Democratic Republic of Congo: South Sudanese refugees flee conflict and face crisis in Ituri
MSF responds to urgent medical needs as violence escalates in South Sudan
With violence intensifying in South Sudan, more than 33,000 refugees have fled to northern Democratic Republic of Congo (DRC). In May, Doctors Without Borders/Médecins Sans Frontières (MSF) launched an emergency intervention to provide essential medical care to a community facing crisis.
“We saw people shooting guns,” says Blessing Halima, a refugee from Morobo County, in South Sudan, who recently fled to Adi, northern DRC, with her six children. “Then we saw planes shooting people from the sky. They began killing people and stealing everything. They took my husband. That’s why we ran.”
She is not alone. In April, Atay Rose travelled for several days through the bush to reach Adi from Panyume, South Sudan. “If we used the main road, we would have been killed,” says Rose. “They rape young girls and even married women. I don’t know if I can go back. There’s still looting. There’s still raping. There’s still the killing of women and children. That’s what we fear the most.”
South Sudan is experiencing its most severe surge in violence since the signing of the peace agreement and the end of its civil war in 2018. The crisis escalated in February, when clashes broke out between government forces and armed youths, known as the White Army, in the northeastern state of Upper Nile.
“We ran away with nothing. They took our food and clothes. Now we are dying of hunger and don’t have anything to sleep on.”
Viola Kani, South Sudanese refugee
The violence quickly spread to other parts of the country, incorporating armed groups in Central Equatoria State, which lies at the southern edge of South Sudan and borders DRC. There have been widespread civilian casualties throughout the country – with more than 730 civilians killed between January and March alone. Between January and June, an estimated 300,000 people were displaced by the violence, according to the UN. Of those, 125,000 fled to neighbouring countries, including Sudan, Ethiopia, Uganda and DRC – where more than 33,000 people have arrived since April, according to the country’s National Council of Refugees.
Instability has led to the total collapse of already fragile public services and MSF has been forced to close two hospitals and scale down operations in the country amid attacks on health facilities.
Most people arriving in the DRC have fled Morobo County in Central Equatoria State, which has become highly volatile due to intensified fighting this year. A few days ago, MSF was forced to suspend all activities in Morobo – including services in camps for internally displaced people – as well as in neighbouring Yei River County. This decision followed the abduction of health workers, including one of MSF’s own staff members.
Arriving with nothing
Ituri province, located in northeastern Democratic Republic of Congo, is where most South Sudanese refugees enter the country. The region has endured decades of conflict, marked by ongoing violence, deep ethnic divisions, and the presence of numerous armed groups. Even prior to the arrival of South Sudanese refugees, health systems were under strain and almost non-existent in the border area.
Many refugees arrive with few or no possessions whatsoever having hastily fled for their lives. “We are suffering,” says Jacob Justin, who travelled alone with nothing but the clothes on his back.
“We are suffering,” says Jacob Justin, who travelled alone with nothing but the clothes on his back. “We have no schools, no hospitals and no access to clean water.”
Viola Kani fled across the border in May with her brother and four children. “We ran away with nothing,” she says. “They took our food and clothes. Now we are dying of hunger and don’t have anything to sleep on.”
Six percent of children aged six to 59 months seen by MSF teams near the border are suffering from severe malnutrition. According to Léonard Wabingwa, MSF medical activity manager in Adi, this represents a major public health problem.
MSF response
To address the growing needs of refugees, MSF launched an emergency response in May. Our teams operate two mobile clinics and have established six community care centres.
In less than two months since activities were launched, over 3,000 medical consultations were carried out. The weekly average of more than 370 consultations continues to increase. Malaria accounts for more than half of all cases, followed by respiratory tract infections and acute gastroenteritis. We screen children under five years old for malnutrition, treating patients with therapeutic food.
“We have also provided care to several survivors of sexual violence, including some as young as 12,” says Wabingwa.
“There are very few international organizations in the region and none that are providing the same range of medical services as MSF. Without support from other partners, there is a risk that further lives will be lost.”
Asiyat Magomedova, MSF head of programs
Risk of disease outbreaks
Measles cases have already been reported among the refugee community. An MSF-supported mass vaccination campaign, targeting 62,000 children, is set to begin in August to reduce the risks of an outbreak. A parallel vaccination campaign will seek to provide routine vaccinations to a further 520 infants and 310 pregnant women.
“Instability in South Sudan means routine vaccinations have been interrupted,” says Félicien Lwiteo, MSF project coordinator in Adi. “If you are running for your life, it is difficult to attend a medical appointment. There’s a real risk of disease outbreaks and it’s vital that we act quickly.”
MSF is also working on critical infrastructure projects. Our teams are installing six water distribution points and 200 latrines and showers, expected to be completed by mid-August. Additionally, nearly 6,000 non-food item kits containing essential items – such as mosquito nets, buckets, soap and portable toilets – will be distributed to families in need.
Mounting needs, limited support
With more refugees arriving daily in DRC, MSF’s capacity to meet the growing needs is under pressure.
“There are very few international organizations in the region and none that are providing the same range of medical services as MSF,” says Asiyat Magomedova, MSF head of programs covering the area. “Without support from other partners, there is a risk that further lives will be lost.”
In South Sudan, the situation remains “critical,” according to Ferdinand Atte, MSF country director.
“It is crucial to ensure safe and unobstructed access to populations in need and to protect civilians and civilian infrastructure, including medical facilities, before we can consider resuming our activities,” says Atte. “While we are deeply committed to providing care to those in need, we cannot keep our staff working in an unsafe environment.”
For South Sudanese refugees now living in DRC, there is little hope of returning home anytime soon.
“If we go back, that means we are going to die,” says Viola. “How can we go back there?”
