A year after the mass killings of civilians, including patients in the hospital where Doctors Without Borders/Médecins Sans Frontières (MSF) was running an HIV/Tuberculosis (TB) project, in Bentiu, South Sudan, violence and displacement have continued, impeding access to basic health care and food.
Following the fighting that swept through Bentiu a year ago, MSF treated over 230 people for gunshot wounds, while thousands of the town’s residents fled for their lives to the nearby United Nations peacekeepers’ base, where the population swelled from 6,000 people to more than 22,000 within a matter of days. One year later, the number of people seeking protection has increased to over 53,000 displaced people living on a one-square kilometer piece of land cordoned off with barbed wire and guarded by UN troops.
Living conditions at the site were initially life-threatening due to overcrowding and a lack of water and sanitation; they only worsened during last year’s rainy season when the camp was completely flooded. Many people were forced to sleep standing up in knee-deep water with their children in their arms. Several drowned.
Since the arrival of the dry season, living conditions at the site have improved and various aid organizations are providing basic services. MSF set up a tented hospital to provide residents with quality secondary health care while working to ensure access to clean water and sanitation facilities.
Providing humanitarian assistance within a UN base is an absolute last resort for MSF. As an independent, impartial, and neutral medical aid organization, MSF must remain distinct from political and military actors. But in extraordinary circumstances, amid heightened tension and fear, it’s important for people to be able to access medical services where they feel safe.
MSF is also working outside the confines of the UN “Protection of Civilians” (PoC) site. The majority of people affected by the ongoing conflict remain dispersed in hard-to-reach rural areas, with many displaced by fighting multiple times. MSF runs mobile clinics in Ding Ding, Nhialdiu, and in Bentiu town itself, with a focus on basic inpatient and maternal health care.
Assessments of needs in the surrounding areas continue, most recently in Nimni in Guit County and Ngop in Rubkona County. “People have suffered so much because of the floods, it destroyed all our crops,” said a 28-year-old woman from Ngop whose severely malnourished child was hospitalized by MSF in February. “So there is nothing to eat. If you are sick, there is nowhere you can go. The nearest health care facility we used to access before the crisis has no drugs anymore.”
Reduced access to health care is particularly acute in these rural areas. Local facilities often lack support and adequate medical supplies. Proximity to frontlines, military movements, and ongoing shelling and gunfire mean that people are afraid to walk long distances to the few functioning health facilities.
Formerly a vibrant state capital, Bentiu is now a garrison town, with most businesses and market stalls run by government soldiers. Most of the town’s houses were burnt to the ground and have not been rebuilt. A melted TV remote control or lone iron bed frame on the scorched earth are the only clues of what once stood there.
The modern hospital in town where MSF provided TB and HIV care has been ransacked, the windows and doors smashed, medical equipment and drugs scattered about. MSF still runs a mobile clinic with a focus on antenatal care in a cleaned-up outbuilding, but the hospital, now infested with bats and other vermin, is no longer in use.
As the conflict in South Sudan continues, there is no end in sight for the dire humanitarian situation in Bentiu. Ongoing insecurity, active fighting and shelling, and violence against civilians in the vicinity mean that many displaced people currently taking refuge in the PoC site have no choice but to remain there for the foreseeable future. The need for assistance to this population, in the only place where they feel safe, will continue.
In the meantime, MSF continues to provide medical care to more than 100,000 people in the area around Bentiu. But ensuring respect for humanitarian and medical facilities, staff, and patients continues to be a challenge.
Thousands Newly Displaced after Renewed Clashes in Upper Nile State
Increased clashes and continuing tension in Upper Nile since the beginning of April have led to 4,600 newly displaced people at the PoC site in Malakal town, the capital of the state. MSF continues to support the hospital in the PoC in the town.
In Melut, around 1,000 families, mostly of the Shilluk ethnic group, have fled their camp and sought refuge across the Nile in an area called "Noon," approximately 10 kilometers [about 6 miles] from Melut. MSF, one of the few organizations working in Melut, has set up a mobile clinic to assist this population and is preparing to do a supplementary food distribution.