South Sudan

21 February 2017

The protracted conflict in South Sudan's Mayendit and Leer counties is having a profound effect on the local population. Men, women and children are regularly forced to flee their homes to escape fighting, and struggle to access essentials, including food, water and healthcare. In recent weeks, MSF teams have encountered extremely high levels of malnutrition and have launched an emergency response to treat malnourished children.

9 September 2016 - crisis in Juba

In response to the crisis that erupted in Juba in July 2016, MSF initiated emergency response activities in Juba county.

Medical Clinics

On the 12 July after the violence first erupted, MSF started running mobile clinics, which have now provided care to more than 21,000 people. Initially, the teams were providing care for gunshot wounds and injuries sustained as people fled the fighting. Amongst those injured were children as young as two who had been shot when armed men broke into their homes. The teams also noticed people coming for treatment for physical symptoms that were the result of the mental trauma they had endured.

Before closing the clinics in late August, our teams were mostly seeing people in need of treatment for everyday health concerns, albeit ones that reflect the underlying fragility of people’s health. The majority of consultations were for malaria, skin infections, stomach problems, respiratory tract infections, malnutrition and diarrhoea.

Surgical activities

MSF provided surgeries in Juba to people more seriously injured in the violence. The surgical team operated on more than 202 people (including 54 major surgeries) before handing over activities.

Water supply

MSF trucked more than 1.5 million litres of water into Juba. The teams focused on sites to which large numbers of people had initially fled and areas affected by cholera, as the supply of clean drinking water is very important in order to prevent outbreaks.

Cholera response

MSF also intervened in the cholera response in Juba by supporting the MoH in running the city’s cholera treatment centre (CTC) at the Juba teaching hospital. MSF staff provided care at the site and training to MoH staff on best practices for cholera treatment. They also vaccinated over 7,200 people who were at highest risk of contracting the disease.

On 26 August, MSF handed over medical activities in the CTC to the MoH, having treated over 700 people and observing a sharp decrease in patients. Should the numbers increase again, MSF is ready to intervene.

MSF has now closed or handed over all Juba-based programmes that were launched following the clashes. MSF has been operational in the region that today constitutes South Sudan since 1983. In 2016, MSF had been running 17 regular medical projects throughout the country (though at present there are 16 operational projects due to insecurity affecting the 17th) and performed close to a million medical consultations in 2015.

As usual, MSF is continuing to monitor the security situation around the country closely, but our operations in much of South Sudan are ongoing. Many of our teams are currently working to address the ongoing illnesses we have seen in South Sudan for many years (e.g., malaria and malnutrition), which create additional risk for people already very reliant on humanitarian assistance for their survival.

MSF has been working in the region that today constitutes the Republic of South Sudan since 1983.

In 2016, MSF has been running 17 regular medical projects throughout the country and in 2015 undertook close to a million medical consultations.

2016 activities by the numbers

(1 January – 30 April)

  • 235,851 outpatient consultations, of which 88,618 children under 5 years old  
  • 13,716 patients hospitalised, of which 6,058 children under 5 years old  
  • 4,256 surgical operations, and 1,718 war wounded treated  
  • 50,974 patients treated for malaria  
  • 7,050 patients treated for malnutrition, of which 2,449 admitted for intensive treatment  
  • 3,612 babies delivered

Crisis Updates

Activities  2015 International Activity Report

MSF responded to immense medical needs amid a major upsurge in conflict and violence against civilians, as well as an exceptionally severe malaria season.

More than two years of sustained conflict and violence against civilians have taken a huge toll on the people of South Sudan. Over one million people have been displaced and hundreds of thousands have been unable to access medical or humanitarian assistance for months at a time, particularly in Jonglei, Unity and Upper Nile states. MSF scaled up its programmes in response, but access was disrupted repeatedly by fighting and attacks on medical facilities. Compounding this humanitarian crisis, there were frequent drug shortages, even in areas not affected by conflict, and the country also experienced one of its worst malaria seasons in years. MSF treated a total of 295,000 patients for malaria during the year – nearly ten times as many as in 2014.

Extreme levels of conflict, violence and humanitarian need

There was an escalation in conflict and violence in Unity state between April and November, forcing hundreds of thousands of people to flee their homes. Many hid in the bush and swamps and MSF received reports of executions, mass rapes, abductions and the razing of entire villages. Five South Sudanese MSF staff were killed amid the extreme levels of violence, and 13 remain unaccounted for.

MSF was forced to temporarily evacuate from Nyal, in May, and twice from Leer, in May and October. As people sought shelter, the population of the UN protection of civilians site (PoC) in Bentiu in northern Unity state increased from 45,000 to over 100,000 by the end of 2015. MSF runs the only hospital in Bentiu PoC and the team rapidly expanded capacity to meet the enormous medical needs of this vulnerable population. MSF also operated mobile clinics and therapeutic feeding programmes in southern Unity state and Bentiu town whenever access was possible. Many patients suffering from severe violence-related injuries were referred to the MSF hospital in Lankien for surgical care. Thousands also fled into northern Jonglei state, where MSF opened a project in Old Fangak providing assistance in a medical centre, mobile clinics for the region and referrals by boat ambulance. MSF opened another clinic in Mayom, a remote location in northern Unity state, providing basic healthcare and secondary referrals to its hospital in Agok. Teams also responded to outbreaks of diseases including measles, malaria and meningitis in Yida refugee camp, currently home to 70,000 Sudanese refugees.

Read more about MSF's activities in South Sudan in 2015.

Year MSF first worked in the country: 1983.

2015 Key figures
Outpatient consultations 915,900
Patients treated for malaria 295,000
Antenatal care consultations 65,300
Measles vaccinations in response to an outbreak 46,400
Routine vaccinations 38,700
Patients treated in feeding centres 11,600
Patients on first-line ARV treatment 3,400
No. staff in 2015 3,322
2015 Expenditure €81.7 million

Figures from 2015 International Activity Report
and 2015 International Financial Report

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