South Sudan: First Rains Exacerbate Deplorable Living Conditions and Increase Risk of Disease in Tomping Camp, Juba

The first torrential rains of the season have flooded large parts of Tomping camp in Juba, South Sudan’s capital, worsening already unacceptable living conditions for more than 25,000 people packed into the camp and forcing Doctors Without Borders/Médecins Sans Frontières (MSF) to temporarily suspend medical activities at its clinic.

The combination of stagnant water, inadequate drainage, and a dire shortage of functional latrines in a severely overcrowded site greatly heighten risks that diarrheal diseases and skin infections will spread through the camp. This is particularly worrisome because the rainy season has not yet officially started; it will get worse. And the MSF team was already treating large numbers of patients suffering from diarrhea, malaria, and respiratory infections.

“This downpour is just a preview of what is to come,” says Carolina Lopez, MSF emergency coordinator. “The full rainy season starts soon and is always accompanied by a huge spike in malaria cases. Add this to the already precarious living conditions in the camp and it is clear the risk for outbreaks is high. The sanitation conditions in the camp must urgently be improved to avoid a disastrous situation.”

More than 25,000 people sought refuge in the grounds of the United Nations compound in Juba after intense fighting broke out between government and opposition forces throughout the country in December.

The rain has flooded nearly 20 percent of the area allocated for displaced people, leaving their makeshift shelters underwater and destroying their few belongings. "I lived on the other side of the road, one of the areas completely underwater today,” says a young displaced man. “I lost my shelter. The only things I managed to keep fit in my bag. I wonder where I can sleep at night.”

The deluge also destroyed approximately 150 latrines, a serious problem given that the number of latrines was already far below what is recommended for settings like this. An area identified for the construction of new sanitary facilities has now been occupied by people from the flooded areas of the camp seeking drier ground. People have also relocated onto the road, causing severe congestion and restricting the movement of vehicles.

“The major problem is the lack of space,” says Lopez. “People are forced to live on top of each other in extremely cramped and unsanitary conditions.”

The overcrowding and flooding also hinders organizations from providing much needed assistance. After MSF’s clinic in Tomping was partly flooded last Thursday, "the team spent more than two hours cleaning up the clinic before starting to work,” says Lopez. “But around noon, the incessant rain forced us to stop consultations for a number of hours, leaving hundreds of people without medical care that day. Since then we have adapted the configuration of the clinic and raised the sunken flooded area in order to deal with the next inevitable rains.”

MSF has been providing medical humanitarian assistance in South Sudan for more than 30 years. After fighting broke out in Juba in December 2013 and then in several other states, MSF increased its capacity to rapidly respond to emergency medical needs in the country. MSF teams are now working in 20 projects in nine of the ten states in South Sudan, providing basic health care, surgery, vaccinations, as well as clean water to people who fled their homes.