South Sudan, the youngest country in the world, was engulfed by severe instability throughout 2022 and into early 2023 eight out of its ten states being rocked by violence. This upheaval triggered extensive population displacements, predominantly in the Abyei Special Administrative Area and regions such as Twic County. These mass displacements have been aggravated by a historical backdrop of conflict, an increasing climate crisis, economic hardships, and lack of access to life-saving healthcare.
Most of the people in this internally displaced camp in Abyei are Nuer. Some fled violence in Agok, while others have come from Unity state to escape the flooding, particularly around Bentiu.
Akur has seven children. She explains, "The area is very overcrowded, and people are still arriving. It was okay at first, but since April, we have been suffering. New arrivals don't receive ration tokens, and they can't get help with shelter and food. So, we take care of them, even though we don't have enough ourselves. This is additional pressure we can't live with, but people can't eat alone; we should eat together, and we have to share what little we have."
Amidst the already dire situation in Abyei, a new challenge arose: an influx of returnees and refugees fleeing the horrors of Sudan's ongoing war. Indeed, there has been a significant influx of internally displaced people and refugees into South Sudan since the fighting outbreak on April 15. Families who had been displaced from their homes sought refuge in Abyei, hoping for safety and a chance to rebuild their shattered lives.
Abdhul Nasir Adam, Hammad, wife, three children, currently in the United Nations transit center in Abyei, have fled Sudan. "There are many, many families who are stuck in dangerous places and are desperate to come here. But the journey is too difficult, too expensive, and too dangerous. There are frequent attacks on people fleeing and a lot of looting. They take everything. We need transport, and we need protection. The situation is unbelievably terrible. There is fighting and shooting all the time, and we have all lost family and relatives. I lost three family members in an airstrike in Khartoum. I fled Khartoum and went to Nyala. I have nothing left at all."
As of end of November, over 400,000 individuals, predominantly South Sudanese returnees, as well as refugees have crossed the border. The large number of arrivals, particularly women and children, presents challenges for transit sites. Rising market prices have contributed to worsening food insecurity. In addition to what South Sudan already suffers from, such as regular disease outbreaks, flooding, displacements and high rates of malnutrition.
With Abyei being a war-torn region, many remote areas are completely isolated, making it nearly impossible for people to access healthcare facilities. Floods posed a great threat during the rainy seasons, while conflict poses another in the dry season. Equipped with medical supplies and a purposeful spirit, MSF teams travel long distances, to provide healthcare with the help of village volunteers.
Around the region, MSF has 17 integrated community case management sites manned by trained local volunteers and in collaboration with local health authorities. MSF team travels to the village health posts to bring medicine and support the trained community health workers.
Awa, team leader of integrated community case management, is carrying an unwell child to the vehicle before transporting him and his mother to the hospital.
"We assist the people and provide advice and information, helping them recognize the signs and understand what to do before it becomes serious. This is particularly important for malaria and diarrhoea, which are common problems. We inform people when they should seek help." says Awa.
The trained community health workers also shares how hard the crisis makes things for them , and how grateful they are for the help they receive from MSF. Since the start of the activities in 2020, things have improved in the communities because they can recognise the warning signs as they have been trained. "We are not nurses, but we have received training, and being able to help means a lot."
Mary Ajok (picture above) is a village volunteer at the health post. She explains, "I have been an MSF volunteer since 2015. We see 2,500 to 3,000 patients a year, with the biggest problems being malaria and pneumonia. The suffering caused by the flooding is immense. I can conduct malaria tests and check people's temperature. If they test positive for malaria, I can provide treatment. If the case is serious or if I can't determine the issue, I send them to the hospital. We also screen for malnutrition and dehydration, receiving refresher training every three months. I am an elderly woman with a lot of work to do, but this is very important, and I am proud to help the community. Yes, I feel happy and proud. Before MSF came here, the people were suffering much more. We also work with the community to raise awareness of signs of illness. This makes a big difference because people can get help before their condition worsens, especially for malaria and diarrhoea. Life here is hard, and we are displaced by flooding every year. We have to spend months on the side of the road to escape the floods, typically from August to January. It's been like this every year for six years, and every year, the farms are destroyed. The village has 1,500 families, but due to the crisis, 150 families share shelter with another family – we have 150 extra families to look after."
Nur Mawien is a nursing team supervisor at Ameth Bek Hospital, Abyei. Being form the community himself, he explains the key role of the MSF-supproted hospital: "Having the hospital means a lot to the community, people feel safe there. Simply having a hospital is not enough, it is having a hospital that is running well that serves everyone that is important. That means that everyone wants to come to this hospital, and they travel far distances to get here. Everyone knows this is a good hospital. The problem is many patients come to our facilities do not meet the admission criteria. This is a secondary level health care facility and that’s hard for people to understand. Secondary care means we only treat people with serious illnesses—we don’t have the capacity to do more."
While MSF’s mobile clinics cater to the immediate healthcare needs of these remote communities, MSF also provides secondary healthcare services at the main hospital in Abyei, providing an array of services including inpatient care, round-the-clock emergency room access, surgical care, critical care including the close monitoring unit, comprehensive maternal and neonatal care, treatment for chronic illnesses, and mental health support. Since the start of the year, over 50,000 patients have sought medical care from the hospital, and more than 15,000 consultations were carried out in the emergency ward.
A baby boy was born via caesarean section at Ameth Bek Hospital in Abyei. Between January and September, medical teams performed 1,504 surgical operations, and assisted around 350 deliveries.
The hospital is a beacon of hope, a place where lives are transformed, and healing takes place. MSF doctors, nurses and support staff work tirelessly, dedicating their expertise to a community that has long been neglected.
© 2026 MSF
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