South Sudan: The stark choices facing displaced people in Aburoc

One year after fighting erupted across South Sudan´s Upper Nile region, many of those who fled the violence remain in the village of Aburoc. But soon this community will face a difficult choice: stay in the area, where living conditions are harsh and getting worse or return home to their old villages where tensions persist.

Monday, February 19, 2018 — “I tell my children that when it is time to die, we will die”, says Ana, a mother of seven sitting outside her makeshift hut. “We originally fled Malakal town; then last year fighting forced us to move twice as our homes were destroyed.”

In May, there were more than 38,000 people fleeing the violence for Aburoc. But when they arrived there was no shelter, water or food. Clashes between government and opposition forces were getting closer and the community was contemplating another move.

In the following months many left for the North. What remains is a market, a few tea shops, churches and even a bicycle repair shop. Heavily laden tractors from Sudan supply the stalls, but money to buy goods is in short supply.

Most live in tightly clustered wicker shelters with badly ageing plastic sheeting as roofs. Things are only marginally better frome when they were living in the open.

“This constant fleeing from one town to another has taken its toll on the community. While some are planning ahead, others are still mentally and physically exhausted by the ordeal of last year,” says Paiva Dança the MSF project manager for Aburoc. “Some can´t think about the future; they will most likely follow the group decision.”

The community of 8,500 people will have to make a grave decision over the coming months. Between February and May, water will become scarce. The expensive option of water trucking from the distant Nile is still under discussion between the humanitarian community and the authorities.

“Even though some of the international NGOs based in Aburoc are racing to provide water, it is important to remember that eight months ago there was a cholera crisis in the camp. If we are to avoid such outbreaks again the quantity and quality standards of the water must be maintained”, says Jaume Rado, MSF´s Head of Mission in South Sudan.

“Peace in this part of South Sudan is fragile,” says Jaume Rado. “These IDPs [internally displaced persons] need to feel secure enough with the decision to go home when the time comes. Until then they should be able to stay where they are.”

Today three options exist for the displaced community currently in Aburoc. They can stay put, perhaps for another year, and potentially see the conditions degenerate further, with diminishing access to clean water. They can return home to their villages and perhaps face the same violence they had fled from. Or, they can go north to Sudan, far from friends and family, where living conditions in the refugee camps are rough.

When asked if she would leave, one woman said, “Sudan is not my home. I will only go north if the water goes bad. Otherwise, I will stay here.”

But elsewhere another woman had made a different decision. “I will return home to my village in the coming weeks regardless of what happens. It was a good place and my family would be better there.” Her friends nod in agreement.

Some humanitarian organisations in the area are starting to leave as they move to other emergencies. But the community still needs their support, as life in Aburoc is unsustainable without the provision of food, water, shelter and medical care.

Even now food rations are so low, many IDPs have to find alternative ways to eke out an income to buy the essentials. Some as daily labourers for NGOs, others make and sell charcoal. It is not uncommon to hear of widowed women distilling and selling the local moonshine, called Marrisa, for a few South Sudanese pounds.

MSF teams have have been with many of these people throughout their traumatic journey. Two of its projects, in Wau Shilluk and Kodok, were destroyed by fighting and, as the population ran, MSF followed. In early February 2017, a small field hospital was opened in Aburoc  to cater for the swelling numbers.

“In the early days we mainly saw patients with respiratory diseases, diarrhoea, all conditions linked with exposure to the elements. We were very concerned for patients who needed medication, such as those living with HIV,” explained Irenge Lukeba Landry, MSF medical activity manager at the time

“To the best of our abilities we will support the right of people to either stay in Aburoc or return to their homes. In this case it means providing medical and humanitarian services where communities decide to be,” says Jaume Rado. “We hope other humanitarian groups will do likewise.”

Leaving the village is difficult as people come to the mobile clinic in dribs and drabs. But by 3pm it is essential that the convoy leaves. For security reasons the team needs to be back in the base before nightfall.<br/>The team tells the commuter elders that they will be back in a weeks time. Photographer: Philippe Carr/MSF
One woman, who has had a possible stroke is brought by stretcher. A decision is made by the medical team that she needs to be brought to MSF’s Malakal hospital as her situation is critical. The MSF doctor decides that she can’t travel by road as the ride is too rough. Instead a boat is rented from the local fishermen and the next day they travel.<br/><br/>The woman’s family explains that they would have tried to carry the woman to hospital on their back to the hospital at Aburoc had the team not arrived. Photographer: Philippe Carr/MSF
Malaria is one of the leading source of illness and mortality in South Sudan, yet in most rural areas there is little in terms of preventative measures or the necessary treatment. When the team visits Dethok it is able to take blood tests and supply the necessary medication for those suffering from the disease. Photographer: Philippe Carr/MSF
Passing through certain areas is only possible with the help of a tractor which tows the MSF Land Cruiser. Half way along the road the team comes across a wide swamp that can only be passed with the tractor. Photographer: Philippe Carr/MSF
The team dispatched is made up of drivers, a logistical coordinator, a doctor, a nurse and a community health advisor. Photographer: Philippe Carr/MSF