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Juba – Report by Al-Naeim Mubarak Kuol
Akobo, in eastern Jonglei State, South Sudan, is facing a worsening humanitarian and health crisis following months of fighting that displaced most of the town’s residents and destroyed essential services, as large numbers of people have begun returning to a town lacking basic necessities.
Médecins Sans Frontières (MSF), also known as Doctors Without Borders, said more than 100,000 people have returned to Akobo after fleeing to Ethiopia during the fighting earlier this year, only to find the town’s health and other essential facilities looted and destroyed.
The South Sudan People’s Defence Forces (SSPDF) launched an offensive on Akobo on 6 March, forcing most residents to cross the border into Ethiopia, where they received little or no humanitarian assistance. In mid-April, following renewed clashes, opposition-aligned armed groups regained control of the town, paving the way for the gradual return of residents.
Health System Collapses
MSF said Akobo’s health system has almost completely collapsed after all 15 surrounding health facilities were looted, damaged and abandoned. Cold-chain equipment was also destroyed, bringing vaccination services to a complete halt.
Akobo Teaching Hospital, one of the area’s main health facilities, was extensively looted and left without electricity, fuel, beds, medical equipment and essential medicines.
When MSF resumed activities at the hospital on 11 May, medical teams were immediately confronted with a large influx of patients. During the first five days alone, more than 600 people received medical care.
By 14 June, 684 patients had been admitted to the hospital, despite the facility having a capacity of only 30 beds. During the same period, medical teams provided 5,106 outpatient consultations and recorded 30 deliveries.
MSF said the number of consultations conducted in a single day is now roughly equivalent to what the hospital used to provide in an entire week before the conflict, highlighting the scale of the accumulated healthcare needs.
Malnutrition Threatens Children
Akobo is also facing a severe food crisis. The town is currently classified at Phase 5 of the Integrated Food Security Phase Classification (IPC), the highest level and one associated with famine conditions.
Screening conducted among children aged between six and 59 months from 11 May to 14 June found that 36 percent were suffering from malnutrition, including 15 percent experiencing severe acute malnutrition.
MSF warned that months of disrupted health and food services have had serious consequences for children and families, while the overall humanitarian response remains far below the scale of needs.
Difficult Conditions for Pregnant Women
Elizabeth Nyachin Koang, an MSF traditional birth attendant and midwife in Akobo, said pregnant women are facing extremely difficult conditions due to the loss of essential medical equipment used for antenatal care and deliveries.
She said that until the beginning of June, patients, including pregnant women, had been sleeping on the floor, while medical teams were struggling to monitor pregnancies and assess fetal development because of the lack of equipment.
The situation has also affected patients living with chronic diseases, including people with HIV, whose treatment was interrupted. During the displacement, some families were forced to survive on wild leaves and fruits.
Severe Water and Sanitation Crisis
The crisis extends beyond healthcare and food security, with Akobo also facing a severe water and sanitation emergency.
Before the conflict, the town relied on 17 water towers and 35 boreholes connected to an underground water network. All of these facilities were destroyed or looted during the fighting.
Today, only eight hand pumps remain operational, providing enough water for approximately 5,000 people out of a population of more than 100,000. As a result, most residents now depend on untreated river water, while open defecation is widespread.
Warning of Cholera and Malaria Outbreaks
MSF warned that the collapse of water and sanitation systems, combined with the rainy season, is significantly increasing the risk of waterborne diseases, particularly cholera, which has been spreading across Jonglei State since February.
The risk of malaria is also increasing as transmission accelerates during the rainy season. The situation highlights the urgent need to expand mosquito-net distribution and strengthen malaria diagnosis and treatment services.
Jacob Granger, MSF project coordinator in Akobo, said the current humanitarian response remains far below the scale of needs. He called on donors and humanitarian organizations to urgently increase their interventions, particularly in water and sanitation, food assistance, the rehabilitation of Akobo Teaching Hospital and protection services.
MSF said the resumption of its medical activities has helped restore some critical and lifesaving services in Akobo. However, the organization stressed that its efforts alone cannot meet the enormous needs of the population, calling for a comprehensive and coordinated humanitarian response to prevent the crisis from deteriorating further.
