As the rainy season continues, Ethiopia’s Lietchuor refugee camp—which shelters some 40,000 people who fled violence in South Sudan—has become a lake dotted with islands. As a result, Ethiopia’s Administration for Refugee and Returnee Affairs (ARRA) and the UNHCR have decided to close the camp and must find an appropriate site to relocate the refugees.
Heavy rains and flooding have also caused serious damage in Pagak and Pamdong transit camps, also in Ethiopia’s Gambella region, but Lietchuor camp is the worst affected. The camp is located on flat, bare “black cotton soil” on which floodwater pools and stagnates. The newly constructed tukuls (mud huts) for the refugees are completely flooded. The road built on a strip of elevated land is the only remaining habitable area, and some of the refugees have set up their tents there. Others have left the camp, with hundreds sheltering with host communities in nearby villages or in churches.
Shelters in the camp were blown down during the most recent rainstorm on August 24. The nearby Doctors Without Borders/Médecins Sans Frontières (MSF) compound was also flooded. Strong winds blew down the plastic sheeting covering the roof of the staff tent, forcing the team to relocate. Inside the camp, the hastily–built latrines overflowed, with some collapsing completely.
However, MSF medical facilities were spared and remain operational. Despite now essentially being on an island surrounded by floodwaters, the MSF health center and hospital—which has a total of 107 beds and includes a maternity ward and intensive therapeutic feeding center, all set up in separate tents—both continue to operate.
MSF teams have raised the medical tents to 40 centimeters above the ground and built a drainage system around them, allowing the beds and patients to remain dry.
“Before the rainy season began, we brought in 100 trucks, each carrying five cubic meters of earth, to raise the ground level of the hospital,” says MSF logistics coordinator Suzanne Ceresko. “But every day, when it rains, we still have to pump the water out from around the MSF tents.” Logistics are a vital part of MSF's work, but in cases such as this can represent a considerable cost.
Finding an appropriate alternative site for the refugees is now crucial. The site should be like Kule and Tierkidi camps: not prone to flooding and with trees to provide shade during the dry season’s scorching temperatures, as well as firewood to enable refugees to cook their food rations. The new site also must not present a security risk to the refugee population. The potential sites in Nip Nip, Dima, and Pugnido identified by the authorities do not meet these criteria.
MSF is ready to provide medical care for the refugees once they are relocated, in addition to continuing to provide care in Lietchuor camp, where people still have medical needs. Most patients seen by MSF staff in Lietchuor camp are suffering from malaria and respiratory infections, but hepatitis E and jaundice are also a problem. Between late-May and late-August, 354 cases of hepatitis E and jaundice were detected.
Despite the extremely poor hygiene conditions in the camp, no cases of cholera have been recorded. On August 23, MSF teams completed a cholera vaccination campaign in the camp, immunizing more than 39,000 people against the disease.
MSF’s 120-bed hospital in Itang, near the camps of Tierkidi and Kule, was also affected by the storm. A dyke reinforced by the MSF team to protect the hospital collapsed, and the clinic, which served patients from both the refugee and host communities, is no longer functional. Thirty-five inpatients have been transferred to other tents, while a number of other patients have been referred to health facilities run by other partners.
Access to health care is essential for the refugees in the Gambella region, and solutions must be found to ensure that medical care is available in the camps for all those who need it.
MSF is also present in Kule and Tierkidi camps, where the organization provides health care as well as water and sanitation services.