Country: South Sudan Source: Médecins Sans Frontières After escaping violent attacks in Jonglei and Upper Nile, thousands of people are surviving outdoors with little food, water, or medical care. “I have lived through many wars, but this kind of displacement has never happened before, ” says 77-year-old Moses, who fled his home in Lankien, South Sudan, as conflict intensified. “I have never seen civilians’ homes burned to ashes on such a scale. We are now living under the trees. ” Moses is one of tens of thousands of people who have been forced to flee their homes due to an escalation of violence between government forces and opposition groups in and around Lankien in Jonglei state, and along the Sobat River in Upper Nile. Many families fled on foot and walked for days to escape attacks and burned villages. In towns like Chuil, where at least 25, 000 have sought refuge, people are living outdoors without any shelter, or in makeshift settlements without adequate food, clean water, or health care. Doctors Without Borders/Médecins Sans Frontières (MSF) is scaling up medical and humanitarian support for displaced people in Chuil and in Ulang county. Our teams are providing primary health care and referrals, donating relief items, and supporting water and sanitation to reduce the risk of disease. Our teams also travel through swamps and rivers by boat to run mobile clinics in nearby Yakuach, Tanakuacha, and Pathiel, and have provided over 1, 300 medical consultations while referring some patients for higher-level care. “This situation is about life and death, ” says Nyamai, a mother of three living in an informal displacement site in Chuil. “At one point, we survived by boiling leaves from the trees and eating them. We had nothing else. The needs go beyond hospital care and medicine. We need food, water, and shelter. Without these, survival here will not be possible. ” Attacks on health facilities push care farther out of reach The crisis is unfolding in a region where access to health care was already limited and humanitarian access remains limited and irregular. Attacks on health facilities are only worsening the situation: In 2025, the MSF-supported hospital in Ulang was looted and destroyed, and just last month, Lankien Hospital was bombed, resulting in the closure of the two main referral hospitals in the region. At one point, we survived by boiling leaves from the trees and eating them. We had nothing else. “We are seeing a deeply alarming pattern of attacks on health facilities and health care workers, alongside violence against civilians, ” said Tuna Turkmen, MSF emergency project coordinator. “Chuil now hosts a large number of civilians, including women, children, and the elderly, who have fled fighting. It also provides one of the few functioning health facilities in the area, and many aid organizations are coordinating their medical and humanitarian activities from there. It is essential that communities can access these services, and that humanitarian and medical workers can carry out their work safely and without restriction. ” “In swampy areas around Lankien, thousands remain in dire conditions, still waiting for assistance, ” said Turkmen. “People continue to arrive every day. Displaced MSF medical staff there are doing everything they can, but patients die due to lack of medicine. MSF has requested access from local authorities, so far without success. ” Humanitarian organizations are increasing activities in the Chuil area and in Minkaman, but the response still falls short, and many remote communities remain without lifesaving assistance. Safe, sustained, uninterrupted humanitarian access must be guaranteed. MSF calls on all parties to the conflict to take all feasible measures to spare civilians from the effects of hostilities. Civilians and civilian infrastructure, including health care, must never be targeted; direct attacks against them constitute serious violations of international humanitarian law. Any further escalation of fighting in or around Chuil would have devastating consequences for civilians sheltering there and severely disrupt lifesaving medical and humanitarian assistance. Scaling up support to fill the gaps More than 70 MSF staff members who were also displaced from Lankien are now supporting the response in Chuil. Our teams there upgraded the primary health care center, increasing its capacity to 60 beds for emergency care, malnutrition treatment, maternal health services, and trauma stabilization. Since late February, MSF teams have provided 2, 200 consultations, admitted 172 patients to Chuil primary health care center, and referred 16 for further treatment. The MSF team offloads relief items from a helicopter in Chuil (left), where they will be distributed to displaced people as part of MSF’s emergency assistance. South Sudan 2026 © Isaac Buay/MSF Our teams also distributed relief items — including mosquito nets, blankets, soap, jerrycans, sanitary pads, plastic sheeting, and empty sandbags — to more than 1, 500 families to help them cope with the harsh living conditions, with more distributions to follow. And to help with water and sanitation services, MSF is building 300 latrines and constructing a water purification plant. In the coming weeks, MSF will establish a health post in Tanakuacha while our teams will continue running mobile clinics in Yakuach and Pathiel, providing referrals, mental health activities, outpatient consultations, and sexual and reproductive health services. In Minkaman, Lakes state, MSF is providing consultations to new arrivals from Jonglei through mobile clinics. We have also made medical donations to Minkaman primary health care center and are reinforcing their capacity to respond to outbreaks. Our water and sanitation teams have drilled two boreholes, repaired broken hand pumps, and are rehabilitating a surface water treatment plant and constructing emergency latrines. Displaced by violence, left without protection Despite the humanitarian response, major gaps remain, particularly in nutrition and in water, sanitation, and hygiene, raising the risk of cholera and other waterborne diseases. Screenings by MSF in Chuil show alarming malnutrition levels: Of 1, 263 children under 5 screened, 54 percent were acutely malnourished, while 21. 