On August 29, 2009, a violent attack in Twic East County, Jonglei State, in southern Sudan, resulted in the reported deaths of 42 people, many of them women and children. More than 60 people were wounded and official numbers state that up to 24,000 people were displaced from 17 villages, with the largest concentration of people gathering in Panyangor and Kongor.

This latest attack is just one in a series of escalating so-called inter-ethnic clashes in Jonglei, Upper Nile and Lake States, which official statistics claim have displaced up to 140,000 people. Attacks by the Lord's Resistance Army (LRA) in the Equatorial States have also reportedly forced 65,000 Sudanese from their homes this year, and resulted in the deaths and abductions of hundreds of others. This combination of violent attacks across the region aggravates an already dire humanitarian situation for the people of southern Sudan.

"We have seen a drastic escalation in violence across southern Sudan this year - from the Equatorial States besieged by LRA attacks, to the brutal clashes in Jonglei, Upper Nile and Lake States", says Jonathan Whittall, MSF Head of Mission in southern Sudan. "The violent clashes are different to the traditional 'cattle rustling' that normally occurs each year. Women and children, usually spared in this fighting, are now deliberately targeted and the number of deaths are higher than the number of wounded.

"In the last six violent incidents that Médecins Sans Frontières (MSF) responded to in Jonglei and Upper Nile States over the last six months, official figures show that 1,057 people were killed in contrast to 259 wounded, with more than 60,000 displaced. This is new - the intention is to attack a village and to kill. The result is a population living in total fear, with significant humanitarian and medical needs."

Immediately after the latest violence erupted, an MSF team traveled to Twic East County to support local health facilities and to assess medical and humanitarian needs. MSF donated medical supplies to help treat the injured being cared for in a local health centre in Panyangor and is now actively screening for malnutrition - referring any malnourished to the health centre for treatment.

MSF is also carrying out an emergency food distribution, targeting 4,500 children under five years of age, to try to prevent malnutrition and to cover the gap before more assistance arrives.

"People fled from their villages without anything," Whittall continued. "With constant rumours of further violence, they are completely terrified. They urgently require humanitarian assistance – with food and shelter the most pressing priorities. The situation is particularly worrying with the current hunger gap, exacerbated by late rains and insecurity this year. We are distributing emergency food to the children now – as many of them haven't eaten for days."