South Sudan was hit by multiple emergencies in 2020, including escalating violence, COVID-19, severe flooding, and high levels of food insecurity. A total of 7.5 million people – around two-thirds of the population – were in need of humanitarian assistance. Doctors Without Borders (MSF) responded to the urgent medical and humanitarian needs, while ensuring essential healthcare services continued in the 16 projects we run in the country. 

There were repeated outbreaks of intense fighting, some lasting for months at a time, across South Sudan in 2020. Between January and October, more than 2,000 people were killed – including a South Sudanese member of our staff – and tens of thousands of people were displaced.

In Jonglei state and the Greater Pibor Administrative Area, our teams in Pieri, Lankien and Pibor provided emergency medical care to people arriving in mass influxes of casualties, many with serious gunshot and stab wounds. The most critical patients from Pieri and Lankien were evacuated by plane to our hospital in the Protection of Civilians (PoC) site in Bentiu for surgery. Our teams also improved water and sanitation for the thousands of people who took refuge in an area next to the United Nations Mission in South Sudan (UNMISS), in Pibor town.

In June, we suspended activities in Pibor after most of our staff sought safety in the remote bush area. When violence broke out again in August, we launched an emergency response. The project was closed in December, to enable the reorganisation of our medical activities in a more agile and efficient manner to respond to the community’s emergency health needs.

As the COVID-19 pandemic spread globally in early 2020, concerns that an outbreak would exacerbate an already dire humanitarian situation led MSF to integrate COVID-19 measures and new activities into all existing projects across the country and start dedicated projects in Juba and Malakal teaching hospitals. In Juba, we focused on strengthening infection prevention and control measures in health facilities, including the teaching hospital, and in the national public health laboratory, the country’s primary testing facility. Our teams also trained healthcare workers, donated supplies, conducted health promotion activities, and set up handwashing points in several public locations.

In July, UNMISS announced it would begin to hand over the five PoC sites in the country to the national government. In Bentiu and Malakal PoCs, where we manage hospitals, the process had not yet started. However, in Bentiu, patients and community members voiced concerns to our staff about their safety once the UN is no longer protecting the site. In both PoCs, our teams continued to treat conditions caused mainly by the living conditions, including malaria, diarrhoeal disease, hepatitis E, cholera, typhoid fever, trachoma and skin infections, and call for improved water and sanitation. 

In Yei county, following new waves of displacement, MSF outreach and mobile teams distributed relief items and offered general medical consultations, immunisations and psychosocial help. We also supported the paediatric ward of Yei state hospital and ran general healthcare services at our clinic in Jansuk. At our clinic in Doro camp, and in the hospital in Bunj in Upper Nile state, we provided medical care to refugee and host communities, including vaccinations, treatment for malaria and 
malnutrition, care for survivors of sexual and gender-based violence, and assistance with births.

We offered paediatric and maternal healthcare throughout the year at Aweil state hospital, which serves around 1.3 million people. In October, we supported the health ministry’s response to a seasonal peak in malaria, with rapid diagnostic tests, medication, and supervision at the hospital and in general healthcare centres.

In Abyei, a disputed area between Sudan and South Sudan, our 180-bed hospital in Agok town continued to provide surgery, neonatal and paediatric care, and treat people for snakebites and diseases such as HIV, tuberculosis, malaria, and diabetes.

In July, we closed the projects we had been running for 14 years in Yambio county, Western Equatoria state. These projects focused on seasonal malaria chemoprevention for vulnerable children in rural areas, support for the regional hospital, and an intervention assisting demobilised child soldiers.

No. staff in 2020: 3,555 (FTE) » Expenditure in 2020: €77.8 million MSF first worked in the country: 1983