5 percent of 609 pregnant and breastfeeding women screened were acutely malnourished. Referrals of complicated cases remain a challenge as well. “Humanitarian organizations are increasing activities in the Chuil area and in Minkaman, but the response still falls short, and many remote communities remain without lifesaving assistance, ” said Zakaria Mwatia, MSF head of mission in South Sudan. “We call for an urgent and coordinated scale-up of other humanitarian actors to reach people in the hardest-hit areas — especially those still cut off from aid. Without sustained support, the risk of disease outbreaks and further displacement could rapidly escalate into catastrophe. ” Stories of the displaced Rebeca, displaced in Yakuach “I depended on that care” I worked for many years in Lankien as a traditional birth attendant, helping many women give birth safely. When modern medicine became more available, I started working with the hospital. Even after helping women deliver at home, I always advised them to go to the health facility, including the MSF hospital in Lankien, so they could be checked. After the conflict started in Jonglei, especially in Lankien, I lost everything. People began to flee, but I refused to leave at first. I am old, and I have been sick for the past five years. My life has not been easy. I was a regular patient at the MSF hospital in Lankien, and I depended on that care. When the hospital was destroyed, and I saw many houses being burned, including the market that was bombed, I lost hope. I said to myself, “If I die, let me die in my own home.” I did not want to move anymore. The town became empty. Everyone left. My family, my children, and my grandchildren refused to leave me behind. When I saw that staying would put their lives in danger, I agreed to leave with them. We came here to Yakuach. We have built a small shelter to have some shade, but the rest of my family sleeps outside. We have no mosquito nets, no beds, no blankets, and nothing to cover ourselves at night. When MSF opened the clinic here, I went there and received some medicine. But I cannot take medicine because I have nothing to eat. Food is the most important thing we need now. Since we were displaced, I stopped working as a traditional birth attendant. Here I am only a visitor. We lost our home, we lost our things, and we lost everything. We have nothing left to be proud of, or to call myself a traditional birth attendant. “We fled because we wanted to live” I remember the time when we were fighting for this country, what is now called South Sudan. It never happened that our homes were burned like this. That war was between the governments. Civilians were not the target. Our markets were not destroyed. People could still live their lives. Even when we were displaced, we would return and find our homes the same way we left them. This time is different. I was living in Yuai when government forces entered the town. I was forced to leave, and I lost my property. I ran to Waat, thinking I would be safe there, but the same thing happened again. I had to flee from Waat to Lankien, my ancestral land. I thought I would stay there, but again I was forced to run. I carried nothing with me, only my walking stick. This is the worst situation I have ever seen in my life. Lankien is finished. There is nothing left to take us back there. The elderly, the women, the children, no one is spared. I have never seen anything like this before. Hunger is killing us, and at the same time bullets are killing us. Right now, in the Greater Lou-Nuer area, there is not even one house left standing. We arrived in Chuil very tired, both in the body and in the mind. We are sleeping under the trees. I have nothing to eat. These sacks I am using, I borrowed them from businessmen near the river. When night comes, I spread them on the ground and sleep on them. We fled because we wanted to live. Going back to Lankien is not possible. I am old and tired. I cannot walk that long distance again. They forced us to leave our homes, and it feels like they want us dead. What we need now is food, mosquito nets, and blankets to cover ourselves during these cold nights. I hope the organizations will do something to reduce this suffering. Right now, we depend on humanitarian organizations. Today we have the MSF clinic, maybe tomorrow we will have food, shelter, and clean drinking water. But the truth is, whether we survive or whether we die, only God knows. “Look into my eyes” Everyone fled. Those who remained behind are the disabled, the elderly who cannot walk, and the visually impaired. They might die there, and that is my biggest fear. But we have already started to accept this reality. This situation is about life and death, and right now death is chasing us in every direction. We left our homes in Lankien running from bullets and airstrikes. While we were moving through the bush, armed men attacked people. Some were killed and children were abducted. In the group I was traveling with, some girls were taken into the bush. I cannot say what was done to them. I only thank God that they came back alive. During the journey we suffered a lot. We had no food, no medicine. Bees stung us in the bush, mosquitoes were everywhere, and the cold nights were very hard to endure. Many things happened in a very short time. There are no words to explain what we feel now. You may not fully understand what we went through, but if you look into my eyes, and into the eyes of the people here, you may begin to understand the pain we carry. This suffering was brought on us by our own government. At some point we survived by boiling leaves from the trees and eating them. We had nothing else. When we arrived here, the host community received us. They welcomed us because they also know displacement. Many of them came from Ulang. They went through the same suffering, and that is why we are now together here. Now the needs are bigger than hospital care and medicine. We need food, we need water, we need shelter. Without these things, surviving here will not be possible.
Displaced people are sheltering under trees in South Sudan
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