The distressing daily experience of the Médecins Sans Frontières (MSF) team in Batil refugee camp in South Sudan is echoed in the newly-released results of a nutrition and mortality survey conducted in the camp at the end of July. Tragically, some of the refugees whose family members had died before they reached the camp cited “tired of walking” as the cause of death. This suggests an incredibly weak and vulnerable population arriving at the camp, and points to the massive need for assistance to those that managed to arrive alive, but weak.

The newly constructed Batil camp started to accommodate large numbers of refugees in early June, when some 35,000 refugees crossed the border from Sudan’s Blue Nile State. Since the refugees’ arrival at the camp, mortality for the total refugee population has been substantially above the emergency threshold, with mortality for children under five years old at more than double the threshold (the internationally recognized emergency rate is one or two deaths daily per 10,000 children).

 South Sudan © Olga Overbeek
In Batil camp, medical coordinator Helen Patterson discovers a little boy, Muhammed, who is severely malnourished and needs to be taken to the hospital immediately. A recent survey in the camp indicates mortality for children is over double the emergency threshold.

Between three and four children under the age of five have been dying every day in Batil camp. 58 per cent of reported deaths among the refugees since their arrival at the camp have been children under five. In addition, more than 25 per cent of reported deaths were for people over 50 years old. In many emergency interventions, children under five are the first priority, but to see this level of mortality in people over 50 is unexpected and indicates a particularly dire health situation.

The major cause of death reported while these refugees have been in Batil camp is overwhelmingly diarrhea, constituting more than 90 per cent of deaths, with malnutrition likely to have been a contributory factor in many cases. A quarter of children under five years old are malnourished, and 10 per cent are in the most severe acute stage of malnutrition, requiring urgent therapeutic feeding. Even more shocking, half of the children under two years old in the camp are moderately or severely malnourished.

The rainy season and cold nights are making matters worse, particularly since many households have only one blanket to share between often six or more people. While respiratory tract infections constituted around 10 per cent of consultations by MSF medics in Batil in June, they have been rising alarmingly and last week they constituted more than 40 per cent of the consultations.

MSF has more than 180 expatriate staff and more than 800 locally recruited staff on the ground in the five camps for Sudanese refugees in South Sudan. The first emergency interventions began in November 2011, when refugees first arrived in Yida and Doro camps in South Sudan. MSF rapidly expanded its emergency activities over the following months as the number of refugees grew, as the rainy season started, and as the health situation in the camps deteriorated.

In its tented field hospital in Batil camp, MSF now has more than 1,600 children suffering from severe acute malnutrition in its therapeutic feeding programme. Every week about 30 of these children need to be admitted into intensive care with life-threatening medical complications such as diarrhea or respiratory diseases. Since the Batil camp was set up in May, MSF has conducted more than 14,500 medical consultations, as well as assisting with the set-up of water distribution networks and the distribution of basic survival essentials when the refugees first arrived.

“This new data reflects exactly what I see every day,” says Helen Patterson, MSF’s medical coordinator for Batil camp. “This is a health catastrophe. With half the children under two years old malnourished, and living in cold, wet conditions, and hundreds falling ill with diarrhea and respiratory diseases, our field hospital is overwhelmed with critically ill patients. We’re pushing the boundaries of what’s possible logistically to get staff and supplies here and continue saving lives.”

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