In Upper Nile and Jonglei there is more fighting now than there has been in the past year and a half. The health situation hasn't improved and there are still only a few organisations that are offering medical assistance. For many Sudanese living in the areas where MSF works, life is just as difficult now as it was before the peace accord." 

As if a hurricane had blown through - that is what the MSF clinic in the village of Pieri resembled when the Médecins Sans Frontières (MSF) team arrived to check on it. Although the buildings were still standing, it had been emptied of everything that wasn't nailed down: laboratory equipment, drugs, beds and food stocks. Even the doors were gone.

The grounds were strewn with ripped packaging and registration cards. However, the worst was that the clinic was almost deserted.

What is happening in southern Sudan?

Christoph Hippchen: "Despite the peace accord signed at the beginning of last year, violence has been increasing again in recent months within the provinces of Upper Nile and Jonglei. MSF was forced to evacuate a large part of our international staff for this reason. Since their departure, at least two of our clinics have been attacked and looted. As a result, at this moment, hundreds of thousands of people cannot obtain medical care.

"The situation is very unstable, so no one knows how long it will be before our doctors and nurses can return. We know it will take months to repair completely the looted clinics. The rainy season is about to start and that makes the transportation of goods extremely difficult."

How are the patients from the evacuated clinics?

CH: "In some places, such as in the town of Nasir, our Sudanese staff has been able to continue treating the patients. However, in other areas, the patients have had to seek refuge.

"In Pieri, we have 25 inpatients and more than 120 tuberculosis patients who need daily medication. We give them each a small supply of drugs to keep with them in case there ever comes a moment when they have to flee. But if they cannot get to a doctor or nurse within a few weeks, then their treatment has been for nothing."

Has the violence led to civilian deaths?

CH: "That is difficult to say, especially since our teams were evacuated from the places where violence poses the largest threat. It is clear that there have been clashes in different places throughout the provinces of Upper Nile and Jonglei. On May 20, we flew six gunshot victims from the village of Yuai to our hospital in Ler where they could undergo surgery. We think that there are many more casualties but those who are critically wounded die before they can reach one of our clinics."

But there is a peace agreement, right?

CH: "The people of southern Sudan finally had hope for a better future when the government and rebels reached a peace agreement after more than 20 years of war. Their optimism is now fading. In Upper Nile and Jonglei there is more fighting now than there has been in the past year and a half. The health situation hasn't improved and there are still only a few organisations that are offering medical assistance. For many Sudanese living in the areas where MSF works, life is just as difficult now as it was before the peace accord."

What is needed to change that?

CH: "It's as if everyone thinks: now that there's a peace agreement, everything will work out in south Sudan. MSF has urged the authorities to take steps to improve security in Upper Nile and Jonglei so that we can quickly start providing medical help again. The people already receive far less humanitarian aid than is needed, and the fighting reduces it even more. The rest of the world seems to have forgotten this region."