"When I met these families a few days ago, I was struck by their despair, which borders on aggression. In the Mending Dot Akok site [approximately 10,000 IDPs], we were surrounded by men, women and children who were slapping their stomachs and holding their fingers up to their mouths to express their hunger in a universal language."

In southern Sudan, thousands of families displaced by the recent armed conflict in the oil-rich region of Abyei are in need of emergency assistance. This is occurring in a region where resources are already extremely depleted. Gabriel Trujillo, MSF program manager in Sudan, is concerned about the lack of mobilization on the part of humanitarian agencies in northern Bahr-el-Ghazal state.

Internally displaced persons (IDPs) arrived in Northern Bahr-el-Ghazal several weeks ago. What is their current situation?

"Approximately 12,000 IDPs have gathered in three sites to the north of Aweil. Thousands of others have dispersed into the bush; probably around 10,000 persons, possibly twice as many. No one knows the exact security conditions. The scattered nature of these groups of IDPs makes access very difficult. Families in these three sites have received practically no aid since their arrival between one and two months ago.

"When I met these families a few days ago, I was struck by their despair, which borders on aggression. In the Mending Dot Akok site [approximately 10,000 IDPs], we were surrounded by men, women and children who were slapping their stomachs and holding their fingers up to their mouths to express their hunger in a universal language.

"They showed me their only resources: leaves and small nuts gleaned from the bush. The men go on hunts but bring back small animals, at the most.

"Hunger has not yet made its mark on the bodies of the adults, but already a few adolescents are showing signs of malnutrition. In the case of the younger children, a rapid nutritional assessment in the three sites revealed some very worrisome signs: a global malnutrition rate of 20 percent in children under five, eight percent of whom are in the severe stage.

"This represents several hundred children who need emergency therapeutic feeding. These IDPs fled their homes without bringing anything along with them. Their straw shelters measuring around four square meters usually contain nothing except an occasional kettle or item of clothing.

"In order to find water, they dug holes a few meters in depth, in which 20 centimeters of muddy water stagnates. In summary, these IDPs urgently need water, food, and basic materials, as well as medical care, particularly nutritional."

"A minority of the former refugees have been repatriated by the United Nations High Commission for Refugees (UNHCR). However, even for these refugees, the conditions of return are extremely difficult: they were abruptly left to themselves. But there is nothing for them, including medical services and food."

What are these IDPs fleeing and what are the local capacities to respond to this emergency?

"This emergency is taking place within a context of political tensions, increased food insecurity, and insufficient, poorly funded medical facilities. These population displacements are linked to the fighting between nomads from the Misseriya tribe and the armed forces of the South, which has been occurring since the end of December along the border between northern and southern Sudan.

"These nomads are following their traditional [seasonal] route, but this tribe that supported the north during war is suspect in the eyes of the former southern rebels, and confrontations occur sporadically.

"At the present time, political tensions are very strong in this area near Abyei. This region is very rich in oil, for which the status was not determined at the time of the 2005 peace accord between the North and the South. Therefore, one part of the population has moved toward the southwest, to the north of Aweil, whereas the pressure on local resources has already grown due to the return of some 20,000 former refugees, because those people who fled during the war to a neighboring country or to the north of the country are gradually returning.

"In the entire south of Sudan, almost two million persons have already returned and this return is still ongoing. The prospect of next year's elections may induce a few hundred thousand refugees who are still living outside of the country to come back. A minority of the former refugees have been repatriated by the United Nations High Commission for Refugees (UNHCR). However, even for these refugees, the conditions of return are extremely difficult: they were abruptly left to themselves. But there is nothing for them, including medical services and food.

"We are familiar with this region from having worked there for years. We know that there is still no healthcare system and that malnutrition is prevalent among children under five, even in good years.

"Today, even as needs are growing, the situation is even worse. The flooding from last year and the closing of the border for two months have both markedly decreased the quantities of food available. The price of food is increasing, sometimes up to three times the normal market price. At the same time, humanitarian aid is declining. The World Food Program (WFP) has stopped general food distributions because southern Sudan is no longer experiencing armed conflict. As such, we are seeing an accumulation of aggravating factors."

What is the response of international organizations?

"We have alerted the humanitarian aid actors present in Bahr-el-Ghazal to the seriousness of the situation. Furthermore, on our side, we are implementing an emergency operation.

"We have opened out-patient feeding centers, including one on the IDP site; 800 malnourished children are already receiving therapeutic feeding. For those who require hospitalization, we have opened a therapeutic feeding unit at the Aweil Hospital, with a capacity of 100 to 150 beds.

"More than 80 children are being treated there. Three thousand staple goods kits, containing covers, jerry cans, kitchen utensils and soap, will be distributed according to need.

"We are also planning a general food distribution at the Mending Dot Akok site as well as for the provision of water. In addition to nutrition, we are also particularly attentive to the risk of measles and malaria. We have already vaccinated all the children under monitoring in our feeding program against measles.

"Malaria season has not yet begun but the number of cases is already elevated. We are expecting more than 20,000 patients during the peak of the season, including hundreds of severe cases. As such, we are going to set up a treatment unit for complicated cases at the hospital.

"We have been present at the hospital since the beginning of the year in order to improve the obstetrics and gynecology care. As such, we have strengthened this operation to respond to the emergency. However, other actors must also mobilize. We continue to ask other NGOs and the WFP to act quickly, before the rainy reason hinders the ability to gain access to these populations."