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MSF clinic in Pagak reception centre. Ethiopia, March 2021.

Asylum seekers trapped in appalling conditions in Gambella region

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Thousands of asylum seekers from South Sudan have been stuck for months in appalling conditions in a reception centre in Gambella region, western Ethiopia. People are without meaningful access to essential services, especially food. Médecins Sans Frontières (MSF) is worried that conditions will deteriorate even further in the upcoming rainy season.

Nyaluak Tang*, her husband and six children walked for almost one month from South Sudan’s Jonglei State to the Ethiopian border village of Pagak, where they arrived in August 2020.

“We left because of the severe floods in our district, which left us without food,” says Nyaluak. “Another reason was insecurity. One of our children was abducted by another ethnic group, and we feared for the safety of our other children.”

The family came to Ethiopia in the hope of being settled in a refugee camp, getting food and a secure place to live. Ethiopia is hosting a large number of asylum seekers and refugees. In Gambella region alone, more than 337,000 refugees live in seven camps. The registration and relocation of new arrivals has been put on hold for months, however, due to COVID-19 and other challenges.

South Sudanese Refugees | Pagak Reception Centre
Deterioration of refugee camps due to occasional downpours. Ethiopia, March 2021.
MSF/Claudia Blume

Lack of shelter and terrible conditions for asylum seekers

Nyaluak and her family have been stuck in a reception centre in Pagak for eight months now, although it is meant to accommodate asylum seekers only for a short period of time.  The site is also considered unsuitable, as it is prone to flooding and very close to the border.  

About 16,000 asylum seekers from South Sudan, all of them from the Nuer community, the majority of them women and children, are living in a small, fenced-in and overcrowded space that is wedged in between settlements of the host community. Their living conditions are dire.  Thousands of people live in about a dozen overcrowded, decrepit buildings that are little more than sheds, most without any mattresses or blankets.

They are the lucky ones. Hundreds of women and children, including pregnant women and babies, sleep outside, many without any plastic sheets to lie on or blankets to cover them, without any protection against the elements. The hygiene conditions are bad. With the few available latrines often filled up, many people defecate outside. In February and March, MSF treated 1,233 children with acute watery diarrhoea.

South Sudanese Refugees | Pagak Reception Centre
Women and children sleeping outside due to overcrowding in Pagak reception centre. Ethiopia, March 2021.
MSF/Claudia Blume

Finding food can be a dangerous mission

Without being registered, the asylum seekers do not have meaningful access to essential services. People have not received any food assistance since they arrived in Pagak. Everyone is hungry.

“I am collecting forest fruits and leaves that I cook for my children,” says Nyachuol Tut*.

Everywhere in the reception centre, women are cooking bright green leaves in pots on makeshift fireplaces. For many, that’s all they have eaten for months. Others collect firewood, selling it for a few birr (local currency) in the local market to buy millet or other food.  Venturing into the forest to collect wood can be dangerous, however.

“Sometimes we see soldiers from South Sudan who cross the river into Ethiopia, and they beat us,” says Nyachuol.

Asylum seekers also say that children who were playing close to the nearby river that separates Ethiopia from South Sudan have been abducted.

Many mothers are at their wits’ end, including Nyabol Lam*, who arrived in Pagak in February. The single mum fled from Jonglei State with her own three children, and three nieces and nephews after her sister and brother-in-law were killed during inter-communal fighting.  The youngest child is just one year old. They all sleep outside.

“I don’t even have a container to cook, no utensils. We have nothing to eat,” says Nyabol. “The children are just sleeping because they have no energy. We have no clothes, no blankets. Nobody is helping us.”

I don’t even have a container to cook, no utensils. We have nothing to eat. Nyabol Lam, asylum seeker in Ethiopia

Forthcoming rain will add to people’s challenges

With the upcoming rainy season, which starts at the end of April, the situation will deteriorate further if no solution is found. Already, occasional downpours have turned parts of the camp into a swamp. Once the rains fully start, people will no longer be able to sleep outside.

“When it rains, we all seek shelter in the sheds,” says Gatluak Deng*, who sleeps outside with his children and grandchildren. “Because it’s so crowded then, we have to sit up all night. No one has the space to lie down.”

The rainy season will also make it difficult to collect firewood, leaves and forest fruits, and to cook outside. There are already several ponds of stagnant water in the site, creating an ideal breeding ground for mosquitoes.

Malaria is already one of the top killers of children under five”, says Audrey van der Schoot, MSF country director. “In February and March, we treated 593 patients with malaria. We expect the numbers to go up once the rainy season starts, as well as cases of waterborne diseases such as acute watery diarrhoea.”

South Sudanese Refugee | Nyabol Testimony
Children and women living in very poor conditions with a lack of proper shelter and food. Ethiopia, March 2021.
MSF/Claudia Blume

In March, there were four confirmed cases of COVID-19 in Pagak reception centre. With people living together so closely, without masks and proper infection prevention and control measures, COVID-19 and other communicable diseases can spread fast. The situation will likely become worse once the rains start, when everyone is huddled together under the few available roofs.

“The situation needs to be addressed urgently,” says van der Schoot. “Asylum seekers need to be registered in a timely manner, and the process for the establishment of a proper reception centre, in a more suitable location in the region, where they will receive food, protection and other services, needs to be sped up.”

“In the meantime, we urge other organisations to scale up the provision of essential services in Pagak,” she says.

MSF started medical activities in the health post in Pagak in February 2021 and has carried out more than 6,870 medical consultations until the end of March.  Our team treats both asylum seekers and the host community. The top five morbidities for children under five are acute watery diarrhoea, upper and lower respiratory tract infection, malaria and eye infections.

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