High Level Meeting: South Sudan, 69th Session of UN General Assembly

Remarks by Jerome Oberreit, Secretary General, Médecins Sans Frontières

Excellencies, ladies and gentlemen,

Médecins Sans Frontières appreciates today’s invitation to address this High-Level Meeting.  Our medical teams have been working in South Sudan for 30 years. We have 3,800 medical and non-medical staff running 26 projects in 9 out of the country’s 10 states. 

In short, this is our largest deployment in the world today. And with good reason, the violence against civilians and health-care workers has reached shocking levels since the war broke out in December 2013. MSF hospitals that survived bouts of extreme violence during the North-South civil war have not survived this latest round of conflict.

In July, MSF issued a report documenting the pervasive attacks on patients, health-care workers, and medical facilities since the start of the conflict.

Violence against health care is not new in South Sudan. This reality, however, did not blunt the shock of patients being shot in their beds and health facilities being burned, looted, and otherwise destroyed.

Malakal, Leer, Bentiu, Nasir are a few emblematic examples of medical facilities, which were partly damaged and in some cases completely destroyed earlier this year. In Leer our staff had been treating people for two decades.

Deliberate attacks on medical facilities and personnel constitute a clear violation of International Humanitarian Law.

Parties to the conflict must ensure that all people in South Sudan can seek medical care without fear of violence.  States with influence on the belligerents must exert the necessary pressure to ensure respect for humanitarian assistance and civilians caught up in this war.

While attacks on health care have been a disturbing feature of this conflict, the damage of these attacks against medicine goes far beyond these acts of violence.

Disease outbreaks, the general collapse of the health system, pockets of acute malnutrition, and an insufficient aid response from the international community have compounded the already dire situation.

MSF teams are responding to a cholera outbreak, malaria, visceral leishmaniasis, and malnutrition. So far, our medical teams have treated nearly as many children for malnutrition as in all of 2013 – over 16,000 children.

Up until mid-August 2014, MSF teams had already treated 2,500 cases of visceral leishmaniasis, a deadly disease if left untreated. This is a dramatic increase from 2013. And the critical condition of patients presenting to our teams is a likely consequence of the severe deterioration in access to health facilities.

In spite of the deteriorating situation and the declaration of South Sudan as a Level 3 Emergency in February 2014, the aid system seems unable to adapt to meet the most acute needs.  While recognizing recent efforts, the deployment of UN agencies and nongovernmental organizations has been largely confined to the capital Juba and other relatively easy-to-reach areas in the country.

The disparities in aid are striking in the areas in the heart of the conflict. In Unity and Upper Nile states, villages have been burnt and looted. People have been forced to flee into the bush and have been left to cope on their own with little or no food aid or other international assistance.

There are many pockets of people left to fend for themselves in unspeakable conditions. For example, one recent malnutrition assessment in Mandeng, Upper Nile State, found an alarmingly high rate of global acute malnutrition of 23.5 percent.

We must all remain more flexible and adaptive to needs on the ground.

In more accessible areas, MSF has welcomed the decision to open UN compounds to the victims of violence. But protection of civilians should also mean protection from diseases. The level of assistance in the Protection of Civilian sites must not only be maintained but increased.

The response has to be built on the vital needs of displaced individuals wherever they are found.

And so the diagnosis is clear: humanitarian needs are immense and still growing, and the aid system is still running behind. The humanitarian community should be doing everything in its power to prevent this unnecessary loss of life.

As the rainy season ends in the coming weeks, the first priority for us, as humanitarian actors, is to scale up our assistance. We must capitalize on the increasing access to areas that have been inaccessible by road or other means. This includes cross-border operations for the delivery of humanitarian aid.

It is critical that States ensure flexible and adequate funding to fill the vast gaps in assistance.

Parties to the conflict cannot continue to act with a complete disrespect for civilians, the medical mission, and humanitarian assistance.

All of us have been confronted by the scale of the suffering in South Sudan. We may be responding to crises on multiple fronts around the world. But this is not an alibi for failing in South Sudan. 

Thank you