Two years on, South Sudan fighting continues

Tuesday 15 December marks two years of conflict since fighting broke out in South Sudan, resulting in growing humanitarian needs.

Two Years of Fighting in South Sudan

Since fighting broke out in the capital Juba in December 2013, the conflict has continued to spread throughout the country, involving different armed groups and militias.

There have a number of failed deadlines in the peace negotiations. Despite the latest peace deal signed on 26 August 2015, fighting continues.

Throughout the 24 months of conflict, Unity state has been one of the areas worst  affected by violence.

In April 2015, thousands of civilians were forced away from their homes and  into the surrounding bush and swamplands, where they had to survive  on lily bulbs and marsh reeds, or to find protection in the specially built UN ‘Protection of Civilians’ sites in Unity’s Bentiu town.

Today, over 600,000 people are displaced inside South Sudan, with more than 1.2 million displaced in neighboring countries.

The UN Mission in South Sudan (UNMISS) is mandated to protect civilians throughout South Sudan, and their Protection of Civilian sites in Bentiu have grown from around 45,000 people in May 2015 to around 106,000 in November 2015.

However, while the UN has protected civilians inside Protection of Civilian sites in Bentiu there is a lack of effective protection outside of these sites, and big protection gaps still remain in other parts of Unity state.

 ‘Trapped in violence’

Civilians urgently need protection from the unprecedented levels of violence. The level of violence experienced by the population in southern Unity state in recent months is simply unacceptable.

Since May 2015, MSF teams has received consistent reports of targeted attacks on civilian populations including extortions, abductions, mass rapes and killings, villages burnt to the ground and crops looted and destroyed. No one has been spared the violence.

In Bentiu, a woman in her late fifties, who fled Leer town, told MSF in late October 2015:

“When the conflict started, it was between armed groups, but the conflict is now targeting civilians. The armed men collected cows from civilians and they’re killing the people. They’re also abducting girls, and raping women and girls. After they rape, they kill […]. Whenever they find someone in Leer, they kill him or her. They burn the houses. But the real issue is that they kill people. Since May, they kill people and collect all the cows. There’s no cows, no food, nothing left. That’s why we come to the camp [the UN PoC sites] in Bentiu. People who are still in the swamps, hunger will kill them.”


In Nyal, a young man who fled Leer told MSF in early November 2015:

“The people displaced in the bush have no food. All the food stocks are gone. Desperate, a lady walked to town to get food. On her way, she got raped. She is paralysed by fear. She is now hiding in the bush. She is too scared to move again.”

In Leer, a man in his late twenties shared his story with the MSF teams at the end of November 2015:

“For two years, we have feared for our lives and have been hiding in the swamps. We leave our village at 6 am and hide in the swamps till 6 pm. We are in the water. The water reaches our necks. We have to put children on our shoulders, otherwise they drown. As the sun sets, we return to our village. When we get back we see that our houses are burnt, looted. There is nothing left. We try to find food. We eat if we are lucky.”

What medical needs are MSF teams seeing?

MSF’s project in Leer, southern Unity state, was set up in 1988. MSF only restarted medical activities in November 2015, after being forced to evacuate Leer twice (May, October 2015).

In November and December 2015, MSF ran mobile clinics in Leer and Mayendit, home to around 35,000 people. In every location, our teams found alarming rates of malnutrition among children under five years old and dire levels of medical need.

In week 48 (23-29 November 2015), MSF screened 322 children in Thonyor with MUAC (measuring mid upper arm circumference) of whom 4.9% were found to be severely malnourished. In Kak town, 515 children were screened; 5.6% were found to be severely malnourished. These children urgently require sustained access to medical and nutritional treatment.

In southern Unity, the most urgent humanitarian needs are food assistance and nutrition support. Without it, these children and many more will likely not survive.

What is MSF doing in South Sudan and Unity state?

In South Sudan, MSF has almost 3400 national and international staff in 18 locations responding to a wide range of medical emergencies ranging from; the treatment of war wounded and victims of violence, to malnutrition, malaria, cholera and kala azar.

In Unity State, MSF works in four locations:


MSF runs a hospital inside a UNMISS Protection of Civilian site, as well a clinic in Bentiu town and mobile outreach clinics in surrounding villages. The hospital provides secondary and maternal healthcare, with an in-patient department, neo-natal ward, surgery and emergency room. We also run clinics for children under five and malaria treatment points within our community health programme.


MSF runs a health centre in Yida camp for refugees from Sudan and displaced South Sudanese, providing primary and secondary healthcare, along with a therapeutic feeding centre, and malaria outbreak response.


MSF supports the Ministry of Health’s health centre in remote Mayom, by helping with referrals, providing maternal care, outpatient consultations and vaccinations.


MSF has restarted limited medical operations in Leer hospital, which was previously ransacked, with additional therapeutic feeding support. We are also running mobile clinics for displaced people in the villages of Leer, Rupkai, Kak and Thonyor. The mobile clinics focus on children under five who need nutritional support, as well as stabilizing war-wounded patients.

Contact us
Kate Ribet Media Liaison Officer, Doctors Without Borders (MSF) Southern Africa
Kate Ribet Media Liaison Officer, Doctors Without Borders (MSF) Southern Africa
About Doctors Without Borders (MSF) Southern Africa

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