As the crisis spreads in the former Upper Nile state, over 20,000 South Sudanese have fled the horrendous living conditions and fighting around Aburoc’s IDP camp, for Sudan’s increasingly overcrowded refugee camps. While many more of the estimated 18,000 people left behind will take the road north, others will stay in Aburoc, hoping that desperately needed clean water, food and shelter arrive.

“The reasons why we are leaving are mainly security and the lack of food and water. We feel a bit better in Sudan because we are receiving support, and now I am with my family,” said one recent refugee who made the journey to Sudan.

MSF, Doctors Without Borders, South Sudan Kodok, Refugees
Map of the Former Upper Nile State, South Sudan

Doctors without Borders (MSF) kept its operations running in Aburoc when the fighting started in nearby Kodok two weeks ago and 20,000 people arrived. A field hospital providing primary and secondary care has been open for most of the emergency, treating a range of conditions including watery diarrhoea.

“Most of the people we see around Aburoc have packed their few belongings and are waiting for space on a truck departing for the north. Nearly all of those leaving have been forced to abandon their homes and have moved places several times in the past,” says Marcus Bachmann, MSF Head of Mission for South Sudan.

Many were originally from Malakal, moved for safety to the town of Wau Shilluk and when it was attacked earlier this year, fled to Aburoc. Others came to the IDP camp from the nearby town of Kodok after fighting broke out two weeks ago.

MSF, Doctors Without Borders, South Sudan, Kodok, Refugees
Patients await a consultation at MSF’s Outpatient clinic.Photo: Anthony Jovannic/MSF

“This is just one area in a whole region that is being destabilised. Over the last week, fighting has spread to places like Tonga and Kaka, provoking more departures north,” added Bachmann. “We may soon see many other communities forced to take the road north. Many of those still in Aburoc would stay if the conditions improved.”

Until very recently the population gathering around Aburoc was surviving on a maximum of 21,000 litres of water a day from three hand pumps. This is only 1.1 litres per person which is below the daily minimum amount needed for survival, 2.5 litres. The purity of the water is also a concern, as both humans and animals openly defecate in the areas around the water pumps.

Food is starting to arrive in Aburoc’s market from Sudan, but it is at inflated prices that few can afford.

MSF, Doctors Without Borders, South Sudan, Kodok
Water is in short supply in Aburoc. Currently, there is less than 1.5litres per person of clean water available. Photo: MSF

Other humanitarian organisations are starting to deploy to the area, but it is a race against time to help the displaced before the heavy rains arrive and make the transport of humanitarian aid impossible.

“Sadly, there have been reports of deaths amongst some of the people who started to make the 250km journey by foot last week. Many of those people reaching the border with Sudan are sick and exhausted, suffering from dehydration, diarrhoea and malnutrition,” says Bachmann.

“The border camp of Khor Waral in Sudan, already has over 30,000 officially registered refugees, and 20,000 more are waiting to be processed. Overcrowding is already an issue as the planned capacity of the camp was initially only for 18,000 people.”  

MSF, Doctors Without Borders, South Sudan, Kodok
The journey is long and the Sudanese camps are under strain from the huge numbers, finding it hard to provide services to this new population.
Photo: MSF

Unfortunately, the availability of water is low, and the supply of sanitation, shelters and non-food items (including plastic sheeting, and cooking and cleaning utensils) is still not meeting the demand. This could have consequences on the health of the new arrivals.

MSF already manages a hospital in Sudan’s White Nile State, and when the emergency started, the medical organisation dispatched a team of 30 medical staff to Khor Waral to work in close collaboration with Sudanese authorities.


Find out more about MSF's activities in South Sudan.