Juba – Mary Ukuach Deng, 34, recalls the morning when she and her three young children were awoken by a volley of gunfire in the Sudanese capital Khartoum. “I was so scared because of the loud sound of guns that engulfed our neighborhood; we could see soldiers running all over,” Deng says.

She knew that the time had come to gather her belongings and begin the journey back to South Sudan, her country of origin which she fled two decades earlier due to civil war. But it wasn’t going to be an easy journey.

Taking refuge in the border town of Renk in South Sudan, about 453 km south of Khartoum, the family spent several days with no access to water, shelter, food or health care.

Risk of disease outbreaks

Deng is among more than 113 000 people who have sought refuge in similar settlements in South Sudan, prompting a large-scale response from that government, supported by World Health Organization (WHO). Multi-disciplinary teams of experts are being dispatched to support the health needs of those arriving from across the border.

WHO has deployed mobile medical teams comprising clinicians, nurses, and public health officers to help strengthen humanitarian health coordination, disease monitoring, and provision of much-needed health services at these locations.

“The huge population of returnees and refugees has resulted in overcrowding at the transit sites, posing a serious risk of disease outbreaks,” says Dr Ernest Apuktong, the Upper Nile state’s health minister. “We are thankful for the role partners continue to play in supporting our government and people. The arrival of the WHO team has come as a relief to many residents.”

WHO also pre-positioned 269 health emergency kits, containing medical supplies and testing and treatment for cholera, pneumonia, and severe acute malnutrition cases. The kits are helping ensure uninterrupted healthcare services in Renk, Malakal, Panyikang, Raja, Aweil, Paloich and Rubkona areas where most people fleeing the Sudan conflict have gathered. The kits have the capacity to serve more than 100 000 people for three months.

In addition, mobile clinics have been set up in Aweil, currently attending to about 150-200 individuals a day, as well as in the other five counties where people are arriving. At the Wedwil Transit Site in Northern Bahr el Ghazal State, the mobile clinic was allowed to conduct over 1800 consultations as of 1 June. At Paloich Airpot Transit Site, more than 2000 people were seen at the WHO mobile clinic.

“The huge influx of people is increasing the risk of disease outbreaks, putting tens of thousands of lives at risk.”

Dr Fabian Ndenzako, acting WHO Representative for South Sudan.

The United States Agency for International Development (USAID) and the African Public Health Emergency Fund are also supporting the response. USAID contributed US$ 5 million to WHO to support an integrated health response in South Sudan among communities affected by humanitarian crises and acute food insecurity across South Sudan.

“The unfolding humanitarian crises in Sudan is placing a huge burden on the already fragile health system [in South Sudan]. The huge influx of people is increasing the risk of disease outbreaks, putting tens of thousands of lives at risk,” says Dr Fabian Ndenzako, acting WHO Representative for South Sudan.

Delivering medical supplies

“WHO has scaled up its presence on the ground, delivering much-needed medical supplies for timely response, and will continue to support the Ministry of Health and partners on the ground to ensure that refugees and returnees receive the urgently needed basic healthcare services,” notes Dr Ndenzako.

As of 13 June according to the International Organization for Migration, more than 528 500 people have fled Sudan and crossed the border into neighboring countries – Central African Republic, Chad, Egypt, Ethiopia, Libya, and South Sudan – as refugees, asylum seekers, and returnees. In each host country, WHO is coordinating with national authorities for health care, including emergency care and psychosocial support for people fleeing the conflict. In South Sudan, where just 41% of health facilities are fully functioning, national health authorities are already dealing with multiple challenges, including upsurge of malaria cases, and outbreaks of COVID-19, hepatitis E, measles, cholera, and growing malnutrition.