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Activity Update, October 2015

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Lootings of MSF compound in Leer deprive population of access to medical careMédecins Sans Frontières (MSF) employs more than 2,937 South Sudanese staff and 329 international staff to respond to a wide range of medical emergencies and provide free and high quality healthcare to people in need 18 projects in seven out of 10 states in the country and the Abyei Special Administrative Area.

Civilian populations in Leer and Mayendit Counties have been deprived of access to urgently-needed medical and humanitarian assistance once again after the MSF compound in Leer was looted twice by well-organized armed actors on 2 October and 3 October. On both days, the same group of armed men entered the MSF compound with their weapons, intimidated MSF staff with threat of violence and stole medical supplies, vehicles, logistical equipment and personal belongings.

MSF was forced to evacuate its team and suspend its medical activities as it was impossible to continue providing assistance. MSF mobile clinics operating from Leer were a vital lifeline to displaced populations in Leer and Mayendit counties who have no other access to assistance. Many people in these counties have been displaced for months following an upsurge in fighting in southern Unity State this May.  Now, once again, they have no access to medical assistance as there are no medical actors remaining on the ground.

MSF is extremely concerned for the health of populations in southern Unity State who continue to be affected by ongoing conflict, displacement and lack access to urgently needed assistance. This is the third time MSF facilities in Leer have been attacked, targeted or looted since December 2013. MSF denounces the targeting of its medical operations, which deprives populations from the assistance they need. MSF calls on all armed actors to respect international humanitarian law, which protects medical facilities, staff and patients.

MSF hands over medical activities in Nyal

Elsewhere in Southern Unity, in Nyal, humanitarian access has improved, allowing a greater number of humanitarian actors to implement medical and humanitarian operations. In Nyal, MSF has been providing assistance to displaced populations, providing treatment for malnutrition as well as primary and secondary healthcare for children under five years old. In October, MSF was able to hand over its operations to other actors and redistribute its resources elsewhere in the country where assistance is still urgently needed.

Maridi fuel truck explosion in Western Equatoria

MSF has been providing medical assistance to the victims of the devastating fuel truck explosion in Maridi, Western Equatoria State, which claimed more than 200 lives and injured over 160 people.  Many patients injured in the devastating event sustained severe, life-threatening injuries covering large parts of their bodies, requiring reconstructive surgery and long-term care. 

MSF provided surgery and a team of eight medical staff continue to provide medical assistance to burn patients at Maridi Hospital, providing nursing care in support of the ICRC’s surgical response.   The MSF team is now focused on nursing care and infection control in order to increase patients’ chances of survival. Some patients who were in the most critical condition were temporarily referred to Juba Teaching Hospital after being stabilized in Maridi Hospital. MSF also donated medical supplies the Hospital in Juba in support of patients’ care.

Severe malaria season intensifies

MSF continues to respond to an exceptionally severe malaria season affecting many regions in South Sudan. MSF medical data from May to late September of 2015 shows a sustained increase in exceptionally high numbers of severe malaria patients seeking treatment in its projects. In Northern Bahr al Ghazal, Warrap State the Abyei Special Administrative Area, the number of patients being admitted with life-threatening malaria is surpassing the already extremely high numbers of 2014.

MSF is also responding to a severe outbreak of malaria in the Bentiu Protection of Civilians Site (PoC) since July. MSF opened six new health facilities inside the PoC since the outbreak began, providing care to as many as 4000 malaria patients on a weekly basis in September.  That month, MSF participated in a malaria treatment campaign in the PoC, screening over 30,000 children under five and providing treatment to 16,000.  In October, malaria rates have declined in the PoC.

Refugee populations living in South Sudan are also being affected by the severe malaria season. In the Doro refugee camp, in Upper Nile State, MSF is providing hospital care to nearly double the number of severe malaria patients as last year. In the Yida refugee camp in northern Unity State, MSF is treating up to four times more patients for severe malaria and 10 times more simple malaria cases this October than the same month last year.

MSF is increasing its hospitalization capacity in response, as well as placing emergency orders of malaria drugs, providing additional support to healthcare structures and training networks of community healthcare workers in order to provide earlier access to care. MSF urges other health actors to ensure adequate access to malaria treatment and medicines during this severe malaria season.

MSF International President visits South Sudan

MSF International President, Dr. Joanne Liu, recently visited MSF projects in South Sudan, from 29 September to 2 October, where she visited MSF projects in Doro, Aweil and Bentiu.  During the visit, Dr. Liu saw firsthand the severe health risks confronted by populations affected by conflict and violence in Unity State as well as people being impacted by severe outbreaks of malaria.  Dr. Liu also met with other stakeholders in the health sector.

