South Sudan’s Northern Bahr el Ghazal State sits in the remote northwestern corner of the country. It is South Sudan’s poorest state and it has only one full service hospital—a facility in the town of Aweil run by by Doctors Without Borders/Médecins Sans Frontières (MSF), in conjunction with the Ministry of Health—serving an estimated population of 1.2 million people.

The lack of health care in Northern Bahr el Ghazal is now painfully apparent, as an unprecedented malaria outbreak spreads throughout the region. Some people find treatment at community health centers near their homes, but the options are limited and plagued by drug shortages that force others to journey for hours or even days in search of care. MSF staff in Aweil treated more than 2,000 patients with severe malaria between June and September, but many patients arrived in critical condition due to the distances they had to travel.

The images below make clear the consequences of living in a place where a disease outbreak can exploit a shortage of treatment options, and the lengths to which some people will go to get care for themselves and their families.