters of total living space per person, far below the 30 square meters required by international humanitarian standards.

Living conditions and sanitation are inadequate throughout the entire camp, where the population of a small city is squeezed into roughly one-half of one square kilometer. The overall living space for is barely more than 10 square meters per person, a figure that includes pathways and other spaces not used for habitation.

In the most populated areas, there is only one latrine for every 70 people, less than one third of the ratio required by humanitarian standards. Access to clean water also hovers below acceptable levels and many families lack access to essential household items such as blankets.

Many people have been living in the Malakal camp seeking protection from violence and conflict since conflict erupted in December 2013. In 2015, the population of the camp has more than doubled following an influx of 10,000 displaced people in April and a further 16,000 in July-August. MSF operates a 50-bed hospital, including a 24-hour emergency room in the hospital and a detached emergency room inside the PoC.  

Three-month-old Mary James is being treated medical staff in the Malakal Protection of Civilians Camp in South Sudan. For the first two months of her life, Mary slept in a crowded tent with no blanket on a steel bedframe with no mattress. One month ago, Mary’s mother Sarah brought her here with severe, pneumonia. Until recently, Mary has been connected to an oxygen machine. Still now, she struggles to breath through her infected lungs and her exhalations are laboured and raspy. When she cries, she often cannot get the air she needs.
Jacob Kuehn/MSF