11 May 17 15 Jan 18

South Sudan: Fighting and lack of food and water driving people north of the border

South Sudan has been engulfed in a humanitarian crisis since a violent civil conflict began in late 2013. Over the past four months, fighting in the Greater Upper Nile region has forced thousands of civilians from Wau Shilluk and Kodok’s towns fled the violence and moved to Aburoc, a camp for internally displaced people (IDP) in order to look for safety and humanitarian aid.

Doctors without Borders/ Médecins Sans Frontières (MSF) was the only international humanitarian organization providing medical services during this period. Despite efforts water, food, shelter and medical services have all been in very short supply. Now the critical situation and fear of violence had forced over 20,000 of Aburoc’s population to put their lives in risk and flee north to the crowded refugee camps of Sudan. 

In the last two weeks, South Sudanese from Aburoc’s IDP camp have started flooding across the border to Sudan. Many arriving at the border crossing are severely dehydrated and in need of emergency medical care.

As the crisis spreads in the former Upper Nile state, over 20,000 South Sudanese have fled the horrendous living conditions and fighting around Aburoc for Sudan’s increasingly overcrowded refugee camps. While many more of the estimated 18,000 people left behind will take the road north, others will stay in Aburoc, hoping that desperately needed clean water, food and shelter will arrive.

“The reasons why we are leaving are mainly security and the lack of food and water. We feel a bit better in Sudan because we are receiving support, and now I am with my family,” said one recent refugee who made the journey to Sudan.

MSF kept its operations running in Aburoc when fighting started in nearby Kodok two weeks ago and 20,000 people arrived. A field hospital providing primary and secondary care has been open for most of the emergency, treating a range of conditions including watery diarrhea.

“Most of the people we see around Aburoc have packed their few belongings and are waiting for space on a truck departing to the north. Nearly all of those leaving have been forced to abandon their homes and have moved places several times in the past,” says Marcus Bachmann, MSF Head of Mission for South Sudan.

Many were originally from Malakal, moved for safety to the town of Wau Shilluk and when it was attacked earlier this year, fled to Aburoc. Others came to the IDP camp from the nearby town of Kodok after fighting broke out two weeks ago.

“This is just one area in a whole region that is being destabilized. Over the last week, fighting has spread to places like Tonga and Kaka, provoking more departures north,” added Bachmann. “We may soon see many other communities forced to take the road north. Many of those still in Aburoc would stay if the conditions improved.”

Until very recently the population gathering around Aburoc were surviving on a maximum of 21,000 litres of water a day from three hand pumps. This is only 1.1 litres per person which is below the daily minimum amount needed for survival, 2.5 litres. The purity of the water is also a concern, as both humans and animals openly defecate in the areas around the water pumps.

Food is starting to arrive in Aburoc’s market from Sudan, but it is at inflated prices that few can afford.


Many don’t reach the border

Other humanitarian organizations are starting to deploy to the area, but it is a race against time to help the displaced before the heavy rains arrive and make the transport of humanitarian aid impossible.

“Sadly, there have been reports of deaths amongst some of the people who started to make the 250km journey by foot last week. Many of those people reaching the border with Sudan are sick and exhausted, suffering from dehydration, diarrhea and malnutrition,” says Bachmann.

“The border camp of Khor Waral in Sudan, already has over 30,000 officially registered refugees, and 20,000 more are waiting to be processed. Overcrowding is already an issue as the planned capacity of the camp was initially only for 18,000 people.”  

Unfortunately, the availability of water is low, and the supply of sanitation, shelters and non-food items (including plastic sheeting, and cooking and cleaning utensils) is still not meeting the demand. This could have consequences on the health of the new arrivals.

MSF already manages a hospital in Sudan’s White Nile State, and when the emergency started, the medical organization dispatched a team of 30 medical staff to Khor Waral to work in close collaboration with Sudanese authorities.  


The situation described by MSF staff

MSF staff stayed with the population in their journey from Aburoc to Khor Waral camp in Sudan. This is what they have to say:

'I left my mother and father behind': MSF physician Dr. Lazaro Fidelle Nykayo

“There was a lot of tension in Kodok, so people started to move. People were afraid of clashes between the government and opposition. We moved to Aburoc and then to Meganis, but we had no water on the way.

People are leaving Aburoc because they think they won’t get water. That’s the main reason why people are going to Meganis, Sudan. But it is very difficult for people to reach Meganis, it is 250km away, with no water, so people are walking close to the river or they pay a truck to Meganis.  

I left my mother and father behind, in Aburoc. I can’t communicate with them. I don’t know what has happened to them.”

People fight for water: Joseph Oyath, MSF nurse

“The situation is not good because of the water in Aburoc, and that’s the reason why we have so many diarrhea cases. 

The population is gathering under trees. They want to leave, but there are not enough vehicles for everyone to go to Sudan. 

Water is the main reason people go to Sudan, and the other one is security. People go to the boreholes to get water, but there are always people in line. Some even fight because they want to get water. It is not enough.

My family went to the north, but I can’t go because I have to help the people here. I would go to Sudan if I was not working for MSF here, helping the people.”

The journey from Aburoc to Meganis: Waad Dier, MSF outreach supervisor

“On April 26, we left in a truck that we hired with many other people.  It was a very hard situation on the road, no water, no food, and children were crying, people got diarrhea. 

I had the runaway bags, containing essential medical supplies, provided by MSF so I was able to help the people…some were vomiting, others with diarrhea.  We all managed to reach Meganis thanks to the medical assistance we could provide on the way. In all, 350 people came with me in five trucks. 

I would like to stay in the camp because my life is secure here.  However, the living conditions in the camp are not ideal.  At the moment, I am staying with one of my relatives. 

People need water in Aburoc and they also need shelter and food.  The hygienic conditions are very bad, but all of them can’t come to Sudan because they need money to pay for the transport here.”

Waad Dier is currently in Kor Alwaral refugee camp, Sudan

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