'Many of our South Sudanese employees feared that the traditional scarring on their foreheads or cheeks – the marks of tribal identity in many parts of South Sudan – would make them targets of revenge for atrocities.'

Avril BenoîtMSF Project Coordinator, Doro Camp, South Sudan
August 20, 2014

This story appears in the Summer 2014 issue of Dispatches, the MSF Canada magazine. To download the complete magazine or to read previous issues, please visit our Publications page.

Canadian Avril Benoît has watched conflict unfold in South Sudan while helping Médecins Sans Frontières/Doctors Without Borders (MSF) respond to a separate crisis in the country’s north, where people have fled to escape violence across the border in the Republic of Sudan. Here she describes the impact South Sudan's recent conflict has had on those seeking shelter within its borders.


Signing on to a daunting crisis

When I agreed to return to the Doro refugee camp in South Sudan’s Upper Nile State as a project coordinator for MSF last December, I thought I had an idea of what awaited me. I had already witnessed MSF’s emergency response in 2011 when refugees from Blue Nile, in neighbouring Sudan, had fled across the border to Maban County in order to escape the conflict between the Sudanese government and opposition forces.

At the time, MSF was among the first humanitarian organizations to provide emergency services on the ground for those affected by the fighting: erecting clinics, digging latrines, drilling water boreholes and drawing the world’s attention to this new crisis, which had already displaced 20,000 people in a few weeks. In the following months, as armed conflict and aerial bombings in Blue Nile continued, the refugee population swelled to more than 126,000 people spread over four camps, with Doro alone hosting 48,500. I signed on to lead a team of 325 MSF staff who were running a hospital and four outpatient clinics – a daunting prospect in 45°C  heat.



In mid-December 2013, however, another war broke out – a new civil war in South Sudan, in which groups loyal to different factions in the central government split violently along ethnic lines, primarily between the country’s dominant Dinka and Nuer groups. As the fighting spread, MSF began to prepare some of its teams for possible evacuation, while at the same time bringing in specialist teams experienced in emergency response to set up activities in the conflict-affected areas.  In parts of South Sudan, MSF hospitals were looted, staff threatened, and some patients were even killed in their beds.


Far-reaching effects

In Maban, far from the capital city of Juba to the south, people sought to maintain a degree of neutrality from what they perceived as a fight between the Nuer and Dinka that didn’t concern them. But even Maban could not avoid the conflict: Many of our South Sudanese employees feared that the traditional scarring on their foreheads or cheeks – the marks of tribal identity in many parts of South Sudan – would make them targets of revenge for atrocities allegedly committed by members of their communities. They left their jobs and returned to contested villages in order to protect their families, or sought safety across the border in nearby Ethiopia. We worried about their journeys, were sorry to see them go, and scrambled to fill the gaps.



The conflict also had a deleterious effect on the World Food Programme’s food distribution operations: on the only roads to the Maban refugee camps that weren’t blocked by fighting, truck convoys carrying food rations faced bribery demands that were so costly that independent drivers could no longer move the life-saving cargo. The sense of protection and security in the Maban camps collapsed when WFP’s distributions became irregular: in March and April, families only received the equivalent of 15 days’ worth of rations, or one quarter of the calories they needed to survive. Admissions to our malnutrition programs spiked.



A growing food crisis

Hunger compelled some refugees in Maban to sneak back across the border to Sudan, the very place from which they had earlier fled for their lives, in order to sow crops and scrounge for something to eat. Others came into conflict with the host population. Goats were stolen and huts burned, churning a cycle of retaliation. More than a dozen neighbours on both sides died in the clashes.

Armed thieves broke into the facilities of almost all the NGOs operating in Doro – except for those belonging to MSF, thankfully. They stole sorghum cereal, ready-to-use therapeutic foods, high calorie nutrition bars and sugar. Other calamities rose and fell in sync with food distributions: crime, tension between the host and refugee communities, school absenteeism, malnutrition and related illnesses. Gaps in food distributions delayed other activities during a critical time before the rainy season began in June. Handing out non-food items such as mosquito bed-nets and tarpaulins when refugees were hungry would compel them, understandably, to trade away the goods for something to eat. Supplying them with sorghum and maize seeds as part of livelihoods and long-term sustainability strategies wouldn’t work if families were so famished that they ate the seeds instead of planting them.


Emergencies on many fronts

In the early months of 2014, the scale of national suffering caused by this new conflict in the world’s youngest country overshadowed the perils facing the 126,000 Sudanese refugees currently living in Maban. In the first six months, the South Sudanese civil war uprooted a million people from their homes, and forced 370,000 to flee to Ethiopia, Kenya, Uganda and even Sudan (not an option for Blue Nile survivors in the Maban camps who aren’t allowed to register elsewhere as refugees). 

None of these developments were known to be on the horizon when I first returned to Doro. Just about the only event that turned out as I expected was the fury of the winds and rains when they finally came. The rainy season made a mud pit of the roads, shredded plastic sheeting shelters, and created breeding conditions for malaria-carrying mosquitoes.

Strictly speaking, the refugees receiving MSF care in Maban haven’t been directly affected by the conflict to the south. But in every indirect sense that one can imagine, they’ve been affected. They’re victims of wars on either side, with nowhere safe to escape.

Avril Benoît is the MSF project coordinator at Doro Camp, Upper Nile State, South Sudan



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