Assisting people affected by conflict
After conflict broke out in Sudan in 2023, over 600,000 people fled into South Sudan, 80 percent of whom were South Sudanese returnees and the remainder were refugees seeking safety. Our teams set up mobile clinics around transit centers for people returning home and refugees in Renk, a town on the Sudanese border. In Upper Nile State, we helped returnees at Bulukat transit center by operating a medical facility offering general check-ups, vaccinations, social support, and protection programs. We also transferred patients needing hospital care to our facilities in Malakal. Additionally, we assisted people in Wedweil by operating a mobile health clinic and providing daily water trucking. These transit centers remain active in receiving new arrivals.
In Renk, the busiest entry point, we established a measles isolation unit and a therapeutic feeding ward for children with severe malnutrition at the county hospital. In addition, our teams conducted vaccination campaigns and distributed mosquito nets in response to the alarming increase in malaria cases.
During the year, our teams also responded to violence-related emergencies arising from conflicts within South Sudan, which forced thousands of people to flee their homes. In Melut, we offered general health care for displaced families and referrals for patients needing specialist care, and worked to improve sanitation and hygiene facilities. In August, our South Sudan Emergency Response Unit launched an intervention for returnees in Paloich to address high levels of severe malnutrition and an outbreak of measles. We also conducted general health care consultations and distributed relief supplies to families such as mosquito nets, bars of soap, and jerrycans. In Kodok, we focused on addressing the mental health needs of people traumatized by conflict and violence. In Yei, an area affected by ongoing conflict, we significantly expanded our outreach activities through integrated community case management and mobile clinics.
In February 2023, MSF opened a newly rehabilitated hospital in collaboration with the Ministry of Health in Kajo Keji. This project addresses the needs of returnees who fled to Uganda during the war in South Sudan, which also resulted in the destruction of the hospital buildings, and are now returning.
Responding to disease outbreaks
Repeated waves of displacement exacerbated the spread of measles and other diseases in 2023. In Bentiu Hospital, we increased the bed capacity 10 to 25 for the management of severe measles cases, and supported the Ministry of Health in conducting a measles mass vaccination campaign for displaced people during an outbreak. In Lankien, our teams also provided support with case management and vaccinations.
During a cholera outbreak in Malakal, we saw an increasing number of patients with non-bloody diarrhea at the Protection of Civilians camp. Our teams increased the bed capacity of the health facility and conducted health promotion activities in the community.
In September, the health ministry declared a hepatitis E outbreak in Fangak county. In response, we launched a vaccination campaign— the first to ever be conducted in South Sudan during the initial stages of an active outbreak in such a remote location—targeting women and girls of childbearing age, the group most vulnerable to the disease.
Malnutrition
The primary causes of malnutrition are food insecurity, inadequate access to clean water and sanitation, and substandard health care. Unfortunately, these are all present in South Sudan, along with other contributing factors, such as disease outbreaks, conflict, and displacement. At the end of 2023, the country was grappling with a nutrition crisis affecting approximately 7 million people, a number expected to rise in 2024.
In an effort to tackle this crisis, we set up a pediatric nutrition ward in all our health facilities across the country, where our teams offer inpatient care and run intensive feeding programs for severely ill children.
Sexual and gender-based violence
Our health facilities provide comprehensive care focusing on survivors of sexual and gender-based violence. Lack of access to care for survivors of sexual violence remains a key challenge in the areas where we operate, so our teams have been working with community-based care models to address access challenges, while advocating with all relevant organizations to scale up their response.
MSF Academy
We have faced recruitment hurdles due to years of conflict and underinvestment in health care in South Sudan, resulting in a shortage of qualified health professionals and medical infrastructure.
To combat this, we set up the Academy for Health Care program to improve the quality of health care. In 2023, 171 students graduated from Lankien, Malakal, and Old Fangak after an 18-month training course. We also began training sessions for staff in Ulang.
