JUBA, SOUTH SUDAN/NEW YORK, June 22, 2023—Thousands of people fleeing conflict in Sudan are arriving in areas of South Sudan where inadequate water, sanitation, food, and shelter may soon become catastrophic, Doctors Without Borders/Médecins Sans Frontières (MSF) warned today, calling on the medical and humanitarian community to launch a coordinated response.
Diseases caused by contaminated water, inadequate food, and exposure to severe weather may only worsen with the onset of the rainy season in transit camps and other areas where new arrivals are staying, MSF said.
“We are treating patients for acute watery diarrhea, malaria, respiratory tract infections, and eye infections,” said Dawai Apayi, an MSF emergency nurse in the border town of Renk, Upper Nile state. “Once the rains come, they will also be prone to disease outbreaks such as cholera. To prevent this, it is crucial to meet people’s basic needs by providing them with shelter, clean water, and hygiene facilities. If these needs are not addressed promptly, we fear disease outbreaks and a health catastrophe that could endanger the lives of thousands.”
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Hundreds of thousands of displaced people
More than 127,000 people have sought refuge in South Sudan since an intense and ongoing armed conflict erupted in Sudan in April. Most are South Sudanese nationals who were living in Sudan, including many women or children.
Between 800 and 1,000 people cross into Renk each day on donkey carts, often after making long and dangerous journeys to reach the border. The main transit center is far over capacity with more than 12,000 people. Many families are camping outside it, shading themselves from the sun with whatever materials they can find.
“The displaced people, who are already traumatized, have very limited access to food, shelter, sanitation, and other essentials,” said Jocelyn Yapi, MSF head of mission in South Sudan. “There is an urgent need for the authorities and others to accelerate the process of transferring them to other parts of the country in a dignified way, while ensuring the provision of basic services for their survival and settlement in South Sudan.”
Emergency response
MSF has launched emergency responses in Upper Nile and Northern Bahr El Ghazal states, running three mobile clinics in Renk and one in Aweil. In Renk, MSF is treating river water to provide safe drinking water for displaced people, while medical teams are screening children for malnutrition and managing a measles isolation ward. MSF teams are also providing mental health support and health education and making referrals to health facilities for people who need specialized care.
Awel Shoul is one of many South Sudanese people returning to their homeland in search of safety. He arrived with his brother who had been undergoing medical treatment in Sudan and was due to have surgery, but had to leave his treatment unfinished when Khartoum became a battle zone.
Awel described their 15-day journey: “We ran for our lives from Khartoum. Along the way, we came across armed men who took our money and belongings. Our mobile phones were snatched as well.”
Crossing into South Sudan, most returnees do not realize that another crisis awaits them.
About a month ago, the Renk transit center was the scene of intercommunal clashes. Since then, some community members have moved out of the center in order to maintain the peace. While some aid is available to people in the transit center, there is no functional response for those outside it.
Malnutrition risks
“We do not have food,” said Anyr Mathok Deng, who is sleeping in a warehouse close to the river in Renk town, after returning to the country following 40 years of living in Sudan. “There are hardly any relief items necessary for survival. Snakes and scorpions are coming from the river. There is not enough clean water. People don’t want to stay here. They are so desperate to leave.”
Local authorities in Renk had announced a plan to transfer returnees to a second transit center in Malakal town, which already hosts a camp for displaced people. However, all travel between Renk and Malakal was temporarily suspended after intercommunal violence broke out in the camp in Malakal earlier in June, leaving at least 17 people dead.
In Aweil, Northern Bahr El Ghazal state, the situation is also dire. While Sudanese nationals are staying in a refugee transit center, many South Sudanese returnees are still living under trees without food, clean water or proper sanitation. Humanitarian needs were already high before the current crisis, but funding cuts have eroded health services in the state.
“The arrival of returnees and refugees is going to have a huge impact on the humanitarian situation in Northern Bahr El Ghazal,” said Margot Grelet, MSF project coordinator in Aweil. “We are already seeing an increase in malnutrition cases."
