18 March 2020

Our medical teams have received a mass influx of 83 wounded patients in Pieri and Lankien over the space of just five days between 9-13 March, and have treated 45 gunshot wounds in Pibor over the past month, as waves of intercommunal clashes in Jonglei State and the Greater Pibor Administrative area of South Sudan continue to have a devastating impact on the population.

“In Pieri, we received 68 wounded people in less than 12 hours,” said Istifanus Chindong Damulak, MSF Medical Team Leader. “It was a massive influx of critical patients, with serious gunshot and stab wounds. In Lankien, we treated a seven months pregnant woman who lost her baby after her abdomen and groin were slashed with a blade and a 10-year-old girl who was stabbed several times.”

Access to healthcare in the area remains a considerable challenge, with many people having to walk long distances and in some cases for several days to reach medical facilities. As a result, many arrived in critical conditions with sepsis from infected gunshot wounds.

MSf, Doctors Without Borders, South Sudan, conflict, displacement
Surgeon John Buckles and medical doctor Martijn Knap perform a laparotomy on 10 years old Nyaduoth. Nyaduoth suffered several stab wounds and was transferred from Lankien to the
MSF hospital in Bentiu Protection of Civilians (PoC) site to undergo surgery. Photo: Gabriele François Casini/MSF

MSF medical teams were able to manage the overwhelming number of critical cases in the primary healthcare centre in Pieri and the hospital in Lankien. The most serious cases were referred by plane to the MSF hospital in the Protection of Civilians (PoC) site in Bentiu, where they underwent surgery.

“We are very worried about the extreme level of violence that some of the patients have been subjected to,” said Claudio Miglietta, MSF Head of Mission in South Sudan. Violence and its consequences require firstly a medical response to address the trauma. But this is not just a matter of providing medical care, it is also a protection concern, with some of the most vulnerable, including young children and pregnant women, being targeted.

“This horrific and brutal violence and targeting of the vulnerable has gone beyond the level of intercommunal violence and cattle raiding violence we have recently seen. It needs to come to an immediate halt,” Miglietta added.

Life-threatening wounds and extreme violence are not the only consequences of the intercommunal clashes, with thousands recently forced to flee their homes and seek refuge both in remote rural areas and inside a makeshift camp adjacent to the United Nations Mission in South Sudan (UNMISS) site in Pibor town, where MSF has set up an emergency response. In addition to tending to the injured, our teams continue to provide care to pregnant women, address morbidities like malaria, diarrhea and respiratory infections, and have vaccinated over 3,500 children against measles to prevent a potential outbreak. Living conditions for the people in the UNMISS site continue to be dismal with extremely limited access to clean water, latrines, food and adequate shelter.

According to Roderick Embuido, MSF medical coordinator in South Sudan, “the violent clashes have significantly reduced access to health care for the many thousands of people who have fled to the bush. For the ones who sought shelter in the site adjacent to UNMISS and who are now crammed together in a closely confined space, the risk of outbreaks is worryingly high. The prolonged shortage of clean water is making the situation even worse. The needs are extremely high and our capacity to address them is being stretched to its limits.”


For over 30 years, Doctors Without Borders (MSF) has been responding to conflicts, emergencies and neglected diseases in the newest sovereign state that has since 2013, been mired with armed violence. In Jonglei State and the Greater Pibor Administrative area, the conflict has led to the displacement of thousands exposing men, children and women to extreme levels of violence and leaving them in dire need of humanitarian and medical assistance.