MSF operations in response to the medical needs in South Sudan

Abyei Special Administrative Area Agok: Limited access to healthcare MSF hospital

  • Surgery, emergency room
  • Maternal care, obstetrics and a neo-natal ward
  • Inpatient therapeutic feeding centre
  • Vaccinations
  • Snakebites
  • Treatment for HIV, tuberculosis and diabetes

Central Equatoria

Juba County: Cholera response

Cholera readiness, training for cholera treatment and prevention

  • Cholera Treatment Centre on standby
  • Mass cholera vaccination campaign in July-August
  • Cholera response training for healthcare workers

Greater Pibor Administrative Area

Pibor: Remote location and limited access to healthcare

MSF health centre and outreach clinics

  • Primary healthcare with inpatient department
  • Emergency room
  • Maternal care
  • Health Units in Gumuruk and Lekuangole (primary health care, malaria and diarrhoea)

Jonglei State

Bor: Technical support to Bor state hospital

  • Emergency room, Triage, Pharmacy
  • Pediatric inpatient department
  • Vaccinations
  • Lab and Waste management

Lankien: Remote location, limited access to healthcare, periodic violence and displacement

MSF hospital, mobile outreach clinics

  • Primary, secondary healthcare, surgery
  • Maternal care, obstetric, neo-natal ward
  • Nutrition services (ambulatory and inpatient)
  • Kala azar, HIV and TB
  • Mobile outreach clinics in Chuil and Yuai

Old Fangak: Remote location, limited access to healthcare, periodic conflict and displacement

MSF hospital

  • Inpatient /outpatient care and emergency room
  • Inpatient therapeutic feeding centre
  • Ante-natal care and deliveries
  • Assessments in surrounding villages and referrals by ambulance boat

Northen Bahr El Ghazal State

Aweil: Limited access to healthcare

Support to Aweil State Hospital

Maternal care, obstetrics, ante-natal care and vaccinations
Inpatient therapeutic feeding centre
Pediatric and neo-natal ward
Minor surgery
Emergency malaria outbreak response

Unity State

Bentiu: Displaced population, limited access to healthcare

MSF hospital inside UN PoC site, mobile outreach clinic

  • Secondary healthcare, inpatient department, surgery and emergency room
  • Maternal care, obstetrics, and neo-natal ward
  • Inpatient therapeutic feeding centre
  • Clinics for children under 5 and malaria treatment points in the PoC
  • Community health program
  • Mobile clinics in Bentiu Town

Leer: Remote location, conflict and displacement

Medical activities suspended due to lootings of MSF compound by armed actors in October

  • Mobile clinics for displaced populations, focused on children under five
  • Stabilization of war-wounded patients
  • Activities suspended due to repeat lootings by well-organized armed groups

Mayom: Limited access to healthcare

Support to Ministry of Health healthcare center

  • Secondary care referral
  • Maternal care
  • Outpatient consultations
  • Vaccinations

Yida: Refugees from Sudan and serving host population

MSF hospital in a refugee camp

  • Primary and secondary healthcare - inpatient department
  • Inpatient therapeutic feeding centre
  • Mobile outreach clinic
  • Outbreak response for malaria

Upper Nile State

Malakal and Wau Shilluk: Violence and displacement

Hospital in UN PoC site and mobile outreach clinics

  • Secondary healthcare - inpatient department
  • Inpatient therapeutic feeding centre
  • Emergency room and triage
  • Kala azar and TB and HIV
  • Mobile outreach clinic in Wau Shilluk: ambulatory therapeutic feeding program, kala azar, TB, emergency room for simple cases (limited capacity in June and July due to access constraints)

Melut: Violence and displacement

MSF hospital in Denthoma 1 camp, MSF clinic in PoC

  • Primary, secondary healthcare, emergency room
  • Inpatient and ambulatory therapeutic feeding program
  • Kala azar, TB

Maban Doro: Medical assistance for Sudanese refugees and host population

MSF health centre and outpatient health units

  • Secondary healthcare
  • Maternal health
  • Mental health services
  • Vaccinations
  • Primary healthcare in outreach health unit
  • Support to Bunj town hospital

Maban Batil: Medical assistance for Sudanese refugees and host population

MSF clinic

  • Secondary healthcare
  • Maternal and pediatric care
  • Inpatient therapeutic feeding centre

Warrap State

Gogrial: Remote location and limited access to healthcare

MSF reference health centre

  • Primary healthcare, Surgery
  • Maternal healthcare, obstetrics, ante-natal and post-natal care
  • Malaria response unit and support to surrounding health centres

Western Equatoria State

Yambio: HIV response Community-based test and treat program

  • Outreach and mobile clinics
  • HIV testing and treatment
  • Training of community healthcare workers

Maridi: Response to fuel truck explosion

Supporting medical response for burn victims in Maridi Hospital

  • Provision of nursing care
  • Donations of medical supplies
  • Medical training

Neighboring Countries:


Gambella region refugee sites

  • Primary and secondary healthcare
  • Mobile outreach clinics


Refugee camp in White Nile State

  • Primary and secondary healthcare
  • Nutrition program
  • Water and sanitation activities


Refugee camps and reception centres in Adjumani District

  • Primary and secondary healthcare
  • Malaria prevention activities
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