18 May 2017

Nola Aniba Tito, 27, is one of the medical translators working in MSF health centre in Ofua 3 zone, in Rhino refugee settlement. Originally from a town in the Equatoria region, she fled violence in South Sudan in July 2016 with her children and started working with MSF in March 2017. As 86% of all South Sudanese refugees in Uganda are women and children, Nola is one of the many female heads of households.

MSF, Doctors Without Borders, Uganda, South Sudanese Refugees
Nola Aniba Tito, 27, is one of the medical translators working in MSF health centre in Ofua 3 zone, in Rhino settlement.
 Photo: Yuna Cho/MSF

I was living with my two children and expecting another child. My husband was in Juba, South Sudan. In my neighbourhood, everyone was fleeing because we were seeing child abduction, rape, looting, forced marriage, and killing between tribes almost every day. Schools were attacked and children slaughtered like chicken. If people from the other tribe come, they kill everyone from the other tribe and leave their own tribespeople. Moreover, there was no access to health care, especially after many NGOs left the country.

One day, men knocked on the door of our house and threatened to open it. I was very scared so I didn’t open it, but instead carefully opened the window and saw them holding guns. I cried and shouted so much that neighbours came and the men just left. That’s when I decided to leave my home right away, without any belongings, just with my children and three of my brother’s children, who hasn’t been able to cross into Uganda. Even on the way to Uganda, there is fear of killing and violence and that is why my brother is still in South Sudan.

MSF, Doctors Without Borders, Uganda, South Sudanese Refugees
"I was lucky to make it to Uganda. But upon arrival in the camp, we found no water, no food, and no health services." Nola Aniba Tito
Photo: Fabio Basone/MSF 

I was lucky to make it to Uganda. But upon arrival in the refugee settlement, we found no water, no food, and no health services. Sometimes we had no water for more than a week. How can we live without any water to use and drink? I also had to walk a very long distance to the hospital outside the refugee settlement to deliver my baby, who is now seven months old. We left with nothing, not even a penny to buy food or to pay for transport to the hospital. So the start of MSF health services in the settlement helped people a lot.

MSF also helped me in terms of job opportunities. After I was hired as a medical translator for MSF, my life changed. I used my earnings to build our house and to buy clothes and vegetables for the children. Another good thing is that during my time at work, I don’t have to think about all the problems I have. But at night, I can’t stop thinking about what is going to happen to me and my children. I am also scared that something bad could happen to me when I am sleeping. In the refugee settlement, there are cases of violence, abuse, and rape, and being a female head of family is not safe. So I can’t sleep until 2:00 or 3:00 in the morning.

MSF, Doctors Without Borders, Uganda, South Sudanese Refugees
People take the opportunity to get much needed water when a water truck gets stuck in the mud after heavy rain.
Photo: Fabio Basone/MSF

Because people here don’t have enough food and water, and there is no work and nothing to do, they escape with alcohol, smoking, and eventually violence. I know a 15-year-old girl who was raped in the refugee settlement and contracted HIV/AIDS and Hepatitis B. Some people even try to kill themselves and their family, saying that it is better to die than live in an inhumane situation, or they go back to South Sudan. I am also very concerned about my children’s future. If they don’t have opportunities to go to school, what can they do when they grow up? If MSF leaves here and I lose my job, how is my family going to live?


There are 86,770 South Sudanese refugees in Rhino settlement, located in the Arua District, northwestern Uganda. MSF has been working in Ofua zones in Rhino since February 2017, operating a health centre with an inpatient and maternity ward, and two health posts for outpatients. Some 70% of the children admitted in IPD have malaria, which is expected to increase during the upcoming rainy season. Given the high rate of SGBV cases, mental health care is also in place. MSF also has a community health surveillance team monitoring mortality/morbidity, nutrition, immunisation needs, and experience of violence.

One of the biggest issues in Rhino is access to clean water. To reach certain Ofua zones, water trucks have to drive more than one-and-a-half hours one way, which during the rainy season may be delayed or made entirely impossible. On average in March 2017, the refugee population in Ofua zones received around 6.5 litres per person per day. MSF is providing an average of 70,000 litres per day, with work ongoing to drill boreholes to provide more water.

Find out more about MSF's activities in Uganda