Juba/Nairobi, 27 April 2015: Continuing clashes in Upper Nile state are leading to more deaths and displacements of people, some of whom are already displaced and living in dire conditions, the international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) said today. In Malakal, over 6,600 people have fled their homes to seek shelter at the UN protection of civilians (PoC) base, while in Melut, a town north of Malakal; over 1,665 families have sought refuge across the river Nile since the beginning of April. The organisation further called upon all parties to the South Sudanese conflict to allow for necessary humanitarian access to all parts of the country.
This new wave of displacement, sparked by clashes that started at the beginning of this month, has pushed the total number of internally displaced people at the UN base in Malakal to 26,500, since the beginning of the conflict in December 2013 causing congestion. The new internally displaced people are living in big tents, with dozens of families sharing the same tent and sleeping on the floor. MSF continues to provide medical services at the hospital in the UN base, while other agencies are on site to ensure sufficient water supply and proper sanitation. However, with the congestion, the few existing resources are being strained.
“The rainy season is just setting in and with the congestion in the PoC, we have started to see open defecation, long queues at water points due to low water quantity and pressure. Cases of acute diarrhoea are increasing so we are reinforcing our surveillance measures to ensure that outbreaks are prevented. Last year, MSF launched a cholera intervention and cholera vaccination campaign in the camp and we are ready to replicate actions if needed,” said Juan Prieto, MSF head of mission in South Sudan. However, we are afraid that if fighting continues, there will be more displacement, further congestion in the PoC and a deterioration of health and general living conditions.
In Melut, the over 1,665 families that have fled to the west side of the Nile are mostly members of the Shilluk ethnic group who were previously displaced and living in a camp. Most of them have fled to the Noon area, about 10 km across the Nile. These families are living under trees, with extremely limited access to latrines, leading to open defecation and have to travel long distances to fetch water from the Nile. Unless the water is treated, it is not fit for drinking. Other families are scattered all over the west bank of the Nile in Kaka, Kuju and Toruguang Payams, some 80 km away from Melut. These families have no shelter either, and their food resources are slowly getting depleted as they consume what they managed to salvage when they moved at the beginning of the month.
"The biggest problem is water. I have to go to the Nile three to four times a day. It is a 25-minute walk each way," said 17-year-old Teresa, a Shilluk who recently fled to Noon. “We are worried for our lives and for the future, if we survive.”
MSF is supplying each family with water treatment kits in order for them to have clean water, as well as using speed boats and donkeys to transport and distribute food and non-food items to families scattered in different parts of Noon. The organisation is regularly conducting mobile clinics with outpatient and emergency room services for the population in Noon, and referring acute medical cases to health facilities in the towns of Melut and Kodok. In a day, MSF treats an average of 150 patients for diseases like measles, acute watery diarrhoea, and respiratory tract infections in Melut. However, due to continued fighting in the area, MSF is sometimes forced to suspend its activities, as a preventive measure, leaving the population in an even worse position.
“The people here have been on the move since the war started, they have nowhere to call home any more as insecurity has made them nomads, moving from one place to another in search of safe havens to stay. Whenever clashes start, they are prompted to move. Children under the age of five years and pregnant women are especially vulnerable during these times,” said Joao Martins, MSF project coordinator in Melut.
The security situation in Upper Nile, and in other states severely affected by the conflict, remains unstable. Mistrust between communities leads to clashes which, in turn, have massive humanitarian consequences. People are constantly on the run and yet the areas to which they flee do not offer favourable living conditions. In some states, like Upper Nile, some people have been forced to flee so many times that they don’t have a place to call home anymore.
As many more people get displaced, some to remote areas where they have hardly anything to live on, MSF calls upon all armed groups to facilitate the free movement of humanitarian assistance and personnel to all parts affected by the South Sudanese conflict. Only in this way can lives be saved.
MSF has been working in the region that today constitutes the Republic of South Sudan since 1983. MSF responds to emergencies, including large-scale displacement, refugee influxes, alarming nutrition situations and peaks of diseases such as measles, malaria, acute watery diarrhoea and kala azar, in addition to providing basic and specialised healthcare services. Since conflict began in South Sudan in December 2013, two million people have been displaced from their homes. Some live in camps while others have fled across the border to neighbouring countries of Kenya, Uganda, Ethiopia and Sudan.