The humanitarian crisis is unfolding rapidly on both sides of the South Sudan and Ethiopia border. Medicine is driving front ale (MSF) warnings as violence, evacuation and widespread cholera outbreaks are pushing communities to the brink.
Clashes between government forces and armed groups risk starting initially in the Upper Nile province of South Sudan and now spreading to other parts of the country. Crossing the border, the Gambella region of Ethiopia is experiencing the effects of this violence. According to the United Nations, around 10,000 displaced people have traveled to Ethiopia since the beginning of March.
“We have already witnessed the violence promoted the spread of cholera in some regions, but a larger and escalating conflict could push the entire country into an unprecedented humanitarian catastrophe,” says Zakariamwatia, MSF mission head in South Sudan. “We urgently call on all parties to the conflict in line with international humanitarian law, to ensure the protection of civilians, healthcare workers and healthcare facilities and to grant unimpeded access to humanitarian and medical assistance.”
South Sudan has been working on the nationwide cholera outbreak since last year. The latest wave, which began in the Upper Nile province, is now spreading further across neighbouring John Ray province, the larger Pibor management area and the Gambella region of Ethiopia.
In Upper Nile, MSF treats people injured in violence and supports cholera treatment facilities in Uranium, Malakal and RENK counties. In Jonglei, MSF responds with Lankien and Akobo. At Akobo, a 100-bed cholera treatment unit installed by MSF at Akobo County Hospital treated more than 300 patients in just over two weeks. MSF is also compatible with Pibor Town, a Pibor management region. Since the beginning of March, the MSF team has treated more than 1,000 cholera patients in South Sudan and received more than 30 patients injured in violence.
Ruach Riek Chuol was admitted to MSF Hospital in Ulang after being injured in violence. “All my goods and assets for my business were burned in the house,” he says. “Everything was destroyed in the fire, including the house I was in.”
In the Gambella region of Ethiopia, MSF has worked with the Ministry of Health to treat more than 560 cholera patients in cholera treatment centres and 100 bed capacity in Matar, Moan and Bullbay units since the start of the response in early March. MSF is implementing oral supply points, implementing community-based activities including water, sanitation, hygiene, hygiene, and door-to-door cholera recognition and water purification efforts, reaching over 5,000 people in multiple locations. In addition to cholera treatment, the MSF team is providing medical care to 160 patients injured in a South Sudan collision.
“I’ve come here because I’m back to Nasir and people are being killed,” said a South Sudan mother, who recently arrived in Burbeye, Ethiopia. “There was nothing to eat. When we arrived in the area where we rested, my children got sick. There were no medical facilities where we could run.”
The situation is rapidly getting worse as violence in South Sudan flees thousands of people crosses borders to seek security. In Wangsoa Warda, a new camp in Brubeye appeared almost overnight, with more than 6,500 new arrivals reported by local managers (many women, children and elderly people) a few days later.
“The displaced people have arrived in Gambella just a little more than what they can carry,” said Joshua Eckley, MSF mission director in Ethiopia. “Our team is responding to the outbreak of cholera and providing care to people arriving in exhausted conditions. There are important needs and without additional support, the situation can get worse.”
The crisis comes as South Sudan and Ethiopia face major cuts in donor funds, including recent USAID cuts. While MSF will not accept funding from the US government, reductions in humanitarian and health assistance will significantly reduce the capacity of other organizations to respond to such a crisis.
“In places like Akaubo in Johnray state, cholera responses have been heavily affected by cuts in funding, including the closure of critical health services,” Mwatia says. “Many mobile clinics have already been closed following cuts in US funding, and some organizations supporting healthcare facilities, including cholera treatment units, have suspended all activities, part of a wider trend across the country.”
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South Sudan’s healthcare system suffers from chronic lack of funding, lack of skilled medical staff, medicines and supplies, and has limited capacity to respond to emergencies. A country already struggling to meet its own medical and humanitarian needs is being put on an even greater burden with the arrival of more than a million people fleeing the war in neighbouring Sudan. Emergency support is needed to provide safe water, run an extensive cholera vaccination campaign and strengthen the ability to treat both cholera patients and trauma cases.
“The disruption in cholera treatment services, combined with a decline in the ability of actors to support oral vaccination campaigns, increases the risk of further spread,” Mwatia says. “We urge donors to allocate emergency funds for emergency response in South Sudan and neighboring Ethiopia amid this escalating crisis.”
